lp3 book Flashcards
androgen
what responsible for
hormones responsible for
muscular development,
physical growth, and
increase in sebaceous gland secretions that cause acne
estrogen
what responsible for
devolopment of uterus
fallopian tubes
vagina
breast development
scrotum
penis
ballsac/in warm weather it expands/cold weather contacts to keep sperm decent temperature
outlet for male urinary and reporuductive tracts- nitric oxide causes vasodilation and increase blood flow and enlargement
epididymis
vas defrens
highly coiled tube that is repsoible for conducting sperm from tubule to vas deferens
carries sperm from epididymis into abdomen ending in seminal cavity, and ejaculatory ducts
prostate
bulboerethal
seminal vesicles
all secrete fluid that help to ensure safe passageway of spem
mons veneers
labia minora
labia majora
pad of adipose tissue that protects pubic bone from trauma
minora- abundant w/ sebaceous glands
majora- serve as preotection to internal organs
ovaries
meiosis
fallopian tubes
produces matures and discharge ovulation
meiosis- chromosomal reduction leaving 22 autosomes and a x sex chromosome
convey the ovum from ovaries into uterus to provide fertilization
uterus
body
isthmus
cervix(vagina)
body-fundus-during pregnancy the body exapands to contain growing fetus
isthmus-also expands to accomdiate fetus, where c section is cut into
cervix-expands into the vagona, that acts as the organ of intercourse and to serve as birth canal
menstruation
stages- proliferative/seceratory/ischemic/meses
bleeding in response to hormone changes. bring ovum into maturity , lasts about 28 day cycles
proliferative-one layer thick cells, produces estotrgen to begin building layers
secretory-causes glands to become corkscrew and dilated with qnatites of glycogen
ischemic- if no fertilization, production of progesterone decreases, uterus begins to degernate
menses-menstrual shedding, around 30-80 ml
menstruation
menarche
cycles
legth
amount
LMP
Menarche: first- average age 12 –@ first can be different. can be spotty, and longer in between
Cycles: average 28 days-start to start-up to 35 can be normal
Length: 4 to 6 days but can be 2-9
Amount: difficult to estimate, 30 to 80ml, if one pad or tampon per hour= heavy bleedin
LMP=first day since first blood
menstruation educational topics
pads/tampons
rotate
NO
wear
clean
pads/tampons-hygiene, changing every 3-6 hrs-//no deodorized or perfume ones// don’t wear most absorbent and keep in for a long time
rotate pads b/c of TSS
no douching-absolutely no-especially on period
wear incintent underwear
cleansing peri area-no douching or sprays-clean from front to back
fern test
estrogen forms a fernlike pattern on microscope the dried
occurs right before ovulation
spinnbarleit test
estrogen can stretch when dominate
stretch mucus between thumb and finger
abstinence
refraining from having relations–therotical 100% success rate
lactation amenorrhea method
suppression of hormones when breastfeeding
if infant is under 6 months and is breastfeed, then there I only 1-5% of failure rate
once menstruation returns does not work-can return at any time
douching
does not work
so do not do
try to suction out sperm
coiutus interrupts
withdrawal before ejaculation
only 82% effective-preejculation is possibe
calendar method
fertility awareness methods
subtract 18 days from shortest cycle
subtract 11 from longest cycle
all days in between are fertile days and avoid relations in those days
basal body temp method
fertility awareness methods
day before ovulation, at rest temapture falls by .5F
during ovulation, temp rises a whole F degree
after this refrain from having relations for 3 days
same time every single day-even on weekends
cercial mucus method
fertility awareness methods
before ovulation- cervical mucus is thick and doesn’t stretch
during ovulation-secretion increases
day of ovulation- it becomes copious, thin watery and transparent
two day method
fertility awareness methods
