OB Chapters 3&4 Flashcards

1
Q

eggs are also called

A

ova
oocytes

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2
Q

breast includes

A

accessory organs
nipple
areola
lobes
alveolar and lactiferous glands

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3
Q

lobes in the breast are for…

A

lubrication

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4
Q

engorged breast causes

A

mastitis (inflammation of breast tissue that can lead to infection)

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5
Q

mastitis treatment

A

-antibiotics given to prevent patient from being septic
-can continue to breastfeed, considered safe

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6
Q

mastitis S/S

A

flu like symptoms
-fever
-chills
-shivers
-body aches
-sweating

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7
Q

engorged breasts caused by

A

not breastfeeding every 2-3 hours

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8
Q

interventions for engorged breasts

A

-pump breast milk
hot compress or put under hot water

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9
Q

ovarian cycle

A

-1 million oocytes at birth
-200K-400K by puberty
-age 35: fewer than 100K

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10
Q

ovulation cycle

A

-occurs on the 14th day
-temp rises 0.5-1 degree F

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11
Q

ovum lifespan

A

24 hours

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12
Q

sperm can live in female body for up to

A

3-5 days

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13
Q

menstruation is

A

-expulsion of uterine lining occuring monthly
-marks the beginning and end of each menstrual cycle

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14
Q

mencarche is…

A

establishment of menstruation in females

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15
Q

menopause

A

period ends

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16
Q

menstrual disorders include

A

-ammenorhea
-dysmenorrhea
-abnormal uterine bleeding
-premenstrual syndrome
-premenstrual dysphoric disorder
-endometriosis

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17
Q

amenorrhea

A

absence of a period

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18
Q

dysmenorrhea

A

painful period

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19
Q

abnormal uterine bleeding (AUB)

A

excessive bleeding

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20
Q

Premenstrual syndrome (PMS)

A

mood swings

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21
Q

Premenstrual Dysphoric Disorder (PMDD)

A

severe PMS that can lead to depression

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22
Q

endometriosis

A

thickening of the uterine lining

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23
Q

endometriosis complications

A

-infertility
-scarring tissues around uterus
-difficulty for sperm and egg to penetrate through scarring tissue

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24
Q

PMS and PMDD tool

A

A.C.D.H.O

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25
Q

A.C.D.H.O

A

A - anxiety (difficulty sleeping, tense, mood swings, clumsiness
C - cravings (craving sweets, salty foods, chocolate)
D - depression (feeling of low self esteem, anger, hysphoria
H - hydration (weight gain, abdominal bloating, breast tenderness, ankle swelling)
O - other (hot flashes, cold swears, N/V, change in bowel habits, aches, acne breakouts)

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26
Q

TX for PMS & PMDD

A

exercise
vitamins
B6 supplements
analgesics (if needed)
eating well
Magnesium (lowers cortisol levels and balances progesterone)

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27
Q

Infertility

A

inability to conceive a child within 1 year of regular unprotected sex

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28
Q

infertility causes

A

-some medications
-abortions
-amenorrhea
-substance abuse
-obesity
-PCOS
-endometriosis

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29
Q

fertility drugs

A

-clomephine citrate (clomid)
-human menopausal gonadotropin (HMG/Pergonal)
Artificial insemination

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30
Q

clomephine citrate method of action

A

-NONsteroidal synthetic antiestrogen used to induce ovulation
-typically D/C’ed after 3 cycles

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31
Q

HMG (Pergonal) method of action

A

induces ovulation by direct stimulation of ovarian follicle

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32
Q

Infertility Diagnostic Procedures for females

A

-assess uterine/vaginal anomalies
-hormone analysis
-postcoital test
ultrasound
-hysterosalpingography
-hysteroscopy
-laparoscopy

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33
Q

Infertility Diagnostic Procedures for Males

A

semen analysis (40% male factor for infertility)
-semen in a cup (must be sent w/i 1 hour)
-no sex for 2-5 days before sample
-if done at home, must be taken into lab w/n 4-6 hours

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34
Q

Infertility Diagnostic tests nonspecific

A

-home ovulation predictor kit
-clomiphene citrate (clomid) challenge test
-hysterosalpingogram
-laparoscopy

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35
Q

nursing interventions

A

-encourage couples to express and discuss feelings
-infertility is a major life stressor
-assist couple to consider other options
-provide education
-explain role of genetic counselor or reproductive specialist
-monitor for adverse effects related to meds
-use of meds can increase risk of mulitple births by 25%

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36
Q

Contraception types

A

-behavioral
-hormonal
-barroer
-permanent

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37
Q

Behavioral Method

A

-abstinence
-fertility awareness (cervical mucus ovulation method, basal body temperature, symptothermal method, standard days method, 2 day method)
-withdrawal
-lactational amenorrhea method

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38
Q

cervical mucus ovulation method

A

jelly like discharge, making it easier for sperm to travel

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39
Q

basal body temperature (BBT)

A

-checking body temperature to see of you’re ovulating
-temp is lowest during the morning
-1 to 2 days before ovulation, temperature rises 0.5-1 degree F in comparison to baseline
-can be higher for up to 3 days

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40
Q

Symptothermal method

A

-combination of cervical discharge method and BBT

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41
Q

Standard Days Method

A

most fertile during days 8-19 of ovulation cycle (+/- 5 days from day 14)

42
Q

2 day method

A

no vaginal discharge for 2 days

43
Q

withdrawal (coitus interruptus)

A

pull it out!

