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NRSG 206: OB > [Exam 1] Chapter 4 - Common Reproductive Issues > Flashcards

[Exam 1] Chapter 4 - Common Reproductive Issues Flashcards

1
Q

What is infertility

A

Inability to conceive child after 1 year of regular sexual intercourse

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2
Q

What is secondary infertility

A

Inability to conceive after previous pregnancy

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3
Q

How do African Americans feel about assistance for Infertility?

A

Assisted reproductive techniques are unnatrual and that they remove the spiritual nature of creation . Will seek spiritual help instead

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4
Q

How do Hispanics feel about relationships?

A

Believe that children validate the marriage so families large

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5
Q

Infertility & Etiology: REproduction requires that four things?

A

Release of normal preovulatory oocyte

Production of adequate spermatoza

Normal transport of gametes to fallopian tube

Subsequence transport of cleaving embryo into endometrail cavity

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6
Q

Infertility & Risk Factors: Major ones for women?

A

Weight Change

Hormonal Imbalances

Tubual BLockages

Reduced Oocyte Quality

Older than 27

History of PID

Exposure to Chemotherpeutic Agents

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7
Q

Infertility & Risk Factors: Major ones for men?

A

Exposure to toxic substances

Weed/Alcohol

Genitials in high temperature

Cushing Syndrome

Mumps

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8
Q

Infertility & Therapeutic Management: Majority of infertility cases treated how

A

with drugs or surgery

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9
Q

Infertility & Therapeutic Management: Treatment options include what?

A

Lifestyle Changes: Weight loss and No Smoking

Clomiphene to promote oovulation

Hormone injections

Intrauterine Insemination

IVF

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10
Q

Infertility & Nursing Assessment: What should the nurse collect here?

A

Full medical history taken from both partners, along with physical examination.

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11
Q

Infertility & Nursing Assessment: What is done during the first visit?

A

Plan of investigation is outlined and complete history taken.

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12
Q

Infertility & Assessing Male Factors: Initial screening should include

A

reproductive history and semen analysis.

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13
Q

Infertility & Assessing Male Factors: What should men do to prepare for semen analysis?

A

Abstain from sexual activity for 24-48 hours

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14
Q

Infertility & Assessing Male Factors: How should a man perform a semen analysis?`

A

Ejaculate into container and deliver to lab within 1-2 hours.

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15
Q

Infertility & Assessing Male Factors: What is analyzed in semen analysis?

A

Volume, viscosity, number of sperm, sperm viability, motibility, and shape

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16
Q

Infertility & Treatment: What to know for Climiphene Citrate (Clomid)?

A

Nonsteroidal synthetic antiestrogen used to induce ovulation. Discontinued after three cycles

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17
Q

Infertility & Treatment: What to know for Human Menopausal Gonadotropin (HMG)?

A

Induces ovulation by direct stimulation of ovarian follicle

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18
Q

Infertility & Treatment: What to know for Artifical Insemination

A

Insertion of prepared semen sample on cervical cavity. Enables sperm to be deposited closer to improve chances

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19
Q

Infertility & Treatment: What to know for In Vitro Fertilization (IVF)

A

Oocytes fertilized in lab and transfered to the uterus.

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20
Q

Infertility & Treatment: What is In Vitro Fertilization (IVF) indicated for

A

Indicated for tubual obsturction, endometriosis, pelvic adhesions and low sperm counts

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21
Q

Infertility & Treatment: What to know for Gamete Intrafallopian Transfer (GIFT)

A

Oocytes and sperm are combined and immediately placed in the fallopian tube so fertilization can occur naturally. Requires laparoscopy

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22
Q

Infertility & Treatment: What to know for Intracytoplasmic Sperm Injection

A

One sperm injected into cytoplasm of the oocyte to fertilize it. Indicated for male factor infertility

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23
Q

Infertility & Treatment: What to know for Donor Oocytes

A

Eggs/Sperm retireved from donor and eggs inseminated and transfered with IVF

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24
Q

Infertility & Treatment: What to know for Preimplantation Genetic Diagnosis (PGD)