if person feels secretions for 2 days on a row, avoid relations
sympothermal method
fertility awareness methods
takes temperature and analyzes mucus
refrain from intercourse until 3 days after rise in temperature and 4th day after mucus change
cycle beads
fertility awareness methods
first bead-red-first day of flow
6 brown beads-safe days
12 glow in dark beads-fertile days
13 brown safe beads
ovulation detection
fertility awareness methods
kits that can detect ovulation
are 98-100%efective
spermicides
does not
failure rate
called
contraindicated
vaginal suppositories
increased effectiveness
cause death of sperm before they can reach the cervix by changing ph
does not protect sti
failure rate of 20%
some called feminine hygiene are for cleanliness and not for contraception
contraindicated w/ acute cevicitis because might further iritate cervix
in vaginal suppositories- sit supine and wait 30 mins so it stays
increased effectiveness w/condom and diaphragm
diaphragm
% failure
prescribed
should remain
contraindications
works best
circular ribber disk that is placed over ceriix before intercourse
18% failure rate
prescribed -pregancy,surgery or wt gain =get another one
should remain in place 48 hrs after relations
contraindications-history of TSS/allergy//history of uti
works best with spermicides
male/female condoms-barrier methods
failure rate
prevents
condzitdiations
latex rubber sheath- keep tip out
don’t use both male/female condoms at same time
between 5-15% failure
prevent sti
contraindicated with latex allergy
cap
failure rate
in place
dont leave
need
good for
works best
physical barrier
35% effective
in place for 6 hrs after intercourse and up to 24 hrs
don’t leave for over 48 hrs
need physician to fit/surgery, wt loss, pregnancy
good for pregnancy and smoker because of inability to use COC
works best with spermicides
combination oral contraceptives
% effective
not effective
bad for
take
pills-daily use-prevent ovum-needs prescription
99%effective
not effective for first 7 days of taking
bad for lactating women d/t decreased milk
take every night at same time
combination oral contraceptives
s/e
notify
nausea/wt gain/headache/tender breast/ breakthrough bleeding/ depression
notify if chest pain, sob, severe headache/ leg pain/ eye problems
estrogen/progesteron transdermal patches
stay on
applied
can
start
obese
stay on for 3 weeks, off for 1 week, where flow will happen
applies to upper arm,torso, abdomen, buttocks
can be worn with water
start new 4 week cycle if patch is taken off
can be harder in obese women to get to hormone level
vaginal ring
do not need to remove
can causes
left in place for three weeks, taken out for 1 week and replaced with another new ring
do not need to remove for intercourse
can cause discharge,mood changes or skin changes
contraceptions dont use if
blood clots
subdermal hormone implants
release
does not
failure rate
s/e
presents ovulation slowly over 3 years and thickens servical mucus
does not protect against sti
failure rate of less then 1%
S/e- irregular menstrual cycle, depression and scarring
im injections
effective
s/e
black box
caution
given every 12 weeks- inhibits ovulation
almost 100% effective
s/e-headache, wt gain, depression, irregular cycles,acne
Black box-font use for longer then 2 years
caution w/ diabetics – they can increase blood glucoses
intrauterin devices
placed
failure rate
how long lasts
se
education
small plastic device inserted through vagona
can be placed within 5 days of unprotected sex as form of emergency contraception
have less then 1% failure
nonhormonal 10 years
hormonal 5-7 yers
s/e are uterine cramping,spotting
education-does not prevent sti, contact if pregnancy’s
vasectomy
done
effective
some
can return
help
additonal
vas deferens are cut and tied in male
done under local anesthesia
99.5%effeective
some sperm can remain for 6 months after
can return to intercourse in 1 wek
ice and proper rest can help
additional birth control until 2 negative sperm tests at 6 and 10 weeks
