Ch.3 Flashcards
during prengnacy and post-partum
Part to woman’s anatomy change
joints: not solid bone; cartilage at joints so pelvis can move and accommodate baby; moving joints
Pelvis -
Mammary gland composed of a number of lobes, divided into lobules
Breasts – Structure
Lactation - feed a baby
Organs for sexual arousal
Estrogen stimulates breast growth in prengnancy
Once ovulation progesterone acts to mature; estrogen stimulates and progesterone mature; progesterone highest when pregnant; not till after first baby breasts fully developed - some bigger after every baby
Physiologic alterations in breast size reach minimal level about 5 to 7 days after menstruation stops - change all time; not completely symmetrical and norm; mostly symmetrical - typ more inflamed right before period and go back to norm after period; some have fibrocystic breast changes - hurt bad with hormone fluctuation; tenderness; change with lactation; best time for BSE 5-7 days after menstruation - better feel of breasts
Breasts - Function
Breast self-examination best carried out during this phase of menstrual cycle
Same time each month and same person does it; imp woman knows what look like so can alert provider not look right; mammogram detect things never feel; stand in front mirror after shower and look and see; higher risk imp know what checking and where - esp armpit
Physiologic alterations in breast size reach minimal level about 5 to 7 days after menstruation stops - change all time; not completely symmetrical and norm; mostly symmetrical - typ more inflamed right before period and go back to norm after period; some have fibrocystic breast changes - hurt bad with hormone fluctuation; tenderness; change with lactation; best time for BSE 5-7 days after menstruation - better feel of breasts
Menarche and puberty
Menstrual cycle = 1 question!!!!!
Prostaglandins
Climacteric and menopause
Menstruation
Menarche - first period
Puberty - starts before cycle/period starts
Menarche and puberty
Menstruation - proliferative - secretory - ischemic (loss blood supply prep for blood supply)
Feedback mechanism (pit), ovaries, and endometrium
Day 1 period - first day cycle - beginning, bleeding; bleed depends on couple days; less than ¼ cup but sometimes more (1-5 days); hormone levels level; ovary have primary follicle start maturing for next round
Bodies always trying to create new life
Huge range of normal for cycle; everything working like supposed to for ovulation to period is 14 days as long as everything work like supposed to - 14 days beyond last period
Know ovulation (14 days after first day of menstruation) - get or avoid pregnancy
Ovulation - want to get to it - estrogen; cervical mucus super thin; moist down south, flush to cheeks, smell good pheromones, boobs look good, feel good
Endometrial cycle
Hypothalamic-pituitary cycle
Ovarian cycle
Other cyclic changes
Menstrual cycle = 1 question!!!!!
2 weeks after ovulation - tell brain not happen and have menses - ischemic phases - FSH = next day because body always trying to create new life
Proliferative - building up; going up of estrogen
Secretary phase - preparing for egg
Ischemic - loss blood supply to prepare for another set
Endometrial cycle
Pit gland - FSH - stimulates primary follicle that pops out next egg - bleeding but body ready for next egg
Proliferative phase: estrogen higher and lining thicker - endometrium grows and estrogen rises - mature primary follicle released - ovulation
Hypothalamic-pituitary cycle
Secretory phase - luxurious velvet - fertilized egg - dropped egg - huge spike in LH; egg released; 14-20 days; same time progesterone - hopefully have baby to progestate to maintain pregnany; estrogen present but progesterone higher
Corpus luteum larger - egg imbeds - dividing and no placenta yet: got use hormones from corpus luteum
LH post pit waiting for LH
Ovarian cycle
Oxygenated fatty acids classified as hormones
Chem in body
Body fluid rich - semen - soften cervix
Effects on:
Prostaglandins
Ovulation
Fertility
Changes in cervix and cervical mucus
Tubal and uterine motility - tubes not contract - cilia inside tubes that move egg
Sloughing of endometrium (menstruation) -
Onset of abortion (spontaneous and induced)
Onset of labor (term and preterm)
Effects on: - Prostaglandins
Transitional phase during which ovarian function and hormone production decline
Incorporates Spans the years from onset of premenopausal ovarian decline to postmenopausal time, when symptoms stop
Perimenopausal - vaginal irritation, periods off, hot flashes at night, ovarian decline
Climacteric
Refers to the last menstrual period - HAS TO BE 12 MONTHS; menopause at 12 months; post-menopuase - after 12 months
Dated with certainty 1 year after menstruation ceases
Average age 51.4 years old - US
Range of ages 35 to 60 years old
Menopause
Females and males achieve ONLY physical maturity at approximately age 17 years old
Women and men are more alike than different in physiologic response to sexual excitement and orgasm - sim to physiology sex
Sexual response cycle is divided into four phases:
Time, intensity, and duration for cyclic completion vary for individuals and situations - women in resolution - ready go again in; not wait fill up with blood
Sexual response
Sexual stimulation results in an increase in circulation to circumvaginal blood vessels - areas brighter - W: breast and genitals; M: genitals; lots of engorgement
