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OB > Ch. 11 nurses role in women's health > Flashcards

Ch. 11 nurses role in women's health Flashcards

1
Q

Screening test are

A

not diagnostic, identify if more test are needed

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2
Q

what screening is done for detection of breast cancer

A
  • monthly self exam
  • annual professional exam
  • mammography as needed
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3
Q

Who should perform BSE

A

all women after 20

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4
Q

When is the best time for BSE

A

1 week after start period

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5
Q

when should professional breast exams be done

A

yearly for all women over 20

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6
Q

How are mammograms performed

A

very low doses of x-ray

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7
Q

what can reduce the discomfort of mammograms

A

having them done after menstrual period

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8
Q

Who should get mammograms

A

all women 40 or older

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9
Q

Who should do vulvar self exams

A

women over 18

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10
Q

What should women do before pelvic exams

A

don’t douche or have sex for at least 48 hrs before

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11
Q

What do pelvic exams check for

A
  • tumors
  • discharge
  • infections
  • unusual pain
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12
Q

How often should women get pap smears:

  • age 21-39
  • age 30-65
  • over 65
A
  • every 3 years
  • every 5 years
  • not needed if normal for past 10 years
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13
Q

Amenorrhea

A

no periods

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14
Q

when is amenorrhea normal

A
  • before menarche
  • during pregnancy
  • after menopause
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15
Q

Primary amenorrhea

A

don’t menstruate by age 16 or by age 14 if no secondary sex characteristics have developed

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16
Q

Secondary amenorrhea

A

no period for at least 3 cycles or 6 months

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17
Q

what increases risk of polycystic ovaries

A

obese teens

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18
Q

why would women who have low body fat experience amenorrhea

A

fat is needed to make estrogen

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19
Q

Metrorrhagia

A

normal bleeding but happens irregularly

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20
Q

Menorrhagia

A

bleeding a lot

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21
Q

how much blood does the average woman lose

A

35 mL

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22
Q

what is considered an excessive amount of blood

A

> 80 mL/month

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23
Q

How does menorrhagia manifest

A
  • soaking through a pad or tampon in 1 hour sever times
  • clots the size of a quarter
  • gushing sensation that leaks through protection
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24
Q

Common causes of abnormal bleeding

A
  • bleeding disorders
  • pregnancy complications
  • lesions
  • breakthrough bleeding from oral contraceptives
  • endocrine disorders
  • failure to ovulate or respond to hormones
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25
Q

laser ablation

A

permanently removes uterine lining without hysterectomy

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26
Q

mefenamic acid

  • what drug class
  • what does it treat
A
  • NSAID

- menorrhagia

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27
Q

Tranexamic acid

  • what drug class
  • what does it treat
  • when is it used
A
  • antifibrinolytic
  • menorrhagia
  • when hormones are contraindicated
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28
Q

what can reduce menstrual flow when taken daily

A

NSAIDs

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29
Q

Mittelschmerz

A

pain around ovulation near the middle of the cycle

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30
Q

Dysmenorrhea

A

painful cramps

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31
Q

when does dysmenorrhea occur

A

after period starts

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32
Q

nulliparas

A

never been pregnant

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33
Q

Primary dysmenorrhea

A

no evidence of abnormality

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34
Q

Secondary dysmenorrhea

A

pathological condition found

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35
Q

when does the pain from dysmenorrhea start and how long does it last

A
  • starts no more than a few hours before period

- last no more than 72 hours

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36
Q

secondary dysmenorrhea common causes

A
  • endometriosis
  • IUD
  • pelvic inflammatory disease
  • uterine polyps
  • ovarian cyst
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37
Q

what hormones effect dysmenorrhea

A

Vasopressin and Prostoglandins

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38
Q

drugs that reduce prostaglandin secretion

  • include
  • used for
A
  • ibuprofen
  • naproxen
  • oral contraceptives
  • dysmenorrhea
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39
Q

