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Nursing Fundamentals II > Intro to Maternal Child > Flashcards

Intro to Maternal Child Flashcards

1
Q

Does the US lag behind rest of world in maternal/child mortality?

A

yes

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2
Q

what are causes of child mortality?

A

low birth weight, education, antiseptic

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3
Q

how is government involved?

A

beginning of state programs for women and children

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4
Q

Family-Centered Maternity Care

A

safe, quality care which began to focus on the whole family

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5
Q

goal of maternal/child health

A

meet the needs of the family unit

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6
Q

Birth Centers

A

need to be a low-risk pregnancy, birth, and postpartum. Not only are these free standing facilities but they also provide women’s health care for non-pregnant women by delivering annual checks and family planning counseling

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7
Q

Preconception counseling - women

A
  • lower child mortality - Talk to men/women about conception long before you even think about it - What healthy choices do I need to make before I have a baby?
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8
Q

Preconception counseling - men

A
  • smoking effects sperm - Alcohol causes FAS, used to think that it was only Mom - Congenital defect, can it be changed prior to conception
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9
Q

Home birth

A
  • Facilitate family bonding - Once health of mom and baby are secured work on bonding - Really want Mom/Dad to go skin to skin right away to start bonding process
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10
Q

home birth cons

A
  • Client should have a low risk pregnancy - Certified midwife must have a DR backup - What is the time from home to hospital in the event of an emergency? - less support
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11
Q

why is there less support for home birth?

A
  • no nurses are available to provide maternal or infant care - Midwife is busy with mom
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12
Q

home birth pros

A
  • Keeps families together in their own environment - Facilitates family bonding
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13
Q

Is it ok to have family in room?

A

ok as long as they don’t impede bonding

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14
Q

what happened when we sent mothers home shortly after giving birth?

A
  • Postpartum infection when moms were sent home early - Insurance companies backed off on sending Moms home so early
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15
Q

How were children viewed in the earlier history of the United States?

A
  • Slow to respond to the health care needs of children despite early studies on children. - Late 19th century strives were being made to decrease childhood mortality. - Discovery of vaccine, public health practices, child labor laws, etc
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16
Q

Current Healthcare Trends

A
  • Cost containment-managed care, HMO, PPO - Home care - Health Insurance - Healthcare Assistance Programs
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17
Q

Healthcare Assistance Programs

A
  • WIC - Healthy Start - March of Dimes
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18
Q

Maternal mortality

A
  • 12.1 per 100,000 live births for all women - 30.5 for African American women - 8.7 for white women
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19
Q

Infant mortality

A

6.8 per 1000 live births

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20
Q

Childhood mortality

A

ages 1-19

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21
Q

Morbidity

A

ratio of sick to well person per 1000 people

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22
Q

Ethical Issues

A
  • abortion - Elective abortion - Mandated contraception - Fetal injury - Fetal therapy - Infertility treatment - Child Health Nursing - Cessation of treatment/terminate life support
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23
Q

Abortion

A
  • don’t comment - give facts - take care of people - If someone asks what you think about it - just provide information
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24
Q

Elective abortion

A
  • not our job to punish or criticize - must put views aside and take care of patient - Just provide info
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25
Q

Mandated contraception

A
  • See with mentally ill/handicapped (1950s) - Not our place to judge - Be supportive - Court ordered
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26
Q

court ordered contraception…

A
  • children repeatedly taken away - alcohol/drug abuse
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27
Q

Fetal injury

A
  • mom tries to abort fetus on own - Chemical impairment
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28
Q

Fetal therapy

A

surgical interventions

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29
Q

Infertility treatment

A

If you are infertile is it right to use tissue made in a lab

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30
Q

Child Health Nursing

A
  • Public health/Home health - Try to keep kids with parents
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31
Q

Cessation of treatment/terminate life support

A

mom or baby

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32
Q

Societal Issues

A
  • cycle of poverty - homelessness - access to health care - prenatal care - Medicaid - violence - adoption
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33
Q

cycle of poverty

A
  • can it be broken - poor parenting - can someone rise above
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34
Q

access to health care

A
  • hopefully it gets better
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35
Q

prenatal care

A
  • advocate for everyone
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36
Q

medicaid

A

help someone sign up

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37
Q

violence

A
  • not always men/women - could be parent/kids and kids/parents
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38
Q

adoption

A
  • always a choice - talk openly with parents
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39
Q

legal issues

A
  • Nurse Practice Act - Standard of Care - Accountability - Malpractice - Documentation
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40
Q