Venous congestion is localized primarily in the genitals and to a lesser degree in breasts and other parts of the body - under arms, things sweaty during cardio
Arousal is characterized by myotonia (muscle tone), resulting in voluntary and involuntary rhythmic contractions - orgasm: body do things can and cannot control: muscle spasms, toe curling, oh faces, eyes roll back in head, vocalizations; sometimes can and cannot control it
Women and men are more alike than different in physiologic response to sexual excitement and orgasm - sim to physiology sex
Excitement - ovulation time; horny, foreplay
Plateau - angle, position, rhythm right
Orgasmic
Resolution - afterglow
How go from each phase - depends on how are
Sexual response cycle is divided into four phases:
Number one killer women: heart disease, then lung cancer
Health Promotion & Disease Prevention
Caring for women across the lifespan
Adolescents
Young and middle adulthood
Late reproductive age
Health Promotion & Disease Prevention
First enter the healthcare system as young women for the purpose of contraception or women’s health exams - women largest consumer healthcare; first exposure - and tell people who to go to
Entering for birth control: society told women their responsibility to manage our fertility
teenagers/young adults - get contraception
Teenage pregnancies: sexually active who do not use regular contraception has 90% of conceiving in the first year; declining versus 10 years; more resources and edu; higher risk for birth comps bodies not done going and not have resources older women have
10 yrs ago - first pregnancy by age 20; 51% pregnancies all planned regardless age
Adolescents
Contraception
Pelvic and breast screenings - 21 for pap smear
Young and middle adulthood
Increased risks with pregnancy, emergence of chronic diseases
Waiting until later in life to start babies; bad lifestyle: overweight and obese
Starts at 35 yrs - starting fams at this age
Eggs old and body older
Late reproductive age
Preconception counseling and care -
Pregnancy
Fertility control
Infertility
Menstrual problems
Perimenopause
Women help everyone come; always in healthcare sys - always get other people to come
Care at specific stages of a woman’s life
adolescents; how care for body; prepare for pregnancy and bodies; help modifiable risk factors help take care of now; time know pregnant done with first trimester and done things that affected development of baby - change behaviors that affect fetus
Educated enough
Preconception counseling and care -
Doing with women as age and norm
Pregnancy
Doing with women as age and norm
Fertility control
Doing with women as age and not norm
Infertility
Doing with women as age and not norm
Menstrual problems
Doing with women as age and norm
Perimenopause
Do health assessment, disease prevention
Substance use and abuse
Nutritional probs
Stress
Mental health conditions
Sleep disorders
Environmental and work place hazards
Risky sexual practices
Risk for certain medical or gynecologic conditions
Female genital mutilation
Human trafficking
Identification of risk factors
Prescription drug use - drugs taking
Illicit drug use
Alcohol consumption
Cigarette smoking - vaping
Caffeine
Substance use and abuse
Nutritional deficiencies - vit D, C, Ca, iron, B12
Obesity - DM, HTN, ⅓ women in US, BMI >30; even more are overweight
Eating disorders
Lack of exercise (150 minutes/week of moderate exercise)
Nutritional probs
Anorexia
Bulimia nervosa
Eating disorders
Nurses help with stress: Quit, sleep, gym
Stress
Ebbs and flows; ACE score; N students highest than any other program - trauma bonded
Mental health conditions
7-8 hrs goal
Sleep disorders
Constitues: no contraceptives, more than 1 partner, drunk sex, nonconseual sex
Doggy style is not - position
Risky sexual practices
Fam assessments (hx cancers)
Risk for certain medical or gynecologic conditions
Cultural pracs
Clit removed - anatomy very diff - 100% illegal in US
Female genital mutilation
Huge and huge issue in KC
One hubs sexual and job
Stadiums and Walmart
Human trafficking
Physical or emotional abuse
Sexual assault
Builds up - abusive incident - honeymoon phase - cycle of events
Anyone can be violent
Controlling - Can be emotional and verbal abuse so no wounds
Isolation
Controlling all aspects of the woman’s life
Intimate partner violence (IPV)
Pregnancy increases the risk
Physical or emotional abuse
Money
Shelter
Time
Food
Reproductive Coercion - form of abuse - partner controls fertility; can work other way around; trap into it; goes both ways but is more often male partner making do it
Controlling all aspects of the woman’s life
History
Physical examination
Pelvic examination - providers
Women with special needs/disabilities
Adolescents (ages 13 to 19 years old)
Assessment of the woman
External inspection (do as nurses and external genitalia) and palpation
Vulvar self-examination
Papanicolaou test - once 21
Pelvic examination - providers
Fasting blood glucose (Age 45+)
Total blood cholesterol
Lipid profile
Urinalysis
STI (age <25 and as needed if sexually active)
Mammogram (age 40)
Clinical Breast Exam (age 20+)
Tuberculosis skin testing (as needed for high risk)
Pap test (age 21-65)
Pelvic exam (until age 70)
Colon cancer screening (age 45!!!!!)
Bone mineral density (DEXA scan) (age 65)
Health screening for women across the lifespan