endometriosis

A

tissue that resembles endometrium outside the uterus

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40
Q

what can endometriosis cause

A
  • pain
  • pressure
  • inflammation to adjacent organs
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41
Q

dyspareunia

A

painful sex

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42
Q

what meds treat endometriosis

A
  • danazol
  • agonsit of ganadotropin (nasal)
  • lupron (IM)
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43
Q

what are women with endometriosis at increased risk for

A

osteoporosis
serum lipid changes
infertility

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44
Q

what are surgical treatments for endometriosis

A

hysterectomy

laser ablation

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45
Q

what causes PMS and PMDD

A

serotonin responses to normal changes in estrogen

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46
Q

Symptom criteria used for PMDD

A
  • happens between ovulation and period
  • improves after period
  • 5 of the common symptoms occur
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47
Q

common symptoms of PMDD

A
  • depression
  • anxiety
  • irritable
  • difficulty concentrating
  • lethargy
  • food cravings
  • change in sleep
  • breast tenderness
  • bloating
  • weight gain
  • headache
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48
Q

treatment for PMDD

A
  • diet high in complex carbs and fiber
  • stress management
  • exercise
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49
Q

meds for PMDD

A
  • oral contraceptives
  • diuretics during luteal phase
  • NSAIDs
  • SSRIs 2 weeks before period and stopped when it starts
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50
Q

Vaginal epithelium at birth

  • controlled by
  • rich in
  • pH
A
  • estrogen from the mother
  • glycogen
  • 3.7 to 6.3 (low)
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51
Q

Vaginal epithelium during childhood

A
  • atrophies
  • contains little glycogen
  • pH 7
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52
Q

When does estrogen influence come back after the mothers leaves

A

puberty

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53
Q

Interactions of glycogen and estrogen in the vaginal epithelium results in

A

growth of lactobacilli

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54
Q

what does lactobacilli do

A

produces bacteriostatic action and drops pH to 3.5-4.5

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55
Q

what factors predispose vagina to infection

A
  • antibiotics
  • douching
  • sex
  • uncontrolled diabetes
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56
Q

normal vaginal secretions are made up of

A
  • creamy white epithelial cells

- mucus from cervix, skene glands and bartholin glands

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57
Q

what is mucus like during ovulation

A

clear and slippery with spinnbarkeit

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58
Q

spinnbarkeit

A

stretching without breaking

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59
Q

what is mucus like after ovulation

A

cloudy and sticky

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60
Q

what can temporarily change the vagina’s pH

A
  • deodorant soap
  • perfumed toilet tissue
  • douching
  • spermicides
  • tampons
  • hot tubs or swimming pools
  • tight synthetic clothes
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61
Q

what are the classes of gynecological infections

A
  • toxic shock
  • STI
  • pelvic inflammatory disease
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62
Q

what micro-organism causes toxic shock

A

staphylococcus aureus

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63
Q

what does staphylococcus aureus cause if it enters the blood

A
  • shock
  • coagulation defects
  • tissue damage
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64
Q

what factors increase the risk for TSS

A
  • high-absorbency tampons for prolonged periods

- diaphragm or cervical caps esp. after childbirth

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65
Q

symptoms of TSS

A
  • sudden fever
  • flulike symptoms
  • hypotension
  • sunburn like rash
  • skin peeling on palms and soles 1 to 2 weeks after illness
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66
Q

how often should tampons be changed

A

q4h

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67
Q

what is the treatment for TSS

A

hospitalization

  • vasopressor drugs
  • antimicrobial meds
  • fluid replacement
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68
Q

Candidiasis

A

yeast infection

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69
Q

symptoms of candidiasis

A
  • itching
  • burning on urination
  • inflammation
  • cottage cheese discharge
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70
Q

how is candidiasis diagnosed

A

id of spores

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71
Q

How does candidiasis effect babies

A

can infect them at birth

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72
Q

what is the treatment for candidiasis

A
  • monistat (miconazole nitrate)
  • gyne-lotrimin (clotrimazole)
  • mycostatin (nystatin)
  • diflucan (fluconazole)
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73
Q

