Maternity/Infant Health (Exam Two) Flashcards
What is the most common cause of alterations in pelvic support?
Childbirth
Involving the uterus and cervix, what occurs during uterine displacement and prolapse?
- The uterus tips posteriorly (tip to the back)
- The cervix rotates anteriorly (rotate to the front)
What are the signs and symptoms of uterine displacement?
- Pelvic pain
- Back pain
- PMS
- Painful intercourse
What becomes visible during a uterine prolapse?
The uterine will be seen protruding out from the vagina
Which condition is more serious, uterine displacement or uterine prolapse?
Uterine prolapse
What is cystocele?
Protrusion of the bladder into the vagina
What are the causes of cystocele?
- Childbirth
- Obesity
- Age
What are the signs and symptoms of cystocele?
- Heaviness inside of the vagina
- Urinary incontinence
What is rectocele?
Herniation of the anterior rectal wall through vaginal tissue
What are the management options for both cystocele and rectocele?
- Surgical repair
- Pelvic physical therapy
What are genital fistulas?
Perforations between genital track organs
What are the signs and symptoms of genital fistulas?
- Depends on location
- Leaking of urine
- Gas
- Feces in vagina
What are the treatment options for genital fistulas?
-Surgical repair (surgery may not always fix it)
What percentage of females experience urinary incontinence? It is common after what procedure in women?
- 75% of females
- Vaginal childbirth
Urinary incontinence increases with what?
- Parity (number of births)
- Age
- Obesity
- Smoking
Ovarian cysts are often associated with what?
Menstrual cycle
What are the two types of ovarian cysts?
- Follicular cysts
- Polycystic Ovarian Syndrome (PCOS)
Follicular cysts are most common in…
Normal ovaries of younger females
Follicular cysts generally present with ___________, unless it ________.
- No signs or symptoms
- Ruptures
If a follicular cyst ruptures, what will the female experience?
Pelvic pain
What will happen to the follicular cyst if it does not rupture?
It will shrink in size after 2 or 3 menstrual cycles
What are the treatment options for follicular cysts?
- NSAIDS
- Oral contraceptives
- Larger cysts can be surgically removed
What is polycystic ovarian syndrome (PCOS)?
- Endocrine imbalance
- Multiple follicular cysts due to overproduction of estrogen
What hormones will be increased with polycystic ovarian syndrome (PCOS)? Which hormones will be decreased?
- Increase in estrogen, testosterone, and luteinizing hormone (LH)
- Decrease in follicle stimulating hormone (FSH)
What are the treatment and management options for polycystic ovarian syndrome (PCOS)?
- Encourage diet
- Encourage weight loss
- Oral contraceptives
- Metformin
What are the signs and symptoms associated with polycystic ovarian syndrome (PCOS)?
- Obesity
- Hirsutism
- Irregular menstrual cycles
- Infertility
- Glucose intolerance
- Hyperinsulinemia
Where do uterine polyps originate?
In the endometrium or the cervix
Uterine polyps can be surgically removed in an outpatient setting if they are located where?
In cervical tissue
After the removal of a uterine polyp, what education should the nurse provide to the patient?
- No tampons for one week
- No sex for one week
- Signs and symptoms of infection
- Notify HCP if they experience heavy bleeding
What age group is most likely to develop uterine polyps?
Multiparous women older than 40
What is the most common type of benign tumor?
Fibroid tumors
These women are at a higher risk for developing fibroid tumors?
- African Americans
- Nulliparity (no pregnancies)
- Obese
What are the signs and symptoms of fibroid tumors? Which of these symptoms are specific to large tumors?
- Typically asymptomatic
- Abnormal uterine bleeding
- Anemia
Specific to large tumors:
- Back pain
- Pressure in lower abdomen
- Constipation
- Dysmenorrhea
Fibroid tumors are heavily influenced by what? What will this impact?
-Influenced by estrogen
- Implantation
- Maintenance of pregnancy
Regarding pregnancy, fibroid tumors may cause what?
- Miscarriage
- Pre-term labor
- Difficult labor
What are the management options for fibroid tumors?
- NSAIDS
- Oral contraceptives
- Growth hormone agonist
- Uterine artery embolization
Why would a women with fibroid tumors be prescribed growth hormone agonists?
They will decrease the size of the fibroid
What is uterine artery embolization?
Blocks the blood supply (perfusion) to the fibroid tumor causing it to shrink
Regarding fibroid tumors, what signs and symptoms would indicates the need for a hysterectomy?
- Very large tumor
- Severe bleeding
- Tumor is obstructing other organs
What are the nursing interventions for fibroid tumors?
- Discuss fertility
- Obtain consent
- Discuss childbearing
- Monitor bleeding
How long will a patient stay in the hospital after having a hysterectomy?
1 to 2 days
What signs and symptoms might the patient experience postop from a hysterectomy? What education should the nurse provide to this patient?
- Pain
- Fatigue
- Depression
- Promote pelvic rest
- Patient can engage in sexual intercourse after healing
What is the most common type of reproductive cancer?
Endometrial cancer
What are the risk factors for developing endometrial cancer?