A

Used to identify genetic defects in embryos created through IVF before pregnancy

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25
Q

Infertility & Treatment: What to know for Gestational Carrier

A

Laboratory fertilziation takes place and embryos transfered to the uterus of another woman, who will carry pregnancy

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26
Q

Infertility & Assessing Female Factors: Diagnostic tests to test infertility include what

A

Assess ovary function

Ovulation preductir

Urinary LH level

Clomiphene Citrate Challenge test

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27
Q

Infertility & Assessing Female Factors: What are Home Ovulation Predictor Kits?

A

Contain monoclonal antibodies specific for LH and use ELISA to determine amount of LH present in urine. Significant color change indicates LH surge and most fertile day of month

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28
Q

Infertility & Assessing Female Factors: What is the Clomiphene Citrate Challenge test?

A

Used to assess womans ovarian reserve (Ability of eggs to become fertilized)

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29
Q

Infertility & Assessing Female Factors: How is the Clomiphene Citrate Challenge test performed?

A

LSH levels drawn on day 3 and on day 10 after woman has taken 100 mg clomiphene on days 5-9. FSH > 15 is considered abnormal

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30
Q

Infertility & Assessing Female Factors: What is a Hysterosalpingography?

A

Assesses patency of fallopian tubes. 3-10 mL of contrast slowly injected through catheter into the endocervical canal so that uterus and tubes can be visualized during fluroscopy.

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31
Q

Infertility & Assessing Female Factors: What if fallopian tube patent in Hysterosalpingography?

A

Dye will ascent upward and distend the uterus and tubes and will spill out into the peritoneal cavity

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32
Q

Infertility & Assessing Female Factors: What is a Laparoscopy?

A

Used when abnormalities are found on ultrasound. Endoscope inserted through small incision in anterior abdominal wall.

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33
Q

Contraception & Types: Can be divided into what four types?

A

Behavioral Methods

Barrier Methods

Hormonal Methods

Permanent Methods

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34
Q

Contraception & Types: What are behavioral methods?

A

Abstinence

Fertility Awareness

Withdrawal

Lactational Amenorrhea Method

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35
Q

Contraception & Types: What are Barrier Methods?

A

COndom

Diaphrahm

Cervical Cup

Sponge

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36
Q

Contraception & Types: What are Hormonal Methods?

A

Oral Contraceptive

Injective Contraceptive

Vaginal Ring

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37
Q

Contraception & Types: What are permanent methods?

A

Tubal ligation or essure for women

Vasectomy for men

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38
Q

Contraception & Fertility Awareness-Based Methods: What does this refer to?

A

Any natural contraceptive method that does not require hormones, pharmaceutical compounds, or surgery to prevent pregnancys

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39
Q

Contraception & Fertility Awareness-Based Methods: What do these focus on?

A

Physical signs and symptomss that change with hormone fluctution throughout womens menstural cycle to predict a womans fertilitys

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40
Q

Contraception & Fertility Awareness-Based Methods: When does ovulation occur?

A

On one day each menstrual cycle.

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41
Q

Contraception & Fertility Awareness-Based Methods: What is the fertile window?

A

The potentially fertile dyas up to and including the day of ovulation

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42
Q

Contraception & Fertility Awareness-Based Methods: What is the theme of this method?

A

That women can reduce their change of pregnancy by abstaining from coitus or using barrier methods during times of fertility

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43
Q

Contraception & Fertility Awareness-Based Methods: When is a single ovum released?

A

14 days before next menstrual period . Lives for 24 hours

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44
Q

Contraception & Fertility Awareness-Based Methods: How long can sperm live?

A

Up to 5 days . Therefore unsafe period is 3 days before and 3 days after ovulation.

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45
Q

Contraception & Fertility Awareness-Based Methods: What must we do since exact time of ovulation cannot be determined?