Symptoms of Trichomoniasis

A
  • discharge green, thin, smelly
  • itching
  • edema
  • redness
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74
Q

Trichomoniasis is diagnosed by, how long does it take

A
  • under microscope

- 10 min

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75
Q

How does Trichomoniasis effect baby

A

doesn’t but, can cause postpartum infection

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76
Q

Treatment for Trichomoniasis

A

=Flagyl (metronidazole) not during 1st trimester

-Gyne-lotrimin (clotrimazole) symptoms during first trimester

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77
Q

what kind of enviorment is best for trichomoniasis

A

alkaline

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78
Q

How is trichomoniasis spread

A

sex

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79
Q

what should be avoided during treatment with Flagyl

A

alcohol

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80
Q

symptoms of bacterial vaginosis

A

thin, fishy, grayish discharge

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81
Q

how is BV diagnosed

A

microscope and rapid detection tests

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82
Q

How does BV effect baby

A

preterm delivery

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83
Q

what is the treatment for BV

A
  • Flagyl (metronidazole) for symptoms

- restore normal flora

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84
Q

What STI are all pregnant women screened for

A

BV

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85
Q

Chlamydia symptoms

A
  • yellowish discharge
  • painful urination
  • often asymptomatic in women
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86
Q

Diagnosis of chlamydia

A
  • culture
  • DNA from urine
  • NAAT
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87
Q

how does chlamydia effect baby

A
  • transmitted via birth
  • conjunctivitis
  • pneumonia
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88
Q

Treatment for chlamydia

A
  • Azithomycin
  • doxycycline
  • erythromycin
  • eye care for all newborns
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89
Q

what are the complications of chlamydia

A

scarring of Fallopian tubes

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90
Q

Gonorrhea symptoms

A
  • purulent discharge
  • painful urination
  • dyspareunia
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91
Q

diagnosis of gonorrhea

A
  • culture
  • NAAT
  • results in hours
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92
Q

how does gonorrhea effect baby

A

transmits to eyes during birth causing blindness

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93
Q

treatment for gonorrhea

A
  • eye care for all newborns
  • cefriaxone
  • azithromycin
94
Q

complications of gonorrhea

A

pelvic inflammatory disease with tubal scarring

95
Q

Symptoms for primary stage syphilis

A

painless chancre on genitals, anus, lips

96
Q

symptoms of secondary syphilis

A
  • 2 months after primary
  • enlarged spleen and liver
  • headache
  • anorexia
  • rash
  • warlike growths
97
Q

symptoms of tertiary syphilis

A
  • may be years after secondary
  • heart dmg
  • blood vessel dmg
  • nerve dmg
98
Q

diagnosis of primary syphilis

A
  • scrapings of chancre

- serology tests

99
Q

diagnosis of secondary or tertiary syphilis

A
  • serology test
  • rapid plasma reagin
  • FTA-ABS
100
Q

how does syphilis effect baby

A
  • crosses placenta
  • congenital syphilis
  • stillbirth
  • miscarriage
101
Q

Treatment for syphilis

A
  • Benzathine penicillin G
  • tetracycline (not in pregnancy)
  • erythromycin
102
Q

how is syphilis spread

A
  • most contagious in primary or secondary
  • sex
  • sharing needles
103
Q

Herpes genitalis is caused by what

A

herpes simplex virus 1 and 2

104
Q

Symptoms of Herpes

A
  • clusters of painful vesicles
  • vesicles rupture after 1-7 days
  • Heal in 12 days
105
Q

Herpes is diagnosed by

A

viral culrture antibodies

DNA rapid test

106
Q

How does herpes effect babies

A
  • miscarraige
  • stillbirth
  • active infection needs C-section
  • CNS problems
107
Q

