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Repro > Module 2: Women's Health: Well- Woman across the Lifespan ( Health Promotion/ Reproduction/ Hormonal Regualtion) > Flashcards

Module 2: Women's Health: Well- Woman across the Lifespan ( Health Promotion/ Reproduction/ Hormonal Regualtion) Flashcards

1
Q

What is Reproduction?

A

Reproduction is the total process by which organisms produce offspring

Conception

Gestation

Childbirth

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2
Q

What is the scope of Reproduction?

A

Not Pregnant vs Pregnant

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3
Q

define conception

A
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4
Q

define germ cell

A
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5
Q

define fertilization

A

when egg and sperm meets

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6
Q

define gestation

A
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7
Q

define sexual intercourse

A
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8
Q

define contraception

A
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9
Q

structure of female

A
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10
Q

Physiological Process

A

Gametogenesis

Ovulation

Fertilization

Cleavage

Implantation

Zygote/Embryo/Fetus

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11
Q

Reason for No Pregnancy ( Intentional)

A

Abstinence
Contraception

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12
Q

Reason for No pregnancy ( Unintentional)

A

Infertility
Menopause

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13
Q

What does the annual Examination consist of?

A

Health Hx
Family HX
Menstrual HX ( first onset of cycle)
Pregnancy Hx
Sexual HX
STI’s
Pap Smear
Gyn prx
Social Hx
Medication hX

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14
Q

Cultural Cosiderations

A

The nurse should:

Trust that woman is expert on her life, culture, and experiences

If asked with respect and genuine desire to learn, woman will tell nurse how to care for her

May be considered inappropriate for woman to disrobe completely for physical examination

In many cultures a female examiner is preferred

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15
Q

Intentional Prevention of Pregnancy

A

Effectiveness

Convenience

Affordability

Duration of action

Return of fertility

Effects on uterine bleeding

Side effects

Adverse effects

Medical contraindications

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16
Q

What does contraceptives do to the body?

A

-Supress ovulation by inhibiting FSH and LH
-change endometrium making implantation less likely
-Thickens the cervical mucus ( Preventing sperm penetration)
- Reduce sperm transport in upper genital tract ( Fallopian tubes)

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17
Q

Contraceptive Methods: Periodic Abstinence ( Pull out method)

A

Coitus interruptus: when a man pull out before ejaculation

Typical 1st year failure rate – 27%

Advantages:

Immediate availability, no devices, no cost, no chemical involvement.

Disadvantages:

High probability of pregnancy, STI

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18
Q

Contraceptive Methods: Periodic Abstinence (FAM)

A

Typical 1st year failure rate – 25%

Advantages:

Low-to-no cost, absence of chemicals/hormones, lack of alteration in menstrual pattern, acceptable method for cultural/religious reasons

Disadvantages:

Strict record keeping required, complete abstinence is required during fertile period

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19
Q

Barriers to condoms ( Male)

A

Male Condom – Latex / Polyurethane / Natural membranes

Failure rate: Typical users – 18%, Perfect users – 2%

Advantages: Readily available, safe, effective against STDs, no hormones

Disadvantages: May decrease enjoyment of sex, breakage/slippage

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20
Q

Barriers to female condoms

A

Advantages: Provides protection to the labia

Disadvantages: Lubricant does not contain spermicide, device difficult to place

21
Q

Barriers to Diaphragm

A

Shallow, dome-shaped device that covers the cervix

Latex or silicone

May be placed 6 hours prior to intercourse, must remain in place for 6 hours after intercourse

Failure rate: Typical users - 12 – 20%

Advantages: Nonhormonal

Disadvantages: Reluctance to insert or remove; use >24h may increase risk of Toxic Shock Syndrome (TSS)

22
Q

COC ( Combined Oral Contraceptives )

A

Side Effects: HA, breast tenderness, weight gain, BTB, yeast infections, decreased libido, mood swings, N&V, edema

Adverse Events: VTE, stroke

Contraindications: history of thromboembolic d/o, cerebrovascular or coronary artery disease, breast cancer, estrogen-dependent tumors, pregnancy

Duration of effect: 24 hours

Failure rate: Typical use: 5 - 10%; Perfect use: 0.1%

Advantages: Regular, predictable menses, reversible

Non-contraceptive benefits: Risk reduction for PID, ectopic pregnancy, anemia, menorrhagia, dysmenorrhea, PMDD, endometriosis, acne, long-term protection against uterine and ovarian cancer

Disadvantages: Must be taken daily, do not provide protection from STDs

23
Q

Combined Estrogen & Progesterone Products ( Transdermal Patch)

A

Delivers continuous levels of progesterone & EE

Apply once/week for 3 weeks

Duration of effect: 7 days

Failure rate: < 2% in women weighing < 198 lbs.