A

2-3 days are added to the beginning and end to avoid pregnancy

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46
Q

Contraception & Fertility Awareness-Based Methods - Cervical Mucus Ovulation Method: What is cervical mucus?

A

Jellylike vaginal discharge from cervix

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47
Q

Contraception & Fertility Awareness-Based Methods - Cervical Mucus Ovulation Method: What does this assess?

A

The character of the cervical mucus. In days preceding ovulation, this mucus helps draw sperm up and into fallopian tubes and helps them survive

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48
Q

Contraception & Fertility Awareness-Based Methods - Cervical Mucus Ovulation Method: How does mucus appear as ovulation draws closer?

A

Mucus becomes more abundant, clear, slippery, and smooth. can be stretched between two fingers without breaking

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49
Q

Contraception & Fertility Awareness-Based Methods - Cervical Mucus Ovulation Method: What is the name for the mucus during ovulation?

A

Spinnbarkeit mucus.

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50
Q

Contraception & Fertility Awareness-Based Methods - Cervical Mucus Ovulation Method: Mucus after ovulation?

A

Becomes thick and dry under the influence of progestero

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51
Q

Contraception & Fertility Awareness-Based Methods - Cervical Mucus Ovulation Method: How does cervix feel near ovulation??

A

Is soft and is high/deep in the vagina, the os is slightly open, and the cervical mucus is copious and slippery

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52
Q

Contraception & Fertility Awareness-Based Methods - Basal Body Temperature Method: What does this refer to?

A

The lowest temperature reached on awakening.

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53
Q

Contraception & Fertility Awareness-Based Methods - Basal Body Temperature Method: How is this performed?

A

Temp taken orally before rising.

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54
Q

Contraception & Fertility Awareness-Based Methods - Basal Body Temperature Method: How are temperatures here?

A

Preovulation temp suppressed by estrogen, where postovulation temp are increased under influence of heat-inducing progesterone

Temps rise within a day or two after ovulation and remain elevated for two weeks after

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55
Q

Contraception & Fertility Awareness-Based Methods - Basal Body Temperature Method: How is this used to prevent pregnancy?

A

Should not have sex until BBT has been elevated for 3 days

56
Q

Contraception & Fertility Awareness-Based Methods - Symptothermal Method: What is this?

A

Relies on combo of techniques to recognize ovulation, including BBT, mucus changes, and alterations in cervix

57
Q

Contraception & Fertility Awareness-Based Methods - Standard Days Method: What is this?

A

Develop for women with menstural cycle between 26-32 days. Should avoid sex on days 8 through 19. May use cyclebeads to assist them here

58
Q

Contraception & Fertility Awareness-Based Methods - Standard Days Method: What does this method identify?

A

A 12-day fertile window of a womans menstrual cycle.

59
Q

Contraception & Fertility Awareness-Based Methods - Two-Day Method: How is this done?

A

Women observe the presence or absence of cervical secretions by examining toilet paper or underwear. If secretions present, she is fertile and avoids unprotected intercourse

60
Q

Contraception & Fertility Awareness-Based Methods - Two-Day Method: How do color-coded beads help?

A

Red bead represents first day of menstrual period. Beads moved one day. Brown are when pregnancy unlikely and white represents her fertile days

61
Q

Contraception & Withdrawal (Colitus Interruptus): What is this?

A

Man controls his ejaculation during sex and ejaculated outside vagine

62
Q

Contraception & Lactational Amenorrhea Method: How is this done?

A

Continuous breast-feeding usually can postpone ovulation adn thus prevent pregnancy. Breast-feeding stimulates prolactin which is needed for milk production and inhibits release of gonadotropin which is necessary for ovulation

63
Q

Contraception & Lactational Amenorrhea Method: This can be effective for how long?

A

Up to six months

64
Q

Contraception & Lactational Amenorrhea Method: What must woman do to make sure this works?

A

Has not had period yet

Infant younger than 6 months

Breast feeds 6x/day on both breasts

Breasts feeds on demand every 4 hours.

Nighttime feedings provided every 6 hour

65
Q

Contraception & Barrier Methods: What are spermicides?

