Repro Exam 1 Flashcards
1
Q
Sexual response phases
A
motivation, arousal, genital congestion, orgasm, resolution
2
Q
motivation
A
desire, libido
3
Q
what can motivation be affected by?
A
medications, personality, temperament, medical conditions, lifestyle, environmental stressors
4
Q
arousal
A
a state of release of neurotransmitters
5
Q
genital congestion
A
increased blood flow, clitoral swelling and vulval engorgement, vaginal lubricaiton; in males, erection
6
Q
orgasm
A
rapid contraction of pelvic muscles
7
Q
resolution
A
wellbeing, neurotransmitters prolactin, ADH, oxytocin, final stage of sexual response cycle
8
Q
What populations are at risk for sexual dysfunction
A
adolescents, newly unpartnered, gender minorities, disabled
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
10
Q
Why are newly unpartnered at risk of sexual dysfunction
A
sudden lifestyle changes may increase # of partners
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
12
Q
Why are disabled at risk for sexual dysfunction?
A
ignorance, poor decision making, developmental issues
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
14
Q
sexual acts
A
behavior that includes the genitalia and erogenous zones
15
Q
sexual identity
A
biological sexual characteristics of male or female, what you were born as/with
16
Q
HPV vaccine
A
receive in teen years up to 26 years old
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)
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
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
20
Q
sexual history should include
A
Menarche
Menstruation
Pregnancy
Menopause
Contraception
21
Q
menarche
A
first period
22
Q
menstruation
A
every 28 days; when was your last menstrual period
23
Q
menopause
A
12 months after last menstrual period = menopause
24
Q
When asking about pregnancy….
A
how many times they’ve been pregnant, includes miscarriages
25
menopause charcteristics
hot flashes, night sweats, vaginal dryness, painful sex, urogenital atrophy
26
what can you do for menopause
HRT...
27
Who is HRT contraindicated for?
use with caution in pts with cardiovascular disease, DVT, breast cancer
28
What can you educate pts to do instead of using HRT?
CAMs: vitamin E, hypnosis, CBT, deep breathing, guided imagery, herbal therapies, weight loss
29
3 types of menopause
biological - average age of 52
surgical - oophrectomy or medical ablation of ovaries
premature - ovarian failure before age 40
30
What can cause biological menopause to occur earlier?
smoking or if have shortened cycles
31
hormonal response to menopause
there is no E2 production (follicle depletion) which increases FSH but there is no period
32
climacteric phase
transition phase where ovarian function and hormone function decline
33
adolescents seek care when
there's a problem or for contraception, pregnancy
34
young/middle adult health promotion
pelvic and breast screening and healthy lifestyle promotion; 21 for first pap smear; new onset of chronic diseases at 35, empty nest syndrome = depression
35
late reproduction age health promotion
breast and ovarian cancers are more prominent; encourage screening
high divorce rates = trying new partners
36
barriers for seeking health promotion
financial, cultural, environmental
37
financial barrier
delays seeking care
38
cultural barrier
lack of trust, language barrier, experiences with discrimination
39
desired health outcomes for cultural barriers
HCP has knowledge + understanding of culture, language, values, priorities, health beliefs of those in various ethnic groups
40
environmental barriers
are HCP or centers easily accessible?
41
cultural knowledge is
beliefs and values that guide thinking, decisions, and actions of the family
passed from one generation to the next, influences health behaviors
42
cultural issues will affect
childbearing beliefs and practices, personal space, time and orientation, family roles (who will be their support during childbirth)
ASK OPEN ENDED QUESTIONS
43
gender issues
LGBTQ feel stigmatized, heterosexuality is often assumed-ask how they prefer to be addressed
44
gender minority
individuals whose gender identity (what they identify as) or expression (masculine, feminine, other) is DIFFERENT from their sex at birth
45
gender concordance
patient's gender matches the providers gender
46
sexual orientation
persons emotional and sexual attraction to another person + behavior and/or social affiliation that comes with this attraction (gay, lesbian)
47
T/F women who have kids are at a higher risk for cancer
False; women who have not had kids are at higher risk
48
IPV
includes actual or threatened physical, sexual, psychological, emotional, stalking abuse by intimate partner
49
what actions should you take with a patient experiencing IPV
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
50
S/S of IPV
missed appointments, partner will not leave patient, unexplained wounds, incongruent injury with given story, depression, anxiety, victim saying she deserved it or provoked partner
51
Moral distress
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)
52
ANA code of ethics describes
the goals, values, and obligations of nursing
53
ethical principles
Beneficence
Nonmaleficence
Fidelity
Veracity
Autonomy
Justice
54
Ethical dilemmas in the care of women and children:
the mom who refused treatment (chemo) in order to have a healthy fetus; terminating a severely abnormal fetus
55
Black women and pregnancy
they have a 3-4 x higher maternal mortality rate and two time higher rate of complications
56
EBP definition
Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.
