EXAM 1 Flashcards
low birth weight and preterm birth is most common in which race and how much do they weigh
less than 2,500 grams
black babies
maternal mortality is typically due to
hemmorrhage, infection, HTN
obesity, HTN, diabetes can cause
infertility
congenital abnormalities of fetus
miscarriage
death
what is a lay midwife
midwife with no training
what are international concerns for women
human trafficking
female genital mutilation
what is the leading cause of death in women
heart disease
what are the 5 concerns of pregnant women
nutrition no smoking no alcohol violence prevention support system
when you aren’t sure of what to for a procedure, what is the first thing you should do
look at policy procedure manual
what is risk management
series of checks and balances
decrease injury to patient
what is failure to rescue
not acting on early signs of distress
what is the biggest barrier of womens access to care
inability to pay
what are some ethical issues within prenatal nursing
reproductive technology allocation of resources older age pregnancies 3rd party payers induced ovulation/in vitro fertilization multifetal pregnancy reduction intrauterine fetal surgery treatment of very low birth weight infants
how long is family planning/prenatal care
from preconception until baby is 1 year old
what is a nuclear family
husband, wife, children (biological/adopted)
single parent family
non traditional
most socially vulnerable (school achievement, promote high risk behaviors, health status)
married blended family
married couple with children from previous relationship
extended family/multigenerational what do they offer
social, emotional, financial support
what is the family systems theory
family is the most important role
1 change in one family member can impact whole family
beliefs/values are the most powerful role in actions of individuals
what is focused on with low risk vs. high risk familys
low risk is assisting/promoting healthy pregnancy
high risk may need to focus on additional illnesses
what is cultural competence
understand your own culture and understand patients have their own culture
what is acculturation
retain some of your culture, adopt practices from the dominant society (2 groups come in contact)
assimilation
loss of cultural identity, become dominant culture
ethnocentrism
believing that your beliefs and values are the best and only right way
in asian american births, what does the father due
it is common to see him not participate in birthing process
in european-american births, what does the father due
common to see father participate in birthing process
what are the vulnerable populations for women
racial/ethnic minorities adolescent girls older women incarcerated women women in rural areas homeless women
what is primary preventative care
immunizations, car seats, exercise, nutrition
what is secondary preventative care
screenings, “target specific populations”, STD vaccines after beginning sex
what is tertiary preventative care
rehab/treatment to prevent further deterioration
what is the care management for home care
safety of the home
assess environment for all parties
infection control
climate control
what do external and internal structures of the female body grow in response to
estrogen
progesterone
what does the uterus play a role in
receiving, implanting, retaining fertilized egg
menstruation
housing/expulsion of fetus
what occurs in the fallopian tubes
ovum is fertilized by sperm
what is the endometrium
lining of the uterus
highly vascular
what do the ovaries do
produce ova/eggs
hormone production
ovulation
where are the mammary glands located
between 2nd and 6th rib
what can affect lobules size and shape
age
nutrition
genetics
estrogen levels stimulate growth
what are the functions of the lobules
breast feeding
sexual arousal
what is menarche
1st menstruation
average age is 13
what is puberty
childhood transition to sexual maturity
how long is the average menstrual cycle
28 days
what does the menstrual cycle do
prepares uterus for pregnancy
how long is menses typically
5 days
50 ml of blood
what can menses be influenced by
physical, emotional, and environmental factors
what are prostaglandins (PG’s) and where are they produced
oxygenated fatty acids (hormones)
uterus
what are PG’s responsible for
smooth muscle contractility
key role in ovulation
moderate hormonal activity
influence estrogen and progesterone
what can PG’s do to the rest of the body
upset stomach, diarrhea, cramps, irritability, sleep disturbances
what is the cimacteric phase of menopause
transition phase of the body
transition from ovarian to decrease in hormone production
what is perimenopause
before women stops the menstrual cycle no estrogen being produced from the ovaries over a 4 year span decrease in ovarian function less ova/eggs released
what is menopause
last menstrual period
1 year of no bleeding
between ages 35-60
average age is 51.4
what are the barriers to seeking healthcare
financial issues
