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ch 1 female repro contraception Flashcards

1
Q

3 layers of uterus from inner to outer

A

endometrium
myometrium
perimetrium

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2
Q

clusters of epithelial cells within lobules of breasts that secrete colostrum and milk

A

clusters of acini

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3
Q

changes in breasts throughout menstrual cycle (3)

A

sensitivity
size
nodularity

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4
Q

when should women do self breast exams

A

5-7 days after period ends

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5
Q

regularity of menstrual cycle influenced by (4)

A

age
physical health/fitness
psychosocial/emotional status
environment

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6
Q

menarche

A

first menstruation

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7
Q

puberty

A

transitional stage between childhood and sexual maturity

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8
Q

“normal” cycle average

A

28 days (1st day of flow to 1st day of next flow)

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9
Q

variation in menstrual cycles (cycle of duration and # days)

A

21-35 days cycle

2-6 days flow

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10
Q

normal blood loss during cycle

A

20-60 mL

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11
Q

3 cycles within menstrual cycle

A
  1. chemical cycle (steroidogenesis) - brain
  2. ovarian cycle - ovary
  3. endometrial cycle - endometrium
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12
Q

hormones within chemical style of menstruation

A

GnRH
FSH
LH

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13
Q

hormones within ovarian cycle of menstruation

A

estrogen

progesterone

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14
Q

purpose of LH

A

maturation and release of 1 ova (ovulation)

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15
Q

endometrial response to increased progesterone and estrogen from ovaries

A

mature, edematous, vascular and glandular secretions ready for implantation of zygote

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16
Q

endometrial response to no fertilization, corpus luteum regresses, decreased progesterone and estrogen

A

vasospasm and vasoconstriction, necrosis of tissues, sloughing (menses)

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17
Q

effect of HCG (human chorionic gonadotropin) on corpus luteum

A

keeps corpus luteum alive for 12 weeks through progesterone

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18
Q

indicators of ovulation

A
  • basal body temp increases 0.5-1 degree F for 10-12 days
  • cervical secretions change (increased, spinnbarkeit, ferning)
  • cervical os dilation
  • mittelschmerz
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19
Q

what is spinnbarkeit

A

cervical mucus stretches > 6 cm

egg white

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20
Q

what is ferning during ovulation

A

dried, crystalline pattern of cervical mucus

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21
Q

what is mittelschmerz during ovulation

A

sharp lower abdominal pain during ovulation

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22
Q

lifespan of corpeus luteum if HCG is not present

A

14 days

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23
Q

pituitary: primary hormone during 1st half of cycle

A

FSH

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24
Q

what hormone is critical for maintaining zygote/embryo

A

progesterone

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25
pituitary: primary hormone during 2nd half of cycle
LH
26
ovarian: primary hormone during 1st half of cycle
follicular - estrogen dominant - maturation of ovarian follicle
27
ovarian: primary hormone during 2nd half of cycle
luteal - progesterone dominant - follicle after ovulation
28
endometrial: 2 stages during 1st half of cycle
- menstrual: shedding of endometrium | - proliferative: building up of endometrium
29
endometrial: 2 stages during 2nd half of cycle
- secretory: endometrium mature and functional | - ischemic: vasospasm and death of functional layer
30
how long do you have to go without a period to be considered in menopause
12 months in a row
31
climacteric
transitional phase during which ovarian function and hormone production decline
32
perimenopause
period of time preceding menopause, lasts about 4 years | average onset is 51-52 years
33
physical changes during perimenopause (4)
- bleeding - genital changes - vasomotor instability (hot flash) - mood and behavioral changes
34
health risks for perimenopausal women (3)
- osteoporosis - coronary heart disease - UTIs
35
factors to consider when choosing contraception
- side effects/risk of use - reliability - ease of use - relative cost - STI protection - woman's comfort level with method - partner's willingness to use - culture and religion
36
informed consent - BRAIDED
``` Benefits Risks Alternatives Inquiries and questions Decisions, may change mind Explanations Documentation ```
37
methods of contraception
- coitus interruptus (withdrawal) - temporary methods (FAMs, barrier, hormonal) - long acting reversible (IUC/IUD, hormonal) - permanent (sterilization)
38
FAMs
fertility awareness methods | -relies on avoidance of sex during ovulation
39
how long can ova live
12-24 hr
40
how long can sperm live
24-28 hr
41
when does ovulation occur
14 days before next period begins
42
billing method
using cervical secretions to determine fertility
43
temporary methods: barriers (5)
- spermicides - condoms (male/female) - diaphragm - cervical caps - contraceptive sponges
44
method of action of spermicides
- reduces sperm mobility | - destroys sperm cell membrane
45
advantages of spermicides
- safe - OTC - no male involvement
46
important teaching for pt using spermicides
read instructions (varies)
47
disadvantage of spermicides
-contradicted in those at high risk for HIV
48
important teaching for pt using condoms
- correct use is critical | - teach pt how to use condom
49
teaching for pt using female condom
can't use female and male condom at same time
50
danger of using diaphragm/sponge
can lead to toxic shock syndrome
51
teaching for use of diaphragm
- leave in for atleast 6 hours after sex (but no more than 8 hours) - must be fitted by provider
52
two categories hormonal methods
- combined estrogen and progestin | - progestin only
53
what type of birth control prevents ovulation
combined hormonal
54
meds that interfere with combined oral contraceptive (5)
- anticonvulsants - anti TB - antifungals - anti HIV - st johns wort
55
contraindications for combined oral contraceptives (5)
- pregnant/breastfeeding - Hx of thromboembolic disorders - breast cancer - smoking and over 35 yrs - diabetes with known vascular complications
56
teaching for use of combined oral contraceptive patch
- replaced every month | - less effective if >198 lbs
57
warning signs for complications of using combined hormonal contraceptives - ACHES
``` abdominal pain chest pain headache eye problems severe leg pain ```
58
teaching for use of oral progestins (minipill)
must be taken at same time every day
59
teaching for use of injectable progestins
do not massage site
60
long acting reversible contraceptives
- injectable progestin - implantable progestin - intrauterine contraceptive: progestin and copper
61
cautions before inserting IUC/IUD (3)
- undiagnosed vaginal bleeding - pregnancy - active/recent infection
62
teaching for IUD/IUC
- check strings - no signs of infection - don't remove yourself
63
warning signs IUD - PAINS
``` period late abdominal pain infection exposure not feeling well strings ```
64
permanent methods of contraception
female sterilization: - tubal occlusion - tubal reconstruction male: - vasectomy
65
teaching for breastfeeding (lactational amenorrheal method) method of contraception
- 6 months - no more than 4 hours between feeds during day - no more than 6 hours between feeds during night - no supplementation
66
pregnancy that ends before 20 weeks
abortion
67
least effective methods of contraception
fertility based awareness methods spermicides (withdrawal method)
68
most effective methods of contraception
reversible: - implant - IUD permanent: - male sterilization vasectomy - female sterilization

OB (21 decks)

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