Treatment for herpes

A
  • no cure
  • Zovirax (acyclovir)
  • Valtrex (valacyclovir)
  • sitz baths
  • wearing loose cotton underwear
108
Q

Condylomata acuminatat

A

HPV

109
Q

what are the symptoms of Condolyomata acuminatat

A

-dry warlike growths

110
Q

What HPV cause warts

A

6 & 11

111
Q

What HPV cause cervical disorders

A

16 & 18

112
Q

how does hpv effect babies

A
  • obstruct birth canal

- laryngeal papillomas

113
Q

At what age is the HPV vaccine given

A

11-26

114
Q

Treatment for HPV

A

cryotherapy
electrocautery
laser
podophyllin

115
Q

Diagnosis of HPV

A

Pap test

116
Q

HIV early symptoms

A
  • no symptoms at first
  • weight loss
  • night sweats
  • fever and chills
  • fatigue
  • enlarged lymph nodes
  • rash
  • diarrhea
117
Q

HIV late symptoms

A
  • immune suppression
  • infections
  • malignancies
118
Q

Test for HIV

A
  • serology test
  • ELISA
  • positive western blot test
119
Q

How does HIV effect babies

A
  • transmitted before birth

- must be bottle fed

120
Q

Treatment for HIV

A
  • no cure

- antiretrovirals

121
Q

How is HIV transmitted

A
  • blood
  • sex
  • mother to child
122
Q

Who is at higher risk for HPV

A

women who douche

123
Q

How is Hep B transmitted

A

sex (especially anything rectal)

124
Q

Symptoms of Hep B

A
  • malaise
  • anorexia
  • nausea
  • fatigue
  • liver failure
125
Q

when is the hep B vaccine given

A

if you are exposed

126
Q

what is pelvic inflammatory disease

A

infection of the upper reproductive tract

127
Q

What is the most common cause of PID

A
  • asymptomatic STIs
  • N. gonnorrheae
  • chlamydia trachomatis
128
Q

What are the complications of PID

A
  • Scarring of fallopian tubes
  • ectopic pregnancy
  • infertility
129
Q

Symptoms of PID

A
  • vary by effected area
  • fever
  • chronic pain
  • abnormal discharge
  • nausea
  • anorexia
  • irregular bleeding
  • tenderness
  • elevated leukocytes
  • elevated sedimentation rate
130
Q

Treatment for PID

A

antibiotics

antimicrobias

131
Q

what does douching increase the risk of

A
  • PID
  • bacterial vaginosis
  • ectopic pregnancy
  • infection
132
Q

what is the optimum timing between pregnancy

A

12-24 months

133
Q

Natural family planning is

A

using protection or not having sex while fertile

134
Q

Ovum is viable for how long

A

24 hrs after ovulation

135
Q

How long is sperm viable

A

48-72 hours

136
Q

Failure rate of natural family planning

A

20%

137
Q

When is basal body temp taken

A

on waking up before activity

138
Q

How does basal temperature change during ovulation and how long does it last

A

raises about 0.2 C (0.4 F) and remains higher for the last half of cycle

139
Q

What can interfere with the accuracy of BBT

A
  • poor sleep
  • illness
  • jet lag
  • sleeping late
  • alcohol evening before
  • heated blankets or water beds
140
Q

Billings method uses

A

the character or amount of mucus

141
Q

What factors interfere with billings method

A
  • antihistamines
  • infection
  • contraceptive foams or jellies
  • sexual arousal
  • sex
142
Q

What is the benefit of Billings method

A

can be used in women whose cycles are irregular

143
Q

When does ovulation occur

A

days before period

144
Q

How long is a woman fertile

A

5 days before and 1 day after ovulation

145
Q

Contraceptive effects

A
  • prevent ovulation
  • makes mucus thick and resistant to spern
  • makes uterus less hospitable
146
Q

