Female Reproduction and Contraception Flashcards
1
Q
what part of the vagina allows for expansion during childbirth
A
the transverse, tubular folds with rugae
2
Q
what is the acidity of the vagina
A
pH of 4-5
3
Q
what are the 3 layers of the uterine wall
A
endometrium, myometrium, perimetrium
4
Q
puberty is defined as
A
transitional stage from childhood to sexual maturity
5
Q
what age is considered puberty
A
between 8-11 years
6
Q
what is menarche
A
a woman’s first menstruation, usually around 12
7
Q
what is menopause
A
the end of woman’s reproductive phase, occurs around age 50-55
8
Q
what is perimenopause
A
begins in late 40s, with irregular periods, estrogen production declines
9
Q
what is menstruation
A
periodic uterine bleeding that begins 14 days after ovulation if pregnancy does not occur
10
Q
a marked increase in this hormone triggers puberty
A
estrogen
11
Q
what can cause things to get stuck in fallopian tubes
A
gonorrhea, chlamydia, scar tissue causing lumen to get smaller
12
Q
if pregnancy develops in the fallopian tubes it is called what
A
an ectopic pregnancy
13
Q
day 1 of a woman’s menstrual cycle is what
A
the first of menstrual bleeding
14
Q
approx. day 14 of woman’s menstrual cycle is what
A
ovulation
15
Q
what constitutes ovulation
A
dominant follicle is released into the fallopian tube to prepare for fertilization
16
Q
how long does an ova live without being fertilized
A
24 hours
17
Q
the leftover pieces of the dominant follicle become what
A
the corpus luteum
18
Q
what is the role of the corpus luteum
A
it releases large amounts of progesterone to thicken the endometrial lining of the uterus to prepare for implantation of an embryo
19
Q
what triggers menstrual bleeding to occur
A
if after 14 days the uterus is not implanted, the release of progesterone and estrogen significantly drop resulting in the shedding of the endometrium
20
Q
where does fertilization occur
A
the ampulla of the fallopian tubes
21
Q
after fertilization what happens to the fertilized ovum
A
it will travel down to the uterus over course of 3-4 days
22
Q
when does implantation occur
A
6-10 days after conception
23
Q
why does ovulation cease during pregnancy
A
due to high levels of estrogen and progesterone production
24
Q
where do 95% of ectopic pregnancies occur
A
in the ampulla of the fallopian tubes
25
what is the leading cause of 1st trimester miscarriage
ectopic pregnancy
26
what are some symptoms of ectopic pregnancy
- missed/late period
- dark red/brown vaginal bleeding
- pain and tenderness, escalating from dull to colicky
27
how is an ectopic pregnancy diagnosed
high index of suspicion, pregnancy test, transvaginal ultrasound
28
what is the main concern of an ectopic pregnancy
tubal rupture and shock
29
surgical treatment for ectopic pregnancy
surgical removal of part of tube or laparoscopic removal
30
medical treatment for ectopic pregnancy
methotrexate
31
how does methotrexate treat ectopic pregnancy
antimetabolite and folic acid antagonist destroys rapidly dividing cells
32
when treating ectopic pregnancy with methotrexate what is important nursing care
- monitor BP, H & H, pain, bleeding, psych issues, unexpected pregnancy
33
what is the impact of an ectopic pregnancy
- leading cause of infertility
| - recurrant ectopic pregnancy
34
what is the recurrent ectopic pregnancy rate after surgery
10-25%
35
what is the recurrent ectopic pregnancy rate after methotrexate treatment
10-12%
36
important safe handling for methotrexate
pregnant women should not handle
37
pt teaching with methotrexate
no alcohol, or folic acid, no sun exposure
38
what hormone is secreted when pregnant that is used to determine if pregnant
human chorionic gonadotropin (HCG)
39
what is the role of HCG (human chorionic gonadotropin)
stimulate the corpus luteum to continue to secrete estrogen and progesterone to maintain pregnancy until placenta is functioning
40
what 4 hormones are important for pregnancy
- estrogen
- progesterone
- human placental lactogen
- relaxin
41
what is the important of progesterone during pregnancy
most important because it maintains the endometrium and relaxes uterine muscles preventing abortion
42
what does human placental lactogen provide
it increases the availability of glucose for the fetus
43
what does relaxin do
inhibits uterine activity and softens connective tissue and relaxes pelvic joints allow baby to fit through
44
what can compromise the placenta
malnutrition, HTN, drugs, smoking
45
what is the purpose of the placenta
oxygenation and sustaining fetus
46
where does the placenta form
the site of embryo implantation
47
when does maternal-placental circulation begin
day 17 when the baby's heart starts beating
48
when is the placenta fully formed
by week 12
49
how big is the placenta
half the size of the uterus
50
what 2 membranes make up the placenta
the chorion and amnion
51
which membrane of placenta contains blood vessels
chorion (cords)
52
chorion is on what side of the placenta
the uterine side
53
what does the chorion have that allows for exchange of oxygen and nutrients from maternal bloodstream
the chorionic villi that burrow into endometrium of mothers uterus
54
which membrane is closest to fetus
the amnion
55
which membrane is the inner membrane that creates the sac and contains the amniotic fluid
the amnion
56
which membrane creates the outer covering of the umbilical cord
the amnion
57
how much amniotic fluid is there at full term
between 800-1200mL
58
what is hydramnios/polyhydramnios
greater than 2 L of amniotic fluid
59
what is oligohydramnios
less than 300cc of amniotic fluid
60