Advantages: Greater compliance, decreased adverse effects, reversible

Disadvantages: Similar to COCs

24
Q

Combined Birth Control ( Vaginal Ring)

A

Delivers continuous levels of progesterone & EE

Duration of effect: 3 weeks

Failure rate: < 2%

Advantages: Reversible

Disadvantages: Similar to COCs, vaginal irritation/discharge

25
Who can not used combined Hormonal contraceptive?
Women with: Uncontrolled hypertension Migrained with aure Smoking at age 35+ liver disease undiagnosed abnormal bleeding estrogen dependent or neoplasia
26
What are serious side effects of contraceptives that must be reported to a HCP?
Hepatic mass or abdominal RUQ pain Severe pains in chest, left arm, neck Headache, Unilateral numbness, weakness, tingling Hemoptysis Eye problems- Loss of vision, proptosis, diplopia, papilledema Severe pains, tenderness, swelling, warmth in legs Slurring of speech
27
What is the name of the injectable progestin?
Depo- Provera ( Medroxyprogesterone Acetate)
28
Depo Injection
Hepatic mass or abdominal RUQ pain Severe pains in chest, left arm, neck Headache, Unilateral numbness, weakness, tingling Hemoptysis Eye problems- Loss of vision, proptosis, diplopia, papilledema Severe pains, tenderness, swelling, warmth in legs Slurring of speech
29
IUD (Hormonal)
Mirena, Skyla, Kyleena Duration: 3-5 years Failure: 0.2 – 0.8% Advantages: LARC, safe breastfeeding, often stops menses, quick return to fertility Disadvantage: invasive insertion
30
IUD ( Non-hormonal)
Paraguard Copper Duration: 10 years Failure: 0.2 – 0.8% Advantages: nonhormonal, LARC, safe breastfeeding, quick return to fertility Disadvantages: invasive insertion, increased bleeding
31
When is Emergency Contraception used?
- used within 72-120 hours of unprotected intercourse to prevent implantation
32
Emergency Contraceptive
Preven Kit (Yuzpe): 4 combined OCs, 2 doses given 12 hours apart, antiemetic may be necessary 1 hour prior to first dose. 40% will experience severe N&V Plan B One-Step: single progestin-only pill (OTC) Next Choice: 2 levonorgestrel tablets, 2 doses given 12 hours apart – may be taken together Ella – one pill orally within 120 hours of unprotected intercourse IUD insertion is also an option and is effective if given within 120 hours of exposure to unprotected intercourse. There are no contraindications to Emergency Contraception except confirmed pregnancy
33
Female Sterilization
Tubal Ligation (bilateral salpingectomy) Tubal Occlusion - Essure - transcervical placement of occlusive device in fallopian tubes via hysteroscopy, confirmed by hysterosalpingogram. Failure rate: 0.5% Advantage: permanent contraception Disadvantages: Must use back-up contraception for three months after placement of Essure, pain
34
Male Sterilization
Vasectomy - sealing, tying, or cutting of the vas deferens Failure rate: typical 0.15%, perfect 0.10% Advantage: safer, simpler, less invasive, easier to recover from, less costly and more effective Disadvantages: Alternative contraception is required until the ejaculate is deemed free of sperm
35
What is an abortion ?
purposeful interruption of a pregnancy before 20 weeks of gestation, can be done elective or therapeutic
36
What are the indication for getting an abortion?
Woman’s request Genetic disorder of fetus Rape and incest Preserving the health of the woman Legal and moral issues – Roe V. Wade 1973
37
How is an abortion done in your first trimester?
Surgical (aspiration) abortion Medical abortion Methotrexate and misoprostol Mifepristone and misoprostol
38
How is abortion done in your second -trimester?
Dilation and evacuation or by cervical preparation with prostaglandis
39
What are nursing consideration for Abortion ?
Potential complications Infection Retained products of conception Excessive vaginal bleeding Emotional concerns Contraceptive planning
40
Menopause: The Climacteric Period
Peri-menopause – 4 years leading up to it Transition from normal cycles to menopause Irregular cycles--longer between menses DUB/endometrial hyperplasia common in obese women Menopausal symptoms
41
Menopause: The Climacteric Period
Peri-menopause – 4 years leading up to it Transition from normal cycles to menopause Irregular cycles--longer between menses DUB/endometrial hyperplasia common in obese women Menopausal symptoms
42
What are types of Menopause
Biological , Surgical and Premature Ovarian Failure
43
Biological Menopause
Commences with the last menstrual period (average age=52 yrs) and continues with the subsequent absence of menses for 12 months. Occurs earlier in women who smoke or have shortened cycles Transitions women from a reproductive to a non-reproductive stage whereby follicle depletion (no E2 production) leads to increased FSH levels
44
Surgical Menopause
May result with surgical removal or medical ablation of the ovaries.
45
Premature Ovarian Failure
Menopause prior to age 40
46
Menopause Manifestation
Hot flashes / Night sweats Sleep disturbance weight gain irritability Irregular menses VAginal dryness/ Atrophy
47
What is the most effective treatment for menopause?
HRT
48
HRT - Menopause management
causes : Flushing and night sweats May improve sleep disturbances - improve fatigue, irritability Treat urogenital atrophy/ vaginal dryness, dyspareunia Osteoporosis prevention Lowers risk for colon cancer
49
Menopause Symptom management
Behavioral changes – fans, dress in layers, avoid triggers – spicy foods, stressful situations Vitamin E Hypnosis Cognitive behavioral therapy

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