tubal ligitation
can return
will
s/e
can cause
fallopian tubes are not connected to ovaries
can return to having relation 2-3 days after
will still have menstrual flow
s/e are vaginal spotting, bleeding and lower ab cramping
can cause eptoptic pregnancy
hysterectomy and essure
h- removing everything so no more pregnancy-no periods
e- spring loaded-stops release of egg and stops flow. divide prevents egg from coming down
scar tissue/pelvic pain- can
can still get periods
emergency postcoital contraception
take
effectve
s/e
plan b-high dose progestin based pills-prevent ovulation-
most can be used3 days
75% effective-dont protects agaitns sti
nausea is se
Ella and copper iud
emergency postcoital contraception
Ella
prescribed only- up to 5 days postcoital
copper iud
can be used- inserted within 72 hours-inhibits imputation and not fertilization
medically induced termination of pregnancy
mifenspitone
methotrecxte
s/e
no/no/follow
effective 95% of time
mifenspitorne-blokcs effect of prgterone
methotrexate- interferes with dna synthesis
se– n/v/d, cramping, prolonged bleeding
no sex, no heavy lifting, follow up in 2 weeks
reproductive alternatives
meds-increase hormones
surgery-sperm instilled into cervix
ivf-extracted egg and sperm fertilized in lab
GIFT-same as IVF but insertered earleir
surrogate
pelvic exams
have patient lay in lithinomy position with knees up
drape patient and make sure comfortable with pillow
make sure patient is breathing slowly and empties bladder
monitor external genitalia for any infection/inflammation- herpes may mean that you need to have c section \
monitor internal gentalia- use speculum-check cervix, usually light pink-any alterations are documented
Pap smears are collected from cervix to see if cancer
vaginal speculum is used for infections
vaginal examinations are used to examine pelvic wall strength and anomalies in organs
mittelshmerz
right side
day
education=meds,devices,legs,
pain during ovulation-felt on one side of abdomen
if on right side, diffentate for appendicitis)
day 14 from first day of menstrural cycle-occurs in teens
Education-heating pads, elevating legs, more rest time,
COC, NSAID(ibuprofen), NO aspirin-makes flow heavier
dysmenorrhea
manifestations
rule out
treatment
painful menstruation-
bloating and lighting cramping a day before flow
sharp pain with aching/pulling when pain starts
rule out PID/tumor
use ibuprofen(nsaid), if doesn’t help use COC
Anovulatory
treatment
a menstrual cycle in which the release of an egg from the ovaries does not occur
primary if doesn’t occur b/c of disease
secondary of occurs b/c of disease
treatment-determain cause
menorrghia
call
abnormally heavy flow
more then 80 ml or one pad an hour
-call doctor for iron supplements
metorrhagia
normal
not normal
dont want
abnormal bleeding between periods-
could be normal for adolescents
, not for adults’ with established cycles.
Dont want elderly to have because of ovarian cancer
menstrural migraine
caused by
often
treatment
headache associated w/ period-dstabilitizing as is, can make worse
often has N/v
caused by hormones, drop in estrogen/
nsaids(ibuprofen) and Botox can help
endometriosis
def
can cause
appearance of endometrial tissue outside the uterus and causing pelvic pain-
can be found anywhere in body, right outside is most common,
can cause infertility problems
endometriosis
s/s
pain during
periods,
sexual intercourse
, bowel movements and/or urination
endometriosis
treatments
pain relief drugs (anti-inflammatories),
oral contraceptives,
ultimately could need surgery in end-if adhesions or scaring
premenstrual syndrome
felt
blood supply
can cause
a group of physical and emotional symptoms that start one weeks before your period
can be felt after ovulation
blood supply to ovaries is decreased
can cause watr retetion, hypoglycemina, fluxuations in calcium and serotonin
premenstrual syndrome
s/s
emotional swings,
fatigue,
bloating,,
hormone fluctuation,
eating more/cravinfs