44
Q

Lactational amenorrhea method

A

if continuously (solely) breastfeeding, CANNOT GET PREGNANT. if you are breastfeeding/formula feeding together, CAN GET PREGNANT

45
Q

Barrier Methods

A

-female condoms
-male condoms
-diaphragm
-cervical cap
-contraceptive sponge

46
Q

Female Condoms

A

-protects against STI
-polyurethane sheath with a flexible ring at each end that is inserted deep into the vagina
-95% effective if used correctly

47
Q

Male condoms

A

-protects against STI
-sheath made of latex or plastic
-latex condom is 98% effective

48
Q

Diaphragm parameters

A

-must be fitted by doctor
-replace every 1-2 years or if weight fluctuates 10 lbs or more, abd. surgery, pregnancy
-may be inserted up to 2 hours prior to intercourse
-can stay in 6 hours post coitus
-Maximum stay of 24 hours, other can lead to TSS
-

49
Q

diaphragm cons

A

does not protect against STI

50
Q

Diaphragm works by…

A

-placed in vagina against cervix to keep sperm from joining with egg
-contains spermicide

51
Q

Cervical Cap

A

-smaller than diaphragm
-only covers the cervix
-made of silicone
-can be inserted up to 36 hours before sex
-usually kept inside for 6 hours post coitus
-fitted by provider
-changed after 1 year
-replace every 1-2 years or if weight fluctuates 10 lbs or more, abd. surgery, pregnancy

52
Q

Contraceptive Sponge

A

-releases 125 mg of spermicide over 24 hours of use
-does not protect against STI
-can be put in 24 hours before sex
-should be left in place at least 6 hours after sex
-should not be left in for more than 30 hours, otherwise could lead to TSS

53
Q

Toxic Shock Syndrome (TSS)

A

complication d/t certain bacterial infections

54
Q

TSS S/S

A

-fever
-abdominal pain
-vomiting
-dizziness
-diarrhea
-weakness
-change in LOC

55
Q

Hormonal Methods of BC

A

-pill (oral contraceptive)
-depo provera injection
-transdermal patch
-nuva ring
-minipill
-long acting reversible contraceptive (LARCs)

56
Q

oral contraceptive

A

-does not protect against STI
-prescription form of BC
-contains hormones that prevent release of eggs and prevent sperm from joining egg
-effective when used correctly
-taken at the same time each day

57
Q

Oral Contraceptive Benefits

A

-decreased menstrual blood loss
-decreased iron deficiency anemia
-regulation of menstrual cycle
-reduction in PMS symptoms
-protection against ovarian/endometrial cancer
-reduction in benign breast disease
-improvement in acne

58
Q

oral contraceptives contraindication

A

-history of thromboembolic disorders
-cerebrovascular disease
-cardiac disease
-breast cancer
-gall bladder disease
-pregnancy
-liver disease
-smoker over the age of 35 years
-infertility
-HTN
-diabetes over 20 years duration

59
Q

hormonal methods

A

-COC estrogen and progesterone
-suppress ovulation
-thickening cervical mucus
-alters uterine lining to prevent implantation
-patient must observe for adverse effects and danger signs
-if one pill missed, take ASAP, and use back up
-certain herbs (St. John. Worts) decreases effectiveness
-anticonvulsants, systemic antifungals, anti TB drugs, anti HIB protease inhibitors decrease effectiveness

60
Q

Signs of potential complications of oral contraceptives

A

A.C.H.E.S

61
Q

A.C.H.E.S stands for

A

A - abdominal pain (liver, gall bladder)
C - chest pain (SOB, blood clot, PE)
H - headaches (sudden or persistent - CVA or HTN)
E - Eye problems (vascular or HTN)
S - sever leg pain (DVT)

62
Q

Depo Provera Injection

A

-does not protect against STI
-prescription form of BC
-injection of progestin that is injected into a woman’s arm or buttocks
-3 month intervals for injection; 150 mg/dose
-prevents release of eggs and prevents sperm from joining eggs for 12 weeks
-SHOULD NOT BE USED LONGER THAN 2 YEARS

63
Q

Depo injection side effects

A

-weight gain
-depression
-acne
-can take up to 9 months for menstrual cycle to return back to normal

64
Q

Transdermal Patch

A

-prescription for of BC
-releases hormones that prevents the release of eggs and prevent sperm from joining with egg

65
Q

Transfermal Patch parameters

A

-2 inch square adhesive
can be placed on lower abdomen, upper outer arm, buttocks, upper torso
-gets changed monthly (3 weeks of wearing it, 4th week take it off)