A

They chemically destroy the sperm in the vagina.

66
Q

Contraception & Barrier Methods - Diaphragm: What is this?

A

Soft latex dome surrounded by a metal spring. Used along with spermicidal jelly or cream and inserted in vagine to cover the cervix

67
Q

Contraception & Barrier Methods - Diaphragm: At what time should this be inserted?

A

4 hours before intercourse but must be left in place at least 6 hours afterwardsd

68
Q

Contraception & Barrier Methods - Diaphragm: What would cause them to be refitted?

A

After pregnancy, abdominal surgery, or weight loss or gain of 10 lbs or more.

69
Q

Contraception & Barrier Methods - Cervical Cap: What does this do?

A

Only covers the cervix and held in place by suction.

70
Q

Contraception & Barrier Methods - Cervical Cap: Made of what?

A

Made of sillicone or latex and used with spermicide

71
Q

Contraception & Barrier Methods - Cervical Cap: Duration for this?

A

Can be inserted up to 36 hours before intercourse and provides protection for 48 hours. Must be kept in vagina for 6 hours after final act and replaced every year

72
Q

Contraception & Barrier Methods - Contraceptive Sponge: What is this?

A

Nonhormonal, nonprescription device that includes a barrier and spermicide. Removed in 1996. Soft concave device that prevents pregnancy by covering cervix and releasing spermicide

73
Q

Contraception & Barrier Methods - Contraceptive Sponge: What does this do?

A

Releases 125 mg of spermicide over 24 hours of use. Can be used multiple times within 24 hours.

74
Q

Contraception & Barrier Methods - Contraceptive Sponge: Steps in using this?

A

Woman first wets it with water and then inserts into vagine with finger. Can be inserted up to 24 hours before and left in place for 6 hours after intercourse. Provides protection for 12 hours.

75
Q

Contraception & Hormonal Methods: WHat hormones do this rely on?

A

Estrogen and Progestin or Progestin alone to prevent ovultion

76
Q

Contraception & Oral Contraceptives: What did the first pill contain?

A

Enovid, was approvided in 1960, and contrained high levels of estrogen to prevent ovulation

77
Q

Contraception & Oral Contraceptives: What health benefits may this provide?

A

Reduced cancer

Tx Endometriosis

Decreased acne

Maintain BMD

Reduced iron-deficiency anemia

78
Q

Contraception & Oral Contraceptives: How do this work?

A

By supressing ovulation by adding estrogen and progesterone to a womans body, mimicking pregnancy.

79
Q

Contraception & Oral Contraceptives: What hormones are affected?

A

Stifles GnRH, which suppresses FSH and LH and this inhibits ovulation. Cervical mucus also thickens.

80
Q

Contraception & Oral Contraceptives: Implantation inhibited how?

A

By suppression of the maturation of the endometrium and alterations of uterine secretions

81
Q

Contraception & Oral Contraceptives: What do monophasic pills do?

A

Deliver fixed dosages of estrogen and progestin

82
Q

Contraception & Oral Contraceptives: What do multiphasic pills do?

A

Alter the amounto f progestin and estrogen within each cycle.

83
Q

Contraception & Oral Contraceptives: Why would progestin only pills be prescribed?

A

For women who cannot take estrogen in combined OCs suhc as woman older than 35 who smokes.

84
Q

Contraception & Oral Contraceptives: What do Progestin only pills do to the body??

A

Thicken the cervical mucus to prevent penetration of the sperm and make the endometrium unfavorable for implantation.

85
Q

Contraception & Oral Contraceptives: Why are progestin only pills not as popular?

A

Breakthrough bleeding and higher risk of pregnancy

86
Q

Contraception & Oral Contraceptives: How does a woman take pills in an extended regimen?

A

Extended regimen consists of taking it for 84 consecutive days followed by 8 days of placebos

87
Q

Contraception & Oral Contraceptives: Periods for a women taking extended OC?

A

Has four withdrawal-bleeding episodes a year.