Nurse Practice Act

A
  • what does it say - std of care for women/child
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41
Q

std of care

A

what is acceptable and what is not

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42
Q

accountability

A
  • highest place of malpractice (especially OB) - family practice shies away from delivering babies now because they always got sued
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43
Q

malpractice

A

Informed consent, competence, full disclosure, information, consent, refusal of care

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44
Q

documentation

A

most important part of nurse’s job

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45
Q

Role of nurse

A
  • care provider - teacher - collaborator - researcher - advocate - manager
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46
Q

care provider

A

direct care to patient

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47
Q

teacher

A
  • education to promote health, prenatal care, and newborn care - extremely important, enormous amount of information to get to mom in a short time - have a plan to get information out
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48
Q

Collaborator

A

Lab, Doctor, OR staff, court

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49
Q

Researcher

A

apply research to practice

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50
Q

Advocate

A
  • humanize and personalize care - Baby taken by court
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51
Q

Manager

A

delegate tasks and coordinate care

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52
Q

Advanced Practice Nurses

A
  • Certified Nurse-Midwives (CNM) - Nurse Practitioner-primary care - Clinical Nurse Specialist (CNS)-not primary care
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53
Q

Certified Nurse-Midwives (CNM)

A
  • provide complete care in uncomplicated pregnancies, during pregnancy, childbirth and postpartum - prescribes meds
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54
Q

Nurse Practitioner-primary care

A
  • No deliveries - Yearly visit - Prescribes meds
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55
Q

Clinical Nurse Specialist (CNS)-not primary care

A
  • Masters - Find specialty they want to work in (wound, ostomy) - Can prescribe wound methods but not meds
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56
Q

Family Issues

A
  • Types of families - High risk families - Cultural influences - Religious influences - Parenting styles
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57
Q

Types of families

A
  • traditional, nontraditional, single-parent, blended, adoptive, multigenerational, same-sex, and communal - whatever the patient says it is
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58
Q

High risk families

A

Social and physical

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59
Q

Cultural influences

A
  • be open - why is it there? - is it hurting anyone? - leave if there is no harm
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60
Q

Religious influences

A
  • female circumcision - virginal in arranged marriages - African tribes and mediterranean
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61
Q

parenting styles

A
  • this is what the parent would like to happen - distinct wants
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62
Q

Mother’s ovum

A

X chromosome

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63
Q

Father’s sperm

A

X or Y chromosome

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64
Q

XX

A

female

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65
Q

XY

A

male

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66
Q

when is genetic sex determined?

A

conception

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67
Q

Sexually undifferentiated

A

even though sex is determined at conception, the reproductive systems of males/females is similar for the first 6 weeks

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68
Q

Sexually differentiation at 12 weeks

A
  • 7th week internal organs begin differentiating - 9th week external organs begin differentiating - 12th week sexually differentiation is about complete
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69
Q

are sex glands active during infancy and childhood?

A

no

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70
Q

when do sex organs become functional?

A

puberty

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71
Q

average age of menstruating

A

9 yrs old

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72
Q

what cause girls to menstruate early?

A

hormones that they ingest

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73
Q

puberty

A

period of life when the body experiences a growth spurt, the reproductive organs develop to adult size and function

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74
Q

when does sexual development begin?

A

conception

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75
Q

is sexual development active during childhood?

A

no

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76
Q

what does the hypothalamus produce to begin puberty?

A

gonadotropin-releasing hormone

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77
Q

when do sex organs become fully functional?

A

during the phase of puberty

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78
Q

are girls born with all the eggs they will ever have?

A

yes

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79
Q

menarche

A

1st menstrual period

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80
Q

menses

A

normal flow of blood and tissue during menstruation

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81
Q

Menopause

A

normal cessation of menstrual function that usually occurs in the 5th or 6th decade of life; the final menstrual period

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82
Q

do you need to use birth control during pre-menopause?

