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Repro > Repro Exam 1 > Flashcards

Repro Exam 1 Flashcards

1
Q

Sexual response phases

A

motivation, arousal, genital congestion, orgasm, resolution

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2
Q

motivation

A

desire, libido

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3
Q

what can motivation be affected by?

A

medications, personality, temperament, medical conditions, lifestyle, environmental stressors

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4
Q

arousal

A

a state of release of neurotransmitters

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5
Q

genital congestion

A

increased blood flow, clitoral swelling and vulval engorgement, vaginal lubricaiton; in males, erection

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6
Q

orgasm

A

rapid contraction of pelvic muscles

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7
Q

resolution

A

wellbeing, neurotransmitters prolactin, ADH, oxytocin, final stage of sexual response cycle

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8
Q

What populations are at risk for sexual dysfunction

A

adolescents, newly unpartnered, gender minorities, disabled

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9
Q

why are adolescents at risk for sexual dysfunction

A

sense of being invincible and are likely to engage in risky behaviors, have a lack of knowledge and lack of resources

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10
Q

Why are newly unpartnered at risk of sexual dysfunction

A

sudden lifestyle changes may increase # of partners

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11
Q

Why are gender minorities (LGBTQIA+) at risk for sexual dysfunction

A

reluctance to seek care due to embarrassment or fear of judgement; fear of disclosing information

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12
Q

Why are disabled at risk for sexual dysfunction?

A

ignorance, poor decision making, developmental issues

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13
Q

Risk factors for sexual dysfunction

A

risky behaviors, STIs, IPV, substance use, underlying medical conditions, medications, (anticonvulsants, antidepressants, antipsychotics, diuretics, narcotics), anything that can sedate or cause hypotension

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14
Q

sexual acts

A

behavior that includes the genitalia and erogenous zones

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15
Q

sexual identity

A

biological sexual characteristics of male or female, what you were born as/with

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16
Q

HPV vaccine

A

receive in teen years up to 26 years old

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17
Q

health disparities

A

housing and neighborhood environment, economic stability, access to health care and quality of care, access to and quality of education, community, and social context (including impact of racism)

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18
Q

interventions for access?

A

grant, how to get patients to appointments, advocate, reach out to social workers, discuss with nurse manager ways to get them back to appointments

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19
Q

5 P’s for health assessment

A

partners: # of partners and gender of partners
practices: safe sex practices or methods
protection: what are you using for protection from infection? condoms? getting tested?
past history of infection
prevention of pregnancies: what are you using as a contraceptive method

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20
Q

sexual history should include

A

Menarche
Menstruation
Pregnancy
Menopause
Contraception

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21
Q

menarche

A

first period

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22
Q

menstruation

A

every 28 days; when was your last menstrual period

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23
Q

menopause

A

12 months after last menstrual period = menopause

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24
Q

When asking about pregnancy….

A

how many times they’ve been pregnant, includes miscarriages

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25
Q

menopause charcteristics

A

hot flashes, night sweats, vaginal dryness, painful sex, urogenital atrophy

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26
Q

what can you do for menopause

A

HRT…

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27
Q

Who is HRT contraindicated for?

A

use with caution in pts with cardiovascular disease, DVT, breast cancer

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28
Q

What can you educate pts to do instead of using HRT?

A

CAMs: vitamin E, hypnosis, CBT, deep breathing, guided imagery, herbal therapies, weight loss

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29
Q

3 types of menopause

A

biological - average age of 52
surgical - oophrectomy or medical ablation of ovaries
premature - ovarian failure before age 40

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30
Q

What can cause biological menopause to occur earlier?

