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XIO > Reproductive > Flashcards

Reproductive Flashcards

1
Q

DES babies

A

birth defects

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2
Q

estrogen - reasons to take

A

Atrophic vaginitis- thinning, drying & inflammation of
vaginal walls
Hypogonadism
🞑 Oral contraception (given with a progestin)
🞑 Dysmenorrhea
🞑 “Hot flashes” of menopause (vasomotor symptoms) 🞑
🞑 Breast & Prostate Cancer
🞑 Osteoporosis

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3
Q

estrogen contraindications

A

 Any estrogen-dependent cancer
 Undiagnosed abnormal vaginal bleeding
 Pregnancy - can cause a miscarriage
 Active thromboembolic
disorder or history of stroke,
venous blood clot
Thrombolytic events—most serious

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4
Q

estrogen adverse

A

Amenorrhea, breakthrough uterine bleeding
 Tender breasts, fluid retention, headaches (increased fluid)

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5
Q

Premarin (Enjuvia®, Premarin®)

A

replace estrogen deficit

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6
Q

leg cramps

A

DVTs usually start in the back of the leg so ask about back of leg when sitting for long periods. will hurt when they cross their legs.

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7
Q

Progestins - produced by…

A

Produced by corpus luteum, then pregnant placenta
 Synthetic derivatives of progesterone

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8
Q

Progestins: Indications

A

Treatment of functional uterine bleeding caused by: after birth
🞑 Hormonal imbalance, fibroids, or uterine cancer
 Treatment of primary and secondary amenorrhea,
palliative cancer & endometriosis
 Prevent conception

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9
Q

Progestins: Indications - palliative treatment

A

of some cancers and
endometriosis
 Prevention of threatened miscarriage relaxing uterine smooth muscles
 Alleviation of PMS symptoms

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10
Q

Progestogens : Indications - Megestrol (Megace) **

A

synthetic progestin
🞑 Adjunct therapy for treatment of breast and
endometrial cancers
****Management of anorexia, cachexia, or unexplained
weight loss in AIDSpatients
🞑 To stimulate appetite and promote weight gain in
cancer patients
🞑 Female infertility

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11
Q

Progestins: Adverse Effects

A

Liver dysfunction- cholestatic jaundice- (flow of bile from
liver slows/stops)
 Thrombophlebitis, thromboembolic disorders,
such as PE
 Nausea, vomiting
 Amenorrhea, breakthrough uterine bleeding,
“spotting”
 Edema, weight gain or loss & depression

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12
Q

Medroxy-progesterone***

A

Action: has effects similar to those of progesterone;
inhibits secretion of Pituitary Gonadotropins thus prevents
ovulation
 Class: synthetic progestogens
 Use: treat absent or irregular menstrual periods,
abnormal uterine bleeding. Also used to decrease
the risk of endometrial hyperplasia & renal cancer
 How supplied: tablets, injections\
Dont give to anyone under 25 - leaches calcium out of bones
*****Depo-Provera = 1 shot coverage for 3 months, caution for
under 25 years of age due to bone density issues.

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13
Q

Medroxyprogesterone (Provera®) - Precautions: Nursing Considerations:

A

🞑 May causemelasma.Not for usein pregnancy
🞑 Teachwomento do BSE (breast self exam)
🞑 Teachwomen:take Provera by mouthwith or without food.
Takeat the sametime every day, with doses not more than
24 hours a part.
🞑 Teachwomen: If a dose ismissed,take it assoon as
possible. If it is almost time for the next dose, skip the
missed dose and go back to the regular dosing schedule.
Do not take 2 dosesat once
🞑 If miss 2 active pill in 3 weeks or miss 3 or more in a
row. Instruct pt to throw out rest of pack and Start a new
pack that day.

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14
Q

Contraceptive Drugs - contraindications

A

Oral medications
🞑 Monophasic, biphasic, and triphasic forms
 Triphasic form most closely duplicates the normal hormonal
levels of the female cycle*
 Depo- Provera- 3 month in 1 shot
🞑 Newer extended cycle products
🞑 Most contain estrogen-progestin combinations

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15
Q

plan B

A

 Levon-orgestrel = Plan B, w/in 72 hrs of unprotected sex &
f/up dose 12 hrs after first dose. ($40-50.00)

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16
Q

Seasonale

A

( extended cycle), both estrogen & progestin,
women will only have 1 menstrual cycle every 3 months

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17
Q

Contraceptive Drugs:
Adverse Effects

A

Drawbacks to the use of these drugs include:
🞑 Hypertension
🞑 Thromboembolism, possible PE, MI, stroke
🞑 Alterations in lipid and carbohydrate metabolism
🞑 Increases in serum hormone concentrations
 These effects are caused by the estrogen
component

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18
Q

contraceptive adverse

A

May alsocause:
🞑 Edema,dizziness, headache, Depression,
nausea, vomiting,diarrhea, increased
appetite, increased weight, breast &
changes, many others

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19
Q

contraceptive interactions***

A

penicillin and Cephalosporins

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20
Q

Contraceptive
Drugs: Interactions - Drugs that may have reduced
effectiveness

A

Anticonvulsants, beta-blockers, hypoglycemic drugs,
oral anticoagulants, theophylline, hypnotics,
tricyclic antidepressants