A

yes

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83
Q

do men make sperm every day?

A

yes

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84
Q

when does sperm count begin to decrease?

A

when they are in their 60s

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85
Q

female changes in puberty

A
  • breast - pelvis - body hair - growth spurt - external genitalia and reproductive organs - early menstrual cycles irregular
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86
Q

female changes in puberty - breast

A

first visible signs of change, nipples and areola protrude from enlargement, glandular and ductal tissue develops and fat deposits begin

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87
Q

female changes in puberty - pelvis

A

widens, hips become rounder/contoured from fat deposits, and becomes favorable for childbirth

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88
Q

female changes in puberty - body hair

A

pubic and axillary develop; becomes thicker with maturation, and varies among ethnic groups

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89
Q

female changes in puberty - growth spurt

A

Growth and changes begins and ends earlier than in males

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90
Q

female changes in puberty - external genitalia and reproductive organs

A

grow larger, vaginal mucosa changes, menstrual cycle begins

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91
Q

amenorrhea

A

absence of menstruation or first period has not begun

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92
Q

male puberty changes

A
  • testes - penis - nocturnal emissions - body hair - increased muscle mass - skeletal growth - voice changes
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93
Q

male puberty changes - testes

A

Growth of testes (first) between 10 – 17 years of age

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94
Q

male puberty changes - penis

A

Penis lengthening and growth begins about 1 year after testicular growth begins

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95
Q

male puberty changes - nocturnal emissions

A

“wet dreams” common in adolescence, often during dreams of sexual content

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96
Q

male puberty changes - body hair

A

○ pubic hair begins at base of penis, axillary hair growth begins in about 2 years, facial changes from fine downy texture to the male beard, increased growth of chest and back hair. Amounts of hair growth varies in ethnic groups.

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97
Q

male puberty changes - increased muscle mass

A

cause by testosterone (50% more than female at maturity)

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98
Q

male puberty changes - skeletal growth

A

longer growth spurts than girls resulting in great height

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99
Q

male puberty changes - voice changes

A

caused by enlargement of the larynx and hypertrophy of the laryngeal mucosa

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100
Q

spermatogenesis

A

formation of male gametes (sperm) in the testes

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101
Q

climacteric

A

woman’s ability to reproduce decreases over a period of years; physical/emotional changes that occur at the end of the reproductive period

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102
Q

perimenopause

A

the time from onset of symptoms associated with climacteric until at least 1 year after the last menstrual period

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103
Q

female reproductive anatomy

A
  • mons pubis - Labia majora and minora - clitoris - vestibule - external vulva - hymen - perineum
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104
Q

mons pubis

A
  • Protection, soft cushion over pubic, protect fetus
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105
Q

clitoris

A

Sexual pleasure

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106
Q

Vestibule

A
  • structures enclosed by labia minora - urinary meatus - vaginal introitus - ducts of skene - bartholin glands
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107
Q

External “vulva”

A
  • mons pubis - labia majora - labia minora - clitoris - vestibule
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108
Q

hymen

A
  • thin fold of mucosa partially separating the vagina from the vestibule - should be there until 4, 5 or 6 years old - might be asked if hymen is intact if sexual abuse is suspected
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109
Q

Perineum

A
  • fibrous and muscular tissue supporting the pelvic structures - distal portion of vulva to the superior part of rectum - below vaginal opening to opening of rectum
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110
Q

female reproductive anatomy - internal

A
  • vagina
  • uterus
  • fallopian tubes
  • ovaris
  • cervix
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111
Q

uterus

A
  • Should not have a septum
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112
Q

Bicornate uterus

A
  • septum down middle of uterus
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113
Q

fallopian tubes

A

might have more than two

pathway between ovary and uterus

114
Q

oviduct

A

fallopian tube

115
Q

cilia

A

hairlike process that beat rhythmically toward the uterus to propel ovum through the tube

