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Mother Baby Unit 3 > Chapter 31 & 32 > Flashcards

Chapter 31 & 32 Flashcards

1
Q

Important considerations when choosing contraceptive methods (14)

A
  • safety (risk for stroke)
  • protection for STDs
  • effectiveness
  • acceptability
  • convenience
  • Education needed
  • Benefits (benefit outweighs risk?)
  • side effects
  • effects on spontaneity
  • availability (prescription needed)
  • expense
  • preference
  • religious beliefs (Catholics use family planning rather than contraceptives)
  • culture (large families gain respect, African cultures prefer to bleed out/menses)
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2
Q

Top 5 contraceptive use in America

A
  • Sterilization
  • oral contraceptives
  • condoms
  • diaphragm (yuck!) with spermicide
  • family planning
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3
Q

Special needs of perimenopausal women regarding contraception and best method for them

A
  • contraception should be used up to 1 year following lase menses
  • sterilization is most common in older women
  • may not understand risk of pregnancy with older age
  • progestin only is best (Mirena IUD, Depo-Provera, progestin only oral)
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4
Q

Differentiate between copper IUD and hormonal

A
  • Mirena is hormonal and last 5 years and is smaller

- Paraguard is copper and last 10 years

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5
Q

Which hormonal birth control is weight sensitive

A
  • Transdermal Patch

- weight more than 90 kg its less effective

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6
Q

Which hormonal birth control is lactation safe

A

-Implanon

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7
Q

Oral contraception teaching

A
  • if N/V/D use back up method for 7 days, this usually indicates altered absorption
  • take progestin same time every day, if 3 hours off use back up method for 7 days
  • Passes in breast milk-Drug interactions include St Johns Wort, anticonvulsants, and some antibiotics (not broad spectrum or antifungals) or anything that stimulates liver metabolism
  • not for diabetics or smokers, high blood pressure,clots, migraines
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8
Q

Chemical Barriers vs Mechanical

A

-spermicides vs condoms, diaphragm and cervical caps

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9
Q

Calender Family Planning Method

A
  • timing of ovulation
  • about day 14 after menses
  • unreliable
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10
Q

Standard Family Planning Method

A
  • using string of colored beads to keep tract of fertile vs infertile days
  • Day 8-19 considered sterile
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11
Q

Cervical Mucus/ Two day Family Planning Method

A
  • spinnbarket is when mucus becomes stretching
  • indicated ovulation
  • intercourse is allowed every other day when there is no mucus present
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12
Q

Sympothermal Family Planning Method

A
  • assessmentof body temp with cervical mucus in addition of bloating, weight gain, mittelschmerz, or increased libido
  • avoid intercourse if these are present
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13
Q

ACHES

A
  • warning signs of oral contraceptives complications
  • A: Abdominal pain
  • C: chest pain, dyspnea, hemoptysis, or cough can indicate PE or MI
  • H: Headache, weakness or numbness of extremity, hypertension can indicate migraines and stroke
  • E: eye problems can indicate migraine, stroke or retinal vein thrombosis
  • S: severe pain or swelling, heat or redness to calf can indicate DVT
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14
Q

Women health initiative

A
  • preventing breast CA, colerectal CA, osteoporosis and CV disease
  • health maintenance and screening
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15
Q

Trich discharge

A
  • thin or frothy
  • malordorous
  • yellow-green or brownish grey
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16
Q

Bacterial Vaginosis Discharge

A

-thin, grayish white with fishy odor

17
Q

Bacterial Vaginosis Treatment

A

-metronidazole (zole) and clindamycin

18
Q

Chlamydia treatment

A
  • azithromycin or doxycycline

- ofloxacin, levofloaxacin or erythromycin

19
Q

Gonorrhea Treatment

A
  • dual with chlamydia
  • ceftriaxone
  • cephalosporins
20
Q

Syphilis Treatment

A
  • Penicillin G or ceftriaxone
  • doxycycline
  • tetracycline
21
Q

TSS S/S

A
  • toxin alters capillary permeability, which allows fluid to leak from blood vessels, leading to hypovolemia, hypotension, and shock
  • direct tissue damage to organs and precipitates serious defects in coagulation
  • flue like symptoms, sudden fever, hypotension, rash resembling sunburn, skin peeling from feet and hands
22
Q

