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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
Q

Who can not used combined Hormonal contraceptive?

A

Women with:

Uncontrolled hypertension
Migrained with aure
Smoking at age 35+
liver disease
undiagnosed abnormal bleeding
estrogen dependent or neoplasia

26
Q

What are serious side effects of contraceptives that must be reported to a HCP?

A

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
Q

What is the name of the injectable progestin?

A

Depo- Provera ( Medroxyprogesterone Acetate)

28
Q

Depo Injection

A

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
Q

IUD (Hormonal)

A

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
Q

IUD ( Non-hormonal)

A

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
Q

When is Emergency Contraception used?

A
  • used within 72-120 hours of unprotected intercourse to prevent implantation
32
Q

Emergency Contraceptive

A

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
Q

Female Sterilization

A

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
Q

Male Sterilization

A

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
Q

What is an abortion ?

A

purposeful interruption of a pregnancy before 20 weeks of gestation, can be done elective or therapeutic

36
Q

What are the indication for getting an abortion?

A

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
Q

How is an abortion done in your first trimester?

A

Surgical (aspiration) abortion

Medical abortion

Methotrexate and misoprostol

Mifepristone and misoprostol

38
Q

How is abortion done in your second -trimester?

A

Dilation and evacuation
or by cervical preparation with prostaglandis

39
Q

What are nursing consideration for Abortion ?

A

Potential complications

Infection

Retained products of conception

Excessive vaginal bleeding

Emotional concerns

Contraceptive planning

40
Q

Menopause: The Climacteric Period

A

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
Q

Menopause: The Climacteric Period

A

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
Q

What are types of Menopause

A

Biological , Surgical and Premature Ovarian Failure

43
Q

Biological Menopause

A

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
Q

Surgical Menopause

A

May result with surgical removal or medical ablation of the ovaries.

45
Q

Premature Ovarian Failure

A

Menopause prior to age 40

46
Q

Menopause Manifestation

A

Hot flashes / Night sweats
Sleep disturbance
weight gain
irritability
Irregular menses
VAginal dryness/ Atrophy

47
Q

What is the most effective treatment for menopause?

A

HRT

48
Q

HRT - Menopause management

A

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
Q

Menopause Symptom management

A

Behavioral changes – fans, dress in layers, avoid triggers – spicy foods, stressful situations

Vitamin E

Hypnosis

Cognitive behavioral therapy

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