116
Q

fallopian tubes - division

A
  • interstial
  • isthmus
  • ampulla
  • infundibulum
117
Q

fallopian tube - interstitial

A

runs into the uterine cavity and lies within the uterine wall

118
Q

fallopian tube - isthmus

A

narrow part of the tube adjacent to the uterus

119
Q

fallopian tube - ampulla

A

wider area of the tube lateral to the isthmus, where fertilization occurs

120
Q

fallopian tube - infundibulum

A

-shaped terminal end of the wide funnel-shaped

121
Q

ovaries

A
  • Produce estrogen and progesterone
  • Produce an ovum with each cycle
  • FSH is released (develops ovum) and LH continues process, egg released by ovary, into fallopian tube and brought into uterus
122
Q

dysfunctional cycle

A

ovum is not release

123
Q

cervix

A
  • External os
  • Cervical canal
  • Internal os
124
Q

external os

A
  • opening of cervix
  • papsmear should not be done here
125
Q

where should papsmear be done?

A

cervical canal

126
Q

Endometrial biopsy

A
  • catheter has to go through internal os and be in uterus
  • this procedure may hurt
127
Q

internal os

A
  • sterile
  • tight opening
  • will feel more resistance here when inserting cath
  • opening to uterus
128
Q

where is iud placed?

A
  • uterus
  • string should protrude from external os
  • can wander but that is not common
129
Q

Round and broad ligament

A
  • no problems in non-pregnant
  • pregnant get intense pains in abdomen when sit/stand, usually towards end of pregnancy
  • may come in thinking they are in labor but if everything is ok it is probably the round/broad ligament
130
Q

does the uterus lay on the bladder?

131
Q

why do women get urinary infection?

A
  • Short distance between meatus and anus is why women get urinary tract infection
  • Bacteria in GI tract
132
Q

do you see urinary tract infection in men?

A
  • not usually in men under 50 yrs
  • more common in men over 50 yrs but is a sign of concern
133
Q

what does a urinary tract infection in a man signify?

A
  • usually something more serious
  • have add’l tests
  • could be a sign of bladder or prostrate cancer
134
Q

support structures of female reproductive organs

A
  • pelvis
  • muscles
  • ligaments
  • blood supply
  • nerve supply
135
Q

female breast

A
  • nipple
  • areola
  • montgomery tubercle
  • alveoli
136
Q

nipple

A

small raised area at center of breast

137
Q

Areola

A

circular area around nipple

138
Q

Montgomery tubercle

A
  • small raised areas in areola
  • Keeps nipple soft
  • Secrete in women if they are going to nurse
139
Q

Alveoli

A

secreting cells/produce milk

140
Q

what is the most common length of the female reproductive cycle?

141
Q

what two things happen at the same time during the reproductive cycle?

A

ovarian and endometrial cycles

142
Q

what directly influences the endometrial cycle to happen?

A

ovarian cycle

143
Q

will the endometrial cycle have a dysfunction if the ovarian cycle does?

144
Q

Corpus luteum

A

is the place on ovary where that particular ovum is growing; job to secrete high amount of progesterone, if conceived need high levels of progesterone to make pregnancy successful; if conception doesn’t occur the corpus luteum decreases secretion of progesterone

145
Q

what are the phases of the ovarian cycle?

A
  • Follicular phase
  • Ovulatory phase
  • Luteal phase
146
Q

Follicular phase

A
  • Days 1 - 14
  • Decrease in estrogen and progesterone just before menstruation stimulates FSH and LH
  • One follicle matures first
147
Q

ovulatory phase

A
  • 2 days before ovulation
  • FSH and LH rise, slight decrease in estrogen, progesterone increase
  • Ovulation occurs could be anywhere between 12 – 15 days; usually day 13 & 14
  • Release of mature ovum
148
Q

why is there a change in cervical mucus during ovulatory phase?

A

helps sperm get to where it needs to be

149
Q

Luteal phase

A
  • from ovulation to end of cycle
  • single most important phase
  • corpus luteum
  • need it to last 13/14 days
150
Q

corpus luteum

A
  • is the place on ovary where that particular ovum grew and was release
  • the left over/collapsed follicle remains and secretes high amount of progesterone
  • if conception occurs need high levels of progesterone to make pregnancy successful
  • if conception doesn’t occur the corpus luteum decreases secretion of progesterone
151
Q

what happens if luteal phase is only 9 days long?

A

ovum gets to uterus too early

152
Q

what happens is luteal phase lasts 17/18 days?

A

endometrial phase has started to slough

153
Q

why may progesterone shots be given during ovarian cycle - luteal phase?