TSS Treatment

A
  • vasopressors
  • antimicrobial theray
  • corticosteriods
  • fluid replacement
23
Q

PID Treatment

A
  • cefoxitin or cefaotan, Doxycycline, Clindamycin, gentamycin
  • IV fluids to PO after 25 hours of treatment
  • antibiotics for 14 days
24
Q

PID nursing considerations

A
  • UA to rule out UTI
  • advise to seek medical attention after having unprotected sex with someone having STD or when unusual vaginal discharge/genital lesion
25
Q

Woman are _____ as likely as men to get STD

A

twice

26
Q

Most common symptoms of STDs

A
  • unusual vaginal discharge
  • vulvar itching or swelling
  • pelvic pain, painful coitis, painful urination, and abdominal tenderness
  • skin eruptions or changes (lesions, ulcers, warts, or blisters)
  • flu like symptoms
  • presence of symptoms in sexual partner
27
Q

Measures that provide comfort and prevent secondary infections

A
  • keep vulva clean but aoid strong soaps, creams and ointments
  • keep vulva dry
  • wear absorbent panties. cotton
  • avoid tight stuff
  • take analgesics
  • cool or tepid sitz bath
  • wipe vulva from front to back and practice hand hygiene
28
Q

Special instructions for Fecal Occult Blood Testing (FOBT)

A
  • avoid asa and nsaids for 7 days prior
  • avoid red meats, raw fruits, vegies, horseradish and vit c for 72 hours prior
  • collect specimen from 3 consecutive poops
  • return slides as directed within 4-6 days
29
Q

Secondary Amenorrhea

A
  • cessation of menstruation for 6 months +
  • caused by DM, TB, hypothryoidism, CNS lesions, birth control, ovairan tumors, stressers, pregnancy
  • treatment is focused at underlying cause
30
Q

Abnormal Bleeding

A
  • abnormal frequency, lenght of time, irregularity or excessive bleeding
  • can be caused by pregnancy (spntaneous abortion), breakthrough bleeding, DM, fibroids, hypothyroidism, coagulation issues, failure to ovulate
  • treatment is combination oral contraceptives, hysterectomy, pregnancy test, coagulation test, laser ablation
  • have women keep diary of episodes, amount, and number of pads
31
Q

Endometriosis manifestations

A
  • cyclic pain and infertility
  • deepunilaterla/bilateral sharp/dull pain
  • dyspareunia (painful intercourse)
  • rectal pain during defecation
  • diarrhea, constipation, sensation of rectal pressure or urgency
32
Q

Endometriosis treatment

A
  • oral contraceptive to supresse endometrial proliferation 6-12
  • progestins to inhibit growth of excessive endometrial tissue
  • testosterone or GmRH to interfere with hormones needed for ovulation and mentration- causes pseudomenopause
  • aromatase inhibitors to inhibit estrogen production in endometrial tissue such as Arimidex or Femara
33
Q

Endometriosis Nursing Considerations

A
  • varies from mild to incapacitating pain
  • suggest nonpharmacological relie such as rest periods, application of heat to lower abdomen, moderate excercise, well balance diet
34
Q

Therapeutic management for PMS

A

-zoloft
-prozac
-oral contraceptives
-BG
-Danazol to relieve mastalgia
carb rich foods

35
Q

What should be considered if postmenopausal woman has vaginal bleeding?

A

-uterine cancer

36
Q

Differentiate between endometriosis pain onset and PMS pain onset

A

-pain occurs at end of follicular phase and goes until period begins vs pain occurring before bleeding starts

37
Q

Symptoms that must always be investigated

A
  • irregular bleeding
  • unusual postmenopausal bleeding
  • unusual discharge
  • dyspareunia
  • persistent vulvar or vaginal itching
  • blood in stools
  • lesions on vulva
  • abdominal bloating or constipation (persistent)
  • anorexia and vomiting

Mother Baby Unit 3 (2 decks)

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