57
evidence-based decision making should include consideration of:
best research evidence, clinical resources, and patient values
58
infant mortality
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
59
neonatal mortality
death of a live birth between birth and < 28 days
60
autonomy
respect parental decisions, facilitate communication and collaboration
61
quality of life
what are the long term complications and care?
62
fidelity
being accountable and responsible, loyal to commitments
63
veracity
being truthful
64
autonomy
self-determination
65
justice
allocation of resources and use of resources equitably
66
what are the most prevalent factors in decision making and problem solving for families?
values and beliefs
67
Ovarian cycle
follicular, ovulation, luteal
68
endometrial (uterus) cycle
menstrual, proliferative, secretory
69
hormones
progesterone, estrogen, LH, FSH
70
male and female condoms protect against
STI, may need to use spermicide
71
diaphragm
place 6 hours before intercourse and must remain in place for 6 hours after intercourse, risk for toxic shock syndrome
72
combo oral contraceptive
suppresses ovulation through hormones; patient must take same time every day (one missed dose can lead to pregnancy)
73
who are Combo contraceptives contraindcated for?
clots, cancer, CAD
74
what are off label uses for COC
acne, endometriosis, dysmenorrhea, reduced risk of endometrial and ovarian cancer and benign breast disease, anemia
75
Side effects of COC
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
76
Fertility awareness method
periodic abstinence, keep a journal or the beads, strict record keeping
77
COC are less effective when taken with
antibiotics or anticonvulants
78
progestin only
for lactating women
79
nexplanon
most effective, lasts up to 3 years
may cause irregular bleeding
80
depo
lasts 12 weeks, safe for breastfeeding women
81
what is a downfall of the depo injection?
return to fertility is about 1 year, do not give to menopausal women b/c can cause osteoporosis-give Ca supplement
82
IUD complications
PAINS
period irregularities
abdominal pain with intercourse
infection exposure
not feeling well
strings missing, STI risk which can cause PID
83
emergency contraceptives
use w/in 72-120 hours
84
Can IUD be used as emergency contraceptive?
Yes
85
how old do you have to be to have tubal ligation or vasectomy?
21+
86
Abortion
purposeful interruption of pregnancy before 20 weeks either elective or therapeutic
87
indications for abortion
woman's request, genetic disorder of fetus, rape/incest
88
abortion in 1st trimester
surgical aspiration, meds (methotrexate, misoprostol, mifepristone)
89
abortion in 2nd trimester
D & E, prostaglandins
90
Risks associated with abortion
infection, retained products, bleeding, emotional concerns
91
nursing care for abortion 1st trimester
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
92
oopherectomy
removal of ovaries
93
hysterectomy
removal of uterus
94
vasectomy teaching
use a backup method of contraception until semen analysis shows no sperm
95
perimenopause
4 years leading up to menopause
irregular cycle, menopausal symtpoms, endometrial hyperplasia
96
HRT risk
VTE
97
management of menopause
weight loss, fans, avoid triggers, vitamin E, CBT, support groups
98
T/F anticonvulsants reduce the effectiveness of OC
True
99
the absence of a temperature increase during cycle indicates
no ovulation during that cycle
100
When assessing a woman using the calendar method of birth control, what should you ask?
obtain a hx of the woman's menstrual cycle lengths for the past 6-12 months
101
s/s of TSS
sudden onset of fever over 38.4° C, hypotension, rash
102
can you use a diaphragm during menses?
No
103
tubal ligation patient teaching
highly unlikely you will become pregnant, offers no protection against STIs
104
prostaglandins
a hormone that oxygenates fatty acids; affects ovulation, fertility, changes in cervix and mucus, tubal and uterine motility, menstruation, miscarriage, and labor
105
HPV s/s
multiple painful lesions, fever, chills, malaise, severe dysuria, irritating vaginal discharge with itching, dyspareunia and postcoital bleeding
106
How do you prevent HPV
vaccine and abstinence
107
when should you get HPV vaccine?
age 11-26, not recommended if older than 26
108
treatment for HPV
laser ablation, cryotherapy, TCA or patient may apply topicals
109
risk factors for breast cancer
age, family history, BRCA gene, obesity, alcohol, sedentary lifestyle, birth control
110
primary prevention for breast cancer
mastectomy + oophorectomy: indicated for high-risk patients
111
secondary prevention for breast cancer
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
s/s of breast cancer
change in breast size or shape, skin dimpling, recent nipple inversion or skin abnormalities. single-duct discharge (may be bloody), axillary lump
113
non-modifiable risk factors of breast cancer
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
Modifiable risk factors for breast cancer
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
Medical mgmt of breast cancer
radiation, chemo, hormone therapies
116
Patient education for post-surgery (breast cancer)
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
Nursing care for post-surgery breast cancer
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
emotional effects of malignant neoplasm of breast in women
concerns about appearance after breast surgery
nurses can help communicate feelings and concerns about accepting changes
119
what is the most common cause of cervical neoplasia?