A

to support possible pregnancy

154
Q

why would you give cholmid?

A

shorten luteal phase

155
Q

what are the phases of the endometrial cycle?

A
  • Proliferative phase
  • Secretory phase
  • Menstrual phase
156
Q

Proliferative phase

A
  • Days 1-14
  • Ovum is now matured and secretes estrogen
  • Rebuild, becomes thicker, prepare for conception
157
Q
  1. Secretory phase
A
  • Near the end of ovulation phase; second half of ovarian cycle
  • Increase of estrogen and progesterone from corpus luteum
  • Progesterone stimulates enrichment of endometrium, very thick and nourished
  • Strong enough to hold product of conception
158
Q

Menstrual phase

A
  • No conception leads to menstrual phase
  • Necrotic areas of endometrium begin to separate from basal layers resulting in menstruation
  • Blends into early start of next phase
159
Q

how long does menstruation last?

A

typically 5 days

160
Q

is it possible to conceive during menstruation?

A

yes; this shows that conception not the problem but the length of the cycles are

161
Q

external male reproductive organs

A
  • penis
  • testes
162
Q

penis

A
  • delivers sperm to sperm to vagina
  • carries urine from bladder to exterior during urination
    *
163
Q

Scrotum

A

holds testicles

164
Q

will heat applied to scrotum kill sperm?

165
Q

internal male reproductive organs

A
  • testes
  • Epididymis/Vas deferens
  • 3 glands - Seminal vesicles, prostate, bulbourethral
166
Q

testes

A
  • produces sperm
  • billions of sperm are made each day
167
Q

epididymis

A
  • Sperm travel from the seminiferous tubules to the epididymis via the rete testis
  • storage and final maturation of sperm
  • Contains smooth muscle
  • Empties into vas deferens then into pelvis to penis
168
Q

vas deferens

A
  • epididymus empties int vans deferens
  • lareger # of sperm are stored here then the epididymis
  • lead to pelvis where it joins the ejactulatory duct
169
Q

3 glands of male reproductive organs

A
  • Seminal vesicles, prostate, bulbourethral glands
  • Active in mfg of sperm
  • Add something to semen to make sperm conducive for conception
170
Q

Prostrate gland

A
  • Starts to get bigger as you age
  • Hard to urinate
  • Urinary tract infections start to occur
171
Q

STD - men

A
  • start infection in urethra
  • urethritis
  • infection may continue to extend along urethra
172
Q

do you use heat to treat std?

A

no; heat on scrotum can cause infertility

173
Q

circumsision

A
  • Remove foreskin of penis
  • Personal choice made by parents
  • Don’t advocate one way over the other
174
Q

parts of penis

A

Root, shaft, and glans penis

175
Q

Prepuce

A

foreskin that covers the glans penis

176
Q

what is the function of seminal vesicles, prostrate, and bulbourethral glands?

A
  • nourish sperm
  • transport sperm
  • protect sperm
  • enhance sperm motility
177
Q

health promotion tests for females

A
  • Breast Self-Exam (BSE)
  • Clinical Breast Exam (CBE)
  • Mammography
  • Vulvular Self-Exam
  • Pelvic Exam
  • Pap Test
178
Q

Breast Self-Exam (BSE)

A
  • Most lumps are found by partner
  • Recommendations differ between agencies
  • Should be done monthly
179
Q

Clinical Breast Exam (CBE)

A
  • Depends on your history
  • Frequencey varies
180
Q

Mammography

A
  • Baseline at 40 yr
  • Every few years after that
  • 45 to 50 - eavery year
181
Q

Vulvular Self-Exam

A
  • Look for lesions or sores
  • Vulvular cancer is rare but requires radical surgery
182
Q

Pap Test

A
  • depends on history
  • 2 to every 3 years
183
Q

Health Promotion Tests for Males

A
  • Breast Self-Exam (BSE)
  • Clinical Breast Exam (CBE)
  • Testicular Self-Exam (TSE)
  • Clinical Testicular Exam
  • Prostate Exam
  • PSA blood test
184
Q