A

smoking or if have shortened cycles

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31
Q

hormonal response to menopause

A

there is no E2 production (follicle depletion) which increases FSH but there is no period

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32
Q

climacteric phase

A

transition phase where ovarian function and hormone function decline

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33
Q

adolescents seek care when

A

there’s a problem or for contraception, pregnancy

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34
Q

young/middle adult health promotion

A

pelvic and breast screening and healthy lifestyle promotion; 21 for first pap smear; new onset of chronic diseases at 35, empty nest syndrome = depression

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35
Q

late reproduction age health promotion

A

breast and ovarian cancers are more prominent; encourage screening
high divorce rates = trying new partners

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36
Q

barriers for seeking health promotion

A

financial, cultural, environmental

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37
Q

financial barrier

A

delays seeking care

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38
Q

cultural barrier

A

lack of trust, language barrier, experiences with discrimination

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39
Q

desired health outcomes for cultural barriers

A

HCP has knowledge + understanding of culture, language, values, priorities, health beliefs of those in various ethnic groups

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40
Q

environmental barriers

A

are HCP or centers easily accessible?

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41
Q

cultural knowledge is

A

beliefs and values that guide thinking, decisions, and actions of the family
passed from one generation to the next, influences health behaviors

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42
Q

cultural issues will affect

A

childbearing beliefs and practices, personal space, time and orientation, family roles (who will be their support during childbirth)
ASK OPEN ENDED QUESTIONS

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43
Q

gender issues

A

LGBTQ feel stigmatized, heterosexuality is often assumed-ask how they prefer to be addressed

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44
Q

gender minority

A

individuals whose gender identity (what they identify as) or expression (masculine, feminine, other) is DIFFERENT from their sex at birth

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45
Q

gender concordance

A

patient’s gender matches the providers gender

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46
Q

sexual orientation

A

persons emotional and sexual attraction to another person + behavior and/or social affiliation that comes with this attraction (gay, lesbian)

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47
Q

T/F women who have kids are at a higher risk for cancer

A

False; women who have not had kids are at higher risk

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48
Q

IPV

A

includes actual or threatened physical, sexual, psychological, emotional, stalking abuse by intimate partner

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49
Q

what actions should you take with a patient experiencing IPV

A

screen her alone
provide hotline number (put # in as co-worker or friend)
be discreet (don’t give pamphlets)
ask if you can involve social worker or police

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50
Q

S/S of IPV

A

missed appointments, partner will not leave patient, unexplained wounds, incongruent injury with given story, depression, anxiety, victim saying she deserved it or provoked partner

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51
Q

Moral distress

A

occurs when a person knows the ethically correct action but is unable to do it and it threatens our core values
(you know this is right/wrong and causes you stress)

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52
Q

ANA code of ethics describes

A

the goals, values, and obligations of nursing

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53
Q

ethical principles

A

Beneficence
Nonmaleficence
Fidelity
Veracity
Autonomy
Justice

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54
Q

Ethical dilemmas in the care of women and children:

A

the mom who refused treatment (chemo) in order to have a healthy fetus; terminating a severely abnormal fetus

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55
Q

Black women and pregnancy

A

they have a 3-4 x higher maternal mortality rate and two time higher rate of complications

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56
Q

EBP definition

A

Integrate best current evidence with clinical ­expertise and patient/family preferences and values for delivery of optimal health care.

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57
Q

evidence-based decision making should include consideration of:

A

best research evidence, clinical resources, and patient values

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58
Q

infant mortality

A

death occurs during the first year of life and is an important summary reflecting social, political, health care delivery, and medical outcomes in a geographic area for 1000 live births

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59
Q

neonatal mortality

A

death of a live birth between birth and < 28 days

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60
Q

autonomy

A

respect parental decisions, facilitate communication and collaboration

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61
Q

quality of life

A

what are the long term complications and care?

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62
Q

fidelity

A

being accountable and responsible, loyal to commitments

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63
Q

veracity

A

being truthful

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64
Q

autonomy

A

self-determination

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65
Q

justice

A

allocation of resources and use of resources equitably

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66
Q

what are the most prevalent factors in decision making and problem solving for families?

A

values and beliefs

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67
Q

Ovarian cycle

A

follicular, ovulation, luteal

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68
Q

endometrial (uterus) cycle

A

menstrual, proliferative, secretory

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69
Q

hormones

A

progesterone, estrogen, LH, FSH

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70
Q

male and female condoms protect against

A

STI, may need to use spermicide

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71
Q

diaphragm

A

place 6 hours before intercourse and must remain in place for 6 hours after intercourse, risk for toxic shock syndrome

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72
Q

combo oral contraceptive

A

suppresses ovulation through hormones; patient must take same time every day (one missed dose can lead to pregnancy)

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73
Q

who are Combo contraceptives contraindcated for?