HPV
120
If HPV lesions are present at birth, what might need to happen
C-section
121
Which types of HPV are highly oncogenic?
Type 16, 18, 45-highest risk of causing cancer of the cervix, vagina, vulva, penis, orphayngeal area
122
Cervical cancer risk factors
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
Cervical cancer screening
Pap screen Q3 year or HPV combo test Q5 years
124
s/s of cervical cancer
abnormal vaginal bleeding, vaginal discomfort, malodorous discharge, dysuria
125
treatment for cervical cancer
surgery, radiation, chemo
126
diagnostics for cervical cancer
colposcopy or cervical biopsy
127
Infertilty (definition)
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
What are the cervical factors affecting fertility?
infections, abnormalities in mucus
129
What are the uterine factors affecting fertility?
anomalies and fibroid tumors
130
What are the ovarian factors affecting fertility?
anovulation and medications
131
What are the tubal factors affecting fertility?
anomalies and endometriosis
132
Other female factors influencing fertility
nutritional deficiencies, obesity, thyroid dysfunction
133
Male factors affecting fertility
congenital disorders, excess androgens, estrogen, cortisol, drug/substance abuse, endocrine disorders
134
Testicular factors affecting fertility
undescended tested, hypospadias, varicocele, torsion, STI, trauma
135
factors affecting sperm transport
drugs, ejaculatory dysfunction, premature ejaculation, idiopathic
136
Female infertility assessment
obstetric hx, menstrual history, pelvic exam, bimanual exam
137
Female infertility diagnostics
FHS, serum progesterone level check, HST, hysterosalpingogram-contrast sonography
138
Males infertility assessment
medical history, urologic exam
139
Male infertility diagnostics
semen analysis, sperm penetration assay, scrotal ultrasound, hormone analysis, testosterone, gonadotropin, FSH, LH
140
Medications for infertility
clomiphene
letrozole
metformin
HMG, FHS, HCG
141
clomiphene
ovulation induction
142
letrozole
ovulation induction
143
metformin
restores cyclic ovulation
144
Assistive reproductive therapy
IVF, GIFT< ZIFT, ovum transfer, TDI, embryo hosting, embryo hatching
145
Alternatives to infertility
adoption, surrogacy, cryopreservation
146
education for HPV
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
primary infertility
couple has never achieved pregnancy
148
secondary infertility
inability to conceive after a previous pregnancy
149
What does a hysterosalpingogram (HSG) and hysterosalpingo-contrast sonography test for?
uterine abnormalities
150
what does serum progesterone test for?
ovulation and assesses adequacy of corpus luteum progesterone production
151
cervical mucus assessment
tests ovulation-during ovulation, expect cervical mucus to have low vicosity + ability to stretch
152
basal body temperature
tests for uterine abnormalities
153
Can use of non-water soluble lubricants, wearing briefs, and increase hot tub + sauna use be a cause of male infertility?
Yes
154
sperm penetration assay measures...
ability of sperm to penetrate egg
155
semen analysis....
detects ability of sperm to fertilize egg-evaluates testosterone, gonadotropin, FSH, LH-need to be abstinent for 2-7 days
156
Non-medical treatment for infertility (woman)
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
Assistive reproductive therapies (ART)
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
Nursing considerations for infertility
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
nursing care for infertility
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
Treatments for HPV
imiquimod, podophyllin, podofilox
161
What diagnostic test is used to confirm a suspected diagnosis of breast cancer?
needle aspiration and biopsy
162
When in her cycle should a woman perform a self-breast exam?
5-7 days after menses ceases
163
What should women not do 24-48 hours before a pap test
douche, use vaginal medication, have sexual intercourse
164
fatty acids classified as hormones that are found in many body tissues and that have roles in many reproductive functions are known as
prostaglandins (PGs)
165
microscopic examination of scrapings from the cervix, endocervix, or other mucus membranes to detect premalignant or malignant cells is called
Pap Smear (papanicolaou)
166
a woman who is older than 35 may have difficulty getting pregnant primarily because
her ovaries may be affected by the aging process
167
IVF-ET
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
biophysical risk factors for reproduction
Altered or mutated genes, inherited disorders, chromosomal anomalies, multiple gestations, large fetal size, ABO incompatibilities
Nutritional concerns and medical and/or obstetric disorders
169
Psychosocial risk factors for reproduction
Smoking, excessive caffeine, alcohol, drug abuse, spousal abuse, addictive lifestyles
maternal emotional well-being
170
Sociodemographic risk factors for reproduction
Low income, inadequate prenatal care, age at both ends of the spectrum reproductive years, parity, marital status, geographic location, race and ethnicity
171
Environmental risk factors for reproduction
Industrial pollution, radiation, chemical exposures, bacterial and viral infections, drugs (OTC, therapeutic, illicit) stress
172
Cervical cancer screening: who should get it?