Breast Self-Exam (BSE) - men

A
  • 10% of breast cancers are in men
  • Should be done monthly
185
Q

Clinical Breast Exam (CBE) - male

A

Yearly to every three years

186
Q

Testicular Self-Exam (TSE)

A
  • Should be done monthly
  • 15 to 30 years old - highest incidence of testicular cancer
  • Feeling should be smooth, same shape; round, slide between fingers without feeling anything that is rough tender or firm
187
Q

Clinical Testicular Exam

A

once per year

188
Q

Prostate Exam

A
  • Base at 40 years
  • Yearly at age 50
189
Q

PSA blood test

A
  • Screening for prostrate cancer
  • Becomes elevated when there is cancer
  • PSA is normal no reason to do biopsy
  • PSA is elevated reason to do biopsy
  • Self test is good for man who will follow up on positive results
190
Q

Family Planning

A

choosing the time to have children

191
Q

Fertility

A
  • capable of bearing offspring
  • 90% of women who do not use contraceptive should conceive within one year
192
Q

Infertility

A
  • not able to get pregnant for one year
  • will look at infertility in couples that are older sooner
193
Q

Primary infertility

A

has never conceived together

194
Q

Secondary infertility

A

conceived at least one time before

195
Q

What is the nurses role in family planning or contraceptive care?

A
  • Teacher, educator, advocate, listener
  • No right to give advice
196
Q

Informed consent

197
Q

What do you need to think about when choosing a contraceptive method?

A
  • Safety
  • Sexually Transmissible Diseases
  • Effectiveness
  • Acceptability
  • Convenience
  • Education needed
  • Side effects
  • Benefits
  • Spontaneity
  • Availability
  • Expense
  • Preference
  • Religion/Personal Belief
  • Culture
198
Q

contraceptive method - safety

A

based on current medical condition and family history

199
Q

contraceptive method - STDs

A

abstinence, condom; iud increases std

200
Q

contraceptive method - effectiveness

A

is it ok to get pregnant

201
Q

contraceptive method - acceptability

A

religion, cultural, their feelings

202
Q

contraceptive method - education needed

A

difference in talking with age levels

203
Q

contraceptive method - Convenience

A
  • if it is percceivedto be difficult to use there is less compliance
  • desired to avoid menstruation
204
Q

contraceptive methods - side effects

A

what can they tolerate

205
Q

how many high school students report being sexually active?

206
Q

adolescent preganancy often occurs from…

A
  • Knowledge/Misinformation
  • Risk-Taking Behavior
207
Q

how would you counsel adolescents about sexuality?

A

be nonjudgemental

208
Q

are perimenopausal women able to get pregnant?

209
Q

perimenopause

A

one year prior to menopause

210
Q

menopause

A

after 12 consectutive months of not having a period

211
Q

can ovulation continue through perimenopause and menopause?

212
Q

perimenopausal women are less likely to conceive but more likely to…

A

experience an unintended pregnancy

213
Q

Said to be safe from pregnancy if no menses for…

A

at least two years in the menopausal woman

214
Q

Methods of Contraception

A
  • Sterilization
  • Hormonal Contraceptives
  • Intrauterine devices
  • Barrier methods
  • Natural Family Planning Methods
215
Q

sterilization

A
  • 99% effective
  • Female=Tubal ligation
  • Male=Vasectomy
216
Q

Male=Vasectomy

A
  • semen sample – need to be zero sperm (6wks/18 ejaculations)
  • use back up until no sperm in semen
217
Q

Female=Tubal ligation

A

use contraceptive for one month

218
Q

Hormonal Contraceptives

A
  • effective as user
  • 97-99% effective
  • Don’t like weight gain, nausea, trial and error with dosing
  • Not made for women over 35 and those who smoke
219
Q

types of hormonal contraceptives

A
  • Hormone implant - norplant
  • Hormone injections - Depo provera
  • Oral contraceptives
  • Transdermal Patch
  • Vaginal Ring
  • Postcoital emergency contraceptives
220
Q

Intrauterine devices

A
  • not the best choice for someone who has never been pregnant
  • in a non-pregnant cervix, trouble putting them in, may puncture cervical canal
  • post-partum mom must be 6 wk, no problem with nursing
221
Q

types of barrier methods

A

chemical and mechanical

222
Q

is the barrier method good for women over 35 years?

