OB Chapters 3&4 Flashcards
1
Q
eggs are also called
A
ova
oocytes
2
Q
breast includes
A
accessory organs
nipple
areola
lobes
alveolar and lactiferous glands
3
Q
lobes in the breast are for…
A
lubrication
4
Q
engorged breast causes
A
mastitis (inflammation of breast tissue that can lead to infection)
5
Q
mastitis treatment
A
-antibiotics given to prevent patient from being septic
-can continue to breastfeed, considered safe
6
Q
mastitis S/S
A
flu like symptoms
-fever
-chills
-shivers
-body aches
-sweating
7
Q
engorged breasts caused by
A
not breastfeeding every 2-3 hours
8
Q
interventions for engorged breasts
A
-pump breast milk
hot compress or put under hot water
9
Q
ovarian cycle
A
-1 million oocytes at birth
-200K-400K by puberty
-age 35: fewer than 100K
10
Q
ovulation cycle
A
-occurs on the 14th day
-temp rises 0.5-1 degree F
11
Q
ovum lifespan
A
24 hours
12
Q
sperm can live in female body for up to
A
3-5 days
13
Q
menstruation is
A
-expulsion of uterine lining occuring monthly
-marks the beginning and end of each menstrual cycle
14
Q
mencarche is…
A
establishment of menstruation in females
15
Q
menopause
A
period ends
16
Q
menstrual disorders include
A
-ammenorhea
-dysmenorrhea
-abnormal uterine bleeding
-premenstrual syndrome
-premenstrual dysphoric disorder
-endometriosis
17
Q
amenorrhea
A
absence of a period
18
Q
dysmenorrhea
A
painful period
19
Q
abnormal uterine bleeding (AUB)
A
excessive bleeding
20
Q
Premenstrual syndrome (PMS)
A
mood swings
21
Q
Premenstrual Dysphoric Disorder (PMDD)
A
severe PMS that can lead to depression
22
Q
endometriosis
A
thickening of the uterine lining
23
Q
endometriosis complications
A
-infertility
-scarring tissues around uterus
-difficulty for sperm and egg to penetrate through scarring tissue
24
Q
PMS and PMDD tool
A
A.C.D.H.O
25
A.C.D.H.O
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)
26
TX for PMS & PMDD
exercise
vitamins
B6 supplements
analgesics (if needed)
eating well
Magnesium (lowers cortisol levels and balances progesterone)
27
Infertility
inability to conceive a child within 1 year of regular unprotected sex
28
infertility causes
-some medications
-abortions
-amenorrhea
-substance abuse
-obesity
-PCOS
-endometriosis
29
fertility drugs
-clomephine citrate (clomid)
-human menopausal gonadotropin (HMG/Pergonal)
Artificial insemination
30
clomephine citrate method of action
-NONsteroidal synthetic antiestrogen used to induce ovulation
-typically D/C'ed after 3 cycles
31
HMG (Pergonal) method of action
induces ovulation by direct stimulation of ovarian follicle
32
Infertility Diagnostic Procedures for females
-assess uterine/vaginal anomalies
-hormone analysis
-postcoital test
ultrasound
-hysterosalpingography
-hysteroscopy
-laparoscopy
33
Infertility Diagnostic Procedures for Males
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
34
Infertility Diagnostic tests nonspecific
-home ovulation predictor kit
-clomiphene citrate (clomid) challenge test
-hysterosalpingogram
-laparoscopy
35
nursing interventions
-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%
36
Contraception types
-behavioral
-hormonal
-barroer
-permanent
37
Behavioral Method
-abstinence
-fertility awareness (cervical mucus ovulation method, basal body temperature, symptothermal method, standard days method, 2 day method)
-withdrawal
-lactational amenorrhea method
38
cervical mucus ovulation method
jelly like discharge, making it easier for sperm to travel
39
basal body temperature (BBT)
-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
40
Symptothermal method
-combination of cervical discharge method and BBT
41
Standard Days Method
most fertile during days 8-19 of ovulation cycle (+/- 5 days from day 14)
42
2 day method
no vaginal discharge for 2 days
43
withdrawal (coitus interruptus)
pull it out!
44
Lactational amenorrhea method
if continuously (solely) breastfeeding, CANNOT GET PREGNANT. if you are breastfeeding/formula feeding together, CAN GET PREGNANT
45
Barrier Methods
-female condoms
-male condoms
-diaphragm
-cervical cap
-contraceptive sponge
46
Female Condoms
-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
Male condoms
-protects against STI
-sheath made of latex or plastic
-latex condom is 98% effective
48
Diaphragm parameters
-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
diaphragm cons
does not protect against STI
50
Diaphragm works by...