cultural issues
gender issues (gender concordance)
what do the caring for women across the lifespan include
preconception pregnancy family planning menstrual problems periomenopause
what is the average age for girls for their first intercoarse
17
when are pap smears recommended
21 or sexually active
what are nutrition issues that relate to risk factors in womens health
appropriate intake of calcium (osteoporosis)
folic acid increase (400 grams when pregnant)
screen for eating disorders
obesity
what is the recommended exercise
20-30 minutes of exercise at least 3 times a week
can prevent CVD, DM, osteoporosis, arthritis
what are the medical conditions common in women
heart disease
lung, breast, colon cancer
diabetes
chronic lung diseases
what do these medical conditions put women at risk for
infertility ovarian cysts STI's pre-term labor miscarriage
what is anticipatory guidance and when is it used
for mental health issues
in anticipation of problem, coping skills
what can substance abuse include
alcohol caffeine cocaine prescriptions drugs
what STI’s are the most common to screen for in women
candida
bacterial vaginitis
HSV
strep
what is amenorrhea
absence of period
absense of menses at age 15 with breast growth development
absense of menses 5 years within breast development
what is secondary amenorrhea
menstrual cycle but then 6 months plus without another
what are the main influences on amenorrhea
pregnancy endocrine disorders thyroid issues pituitary issues polysistic syndrome diabetes
what is the pregnancy hormone
HCG
what can be checked for causes of amenorrhea
urine sample to rule out pregnancy CBC TSH Estrodal Prolactin
what is the female athlete triad and what can it cause
it can cause amenorrhea
increase in exercise, inadequate nutrition
can cause osteoporosis
what is dysmenorrhea
pain during or shortly after menstruation
what can cause dysmenorrhea
early menarchy
nulliparity y (never being pregnant)
lack of exercise
what is primary dysmenorrhea
ovulatory cycles
excessive release of prostaglandins
cause arterioles in the uterus to spasm
what is the treatment for dysmenorrhea
heat exercise relaxation low sodium low fat vitamin E supplements
what is secondary dysmenorrhea and when does it occur
later in life, after 25 years
can be associated with pelvic pathology (endometriosis, fibroids)
what are s/s of dysmenorrhea
bloating
pelvic fullness
pain in the legs
lower back pain
what is the main treatment for dysmenorrhea
TREAT THE CAUSE
what are the s/s of PMS
fluid retention pelvic fullness breast tenderness weight gain irritability depression craving headache fatigue
PMS is a combination of
physical, psychological, behavioral symptoms
how can you manage PMS
diet exercise B6 D3 calcium supplements relaxation
what is endometriosis
presence/growth of endometrial tissue outside of the uterus
IMPORTANT: signs and symptoms of endometriosis include
dysmenorrhea painful intercourse abnormal uterine bleeding infertility *can worsen with each cycle or disappear after menopause
management of endometriosis include
NSAIDS estrogen suppressants oral contraceptives surgery hysterectomy
what occurs in menopause (physiologic)
anovulation (eggs aren't released) menstrual cycle length (longer length in between) ovulation (less frequent) progesterone (not produced) FSH (elevated)
physical changes in menopause include
bleeding (longer, lighter or heavier) genital changes (vagina/urethra are estrogen sensitive) decrease in libido vaginal dryness atrophy incontinence vasomotor instability (hot flash) moods/behavior changes
what are the treatments of vasomotor instability
avoid caffeine
layer clothing
ice water
avoid alcohol
what is osteoporosis
progressive loss of bone mass
decreased estrogen levels
(estrogen converts vitamin D into calcitonin)
what are health risks of perimenopausal women
osteoporosis
coronary heart disease
what are the risks of menopausal hormonal therapy
increases chances of breast cancer up to 5 years after stopping HRT
what medications are used for menpausal hormonal therapy
estrogen estrogen/progesterone SSRI's Gabapentin Clonadine
what are the side effects of menopausal hormone therapy
headache
N/V
brown spots on the skin
depression
what is micromastia
underdevelopment of the breast tissue
what is macromastia
overdevelopment of the breast tissue
what are the two goals when doing the initial evaluation of the breasts
what is benign, what is malignant
assess risk of breast cancer
what are fibrocystic changes
most common (20-50) related to imbalance of estrogen/progesterone
signs and symptoms of fibrocystic changes
lumpiness with or without pain (pain during menstrual cycle)
occur one week before, one week after
pain in younger women, 20 years
moveable, soft, easily touched
what is the management for fibrocycstic changes
surgical removal
NSAIDS
oral contraceptives
avoid alcohol/caffeine
does discovering a solid mass mean it is breast cancer? does it mean your risk for breast cancer is increased?