- Obesity
- Nulliparity
- Infertility
- Late onset menopause
- Diabetes
- Hypertension
- PCOS
- Family history of ovarian/ breast cancer
- Tamoxifen use
What is the MOST significant risk factor for developing endometrial cancer? List other signs and symptoms of endometrial cancer.
*Hormonal imbalance
- Pinkish mucus vaginal discharge
- Lower back pain
- Pelvic pain
What is the cardinal sign of endometrial cancer?
Abnormal uterine bleeding
How is endometrial cancer diagnosed?
- Pap smear
- Biopsy
- Pelvic exam
How many women are diagnosed with endometrial cancer annually? What characteristic do these women have in common?
- Over 100,000
- Obesity
What is the second most common reproductive cancer?
Ovarian cancer
The signs and symptoms of ovarian cancer are usually _____.
Vague
List the signs and symptoms of ovarian cancer.
- Urinary urgency
- Urinary frequency
- Increased abdominal girth
- Abdominal bloating
- Pelvic pain
- Abdominal pain
- Feeling of fullness quickly after eating
How is ovarian cancer diagnosed? Are women who have ovarian cancer usually diagnosed early or late in the disease process?
- Definitive screenings or diagnostic testing does not exist
- The cancer is generally very progressed or in the later stages when found
What ethnicity is most at risk for developing ovarian cancer?
- North American
- European descent
What are treatment options for ovarian cancer?
- Surgical removal of ovaries or uterus
- Cyctoreductive surgery
- Antineoplastic surgery
- Chemotherapy
- Radiation
What is cyctoreductive surgery?
Debulking (shrinking) of the tumor
What treatment options for ovarian cancer are commonly used simultaneously?
- Antineoplastic surgery
- Chemotherapy
- Radiation
What is the third most common reproductive cancer?
Cervical cancer
What common places does cervical cancer spread?
- Vaginal mucosa
- Pelvic wall
- Bowel
- Bladder
The incidence of cervical cancer is highest in what ethnicity?
Hispanic women
90% of cervical cancers are caused by what?
Human papilloma virus (HPV)
What is the most reliable method for detecting cervical cancer? What percent of malignancies does it detect?
- Pap smear
- 90%
Besides a pap smear, what are other methods used to diagnose cervical cancer?
- Colposcopy
- Biopsy
What are the signs and symptoms of cervical cancer?
- Most often asymptomatic
- Abnormal bleeding after sexual intercourse
- Rectal bleeding
- Hematuria
- Back pain
- Leg pain
- Anemia
Abnormal bleeding puts any patient at an increased risk for what?
Anemia
If cervical cancer is considered invasive, what method of treatment is commonly used?
Hysterectomy
What is the fourth most common gynecological cancer?
Cancer of the vulva
What is the most common site for cancer of the vulva?
Labia majora
What is contraception?
- Keeping the egg and the sperm apart
- Intentional prevention of pregnancy during intercourse
What is birth control?
Device or practice that decreases the risk for conceiving
What is family planning?
Conscious decision on when to conceive throughout the reproductive years
The decision to practice conception should be a decision made by who?
- A woman
- A woman and her significant other
What should the nurse consider when looking at fertility awareness based methods (natural family planning) for the patient?
- Cultural beliefs
- Religious belies
How can a women determine when she is fertile or ovulating?
- Fertile test strips
- Basal temperature
- Symptoms (individualized for each woman)
Besides decreasing the risk of pregnancy, condoms also aid in preventing what?
Sexually transmitted diseases (STDs)
If a patient is using diaphragms, cervical caps, or sponges to prevent pregnancy, the nurse should educate them on what?
Toxic shock syndrome (TSS)
What is the point of oral contraceptives?
- To prevent the formation of a follicle, thus prohibiting ovulation
- Suppressing of the surge of the luteinizing hormone (LH)
What are the forms of combined estrogen-progestin contraceptives?
- Oral
- Transdermal
- Vaginal rings
Describe transdermal patches for contraception.
- A new patch is placed on each week for three weeks
- Patch is removed on the four week
- Placement of the patch should be alternated
What method of contraception requires a back-up method for seven days after insertion?
Vaginal ring (i.e. Nuvaring)
What are the warning signs to teach patients who are starting or taking COCs?
HINT: ACHES
A: abdominal pain C: chest pain H: headaches E: eye problems S: severe leg pain
COCs are not recommended for patients with what?
Cardiac issues
What side effect is very common with the Nuvaring?
- Severe leg pain
- Blood clots
It is extremely to educate your patient on what regarding oral contraceptives and antibiotics?
- Antibiotics reduce the effectiveness of oral contraception
- Will need a back-up method
Side effects for COCs is directly correlated with receiving too much of which hormone?
Estrogen
What are the common side effects of progestin-only contraception?
- Irregular bleeding/spotting
- Depression
- Mood changes
- Decreased libido
- Weight gain
- Recurrent yeast infections
- Acne
How does progestin-only contraception inhibit conception?
- Increases the viscosity (thickens) of cervical mucus
- Suppressing of the surge of the luteinizing hormone (LH)
Progestin-only contraceptives are a good option for mothers who are what?
Breastfeeding
_____ may be delayed after stopping injectable progestins.
Fertility