A

clots, cancer, CAD

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74
Q

what are off label uses for COC

A

acne, endometriosis, dysmenorrhea, reduced risk of endometrial and ovarian cancer and benign breast disease, anemia

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75
Q

Side effects of COC

A

ACHHESS
abdominal pain: indicates problem with liver or gallbladder
chest pain or SOB: indicate clot problem
headaches (sudden or persistent): HTN or cerebrovascular accident
hemoptysis
eye problems
severe leg pain: thromboembolic process
slurring of speech: possible sign of stroke

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76
Q

Fertility awareness method

A

periodic abstinence, keep a journal or the beads, strict record keeping

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77
Q

COC are less effective when taken with

A

antibiotics or anticonvulants

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78
Q

progestin only

A

for lactating women

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79
Q

nexplanon

A

most effective, lasts up to 3 years
may cause irregular bleeding

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80
Q

depo

A

lasts 12 weeks, safe for breastfeeding women

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81
Q

what is a downfall of the depo injection?

A

return to fertility is about 1 year, do not give to menopausal women b/c can cause osteoporosis-give Ca supplement

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82
Q

IUD complications

A

PAINS
period irregularities
abdominal pain with intercourse
infection exposure
not feeling well
strings missing, STI risk which can cause PID

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83
Q

emergency contraceptives

A

use w/in 72-120 hours

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84
Q

Can IUD be used as emergency contraceptive?

A

Yes

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85
Q

how old do you have to be to have tubal ligation or vasectomy?

A

21+

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86
Q

Abortion

A

purposeful interruption of pregnancy before 20 weeks either elective or therapeutic

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87
Q

indications for abortion

A

woman’s request, genetic disorder of fetus, rape/incest

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88
Q

abortion in 1st trimester

A

surgical aspiration, meds (methotrexate, misoprostol, mifepristone)

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89
Q

abortion in 2nd trimester

A

D & E, prostaglandins

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90
Q

Risks associated with abortion

A

infection, retained products, bleeding, emotional concerns

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91
Q

nursing care for abortion 1st trimester

A

tell pt. to return to HCP or ER with:
fever 100.4
foul smelling discharge
bleeding greater than 2 saturated pads in 2 hrs or heavy bleeding lasting a few days
severe abdominal pain, backache, cramping
abdominal tenderness when pressure applied

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92
Q

oopherectomy

A

removal of ovaries

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93
Q

hysterectomy

A

removal of uterus

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94
Q

vasectomy teaching

A

use a backup method of contraception until semen analysis shows no sperm

95
Q

perimenopause

A

4 years leading up to menopause
irregular cycle, menopausal symtpoms, endometrial hyperplasia

96
Q

HRT risk

A

VTE

97
Q

management of menopause

A

weight loss, fans, avoid triggers, vitamin E, CBT, support groups

98
Q

T/F anticonvulsants reduce the effectiveness of OC

A

True

99
Q

the absence of a temperature increase during cycle indicates

A

no ovulation during that cycle

100
Q

When assessing a woman using the calendar method of birth control, what should you ask?

A

obtain a hx of the woman’s menstrual cycle lengths for the past 6-12 months

101
Q

s/s of TSS

A

sudden onset of fever over 38.4° C, hypotension, rash

102
Q

can you use a diaphragm during menses?

A

No

103
Q

tubal ligation patient teaching

A

highly unlikely you will become pregnant, offers no protection against STIs

104
Q

prostaglandins

A

a hormone that oxygenates fatty acids; affects ovulation, fertility, changes in cervix and mucus, tubal and uterine motility, menstruation, miscarriage, and labor

105
Q

HPV s/s

A

multiple painful lesions, fever, chills, malaise, severe dysuria, irritating vaginal discharge with itching, dyspareunia and postcoital bleeding

106
Q

How do you prevent HPV

A

vaccine and abstinence

107
Q

when should you get HPV vaccine?