NO!
what is Mastalgia
breast pain
when is mastalgia common
in the reproductive years (teens to late 40’s)
when is mastalgia uncommon
breast cancer
what are the characteristics to assess for mastalgia (breast pain)
cyclic/non-cyclic pain
focal/diffuse
what is a fibroadenoma
solid mass
less than 3 cm
teenage year
most common
when can fibroadenomas get larger
pregnancy
when can fibroadenomas get smaller
when older
what is cellulitis
inflammation and infection of the skin
what are the risk factors for developing cellulitis
obesity large breasts previous surgerys radiation smoking diabetes nipple piercings
what is the most common cause of cellulitis
Mrsa
what are the signs and symptoms of cellulitis
redness inflammation thickened skin warm to the touch can turn into abscess
what is the treatment for cellulitis
antibiotics
what percent of lumps are found by patients
90%
what are the nursing actions/teaching for breast care management
discuss intervals for breast exams
provide written education
therapeutic communication
when are frequent breast exams recommended
starting in 20’s
when are annual mammograms recommended
40 and older
what impacts the development of malignant conditions of the breast
gender age early menarche menopause time of first live birth race (non-hispanic white) personal history nulliparity (never had kid) geographic differences 1st pregnancy after 40
what genetic markers increase your risk for breast cancer
BRCA 1
BRCA 2
what percentage of breast cancer is related to genetic mutations
15%
if the genetic markers are present, how much does it increase the chance of developing breast cancer
85%
if the genetic markers are present, how often are breast exams with immaging recommended
biannually
what is the 2nd leading cause of death in women
breast cancer
1 in 8 women develop it
what is the survival rate of breast cancer
83% 10 years after diagnoses
what percent is males
1%
what is a ductal tumor
in ducts invades tissue solid none mobile non tender
what does the rate of breast cancer growth depend on
estrogen
progesterone
other types of hormones/receptors
what is the most common type of malignant conditions of the breast
invasive ductal carcinoma
what occurs with a nipple carcinoma
with ductal carcinoma
bleeding
oozing
crusting
what are the characteristics of lobular tumors
in lobes
not palpable
imaging needed
what is Inflammatory breast cancer often misdiagnosed as
mastitis
cellulitis
what are the characteristics of inflammatory breast cancer
red inflammed rash stage 2 aggressive
where is the most common site of metastasis (breast cancer spread) in the body
bones
lungs
brain
liver
what is the gold standard for breast cancer
mammography
what is the most significant prognostic criteria for long term survival
nodal involvement
tumor size
when is adjuvant systemic chemotherapy performed
right after removal of tumor
pre-menopause, cancer spread to lymph nodes
what is requried 90 days prior to prophylactic mastectomy
mammogram
to ensure healthy tissue is being removed
what is the most common form of hormonal therapy for breast cancer
Tamoxifen (anti-estrogen)
what is required when on tamoxifen
annual pap smears
eye exams
liver function tests every 6 months
bone density scan every 3 years
what are the side effects of Tamoxifen
anemia N/V Leukopenia Thrombocytopenia hair loss
what are the nursing considerations for therapies
infection control
therapeutic communication
don’t take BP/Place IV/Draw blood on surgery side
what are included in survivorship issues
Vasomotor Symptoms Sexual Dysfunction Osteoporosis Weight Gain Cognitive Changes Cancer-related fatigue Cardiotoxicity/Neuropathy (due to Chemotherapy)