during what test is amniotic fluid measured
biophysical profile (BPP)
61
when is the umbilical cord completely developed
5th week
62
what prevents compression and allows for nourishment
Wharton's jelly
63
what is "nuchal" cord
cord wrapped around fetus' neck
64
what is cord compression
cord sandwiched between fetal head and maternal pelvis
65
what blood vessels are in umbilicus
two arteries and one vein
66
the drop in teen pregnancies is most likely a result of an increase in what form of contraception
IUDs
67
what is FAM
fertility awareness method
68
what is involved in the fertility awareness method
calendar rhythm, natural family planning, basal body temp, cervical mucous ovulation detection
69
what is coitus interruptus
"pulling out"
70
what are disadvantages to coitus interruptus
least effective at 40%, need to be sexually experienced, does not protect against STIs
71
4 barrier methods to contraceptions
- condoms
- diaphragm
- cervical cap
- contraceptive sponge
72
advantages of condoms
- increase male participation
- prolonged intercourse
- low cost
- many protect against STIs
- no prescription
73
effectiveness of condoms
- perfect use 80%
| - typical use 65%
74
disadvantages of condoms
- can leak or rupture
- lubricants can decrease effectiveness
- single use
- dulled penile sensation
75
advantage of female condom
can be inserted up to 8 hours prior to intercourse
76
disadvantages of female condoms
- outer ring can cause irritation
- high cost
- insertion can be awkward or difficult
- noise produced during intercourse
77
what is diaphragm
uses cap over cervix and spermicide to prevent fertilization
78
effectiveness of diaphragms
- just spermicide 70%/60%
| - both 94%/80%
79
advantages of diaphragm
- no script
- spermicide adds lubrication
- pulling out not needed
- safe for breastfeeding
80
disadvantages of diaphragm
- may be irritating
- messy
- interferes with spontaneity for repeat intercourse
- weight gain, may need to get new size
- contraindicated in hx of UTI, cystitis, TSS
81
what is cervical cap
cap that covers cervix and held by suction
82
advantages to cervical cap
- no script
- pulling out not needed
- safe for breastfeeding
83
disadvantages to cervical cap
- limited sizes
-replaced annually
-refit if weight gain
-can't be used during period
can move during intercourse
-contraindicated if hx of TSS
-awkward insertion and removal
84
effectiveness of cervical cap
80%/70%
85
what is contraceptive sponge
polyurethane sponge containing spermicide
86
advantages of sponge
- no script
- low cost
- no pulling out
- safe for breastfeeding
87
disadvantages of sponge
- bulky and awkward
- irritation to spermicide
- effectiveness reduced in parous women
- contraindication in hx of TSS or abnormal paps
88
what is TSS
toxic shock syndrome
89
what is toxic shock syndrome
severe acute septic systemic disease
90
what bacteria usually causes TSS
staph aureus
91
what prevention measure for TSS are there
removal of diaphragm after 6-8 hrs, removal of sponge after 24 hrs
92
characteristics of TSS
- high temp
- diarrhea, vomiting
- weakness and faintness
- muscle aches
- sore throat
- sunburn type rash
- painful urination and abdominal fullness
93
what are oral contraceptives
- the hormone pill taken for 3 weeks and 1 week of placebo sugar pills
94
how do oral contraceptives work
theoretically prevents release of egg from ovaries
95
effectiveness of the pill
95%
96
common side effects of the pill
nausea, weight gain or loss, breast tenderness, spotting, headaches, missed periods
97
when miss pill what do you do
take 2 pills as soon as you remember, if miss two double up for 2 days
98
ECP is
emergency contraception
99
do ECP's interrupt an established pregnancy
no
100
how long after unprotected sex can ECPs be used
5 days
101
what is paraguard
copper IUD, form of ECP if inserted within 5 days after unprotected sex
102
how does paraguard work
prevents fertilized ovum from implanting
103
what is depo-provera
shot/injection that is hormones that stops ovaries form releasing egg
104
what is the effectiveness of depo-provera
99.7% effective
105
effectiveness of paraguard
99.9% effective
106
ortho-evra is what
the patch worn each week for 3 weeks and then 1 patch free week
107
effectiveness of ortho-evra
99%
108
what characteristic makes the patch uneffective
weight of more than 196 pounds
109
what is nuva ring
flexible ring that fits in vagina that is worn for 3 weeks and removed during week 4
110
effectiveness of nuva ring
99% effective
111
what is Mirena
intrauterine devise that contains hormones to prevent pregnancy
112
effectiveness of Mirena
99.1%
113
how long can IUD be in
up to 5 years
114
side effects of IUD
increased cramping, bleeding, vaginal discharge, heavy periods
115
pt teaching for IUDs
monthly string check, and bleeding may be irregular for first few months
116
difference between mirena and paraguard
mirena contains hormones, paraguard does not
117
what is nexplanon
flexible plastic rod implanted into the arm
118
does nexplanon contain estrogen
no
119
how long does nexplanon last
3 years
120
effectiveness of nexplanon
99%
121
what does amniotic fluid contain
albumin, lecithin, skin cells, enzymes, fructose, lanugo, sphingomyelin, urea, creatinine
122
function of amniotic fluid
maintain fetal temp, cushions fetus from trauma, allows musculoskeletal development, lung development and maturity
123
does fetus swallow AF
yes
124
can AF flow in and out of lungs
yes
125
does fetus urinate in AF
yes
126
is AF constantly being produced
yes
127
characteristics of AF
odorless, clear, transparent fluctuating volume