A

age 11-26, not recommended if older than 26

108
Q

treatment for HPV

A

laser ablation, cryotherapy, TCA or patient may apply topicals

109
Q

risk factors for breast cancer

A

age, family history, BRCA gene, obesity, alcohol, sedentary lifestyle, birth control

110
Q

primary prevention for breast cancer

A

mastectomy + oophorectomy: indicated for high-risk patients

111
Q

secondary prevention for breast cancer

A

mammogram yearly 40-44,
45-54 yearly screening highly recommended,
55+ screen every other year or yearly if they’re in good health
self-exam monthly

112
Q

s/s of breast cancer

A

change in breast size or shape, skin dimpling, recent nipple inversion or skin abnormalities. single-duct discharge (may be bloody), axillary lump

113
Q

non-modifiable risk factors of breast cancer

A

age, previous hx of breast cancer, immediate family hx of breast cancer, inherited BRCA1 and BRCA2 gene mutations, previous hx of ovarian, endometrial, colon or thyroid cancer, high breast tissue density, early menarche, late menopause (after 55)

114
Q

Modifiable risk factors for breast cancer

A

nullparity OR first pregnancy after 30
not breastfeeding
use of estrogen-progestin replacement therapy postmenopausal, obesity after menopause, >1 alcoholic drink/day, sedentary, low vitamin D

115
Q

Medical mgmt of breast cancer

A

radiation, chemo, hormone therapies

116
Q

Patient education for post-surgery (breast cancer)

A

avoid driving or lifting more than 10 lbs
take pain meds as soon as the pain begins
perform arm exercises as directed
Call HCP if the inflammation of incision or swelling of incision or arm
Avoid tight clothing, tight jewlery or anything decreasing circulation of affected arm

117
Q

Nursing care for post-surgery breast cancer

A

do not take blood pressure, give injections, or draw blood from the arm of the affected side
inspect and drain incision site
sponge bath for first 48 hours and then shower
pain management

118
Q

emotional effects of malignant neoplasm of breast in women

A

concerns about appearance after breast surgery
nurses can help communicate feelings and concerns about accepting changes

119
Q

what is the most common cause of cervical neoplasia?

A

HPV

120
Q

If HPV lesions are present at birth, what might need to happen

A

C-section

121
Q

Which types of HPV are highly oncogenic?

A

Type 16, 18, 45-highest risk of causing cancer of the cervix, vagina, vulva, penis, orphayngeal area

122
Q

Cervical cancer risk factors

A

HPV
family hx
smoking
suppressed immune system
sex at a young age
multiple sex partners
chlamydia infection
long term use of oral contraceptives/IUD use

123
Q

Cervical cancer screening

A

Pap screen Q3 year or HPV combo test Q5 years

124
Q

s/s of cervical cancer

A

abnormal vaginal bleeding, vaginal discomfort, malodorous discharge, dysuria

125
Q

treatment for cervical cancer

A

surgery, radiation, chemo

126
Q

diagnostics for cervical cancer

A

colposcopy or cervical biopsy

127
Q

Infertilty (definition)

A

couples who have not achieved pregnancy after 1 year of regular, unprotected intercourse when the woman is less than 35 years of age OR after 6 months when the woman is older than 35 years of age

128
Q

What are the cervical factors affecting fertility?

A

infections, abnormalities in mucus

129
Q

What are the uterine factors affecting fertility?

A

anomalies and fibroid tumors

130
Q

What are the ovarian factors affecting fertility?

A

anovulation and medications

131
Q

What are the tubal factors affecting fertility?