The pill contains

A

estrogen and progestin

147
Q

the mini pill contains

A

only progestin

148
Q

who should avoid the mini pill

A

hispanic women with gestational diabetes who are breast feeding

149
Q

How long after delivery can the pill be taken

A

3 weeks, but the mini pill helps with lactation

150
Q

How are multiphasic pills different

A

the hormones change during the cycle to mimic natural hormone activity

151
Q

induced amenorrhea are

A

extended-dose contraception

152
Q

with extended-dose pills how is the period effected

A

only have one once every 3 months

153
Q

what form of the pill is most effective

A

extended-dose

154
Q

Common side effects of birth control pills

A
  • nausea
  • headache
  • breast tenderness
  • weight gain
  • spotting
  • amenorrhea
155
Q

Who should be not take birth control pills

A
  • blood clots
  • heart problems
  • estrogen dependent cancer
  • breast cancer
  • smokes more than 15 cigarettes a day and older than 35
  • poor liver function
  • pregnant
  • undiagnosed vaginal bleeding
156
Q

Why shouldn’t birth control be given after delivery

A
  • high risk for blood clots

- can cause problems with lactation

157
Q

how does breast feeding effect ovulation

A

women who feed 10x per day don’t ovulate for 10 weeks after labor

158
Q

ACHES is used for

-what does it mean

A
  • warning signs that need to be reported for birth control
  • Abdominal pain (severe)
  • Chest pain, dyspnea, bloody sputum
  • Headache (severe). weakness or numbness of limbs
  • Eye problems
  • Severe leg pain or swelling, speech disturbance
159
Q

what reduces the effectiveness of birth control pills

A
  • antibiotics
  • anticonvulsants
  • rifampin
  • barbiturates
160
Q

Implanon does not affect

A

bone density

161
Q

failure rate of implanon

A

0.05%

162
Q

Medroxyprogesterone acetate

A

depo-provera

163
Q

how long does depo last how long can you take it

A

3 months for 2 years

164
Q

how long does it take for fertility to return with depo

A

1 year

165
Q

failure rate of depo

A

6%

166
Q

what are the benefits of depo

A
  • can be taken with antiseizure meds

- reduces blood loss for those with coagulation problems or sickle cell

167
Q

How effective is the IUD

A

98%

168
Q

What is Paragard

A

small T-shaped copper containing plastic device with no hormones

169
Q

how long is ParaGard good for

A

12 years

170
Q

How does ParaGard work

A

makes a hostile enviorment

171
Q

What is Mirena

A

IUD with progestin or levonorgestrel

172
Q

How does Mirena work

A

makes the mucus too thick and sometimes prevents ovulation

173
Q

How often does Mirena get replaced

A

every 3 to 6 years

174
Q

How long til fertility last after IUD removal

A

rapidly

175
Q

What are the side effects of IUD

A
  • cramping and bleeding on insertion
  • increased menstuation
  • dysmenorrhea
176
Q

