repro / womens health (exam 2) Flashcards
what are the 2 primary repro hormones in women?
estrogen and progesterone
where are estrogen and progesterone made?
mostly ovaries, also adrenal cortex
what are estrogen nd progesterone synthesized by?
cholesterol
what are the 3 ovarian estrogens?
-estradiol
-estrone
-estriol
when you’re __________, progesterone si secreted by corpus leutem last half of cycle
not pregnant
when you’re _____, progesterone maintains pregnancy and prepares for lactation
pregnant
days 1-14 of menstrual cycle = ____ phase
follicular
days 15-28 of menstrual cycle are the _____ phase
luteal
what are extreme PMS symptoms?
premenstrual dysphoric disorder (PMDD)
what is characterized by chronic pelvis pain and is a common GYN problem
endometriosis
what anti-depressants are used for PMS/PMDD
SSRIs or SNRIs
what is the first line treatments for PMS/PMDD
anti-depressants
what is the second-line therapy for PMS/PMDD
oral contraceptives (progestins)
what is the treatment of PMS/PMDD if the symptoms are anxiety / insomnia?
benzodiazepines (alprazolam)
what kinds of meds are used to manage symptoms of endometriosis
-NSAIDS
-hormonal contraceptives
-GnRH agonists
what is the drug therapy for menopause?
hormone replacement therapy (estrogen)
example of hormone replacement estrogen in women
conjugated estrogen
pharmacokinetics of conjugated estrogen?
oral = slow release
patch = avoid first-pass
what are the actions of estrogens?
-circulate to target cell (ovary)
-affects primarily the reproductive system
what are uses of estrogens?
-birth control
-menopause
-replacement therapy
-slow bone loss in osteoporosis
-palliative care for breast cancer / prostate cancer
what are adverse effects of of estrogens?
-thromboembolic conditions
what are black box warnings of estrogens?
-cancer
-clots
-dementia
what are contraindications of estrogens?
-thromboembolic disorders
-CV disease
-tobacco use
-hx. of breast/repro cancer
what is sued to prevent hyperplasia of the endometrial lining
progestins
what is our example progestin?
medroxyprogesterone acetate
routes of administration for medroxyprogesterone acetate?
oral, IM, topical
what med acts on endometrial lining to suppress pituitary hormones to inhibit ovulation
progestins
what med prevents spontaneous uterine contraction
progestins
what are uses of progestins?
-contraceptives
-treat amenorrhea and uterine bleeding
-fertility programs
-oncology
-plan B
adverse effects of progestins?
-CV comp.
-Thromboembolic conditions
black box warnings of progestins
-pregnancy
-CV
-thromboembolic
-dementia
contraindications of progestins?
preg/lac
CV disease
thromboembolic disorder
nursing implications of estrogens and progestins
-identify high risk women (medical history, vitals, weight, weight, mammo)
-patch may be applied weekly or bi-weekly
education of estrogen and progestins
-monitor weight
-smoking cessation
-report vaginal bleeding
-teach signs of thromboembolism
why are estrogen-progestin combos used?
smaller doses of both instead on 1 large does decreases symptoms
example of estrogen-progestin combination drug
conjugated estrogen-medroxyprogesterone
what are admin routes of est-progestin combos?
PO, IM, implant, IUD
how does the estrogen part of combo drugs prevent pregnancy?
-inhibit ovulation
-suppress FSH/LH
-stabilize endometrium
how does the progestin part of combo drugs prevent pregnancy?
-thin endometrium
-slow sperm transport
-thicken cervical mucous
-suppress LH surge
uses of estrogen/progestin combos
-contraception
-treatment of PMS/PMDD
-HRT
adverse effects of estrogen-progestin combos?
-CV complications
-thromboembolic conditions
-irregular vag bleeding
what are black box warnings for estrogen-progestin combos
-smoking
-osteoporosis
-thromboembolic events
contraindications of estrogen-progestin combos
-smoking
-women older than 35
-hx of thromboembolic probs
nurse prescribes estrogen replacement therapy to relieve severe menopausal symptoms of hot flashes, which are a result of…
-insufficient gonadotropin secretion
-vasomotor instability
-high estrogen levels
-decreased progesterone
vasomotor instability
after teaching ab warning signs associated with combo hormonal contraception, what statement results in additional education
-breakthrough bleeding is sign of uterine abnormality
-i should go to ER if i get sudden, severe HA that is not relieved with analgesic
-severe leg pain / swelling should immediately be reported
-CV probs are most severe adverse effects associated with oral contraceptives
-breakthrough bleeding is sign of uterine abnormality
-its an adverse effect