A

anomalies and endometriosis

132
Q

Other female factors influencing fertility

A

nutritional deficiencies, obesity, thyroid dysfunction

133
Q

Male factors affecting fertility

A

congenital disorders, excess androgens, estrogen, cortisol, drug/substance abuse, endocrine disorders

134
Q

Testicular factors affecting fertility

A

undescended tested, hypospadias, varicocele, torsion, STI, trauma

135
Q

factors affecting sperm transport

A

drugs, ejaculatory dysfunction, premature ejaculation, idiopathic

136
Q

Female infertility assessment

A

obstetric hx, menstrual history, pelvic exam, bimanual exam

137
Q

Female infertility diagnostics

A

FHS, serum progesterone level check, HST, hysterosalpingogram-contrast sonography

138
Q

Males infertility assessment

A

medical history, urologic exam

139
Q

Male infertility diagnostics

A

semen analysis, sperm penetration assay, scrotal ultrasound, hormone analysis, testosterone, gonadotropin, FSH, LH

140
Q

Medications for infertility

A

clomiphene
letrozole
metformin
HMG, FHS, HCG

141
Q

clomiphene

A

ovulation induction

142
Q

letrozole

A

ovulation induction

143
Q

metformin

A

restores cyclic ovulation

144
Q

Assistive reproductive therapy

A

IVF, GIFT< ZIFT, ovum transfer, TDI, embryo hosting, embryo hatching

145
Q

Alternatives to infertility

A

adoption, surrogacy, cryopreservation

146
Q

education for HPV

A

use a condom/physical barrier to prevent transmission and have an annual pap smear
reinfection can occur w/ repeated contact
annual pap if you woman has been treated for HPV

147
Q

primary infertility

A

couple has never achieved pregnancy

148
Q

secondary infertility

A

inability to conceive after a previous pregnancy

149
Q

What does a hysterosalpingogram (HSG) and hysterosalpingo-contrast sonography test for?

A

uterine abnormalities

150
Q

what does serum progesterone test for?

A

ovulation and assesses adequacy of corpus luteum progesterone production

151
Q

cervical mucus assessment

A

tests ovulation-during ovulation, expect cervical mucus to have low vicosity + ability to stretch

152
Q

basal body temperature

A

tests for uterine abnormalities

153
Q

Can use of non-water soluble lubricants, wearing briefs, and increase hot tub + sauna use be a cause of male infertility?

A

Yes

154
Q

sperm penetration assay measures…

A

ability of sperm to penetrate egg

155
Q

semen analysis….

A

detects ability of sperm to fertilize egg-evaluates testosterone, gonadotropin, FSH, LH-need to be abstinent for 2-7 days

156
Q

Non-medical treatment for infertility (woman)

A

lifestyle changes
abstinence from alcohol, nicotine, recreational drugs
If BMI <17, advise weight gain or address eating disorders/intense exercise regimen
if overweight, advise weight loss

157
Q

Assistive reproductive therapies (ART)

A

remove eggs from woman, fertilize egg in lab, return embryo to women or surrogate carrier-may need to take drugs to stimulate ovulation before ART

158
Q

Nursing considerations for infertility

A

can affect couples giving and receiving physical and sexual closeness
Nurses should be comfortable with their own sexuality, have good therapeutic communication and interviewing, sensitive to nonverbal cues and knowledgeable about couples sociocultural and religious belief

159
Q

nursing care for infertility

A

provide couples with accurate info and dispel myths
help couple and health care team identify and treat possible causes of infertility, provide emotional support,
EDUCATE about other options: IVF, surrogacy, donor egg or semen, adoption
teach women to take folic acid supplements and up to date on immunizations to prepare for possible pregnancy

160
Q

Treatments for HPV

A

imiquimod, podophyllin, podofilox

161
Q

What diagnostic test is used to confirm a suspected diagnosis of breast cancer?

A

needle aspiration and biopsy

162
Q

When in her cycle should a woman perform a self-breast exam?

A

5-7 days after menses ceases

163
Q

What should women not do 24-48 hours before a pap test

A

douche, use vaginal medication, have sexual intercourse

164
Q

fatty acids classified as hormones that are found in many body tissues and that have roles in many reproductive functions are known as

A

prostaglandins (PGs)

165
Q

microscopic examination of scrapings from the cervix, endocervix, or other mucus membranes to detect premalignant or malignant cells is called

A

Pap Smear (papanicolaou)

166
Q

a woman who is older than 35 may have difficulty getting pregnant primarily because

A

her ovaries may be affected by the aging process

167
Q

IVF-ET

A

a type of ART that involves collecting the eggs from the ovaries, fertilizing them in the lab and then returning them to the uterus