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
Chlamydia test: who should get it?
if sexually active, yearly until age 24, yearly ages 25 + if new partner or multiple partners
174
Menstrual Cycle
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
hysterectomy options
total hysterectomy
subtotal hysterectomy
bilateral-salpingo-oophrectomy
panhysterectomy
radical hysterectomy
176
total hysterectomy
uterus and cervix removed
177
subtotal hysterectomy
uterus is removed, cervix is not
178
bilateral-salpingo oophrectomy
ovaries and fallopian tubes are removed
179
panhysterectomy
uterus, ovaries, cerivx, and fallopian tubes are removed
180
radical hysterectomy
uterus, cervix, upper part of the vagina, and adjacent tissue (including lymph nodes) are removed
181
Gravida
of pregancies regardless of outcome
182
Term births
births after 37 weeks gestation
183
preterm births
births between 20-36 weeks gestation
184
Abortion
any pregnancies that ended prior to 20 weeks gestation
185
G =
T + P + A
186
T/F twins/triplets/etc = 1 pregnancy
True
187
What are the least effective contraceptive methods?
barrier, natural family planning
188
What are the nursing interventions that facilitate contraceptive use?
provide info and instructions and help pts make decisions
demonstrate and supervise return demonstration to ensure understanding
189
Assessment for contraceptive use should include?
medical + reproductive hx + family hx
sexual hx of dysfunction and STI hx/treatment
pap test + results, reproductive cancers
problems with uterine support
190
menstrual hx
age of menarche
age of menopause
menstrual problems
191
natural family planning
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
Withdrawal
Advantages: no cost or contraindications
Disadvantages: does not protect against STIs, disrupts sexual intercours
193
Lactation Amenorrhea method
Advantages: no cost or contraindications
Disadvantages: requires exclusive breastfeeding or infant suckling; using a barrier method with LAM increase effectiveness
194
condoms
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
Vaginal sponges
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
Cervical cap
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
Diaphragms
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
spermicidal
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
Combo OC
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
ER contraceptive
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
progestin only
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
Depo-provera
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
Contraceptive patch
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
Vaginal ring
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
IUD
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
Hormone implants
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
Vasectomy
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
tubal ligation
Advantage: high rate of effectiveness
Disadvantage: bleeding or pain at incision site; difficult to reverse
209
sterilization implant
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
____ days or less of gestation are eligible for medication abortions
70 days
211
What meds are used for abortion
Combo mifepristone-misoprostol are recommended as preferred therapy
Mifepristone can be safely used at home
212
Medication abortions are not recommended for...
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
surgical abortion first trimester
suction curettage
214
When does a second trimester abortion take place?
after 13 weeks gestation
215
post-abortion care should include
counseling and a discussion of when to contact the provider
216
Contact HCP after abortion if:
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
average age of menopause
52
218
HRT has a risk for
breast cancer
219
CAMs (complementary alternative methods) for managing menopause
Vitamin E, hypnosis, cognitive behavioral therapy, mind-body therapies, deep breathing, guided imagery, stellate ganglion block, herbal therapies, weight loss, etc.
220
what needs to be present to get pregnant unassisted?
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
HSV
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
Where is breast cancer most commonly found?
in the duct
223
T/F Cigarette makes you twice as likely to develop cervical cancer
True
224
What is the #1 thing that causes flare-ups of HSV?
stress
225
What do you need to know before you prescribe contraceptives?
family hx, health hx, menstrual hx, pregnancy hx, sexual hx, STIs, pap smear, gyn problems, social hx (culture, partners), med hx
226
ER contraception pt education
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
ACHHESS (combo oral contraceptives)
abdominal pain
chest pain
headaches
hemoptysis
eye problems
severe leg pain (DVT)
slurring of speech
228
Does a nurse have to report to parents sexual activity of a adolescent younger than 13?
Yes
13+ no
229
What can you do as a nurse to help with barriers (financial, cultural, environmental)
get others involved i.e. social work
230
sexual orientation
think LBGTQIA+
231
Sexual identity
biological
232
gender identity
think....do you identify male or female?
233
Healthy People 2030 goals (in general)
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