88
Q

Contraception & Oral Contraceptives: Advantages of conraceptives?

A

Regulate/shorten menstural cycle

Decrease severe cramping

Reduce anemia/cancer

Minimize perimenopausal symptoms

Improve PMS symtpoms

89
Q

Contraception & Oral Contraceptives: Disadvantages of contraceptives?

A

Slightly increased breast cancer

Increased migraine headaches

Depression

90
Q

Contraception & Oral Contraceptives: First FDA-approved OC with 365 day combo dosing and dosage?

A

Lybrel . Low dose combained dose of levonorgestrel and ethinyl estradiol

91
Q

Contraception & Oral Contraceptives: Acronym for early signs of complications for users of oral contraceptives?

A

ACHES

92
Q

Contraception & Oral Contraceptives: A in ACHES?

A

Abdominal pain may indicate liver or gallblader problems

93
Q

Contraception & Oral Contraceptives: C in ACHES?

A

Chest pain or SOB may indicate a pulmonary embolus

94
Q

Contraception & Oral Contraceptives: H in ACHES

A

Headaches may indicate hypertension or impending stroke

95
Q

Contraception & Oral Contraceptives: E in ACHES?

A

Eye problems may indicate hypertension or an attack

96
Q

Contraception & Oral Contraceptives: S in ACHES?

A

Severe leg pain may indicate a thromboembolic event

97
Q

Contraception & Injectable Contraceptives: What types are available?

A

Progestin-only and combination estrogen and progestin agents that are effective for 3 months

98
Q

Contraception & Injectable Contraceptives: What is Depo-Provera?

A

IM Injectable of Progesterone only. Given every 12 weeks which contains 150 mg/1 mL.

99
Q

Contraception & Injectable Contraceptives: How does Depo-Provera work?

A

By suppressing ovulation adh the production of FSH and LH by the pituitary gland by increasing the viscosity of cervical mucus and causing endometrial atrophy

100
Q

Contraception & Injectable Contraceptives: Primary side effect of Depo-Provera?

A

Menstural cycle disturbance

101
Q

Contraception & Injectable Contraceptives: What issue has risen because of Depo-Provera?

A

That there may be a decrease in BMD

102
Q

Contraception & Transdermal Patches: What do these avoid compaired to normal OC?

A

Avoids hepatic first-pass metabolism allowing a lower total hormone doses

103
Q

Contraception & Transdermal Patches: What is available in the US?

A

Ortho Evra. Placed in lower abdomen, upper outer arm, or buttocks.

104
Q

Contraception & Transdermal Patches: Duration for Ortho Evra ?

A

For three weeks its applied, followed by a patch-free week during which withdrawal bleeding occurs.

105
Q

Contraception & Transdermal Patches: What hormone does Ortho Evra deliver? And SE?

A

Continuous levels of progesterone and estrogen.

Increased RFvenous thrombosis and embolism

106
Q

Contraception & Transdermal Patches: How do heavier women handle this?

A

Obese women with weight above 198 should be alerted of decreased effectiveness of patch

107
Q

Contraception & Vaginal Rings: What hormones contained here?

A

Estrogen and Progesterone hormones

108
Q

Contraception & Vaginal Rings: How does the NuvaRing work?

A

Flexible, soft, transparent ring that is inserted by user for 3 week period followed by ring-free week to allow withdrawal bleeding

109
Q

Contraception & Vaginal Rings: What is absorbed through the vaginal epithelium?

A

Ethinyl Estradoil and Etonogestrel rapidly absobred. Lower dose needed because its absorbed directly

110
Q

Contraception & Vaginal Rings: Reported problems with this?

A

Erosion of vaginal wall, ring expulsion, intereference with colitus, unplesant ring odor and premature discontinuation

111
Q

Contraception & Implantable Contraceptives: How does this work?

A

subdermal time-release method that delivers synthetic progestin that inhibits ovulation . Delivers 3 years of . Inhibits ovulation and thickening cervical mucus.

