Exam 2 Flashcards
Genital Fistulas
Perforation between genital tract organs
*surgery does not always fix
When does urinary incontinence become increased
Increased number or pregnancies
What do ovarian cysts depend on
Hormonal influences associated with the menstrual cycle
What are the most common cysts in young normal ovaries
Follicular cysts
What causes polycystic ovarian syndrome (PCOS)
Endocrine issue
Increased estrogen, increased testosterone, increased LH
Decreased FSH
S/s of PCOS
Obesity Hirsutism (hair growth) Irregular menses Infertility Glucose intolerance Hyperinsulinemia
Where do uterine polyps originate
Endometrial tissue
Cervix
What are the nursing interventions for post op removal of uterine polyps
No tampons
No sex for a week
Bleeding
Infection
informed consent (BRAIDED) includes
Benefits Risks Alternatives Inquiries (let them ask) Decisions Explanations Documentation
what is the cornerstone of the nursing care for planned interventions
Education
what type of barrier methods can cause toxic shock syndrome (TSS)
diaphragms
cervical caps
sponges
how do oral contraceptives work
inhibit ovulation by preventing formation of a follicle and suppressing LH
what are some warnings/side effects that can occur when on contraceptives (ACHES)
abdominal pain chest pain/SOB headaches (sudden/persistent) eye problems (HTN/vascular accident) severe leg pain (thrombosis)
Progestin Only (mini pill) is good for who
moms who are breastfeeding
won’t affect milk supply
what is an important reminder with the mini pill
must be taken every day at the same time
what can happen after depo is ended
fertility may be delayed for 3 months
what can too much progesterone cause
recurrent yeast infections and acne
what can injectable progestins cause
irregular bleeding/spotting decreased libido weight gain depression mood changes
when is the start dose best to start
first day of menses
if a patient does a quickstart, what is important to educate them on
they can start at any time
use backup contraception for 7 days
if there is one missed dose for combos, what should the patient do
take next tablet and next scheduled pill at the same time
what should the patient do if more than 3 pills are missed
discontinue the pack, allow for withdrawal bleeding, start new pack after
if a patient misses a dose of the progestin only pill, what should the patient do
take the pill as soon as they notice
backup contraception needed for 48 hours after
when is the lactational amenorrhea method not effective
if mom is pumping
where does implantation occur
endometrium
what are the first layers developed of the fetal membranes
chorion
amnion
what is amniotic fluid good for
space for movement/protection
thermoregulation
nutrients/fluid
what does the amniotic fluid prevent
adhering of the amnion to the fetus
umbilical cord compression
what is Polydramnios and what can it indicate
too much amniotic fluid (>2,000)
can indicate GI malformation
TWINS
what is Oligohydramnios and what can it indicate
too little amniotic fluid (<300)
can indicate renal malformations of fetus
what can amniotic fluid be tested for
genetic disorders
what is the umbilical cord protected by
Whartons jelly
what do the arteries do in the umbilical cord
carry deoxygenated blood and waste AWAY from the fetus
what does the vein do in the umbilical cord
carry oxygenated nutrient rich blood TO fetus
what is the placenta considered
endocrine gland
what hormones does the placenta regulate
HCG
Progesterone
Estrogen
HPL (needed for fetal growth/development)
what does the placenta regulate the transport of
gases
nutrients
wastes
what is different about fetal circulation
blood is shunted from the lungs while in utero
if there is a decrease in fetal heart rate, what can this mean
there is a problem with perfusion
how can the fetal heart rate be increased
by doing things with the mom such as turning the mom
what is produced during week 20-24 weeks to reduce sticking of the lungs and reduce surface tension
surfactant
what is L/S (Lecithin/Sphingomyelin)
2 chemicals in the lungs
what should be the L/S ratio and what does it indicate
2:1
indicates lung maturity
what is gravidity/gravida
pregnancy
what is term birth
birth after 37 weeks
what is preterm birth
birth before 37 weeks
what is considered abortion
spontaneous (natural) or medical/therapeutic
nulligravida
no pregnancies
premigravida
pregnant for the first time
what are presumptive signs (what patient feels) of pregnancy
amenorrhea fatigue breast changes (heaviness, dark areola) nausea frequency quickening (movement of fetus)
what are probable signs of pregnancy (observed by the examiner)
Goodell Sign (softening of the cervix) Chadwicks Sign (blueish purple color of cervix) Hegar Sign (softening of the lower segment of the uterus) pregnancy test (can have false positives) Ballottment Sign (fetus bounces when cervix is tapped)
what are positive signs of pregnancy (definite evidence)
ultrasound
fetal heart rate
palpation of fetal movement
what is the Mucous Plugs purpose and when it leaves the uterus does it mean water has broke
acts as barrier against infection for the baby
no, can leave uterus weeks or days before birth
does the heart remain in its normal position during pregnancy
no
displaced to the left
when does the BP drop during pregnancy and is this normal
usually drops around 20 weeks
normal
what can occur if a women remains too sedentary during pregnancy and why
can increase the risk for blood clots
body is in a hypercoaguable state (increased clotting factors, protective mechanism)
what can occur in the nose during pregnancy
nasal stuffiness
espistaxis (bloody nose)
more vascular due to estrogen
what is Melasma
blotchy brown “mask of pregnancy”
common in darker complected females
Linea Negra
fades after birth
what is exaggerated Lordosis
slopping of the back
normal
what is pica and what can it indicate
craving something that isn’t food
usually gives clues to what she is defficient in
what hormone maintains pregnancy
Progesterone
what hormone causes morning sickness
HCG
how does the baby get glucose
relies on the maternal glucose
during the first trimester, what occurs with the mother in regards to glucose
results in decreased maternal BGL
During the 2nd trimester, what occurs with the mother
maternal tissue has decreased sensitivty to insulin
Because the mother has decreased sensitivity to insulin, what 2 important things does this do to the mother and baby
stimulates pancreas of healthy women to produce more insulin
makes more glucose for fetal energy needs
why should the babies BGL be monitored
they are used to high glucose, can become hypoglycemic
what is the most important adaptation for a women to make during pregnancy
accepting the pregnancy, verbalizing the pregnancy
acceptance
what is Couvade Syndrome
dad experiences pregnancy like symptoms
what are the 5 things screened on EVERY pregnant women (need consent)
HIV Syphilis Gonorrhea Chlamydia GBS (Group B Strep)
what can Group B Strep do in pregnancy
pass to the baby, baby can become septic
not an STD
changes with each pregnancy
what should the patients do if the baby isn’t active after 20 weeks
notify the HCP
what are abnormal discomforts for pregnant women
bright red bleeding
uterine contractions
changes in fetal movement
what are the two immunizations that are NOT okay for pregnant women
MMR
Varicella