PMS nursing considerations
keep journal of symptoms
diet- high in vitamin, calcium and sodium
exercise
support groups
amenorrhea
evaluate for
absence of menstrual flow
eval for rights age, pregnancy’s, stress, eating disordeer could be s/s
premenstrual dysphoric disorder
occurs
occurs in luteal and is relieved with menses
premenstrual dysphoric disorder
s/s
make sure
anxiety, fatigue, bloating, irrablity, depression
ensure adequate vitamin intake
female cicumcision
imperforate hymen
polycystic ovary sundrome
removal of clitoris, have difficultly with childbirth or contraception
ring of tissue that obstructs vaginal opening
increased androgen level that prevents ovary maturation
toxic shock syndrome
acute septicemia caused by damage of insertion of tampons
rare but life threatening
TSS
manifestions and end
fever over 102,
hypotension,
sunburn-like rash on palms/feet ,
muscle pain
V/D
reduces platlets
end-organ damage-renal, CNS
tss treatments
take out
antiobiotcs - cephlaspoirns and clindamycines
taking out all tampons-rotate every 3-6, don’t use highly absorb and keep for longer
vulvovaginitis
def
inflamed outer vagina
vulvovaginitis
manifestations
itchy/sore vagina,
discharge,
dryness, pain,
light bleeding
vulvovaginitis
keep
treatments
keep dry, incontinent underwear
yeast infections treatment, Tylenol, nsaids
pelvic inflammatory disease-what is
trasmission
increased
inflammatory conditions in uterus, fallopian tubes and ovaries
sexual tramdission is 75% of pid cases- chylamidia/ gonorrhea
higher chance of infertility
pelvic inflammatory disease
manifestations
discharge
severe pain,
fever 101-102
leukocytosis
heavy yellow creamy purulent discharge
pelvic inflammatory disease
treatments
analgesics
antibiotics-clindamycin
accessory nipples
breast hypertrophy
brast hypoplasia
additional nipples-can be subject to same diseases as normal breast
abnormally large breast due to progesterone levels- can cause pain, surgery can reduce size
reduction in size pf breast
candidiasis
manifestation
patches
vaginial reddening, buring, itching, bleeding, painful intercourse,
thick white patches
thick cream cheese like discharge-watch patches
candidiasis
treatments
teaching//hygeine, use, complete, can be, refrain ,loose, eat
oral/vaginal antifungal agents like “zole” for 3-7 days-nystatin is key ingredient
hygeine, proper use of apllicators, complete entire treatment
can be all over body, breasts, mouth, anal, peri
refrain from alcohol
loose, cotton clothing
eat yogurt
candidiasis
thrives
not necessarily
90%
need
thrives on glycogen
not necessary sti-fungal infection
90% of women will have
need to check glucose level- if struggle with yeast infections - could be diabetes
trichomoniasis
discharge
manifestaions
males
frothy white/greyish green discharge w/ foul odor,
buring/itching of vagina- could be bruising
males will report no symptoms
trichomoniasis
treatment
teaching//hygiene/complete,use,no//
oral metrondolze or tinidazole
perineal hygiene, complete doses. use barrier methods-use condoms and no alcohol
bacterial vaginosis-what is
manifestions
discharge
absence of lactobacilli in vaginal flora
-burning when peeing and itching
milky white to gray discharge with fish smell
bacterial vaginosis
treatment
oral metronizodle// yeast treatments for 7 days
treat partner as well
use probiotics like yogurt as well
clhymida
s/s
discharge
can lead
dysuria, urinary infrequency, but could be asymtpmatic
heavy, gray-white discharge
can lead to PID and infertility
clhymida
risk factors and prevention
rf-many partners + unprotected sex
prevention-no sex ot protected sex
clhymida
treatment
oral doxycycline 7 day or
azithromycin for 1 dose-
–each partner must complete treatment
human pipilomavirus
manfiestatiopns
lesions spread
fibrous tissue overgrowth on vagina
human pipilomavirus
goes
treatment
vaccine
go away on own
podophyllin
or wart removal therapy
child needs vaccine before they become sexually active
herpes
spread
s/s
spread by skin to skin contact