66
Q

nuvaring

A

small flexible ring that is placed inside of vagina
-release hormone to prevent release of egg and prevent sperm from joining
-lasts 3 weeks before it needs to be replaced with new ring
-does not have to be fitted

67
Q

nuva ring side effects

A

-ring odor
-can get exposed (fall out)
-increase vaginal discharge

67
Q

minipill

A

-prosterone only
-low dose
-fewer adverse effects
-OK to take during breastfeeding
-no protection against STIs

68
Q

Long acting reversible contraceptives (LARCs)

A

-T shaped
-provider insertion
-implant or IUD
-hormonal or copper IUD
-TEACH PATIENT TO CHECK FOR PRESENCE OF STRING TO VERIFY DEVICE IS PRESENT

68
Q

hormonal IUD lasts for

A

3-7 years

69
Q

copper IUD…

A

-non hormonal IUD
-causes heavy bleeding
-lasts up to 10 years

70
Q

If LARC string is not found

A

go to doctor, may have dislodged and must be replaced

71
Q

Warning signs for intrauterine device complications

A

think PAINS

72
Q

PAINS

A

P - period irregularities
A - abdominal pain (dyspareunia)
I - infection (abnormal discharge)
N - not feeling well
S - string missing

73
Q

Emergency contraception

A

-can be taken within 72-120 hours after sex
-prevents implantation, will not disrupt already implanted pregnancy

74
Q

EC types

A

-Plan B One Step
-ulipristal acetate (UPA) pills (brand name Ella)

75
Q

Plan B one step

A

-not an abortion pill
-delays ovulation
-taken within 72 hours
-may be ineffective for those with BMI 30<
-one time dose of 1.5 mg levonorgestrel

76
Q

Ulipristal acetate pill (UPA)

A

-ella brand name
-prescription only
-up to 120 hours
-one time dose of 30 mg r

77
Q

Permanent Contraception Females

A

-tubal ligation
-hysterectomy

78
Q

tubal ligation

A

-sterilization for women
-laparascopic procedure
-fallopian tubes are grasped and sealed
-can be either tied and cut, cauterized, or banded
-MUST USE CONTRACEPTIVES FOR 3 MONTHS AFTER
-can cause ectopic pregnancy in certain cases b/c it can untie or regenerate poorly

79
Q

PERMANENT CONTRACEPTION MALES

A

-vasectomy

80
Q

vasectomy

A

-sterilization for men
-usually performed under local anasthesia
-involve vutting vas deferens (which carry the sperm)
- specimen taken between 8 and 16 weeks to ensure sperm count is zero (two cultures must have zero sperm)
-use contraceptives until no sperm confirmed

81
Q

Abortion

A

-purposeful interruption of pregnancy 20 weeks before gestation

82
Q

Abortion types

A

-elective
-spontaneous (miscarriage)

83
Q

why is it only considered abortion before 20 weeks?

A

-fetus is not considered viable until 20 weeks

84
Q

Abortion Methods

A

-medication mangement
-Dilation and Evacuation (D&C)
-vacuum aspiration

85
Q

abortion medication method

A

-2 medications taken
-First is mifepristone tablet 200 mg
-misoprostol (cytotec) taken 24-48 hours after mifepristone

86
Q

Mifepristone does what

A

stops baby from growing

87
Q

misopristol does what

A

contracts uterus to expel fragments

88
Q

Dilation and Evacuation Method (D&C)

A

-cervix is dilated and products are then removed by suction
-uterus is gently scraped by curettage
-can be used for abortion of retained placenta

89
Q

Vacuum Aspiration

A

-most common procedure
-local anesthesia
-cervix not dilated

90
Q

post vacuum aspiration instructions

A

-tell woman to contact provider for fever greater than 100.4F
-chills
-heavy bleeding
-foul smelling discharge
-severe abd. pain
abd. tenderness

91
Q

D&C complications

A

-infections
-retained tissue or hemorrhage
-uterine perforation
-retained products of conception
-cervical tear

92
Q

Medically treated abortion

A

-under 10 weeks
-mifepristone: blocks progesterone, stops development of fetus
-misoprostol: taken 24-48 hours after mifepristone, works to have uterus contract to expel remnants

93
Q

Menopause stages

A
  1. premenopause
  2. perimenopause
  3. menopause
  4. post menoapause
94
Q

prepmenopause S/S

A

-cramps
-anxiety
-mood swings
-artery disease
-irritability
-nausea

95
Q

perimenopause

A

-mood swings
-hot flashes
-night sweats
-vaginal dryness
-irregular periods
-loss of libido

96
Q

menopause

A

-hot flashes
-night sweats
-irregular periods
-loss of libido

97
Q

post menopause

A

-increased risk of osteoperosis
-artery disease
-UTI

98
Q

Therapeutic management for menopause

A

-yoga
-counseling
-hanging out with people going through menopause as well
-wearing loose clothing
-exercise
-avoid spicy foods
-adequate hydration
-reduce alcohol consumption