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Families Final > OB Lecture 6 Review > Flashcards

OB Lecture 6 Review Flashcards

1
Q

Cultural consideration:

A

Culture: a view of the world and a set of traditions a specific social group uses and transmits to the next generation

i. Transcultural nursing
ii. Cultural values
iii. Culture-specific versus culture universal values
iv. Ethnicity
v. Race
vi. Diversity

Sexual orientation - Heterosexual, homosexual, bisexual

Gender identity - Inner sense a person has of being male or female
i. May be same or different from sex assigned at birth

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2
Q

Taking a sexual history

A

Taken by nurses- Can be on admission, in the ER, or clinics

Includes:
Effective communication
Asking the difficult questions, must be asked
1.	Are you sexually active?
2.	LMP
3.	Use birth control?
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3
Q

Menstration history?

A

i. Age of Menstruation? (age of first period)
ii. Cycle Length ? (every 28 days)
iii. Amount of Flow
iv. How long is period ? (5-7 Days)

Definitions

  1. Amenorrhea-The absence of menses
  2. Dysmenorrhea-Painful periods
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4
Q

Types of contraception

A

Barrier Methods -Condoms, Diaphragm, and Vaginal Sponge

Long Acting Reversible Contraception-

  1. Intrauterine Contraception (IUC)-left in place for 3-10 years
  2. Nexplanon-single capsule implant inserted subdermally in women’s nondominant upper underarm-effective for 3 years

Hormonal

  1. Oral Contraceptive birth control pills
  2. Contraceptive skin patch –Skin patch weekly for 3 weeks
  3. NuvaRing- Vaginal contraceptive ring-left in vaginal for 3 weeks
  4. Depo-Provera-injection every 3 months
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5
Q

PMS

A

Symptoms 2 weeks prior to the onset of period
1. The symptoms repeat at the same time each month
2. Pronounced 2-3 days before period begins
3. Cause unknown
4. Symptoms include:
Psychologic-Irritable, lethargy, depression, anxiety
Neurologic-migraines, vertigo
Dermatologic-Acne
Mammary-Swelling and tenderness
5. Usually most women experience some of these symptoms

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6
Q

Women’s Health

What is included?

A

Breast self Examination-
Mammogram 45, and then yearly until 54, then every other year

Pap Smear (Pelvic-Screening has changed)

Menopause is defined as the absence of menses for a full year- Median age 50-51

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7
Q

Bacterial Vaginosis
S/S?
Treatment?

A
  1. not a sexually transmitted disease
  2. Vaginal discharge with a foul odor
  3. Treatment Flagyl orally
    a. NO ALCOHOL while on Flagyl
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8
Q

Flagyl

A

used for Bacterial vaginosis
NO ALCOHOL while taking!
Turns urine a color

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9
Q

Candidiasis
s/s?
treatment?

A
  1. Yeast infection most common
  2. Discharge is usually white, curdy, and itching
  3. Treatment OTC-Monistat 7 or oral Diflucan
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10
Q

What are the reportable STI’s?

A

Syphilis, Gonorhea, and Chlamydia

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11
Q

Chlamydia

A
  1. Chlamydia is the most common STI in the U.S.
    b. Can lead to PID, ectopic pregnancy and infertility
  2. Usually no symptoms
  3. Vaginal discharge can be thin and purulent, and burning
  4. Treatment is 1 gram of azithromycin/ or doxycycline for 7 days.
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12
Q

Gonorrhea

A
  1. Caused by the bacteria Neisseria gonorrhoeae.
    b. If a non-pregnant female contracts the disease, she is at risk of developing PID.
    c. Pregnant-and delivers, can cause blindness to the newborn if not treated.
  2. Usually no symptoms, can have greenish, yellow discharge
  3. Treatment Ceftriaxone 250mg IM and Azithromycin 1 gram orally
    a. Needs to have repeat cultures at 3 months because of the risk of infections.
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13
Q

Herpes

A
  1. 2 types,
    a. HSV-1 is a cold sore
    b. HSV-2 genital infections - If a woman has an active case of HSV-2, delivering vaginally can be fatal for the newborn.
  2. Primary episode is Painful blister like vesicles. The vesicles may appear within a few hours to 20 days after the exposure.
    a. Lesions heal in 2-4 weeks
    i. After lesion heal, the virus enters a dormant phase
    ii. Some never have a recurrence, other have regular outbreaks
  3. No known cure- treatment is acyclovir, Valacyclovir, and famciclovir.
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14
Q

Syphilis

A

2 means of transmission

a. Sexual
b. Vertical-from infected mother to her unborn baby via the bloodstream

If left untreated Syphilis progresses into 4 stages:
1. Primary- one or more chancres appears (highly infectious)
2. Secondary-Mucocutaneous lesion can occur-
May be on the palm of hands or soles of feet, typically appear on trunk
Symptom clear within 2-6 weeks
Patient is highly infectious
3. Latent
Early Latent -Patient has a reactive nontreponemal test, but no symptoms; May have primary and secondary signs
Late Latent + Nontreponemal and treponemal test onset can not be determine
4. Tertiary Stages
Manifestation in skin and bones & cardiovascular system
Patient is not infectious

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15
Q

neurosyphilis

A

Is a site of infection and can occur at any stage of syphilis.

The nervous system is infected within hours after infection, however it can take weeks or years before symptoms are present

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16
Q

congenital syphilis

A

All pregnant women should be tested at their first prenatal visit- requirement by the law of the state

17
Q

testing and treatment of syphilis

A

Testing is from a blood sample
Other STIs usually only require a culture, this one a blood test!
1st test- nontreponemal test
1. VDRL-Venereal Disease Research Laboratory or
2. RPR-Rapid Plasma Reagin test (if these test are reactive then the 2nd test is completed
2nd Treponemal test FTA-ABS test, the TP-PA assay
The fluorescent treponemal antibody absorption (FTA-ABS) test is a diagnostic test for syphilis. Using antibodies specific for the Treponema pallidum species

Treatment

a. depends on stage, however usually with Penicillin G
b. This is reported condition to the health department, then to the state, then to CDC

Reportable STIs: Syphilis, Gonorhea, and Chlamydia

18
Q

HPV

A

HPV is the leading cause of cervical cancer

No symptoms of cervical cancer, that is why it is important for PAP smears

a. Can produce venereal warts
b. Abnormal Pap Smear

2 vaccines are now available for HSV 16 & 18 which cause 70% of cervical cancer
a. Gardasil
b. Cervarix
The CDC recommends both girls and boys receive a 3 dose vaccine before they are sexually active
Age 11-12

19
Q

Pelvic Inflammatory Disease (PID)

A

Inflammatory disorder of the upper female genital tract that includes endometritis, salpingitis, ovarian abscess, pelvic abscess and pelvic peritonitis.

The organism most identified with PID are Trichomoniasis and gonorrhea.
Can be chlamydia

The greatest problem with PID is post infection tubal damage.

This disease is more common in sexually active women younger than 25

Symptoms- abdominal pain, cramping, fever, chills, purulent vaginal discharge, or no symptoms

Diagnosis is based on examination, cultures, CBC, VDRL

Treatment

  1. Need antibiotics.
  2. Can be admitted for IV antibiotics

Families Final (3 decks)

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