1-face
2-genitals
s/s-painful vesicles that tingle,burn, itch or pain
herpes
education//birth,virals,ice,avoid, wear//
treatment
-c secion during birth, antivirals dont cure, use ice for relief, avoid stress. avoid sex, wear condoms
acylcoivor and valactolvir are antivirals
gonorrhea
manifestation
discharge
asymptmatic
males
can cause
pain during urination
slight yellow vagina discharge
20% men asympomatic and 80% women
inflammation can scare testes in males/
can cause PID ,arthritis and heart disease if not treated
gonorrhea
treatment
education
return
im prosefin
cefrixone and arithromycin
finsih antibiotic course, both be treated, use condoms, dont have sex utnil fully treated
return in 7 days to make sure its gone
syphillis
stages
weirdone
primary stage-lesions, highly infections on genitals, mouth, breasts, fingers 3-4 weeks after contact
secondary-2wk - 6 mnth and lesion disappears, rash on palms of feet, sore throat, generalized lympademnopathy
Syphilis
1
2
3
end causes
1-canker for 6 weeks and fades away
2- 2-4 weeks after canker a rash and low grade fever appears
3- latent phase- still can be spread decades away
can cause all types of body problems that leads to death
syphillis
treatment
education
penecillin is treamtent- 1 dose- eitymyocyn and tetracycline if no pen
not trasmitted by sex but by blood.
no apparent symptoms
kegel exercises
Stop the flow of urine during voiding and hold for a few seconds.
Tighten the muscles at the vaginal entrance around a gloved finger or tampon.
Tighten the muscles around the anus as though resisting defecation.
hold for 3 seconds, relax for 3 seconds. Continue the sequence for 25 repetitions twice a day
Keep abdominal muscles and breathing relaxed
Establish a routine because these exercises should be continued for life.
nurses role in reproductive health
Personal education
Community Education
Sensitive information
Nonjudgmental
ovulation
Fsh role
lh role
Ovulation how long before menstruatation
temperature
Rise in female hormones
FSH stimulates ovary to mature
LH stimulates release of the egg into fallopian tube
Ovulation always occurs 14 days before menstruation.
Drop in temp day before ovulation, then 1 degree rise day after ovulation
signs of puberty
hair
emotions
change in voice
increased appetite
fatigue
lab values change
height
breast
interests
Girls can start at 7
pap exams
once
need
give
abnomral
pap
week
once 3-5 years-if positive every 6 months
need negative HPV test
give cerival cancer vaccine in early years-rise in cancer
abnormal results do not mean cancer-removal and biopsy
pap swab test for HPV and cancer
week after menstrual cycle
mammogram
breast self exams
age 45 Is recommended-annual and at risk- recommended 7-10 days aft menstrual cycle
Breast self-exams:
There is very little evidence that doing self-exams or having clinical breast exams routinely is helpful for women at average risk of breast cancer.
PROMOTE-start in teens
4 stages of menopause
average age
will knowwhen
risks
pre-cramps,anxiety,nausea, iratiblity
prei/meno pause- hot flashes, night sweats, irregular periods, loss of lbiido
post menopause-high risk of condiotns like heart disease and uti
52 is average age–peri is 30-40
will know when dont have a period for a whole year
high risk of osteoperosis, UTI, ovarian cancer and CAD
menopause management
Diet
Vitanmins
Remedies
stress
s/eof hrt
high fiber low fat diet
eat vitamin deb
herbs
manage stress
a lot of side effects from HRT-breast cancer, strokes, dvt, osteoporosis ,
nursing management of stis
throuorugh h an p
include sexual behaviors
encourage patient to notifyy parterns
if under 10 consider sexual abuse
AIDS
spread
gores
spread through sperm or blood
Goes from HIV to aids
infertility/subferitliy
when to check
problems
lay down
after 1 year of unprotected and no fertilization
if over 35 check after 6 months
aging, thyroid, ovulation, pid, endometriosis,implamantation problems
have women lay down with legs raised after interocurse