168
Q

biophysical risk factors for reproduction

A

Altered or mutated genes, inherited disorders, chromosomal anomalies, multiple gestations, large fetal size, ABO incompatibilities
Nutritional concerns and medical and/or obstetric disorders

169
Q

Psychosocial risk factors for reproduction

A

Smoking, excessive caffeine, alcohol, drug abuse, spousal abuse, addictive lifestyles
maternal emotional well-being

170
Q

Sociodemographic risk factors for reproduction

A

Low income, inadequate prenatal care, age at both ends of the spectrum reproductive years, parity, marital status, geographic location, race and ethnicity

171
Q

Environmental risk factors for reproduction

A

Industrial pollution, radiation, chemical exposures, bacterial and viral infections, drugs (OTC, therapeutic, illicit) stress

172
Q

Cervical cancer screening: who should get it?

A

Women older than 65 can stop cervical cancer screening if they have not had any precancerous cells found in previous 10 years

Total hysterectomy can stop screening unless the hysterectomy was due to cervical precancer or cancer

Women who have received HPV vaccine still need to get screened

Pap test every 3 years for starting at 21; 30 and older, a pap test and HPV test together every 5 years

may discontinue testing at 65 if regular screenings have been negative

173
Q

Chlamydia test: who should get it?

A

if sexually active, yearly until age 24, yearly ages 25 + if new partner or multiple partners

174
Q

Menstrual Cycle

A

Follicular phase: First day of menstruation and lasts 12-14 days.

Ovulatory phase: begins when estrogen levels peak and ends with the release of a oocyte (egg). The release of the egg is called ovulation

Luteal phase: begins after ovulation and lasts approx. 14 days

175
Q

hysterectomy options

A

total hysterectomy
subtotal hysterectomy
bilateral-salpingo-oophrectomy
panhysterectomy
radical hysterectomy

176
Q

total hysterectomy

A

uterus and cervix removed

177
Q

subtotal hysterectomy

A

uterus is removed, cervix is not

178
Q

bilateral-salpingo oophrectomy

A

ovaries and fallopian tubes are removed

179
Q

panhysterectomy

A

uterus, ovaries, cerivx, and fallopian tubes are removed

180
Q

radical hysterectomy

A

uterus, cervix, upper part of the vagina, and adjacent tissue (including lymph nodes) are removed

181
Q

Gravida

A

of pregancies regardless of outcome

182
Q

Term births

A

births after 37 weeks gestation

183
Q

preterm births

A

births between 20-36 weeks gestation

184
Q

Abortion

A

any pregnancies that ended prior to 20 weeks gestation

185
Q

G =

A

T + P + A

186
Q

T/F twins/triplets/etc = 1 pregnancy

A

True

187
Q

What are the least effective contraceptive methods?

A

barrier, natural family planning

188
Q

What are the nursing interventions that facilitate contraceptive use?

A

provide info and instructions and help pts make decisions

demonstrate and supervise return demonstration to ensure understanding

189
Q

Assessment for contraceptive use should include?

A

medical + reproductive hx + family hx
sexual hx of dysfunction and STI hx/treatment
pap test + results, reproductive cancers
problems with uterine support

190
Q

menstrual hx

A

age of menarche
age of menopause
menstrual problems

191
Q

natural family planning

A

Advantages: no contraindications or side effects

Disadvantages: must have a regular menstrual cycle and have knowledge or willingness to frequently monitor body functions: temperature, as well as vaginal mucus production and consistency. Does not protect agains STIs

192
Q

Withdrawal

A

Advantages: no cost or contraindications

Disadvantages: does not protect against STIs, disrupts sexual intercours

193
Q

Lactation Amenorrhea method

A

Advantages: no cost or contraindications

Disadvantages: requires exclusive breastfeeding or infant suckling; using a barrier method with LAM increase effectiveness

194
Q

condoms

A

Advantage: readily available, protects against STIs, no systemic effects

Disadvantage: allergic reactions may occur, higher rate of protection when combined with a spermicide, must be applied at time of coitus and may be considered disruptive