112
Q

Contraception & Implantable Contraceptives: What is available in US?

A

Nexplanon.

113
Q

Contraception & Implantable Contraceptives: Side effects?

A

Irregular bleeding, headaches, weight gain, breast tenderness, and depression

114
Q

Contraception & Intrauterine Contraceptives: Classified how?

A

Hormonal or nonhormonal

115
Q

Contraception & Intrauterine Contraceptives: How do they prevent pregnancy?

A

Inhibition of sperm obility and sperm viability and change the speed of transport of the ovum in the fallopian tube. Makes endometrium of uterus hostile to implantation by causing nonspecific inflammatory reaction.

116
Q

Contraception & Intrauterine Contraceptives: How does this look?

A

Is a T-Shaped object placed in uterus.

117
Q

Contraception & Intrauterine Contraceptives: Which ones are available in the US?

A

Copper PAraGard, Mirena, and Skyla

118
Q

Contraception & Intrauterine Contraceptives: How does the Paragard work hormonal wise?

A

It is a nonhormal. Based on release of copper ions which are spermicidial. Also causes an inflammatory reaction

119
Q

Contraception & Intrauterine Contraceptives: How do Skyla and Mirena work?

A

Release a low dose of progestin causing thinning of the endometrium and thickening of cervical mucus, which inhibits sperm entry into upper GI tract

120
Q

Contraception & Intrauterine Contraceptives: Limitation barriers to obtaining this?

A

cervical cancer screening, routine testing for gonorhea, or scheduling insertion only during menses are unnecessary

121
Q

Contraception & Emergency Contraceptives: How often is this used?

A

Within 72 hours of unprotected intercourse.

122
Q

Contraception & Emergency Contraceptives: What type available in US?

A

Progestin-Only pills, Plan B One Step,

Next Choice One Dose - Combined estrogen and progestin pills

Insertionof copper-releasing intrauterine system up to 7 days after

123
Q

Contraception & Emergency Contraceptives: Saying for Warning for Potential Complications here?

A

PAINS

124
Q

Contraception & Emergency Contraceptives: P in PAINS?

A

Period late, pregnancy, abnormal spotting or bleeding

125
Q

Contraception & Emergency Contraceptives: A in PAINS?

A

Abdominal pain, pain with intercourse

126
Q

Contraception & Emergency Contraceptives: I in PAINS?

A

Infection exposure, abnormal vaginal discharge

127
Q

Contraception & Emergency Contraceptives: N in PAINS?

A

Not feeling well, fever, chills

128
Q

Contraception & Emergency Contraceptives: S in PAINS?

A

String length shorter or longer or missing

129
Q

Contraception & Emergency Contraceptives: Points to stress concerning this?

A

Doesnt protect against STI

May delay next menses

Report severe abdominal pain imediately

130
Q

Contraception & Emergency Contraceptives: How does Mifepristone work?

A

Chemically induces abortion by blocking the bodys progesterone receptors,

131
Q

Contraception & Sterilization: What methods available for women?

A

Laparoscopic, abdominla, and hysteroscopic methods

132
Q

Contraception & Sterilization - Tubal Ligation: What are teh common techniques here?

A

Mini -Laparotomies and Laparoscopies

133
Q

Contraception & Sterilization - Tubal Ligation: How does a laparoscopy procedure work

A

The abdomen is filled with CO2 so that abdominal wall balloons away from tubes so they can be viewed. GRapssed and sealed with a cauterizing instrument or with rings

134
Q

Contraception & Sterilization - Essure: What is this?

A

Nonsurgical, nonhormonal, permanent birth control. Tiny coil introduced and released into fallopian tubes through cervix and over 3 months, growth blocks the tubes

135
Q

Contraception & Sterilization - Vasectomy: How is this done?

A

Small incision made into scrotum and cutt the vas deferens, which carries sperm from testes to the penis

136
Q

Contraception & Sterilization - Vasectomy: Immediate risks from this?

A

Infection, hematoma and pain

NRSG 206: OB (42 decks)

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