223
Q

Chemical barriers - barrier method

A
  • foam, gels, creams
  • effectiveness 80-85%
  • effectiveness with use of condom 99%
224
Q

Mechanical barriers - barrier method

A
  • condom
  • diaphragm
  • cervical cap
225
Q

Diaphragm - mechanical barrier

A
  • sized to fit, used with spermicide
  • If female gain/lose weight need to be refitted
  • check for holes, new one every year
  • in place 6 to 8 hours
226
Q

Cervical cap - mechanical barrier

A
  • smaller than diaphragm
  • in place 6 to 8 hours
227
Q

Natural Family Planning Methods

A
  • Calendar
  • Basal Body Temperature
  • Cervical Mucus/Ovulation
  • Symptothermal Method
228
Q

why would someone use natural family planning?

A
  • not invasive
  • learn to ready your body
229
Q

Calendar - natutal family planning

A
  • plot out dates
  • avoid intercourse on days your think ovulation occurs
  • sperm lives for 72 hours
230
Q

Basal Body Temperature - natural family planning

A
  • take temp everyday
  • first part of phase temp is about the same each day; close to ovulation see a significant drop and then a rise (at least one degree) at ovulation/not a safe time for intercourse; and then the temp stays the same
231
Q

Cervical Mucus/Ovulation - natural family planning

A

stretchy and thin ovulation is close/occurring

232
Q

Symptothermal Method - natural family planning

A

combine Calendar, Basal Body Temperature and Cervical Mucus/Ovulation

233
Q

what are other methods of contraception?

A
  • Abstinence
  • Breastfeeding
  • Coitus Interruptus
234
Q

Breastfeeding - contraceptive method

A
  • most don’t ovulate but never know when you will ovulate
  • do not use as protection
235
Q

Coitus Interruptus - contraceptive method

A
  • Withdrawal
  • 80% effective
236
Q

infertility factors in men

A
  • Sperm abnormalities
  • Abnormal erections
  • Abnormal ejaculation
  • Abnormal seminal fluid
237
Q

Sperm abnormalities - infertility factor

A
  • Abnormal sperm might be a sign of a genetic disorders
  • Double heads/tails
  • Disfigured
  • Slow activity, low #
238
Q

where would you refer a male with low # of sperm but everything else was fine?

239
Q

where would you refer a male with low # and slow activity of sperm?

240
Q

Abnormal erections - infertility factor

A
  • Impotence
  • Peryronie’s
  • Vericocele
  • Spermatocele
241
Q

Peryronie’s

A

scar tissue along length of penis, painful

242
Q

Vericocele

A

varicose veins in scrotum, changes temp and destroys sperm

243
Q

Spermatocele

A

cyst near at the head of epididymis

244
Q

Abnormal ejaculation - infertility factor in men

A
  • Hypospadius
  • Epispadius
  • May have normal sperm count but it doesn’t get where it needs to
245
Q

Hypospadius

A

opening under side of penis

246
Q

Epispadius

A

opening on top of penis

247
Q

Abnormal seminal fluid - infertility factor in men

A
  • Cloudy, clumps, made consistency different
  • WBC - infection - treat to see if it can be cleared up; can take up to a few mos to treat
248
Q

where might you refer someone who has cloudy, clumpy, or abnormal consistency of seminal fluid?

249
Q

infertility factors - women

A
  • Ovulation disorders
  • Abnormalities of fallopian tubes
  • Cervical abnormalities
  • Repeated pregnancy loss
  • Infections
250
Q

Ovulation disorders - infertility factor in women

A
  • Has partial or no female organs - confirm with ultra sound
  • Majority are just poor ovulation patterns
251
Q

how long would you take basal body temp for to help diagnose ovulation disorders?