What is important for he woman with an IUD

A

check the string weekly for the first 4 weeks then monthly

177
Q

Who should use an IUD

A

only those without infection and in monogamous relationships

178
Q

Ortho-Evra

A

transdermal patch containing norelgestromin/ethinyl-estadiol

179
Q

When should ortho-evra be applied

A

once a week for 3 weeks then 1 week without

180
Q

Who can use the patch

A

women who weigh less than 90 kg or 198 pounds

181
Q

how does nuvaring work

A

releases estrogen and progestin

182
Q

How long is nuvaring work

A

3 weeks with 1 week break

183
Q

Failure rate of nuvaring

A

9%

184
Q

Diaphragms and cervical caps

A

rubber domes that fit over cervix and use spermacide

185
Q

failure rate of diaphragms and cervical caps

A

12%

186
Q

How long should diaphragms be left in place

A

6 hours after sex

187
Q

When should diaphragms be refitted

A

after each birth

after weigh change of 10 lbs or more

188
Q

When should the cap be refitted

A

yearly and after birth, abortion or surgery

189
Q

FemCap

A

latex-free cap

190
Q

Lea’s shield

A

silicone reusable shield used with spermacide

191
Q

how long can vaginal sponge be left in place

A

up to 24 hours after sex

192
Q

What are adverse effects of vaginal sponge

A

dryness and irritation

193
Q

Failure rate of condoms

A

18%

194
Q

Bikini-panty style female condom

A

pouch that fits inside the vagina

195
Q

how long before sex can the bikini-panty style female condom be inserted

A

up to 8 hours

196
Q

Failure rate of female condoms

A

21%

197
Q

how long are films and suppositories good for

A

1 hr

198
Q

How long do you have to wait to douche if using spermicides

A

6-8 hrs

199
Q

failure rate of spermicide

A

21%

200
Q

spermicides may cause

A

irritation and increased risk of infection

201
Q

Plan B

  • contains
  • most effective if used
  • may be effective if used
A
  • progestin levonorgestrel
  • 72 hrs
  • 120 hrs
202
Q

who is plan b not effective for

A

women over 165 lbs

203
Q

Ulipristal acetate

  • requires
  • how does it work
  • taken within
A

Ella

  • prescription
  • prolonging ovulation
  • 5 days
204
Q

coitus interruptus

A

pull out method

205
Q

how does vasectomy work

A

cutting each vas deferens

206
Q

How long before sterile with vasectomy

A

1-3 months

207
Q

how long does it take to do a vasectomy

A

20 minutes under local anesthetic

208
Q

Tubal ligation

A

blocking or ligating the fallopian tubes via electrocautery or clips

209
Q

Minilaparotomy

  • AKA
  • how does it work
A
  • band-aid surgery

- incision near belly button right after labor or above pubis other times

210
Q

laparoscopic surgery

A

ligation through laparoscope

211
Q

traditional approach tubal ligation

A

done during abd surgery usually a C-section

212
Q

how long does it take to recuperate from tubal ligation

A

1-2 days

213
Q

hysteroscope

A

saline fills uterus and essure microinsert is put in fallopian tubes through the vagina

214
Q

How after hysteroscope before effective

A

3 months

215
Q

depo can provide amenorrhea for how long

A

5 years

216
Q

menopause

A

cessation of periods for 1 year because of changes in estrogen levels

217
Q

Climacteric

A

the time before menopause last 2-8 years

218
Q

when does menopause occur

A

age 45-50

219
Q

decreased estrogen increases risk for

A
  • osteoporosis
  • arteriosclerosis
  • increased cholesterol
220
Q

menopause may be induced at any age by

A
  • surgery
  • pelvic irradiation
  • extreme stress
221
Q

what signs should be reported while on hormone replacement therapy

A
  • headache
  • vision changes
  • signs of thrombophlebitis
  • cardiac symptoms
222
Q

contraindications to HRT

A
  • estrogen dependent breast cancer
  • endometrial cancer
  • thromboembolic disease
  • history of melanoma
  • chronic liver disease
  • severe hypertriglyceridemia
  • gallbladder disease
  • seizure disorders
223
Q

Ginseng

A

helps relieve menopausal symptoms

224
Q

Soy products

A

thought to reduce hot flashes and convert vit D into calcitonin

225
Q

Vitamin E

A

stabilize estrogen lvls

226
Q

Black cohosh

A

remifemin

reduce luteinizing hormone

227
Q

signs of osteoporosis

A
  • height loss
  • dowager’s hump
  • upper spine curve
  • fractures
228
Q

how much Vit D and calcium should women take for menopause

A
  • 1200mg cal

- 600 to 800 mg D

229
Q

Fosamax (Alendronate)

A

prevents potential fractures

230
Q

Prolia (Denosumab)

A

reduces bone loss

OB (4 decks)

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