195
Q

Vaginal sponges

A

Advantages: one-time use, may be placed before intercourse, may leave in for up to 30 hours, protects repeated acts of intercourse

Disadvantages: must be left in for at least 6 hours postintercourse; irritation, discomfort, allergic reactions; may increase risk for infections including STIs

196
Q

Cervical cap

A

Advantages: no systemic effects, fits snugly over cervix, may leave in for up to 48 hours for repeated intercourse

Disadvantages: must be left in place for 6 hours after coitus; does not protect against STIs

197
Q

Diaphragms

A

Advantages: no systemic effects, may be placed in anticipation of intercourse, fits over cervix, may leave in place for 24 hours for repeated intercourse

Disadvantages: need additional doses of spermicide for repeated intercourse, leave in place for 6 hours after intercourse, may increase risk of yeast infection, cystitis, and toxic shock syndrome if use is prolonged

198
Q

spermicidal

A

Advantage: no systemic effects, foam, may be used for an immediate emergency contraceptive

Disadvantage: allergic reaction, irritation, frequent use contraindicated for individuals at risk for HIV

199
Q

Combo OC

A

Advantages:suppresses ovulation, take one pill a day, reduces risk for endometrial and ovarian cancer, benign breast disease, anemia, may improve acne

Disadvantages: contraindicated for: history of DVT, PE, hypertension, heart disease; women 35 or older or who smoke; active cancer; genetic clotting disorders, liver disease; has mulitple side effects = nausea, headache, spotting, weight gain, breast tenderness, chloasma); increased risk for blood clots, heart disease, stroke; do not provide protection against STIs

200
Q

ER contraceptive

A

Advantages: reduces risk of pregnancy for one-time unprotected intercourse by suppressing ovulation

Disadvantages: headache, nausea, vomiting, abdominal pain; heavier or lighter menstrual bleeding, fatigue, diarrhea; does not protect against STIs

201
Q

progestin only

A

Advantages: take one pill at the same time every day; can be used during lactation

Disadvantages: weight gain, irregular bleeding, nausea, mood changes, does not protect against STIs

202
Q

Depo-provera

A

Advantages: one injection 4 times/year; can be used during lactation

Disadvantages: weight gain, decreased bone density, delayed fertility, bleeding abnormalities, headache, mood changes, breast tenderness, does not protect against STIs

203
Q

Contraceptive patch

A

Advantages: place a new patch weekly for 3 weeks, then remove for one week

Disadvantages: risk similar to oral contraceptives, increased risk for thrombotic event, less effective for larger women, possible skin irritation, does not prevent STIs

204
Q

Vaginal ring

A

Advantages: inserted and left in for 3 weeks, then remove for 1 week; ring can be left in for 28 days with immediate placement of new ring

Disadvantages: side effects similar to oral contraceptive, vaginal irritation and discharge may occur, does not protect against STIs

205
Q

IUD

A

Advantages: may be used with lactation, can be used by teens, as well as women with medical problems or contraindicatons to other hormonal methods; highly effective; long term contraceptive method; good for 1-10 years; copper releasing IUC can be used as emergency contraceptive; must be inserted with 7 days of inercourse

Disadvantages: low risk of uterine perforation; contraindicated in women diagnosed and treated for pelvic inflammatory disease within the prior 3 months; increase of cramping and bleeding in first few cycles; does not protect against STIs

206
Q

Hormone implants

A

Advantages: once in place, there is minimal discomfort; lasts for several years; can be used during lactation

Disadvantages: side effects similar to oral contraceptives, irregular bleeding, skin irritation at site; does not protect against STIs; must be removed

207
Q

Vasectomy

A

Advantage: high rate of effectiveness

Disadvantage: discomfort for 2-3 days; difficult to reverse; need to use alternative contraceptive method until two post surgery sperm tests indicate procedure is effective

208
Q

tubal ligation

A

Advantage: high rate of effectiveness

Disadvantage: bleeding or pain at incision site; difficult to reverse

209
Q

sterilization implant

A

Advantages: implants placed in fallopian tubes, which causes scar tissue that eventually blocks tubes