252
Q

ovulation disorders - treatment

A
  • Clomid
  • Pergenol
  • Depo provera or progesterone (oral or IM
253
Q

Clomid

A

force to ovulate; make cycle more regular, DR needs to look at cycle, force to ovulate, side effect - possibility of multiple birth - typically twins; warm, acne

254
Q

Pergenol

A

higher incidence of mult. Births - triplets, quads, quints etc….; if you use these meds are you ok with mult. births

255
Q

Depo provera or progesterone (oral or IM)

A

may use to induce period in order to give clomid on a certain day

256
Q

Abnormalities of fallopian tubes - infertily factor in women

A
  • Ovulates ok, partner ok
  • Are they there, are they open
  • Blocked tubes, evaluate to see if it is possible to open them
257
Q

Hysterosalpinogram

A
  • air or dye through to see if tubes are open
  • sometimes this opens tubes
258
Q

what is a possible treatment for abnormal fallopian tubes?

A
  • Invitro
  • if tubes are block and ovulate is ok and partner is ok
  • just cant get ovum to go down the tube
259
Q

Cervical abnormalities - infertility factor in women

A
  • Multiple cervix, can be common to have up to 3, only one goes somewhere others are “blind”
  • Excessive/lack of mucus - mucus helps sperm get where they need to be, might be allergy related
260
Q

Post coital test

A
  • Plan to have intercourse no later than 2 hours before appt
  • Physician put speculum in, will gather fluid from vaginal vault and look at slide
  • If sperm is dead; it means she has hostile cervix/mucus
  • Antihistamines may help - UCLA research study
261
Q

what are possible ways to treat cervical abnormalities?

A
  • Be supportive and help patients through process
  • Artificial insemination
  • Cervical stenosis
262
Q

why would artifical insemination be a good treatment for an abnormal cervix?

A
  • use partners semen and deliver it to the right place
  • man brings in semen sample
  • take semen and inject it into women
263
Q

Cervical stenosis

A
  • Significant menstrual cramps
  • Very small opening of cervix
  • Dilate cervix to get it large enough to allow sperm through
264
Q

Repeated pregnancy loss - infertility factor in women

A
  • Habitual abortion
  • Incompetent cervix
  • DES
  • Fibroids
  • Endocrine abnormalities
  • Immune
  • Exposure to toxin
265
Q

Habitual abortion

A

3 or more miscarriages

266
Q

why would you save fetal tissue from miscarriage?

A

test for chromosomal abnormalities, genetic counseling

267
Q

incompetent cervix - repeated pregnancy loss

A
  • cervix starts to open at about 12 weeks
  • Look at length of cervix, + pregnancy test
  • go in every week, if cervix gets shorter, dr will perform cerclage (stitch up cervix)
  • depending upon how pregnancy is going will determine when stiches will be taken out
268
Q

cerclage

A

stitch up cervix

269
Q

DES - repeated pregnancy loss

A
  • drug used to treat prostrate cancer
  • gave to women in 1950s - 1960s
  • generation that was born from DES mothers, saw abnormalities in female children
  • now seeing problems in the children’s children both girls/boys
270
Q

Fibroids - repeated pregnancy loss

A
  • benign tumors
  • starts to grow because of pregnancy hormones
  • crowds out baby
271
Q

Endocrine abnormalities - repeated pregnancy loss

A

endocrinology issues

272
Q

Immune - repeated pregnancy loss

A
  • may refer to immunologist
  • may have autoimmune disorder
  • women react to fetus - reject fetus
  • blood disorder - treat with levonex/heparin
273
Q

Exposure to toxin - repeated pregnancy loss

A
  • radiation
  • alcohol
  • Accutane (med for acne)
  • lead
  • mercury
  • toxic substance
274
Q

Infections - infertility issues in women

A
  • Chroic low grade infection
  • Endometritis
275
Q

what is the most common cause of infertility in women?

A

luteal phase of ovarian cycle is too short

276
Q

Evaluation of Infertility

A
  • Counseling
  • History and Physical
  • Diagnostic Tests
  • Therapies
277
Q

therapies - evaluation of infertility

A
  • Meds
  • Ovulation induction
  • Surgical procedures
  • Therapeutic insemination
  • Egg donation
  • Surrogate parenting
  • Advanced techniques
278
Q

in-vitro fertilization (IVF)

A

harvest her eggs and his sperm, re-implant

279
Q

GIFT

A

retrieve ova and sperm in her tubes

280
Q

ZIFT

A

fertilize ova outside body and implant in tube and make down to uterus

281
Q

ICSI

A

fertilize 3 or more ova and implant at least 3

Nursing Fundamentals II (13 decks)

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