-placed in vagina against cervix to keep sperm from joining with egg
-contains spermicide
51
Cervical Cap
-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
Contraceptive Sponge
-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
Toxic Shock Syndrome (TSS)
complication d/t certain bacterial infections
54
TSS S/S
-fever
-abdominal pain
-vomiting
-dizziness
-diarrhea
-weakness
-change in LOC
55
Hormonal Methods of BC
-pill (oral contraceptive)
-depo provera injection
-transdermal patch
-nuva ring
-minipill
-long acting reversible contraceptive (LARCs)
56
oral contraceptive
-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
Oral Contraceptive Benefits
-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
oral contraceptives contraindication
-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
hormonal methods
-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
Signs of potential complications of oral contraceptives
A.C.H.E.S
61
A.C.H.E.S stands for
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
Depo Provera Injection
-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
Depo injection side effects
-weight gain
-depression
-acne
-can take up to 9 months for menstrual cycle to return back to normal
64
Transdermal Patch
-prescription for of BC
-releases hormones that prevents the release of eggs and prevent sperm from joining with egg
65
Transfermal Patch parameters
-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
nuvaring
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
nuva ring side effects
-ring odor
-can get exposed (fall out)
-increase vaginal discharge
67
minipill
-prosterone only
-low dose
-fewer adverse effects
-OK to take during breastfeeding
-no protection against STIs
68
Long acting reversible contraceptives (LARCs)
-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
hormonal IUD lasts for
3-7 years
69
copper IUD...
-non hormonal IUD
-causes heavy bleeding
-lasts up to 10 years
70
If LARC string is not found
go to doctor, may have dislodged and must be replaced
71
Warning signs for intrauterine device complications
think PAINS
72
PAINS
P - period irregularities
A - abdominal pain (dyspareunia)
I - infection (abnormal discharge)
N - not feeling well
S - string missing
73
Emergency contraception
-can be taken within 72-120 hours after sex
-prevents implantation, will not disrupt already implanted pregnancy
74
EC types
-Plan B One Step
-ulipristal acetate (UPA) pills (brand name Ella)
75
Plan B one step
-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
Ulipristal acetate pill (UPA)
-ella brand name
-prescription only
-up to 120 hours
-one time dose of 30 mg r
77
Permanent Contraception Females
-tubal ligation
-hysterectomy
78
tubal ligation
-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
PERMANENT CONTRACEPTION MALES
-vasectomy
80
vasectomy
-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
Abortion
-purposeful interruption of pregnancy 20 weeks before gestation
82
Abortion types
-elective
-spontaneous (miscarriage)
83
why is it only considered abortion before 20 weeks?
-fetus is not considered viable until 20 weeks
84
Abortion Methods
-medication mangement
-Dilation and Evacuation (D&C)
-vacuum aspiration
85
abortion medication method
-2 medications taken
-First is mifepristone tablet 200 mg
-misoprostol (cytotec) taken 24-48 hours after mifepristone
86
Mifepristone does what
stops baby from growing
87
misopristol does what
contracts uterus to expel fragments
88
Dilation and Evacuation Method (D&C)
-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
Vacuum Aspiration
-most common procedure
-local anesthesia
-cervix not dilated
90
post vacuum aspiration instructions
-tell woman to contact provider for fever greater than 100.4F
-chills
-heavy bleeding
-foul smelling discharge
-severe abd. pain
abd. tenderness
91
D&C complications
-infections
-retained tissue or hemorrhage
-uterine perforation
-retained products of conception
-cervical tear
92
Medically treated abortion
-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
Menopause stages
1. premenopause
2. perimenopause
3. menopause
4. post menoapause
94
prepmenopause S/S
-cramps
-anxiety
-mood swings
-artery disease
-irritability
-nausea
95
perimenopause
-mood swings
-hot flashes
-night sweats
-vaginal dryness
-irregular periods
-loss of libido
96
menopause
-hot flashes
-night sweats
-irregular periods
-loss of libido
97
post menopause
-increased risk of osteoperosis
-artery disease
-UTI
98
Therapeutic management for menopause
-yoga
-counseling
-hanging out with people going through menopause as well
-wearing loose clothing
-exercise
-avoid spicy foods
-adequate hydration
-reduce alcohol consumption