Disadvantages: another contraceptive method needs to be used until blockage is confirmed, usually 3 months

210
Q

____ days or less of gestation are eligible for medication abortions

A

70 days

211
Q

What meds are used for abortion

A

Combo mifepristone-misoprostol are recommended as preferred therapy

Mifepristone can be safely used at home

212
Q

Medication abortions are not recommended for…

A

patients with ectopic pregnancy, IUD in place, current long-term systemic corticosteroid therapy, chronic adrenal failure, coagulopathy, anticoagulant therapy, inherited porphyria, intolerance or allergy to mifepristone or misoprostol

213
Q

surgical abortion first trimester

A

suction curettage

214
Q

When does a second trimester abortion take place?

A

after 13 weeks gestation

215
Q

post-abortion care should include

A

counseling and a discussion of when to contact the provider

216
Q

Contact HCP after abortion if:

A

Severe abdominal or back pain
Heavy bleeding (soaking two maxi pads per hour for 2 consecutive hours)
Foul smelling discharge
A fever (above 100.4° F (38°C))

217
Q

average age of menopause

A

52

218
Q

HRT has a risk for

A

breast cancer

219
Q

CAMs (complementary alternative methods) for managing menopause

A

Vitamin E, hypnosis, cognitive behavioral therapy, mind-body therapies, deep breathing, guided imagery, stellate ganglion block, herbal therapies, weight loss, etc.

220
Q

what needs to be present to get pregnant unassisted?

A

Functioning reproductive system (male and female)

Sperm and egg

Cervix and uterus to house embryo

Fallopian tube for transportation

A reproductive tract that is functioning properly with hormonal balance (male and female)

Semen that contains adequate sperm and with adequate mobility and deposited close to the cervix to allow travel and fertilization, at the time of ovulation (12 to 24 hours after ovulation)

A cervix that is open enough for sperm to enter; the fallopian tubes must be open and able to allow transfer of the ovum

Uterus must be receptive to implantation

221
Q

HSV

A

herpes-virus, only diagnosed by doing a culture of a lesion

transmitted and don’t know you have it until outbreak

Secretions despite symptoms, asymptomatic days you are at higher risk of transmitting

Breaks in skin make you more susceptible to other viruses; more likely to acquire HIV

Systemic: initial outbreak: fever, achy, headaches, can last 2-3 weeks

222
Q

Where is breast cancer most commonly found?

A

in the duct

223
Q

T/F Cigarette makes you twice as likely to develop cervical cancer

A

True

224
Q

What is the #1 thing that causes flare-ups of HSV?

A

stress

225
Q

What do you need to know before you prescribe contraceptives?

A

family hx, health hx, menstrual hx, pregnancy hx, sexual hx, STIs, pap smear, gyn problems, social hx (culture, partners), med hx

226
Q

ER contraception pt education

A

will not cause abortion, not to be used regularly, make you feel very sick (nausea), use with 72-120 hours (the sooner the better), contraindicated in confirmed pregnancy

227
Q

ACHHESS (combo oral contraceptives)

A

abdominal pain
chest pain
headaches
hemoptysis
eye problems
severe leg pain (DVT)
slurring of speech

228
Q

Does a nurse have to report to parents sexual activity of a adolescent younger than 13?

A

Yes
13+ no

229
Q

What can you do as a nurse to help with barriers (financial, cultural, environmental)

A

get others involved i.e. social work

230
Q

sexual orientation

A

think LBGTQIA+

231
Q

Sexual identity

A

biological

232
Q

gender identity

A

think….do you identify male or female?

233
Q

Healthy People 2030 goals (in general)

A

increase abstinence from alcohol, smoking, and illicit drugs in pregnancy; reduce fetal deaths at 20 or more weeks of gestation; reduce maternal death; reduce C-sections among low-risk women with no prior C-sections; reduce total preterm births; increase # of women getting prenatal care; increase the proportion of women of childbearing age getting enough folic acid; increase the proportion of women delivering a live birth who had healthy weight before pregnancy; increase # of infants being put to sleep on back; increase proportion of infants being breastfed exclusively through age 6 months

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