CMN568 CMN 568 Latest Intro to

CMN568/ CMN 568 (Latest 2024/ 2025) Intro to Family NP Unit 6 Exam Questions and Verified Answers| 100% Correct| Grade A Treatment of pregnancy-related anemia

Treatment:

• Ferrous sulfate 300mg (contains 60 mg of elemental iron) 2-3x day.

(NOTE: Ferrous gluconate is OK, but just be sure that you have enough

elemental iron (60 mg))

• Continue for 3 months AFTER Hb has returned to normal to replenish

iron stores

• Take iron on an empty stomach with orange juice to add absorption

+ Encourage diet high in iron: Beef, liver, beans, whole grains, nuts, dark

leafy greens

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Why is cholecystitis/cholelithiasis more likely in pregnancy? What are S/S and expected labs?

WHY:

+In pregnancy, bile is more likely to form stones and the gallbladder has reduced contractility.--Bile just sits there (sludge!) and you are more likely to form stones.

S/S:

• Anorexia, N/V, intolerance of fatty foods, RUQ & epigastric abdominal 1 / 4

pain, + Murphy's sign

LABS:

• Increased WBC, AST, ALT, bili, & alkaline phosphatase

IMAGING:

+U/S of gallbladder

SYMPTOM MGMT:

+Bowel rest, IV hydration, analgesics, antibiotics

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Risk factors for ectopic pregnancy

• Smoking
• IUD use
• Assisted reproductive technology
• PID (scarring of fallopian tubes, chlamydia known for this)
• Endometriosis
• Previous tubal surgery
• Previous ectopic

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Signs/symptoms of ectopic pregnancy

• Pelvic/abdominal pain especially cervical motion tenderness or

adnexal (lower abdomen laterally, where ovaries are) pain

---NOTE: In some cases, referred pain is felt in the shoulders with an

ectopic pregnancy.

• Abnormal uterine bleeding: light spotting to heavy bleeding 2 / 4

+ Poorly rising BHCG levels in serial titers: should rise 50% every 48 hr

+Absent intrauterine gestational sac - intrauterine sac should be visible when BHCG is 1500-2000

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When do most ectopic pregnancy ruptures occur?Between 6 and 12 weeks gestation

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Management of ectopic pregnancy

• If < 200 BHCG, it may resolve in its own

+ If < 3 cm adnexal mass and no fetal heart motion: Can use

methotrexate protocol (one dose or two doses) NOTE: Beyond scope of

primary care NP.

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Fetoplacental factors contributing to intrauterine growth restriction

(IUGR)

• Genetic disorders
• TORCH infection (Toxoplasmosis, Rubella Cytomegalovirus, Herpes

simplex, and HIV. O means "other" and can be syphyillis, varicella, parvovirus, fifths disease)

• Placental disorders
• Multiple gestation 3 / 4

Herf BBB Maternal factors contributing to intrauterine growth restriction (IUGR)

• HTN
• Anemia
• IBD
• Malnutrition
• Kidney/heart disease
• Substance abuse especially nicotine abuse
• Anticonvulsants

Herf BBB What is PUPPP? When does it happen? How is it treated?

• Pruritic urticarial papules and plaques of pregnancy

-- "white halo" around umbilicus, where rash does not appear -- No lab diagnosis

• Usually happens in 3rd trimester and disappears 2 weeks postpartum
• Treat with topical steroids, antihistamines and Sarna lotion

Herf BBB, DeCherney p 505 Definition of chronic HTN in pregnancy BP > 140/90 before 20th week of pregnancy, OR persistent HTN > 12 weeks postpartum Herf BBB, DeCherney p 455-457 Treatment of chronic HTN in pregnancy

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