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21
Q

fertility drugs - Clomiphene (Clomid®, others)

A

Nonsteroidal ovulation stimulant
🞑 Blocks estrogen receptors in the uterus and brain,
resulting in a false signal of low estrogen levels - this will produce twins sometimes bc more than one egg

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22
Q

fertility - mentropins (Pergonal®)

A

Standardized mixture of FSH and LH
🞑 Stimulates development of ovarian follicles,
leading to ovulation
🞑 May also be given to
men t to stimulate
spermatogenesis
🞑 From urine of post
menopausal women

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23
Q

Chorionic gonadotropin alfa (Ovidrel®)

A

Recombinant form of human chorionic gonadotropin
🞑 Causesrupture and ovulation of mature ovarian
follicles, and maintenance of corpus luteum

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24
Q

Fertility Drugs: Indications

A

Used primarily to induce ovulation in anovulatory
patients

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25
Q

Fertility Drugs: Adverse Effects

A

Tachycardia, phlebitis, DVT, multiple pregnancies**pregnancies,
blurred vision (can indicate a clot - serious-stroke), breast pain, others

26
Q

Uterine- Active Medications

A

Promote labor (stimulants) ie oxytocin or Prevent the start or progression of labor (relaxants)

27
Q

Uterine Stimulants - also called

A

oxytocics -oxytocin hormone secreted from
Posterior lobe of Pituitary gland
1. Oxytocin (hormonal drug)
2. Prostaglandins
3. Ergot derivatives
4. Progesterone antagonist *

28
Q

Oxytocin (Pitocin®) - synthetic form

A

🞑 Used to induce labor at or near full-term gestation,
and to enhance labor when contractions are weak and
ineffectivef

29
Q

oxytocin other uses

A

🞑 Prevent or control postpartum uterine bleeding
🞑 Complete an incomplete abortion (after miscarriage)
🞑 Promote milk ejection during lactation

30
Q

Prostaglandins - uterine stimulants

A

Natural hormones
🞑 Causepotent contraction of myometrium, smoothmuscle
fibers of the uterus
🞑 Used to induce labor by softening the cervix and
enhancing uterine muscle tone
🞑 dinoprostone (Prostin E2,Cervidil®, Prepidil ) and
misoprostol (Cytotec®)( termination of pregnancy
12 wk-20wk)

31
Q

 Ergot alkaloids (alk = toxic)

A

Increase force and frequency of uterine contractions
🞑 Used after delivery of the infant and placenta to
prevent postpartum uterine atony and hemorrhage
🞑 methylergonovine (Methergine®)

32
Q

Progesterone antagonist*- Politically charged
“ Abortion Pill”

A

mi-fe-pristone (Mifeprex®)
🞑 Stimulates uterine contractions to induce abortion
🞑 Given with a prostaglandin drug for elective abortions

33
Q

Uterine Stimulants: Adverse Effects

A

 Hypotension or hypertension, chest pain
 Headache, dizziness, fainting
 Nausea, vomiting, diarrhea
 Vaginal pain, cramping
 Leg cramps, joint swelling, chills, fever,
weakness, blurred vision

34
Q

Uterine Relaxants: Tocolytics

A

Stop Labor “To-cease-labor”
 Used to stop labor that begins before term to prevent
premature birth
 Generally used after 20th week of gestation(5 mon)

35
Q

: Tocolytics - INMT (it’s not my time)

A

= Indomethacin-anti/inflammatory
N= Nifedipine-CCB
M= Mag Sulfate-relax smooth uterine muscle
T= Terbutaline –BB, dec uterine contractions

36
Q

oxy - increase t - it’s not my time

A
37
Q

Uterine Relaxants: Tocolytics

A

Uterine contractions that occur between the 20th
and 37th weeks of gestation are considered
premature labor
 Nonpharmacologic measures
🞑 Bed rest (be on left side - to keep flow of blood going), sedation, hydration

38
Q

Magnesium sulfate IV***(don’t need to know anything else on this slide)

A

Magnesium sulfate IV also used to stop labor**must have Ca-Glucanate to tx Mag toxic

39
Q

Uterine Relaxants: Adverse Effects

A

 Palpitations, tachycardia, Hypertension, others
 Tremors, anxiety, insomnia, headache, dizziness,
others
 Nausea, vomiting, anorexia, bloating, diarrhea,
constipation
 Hyperglycemia, hypokalemia
 Dyspnea, hyperventilation

40
Q

Uterine Relaxants: nursing implications

A

 Assess baseline vital signs, weight, blood
glucose levels, renal and liver function studies
 Assess whether the patient smokes
 Assess history and medication history
 Assess contraindications, including potential
pregnancy

41
Q

relaxants cont*****

A

 Before giving any uterine stimulants, assess the
mother’s vital signs and fetal heart rate, Q 15 min
 Uterine relaxants are used when premature labor
occurs between the *****20th and 37th weeks of
gestation

42
Q

 Estrogens and progestins - nursing implications

A

Give IM doses deep in large muscle masses, & rotate sites - very viscous so do it deep - won’t leak

43
Q

infertility - Advise patients to

A

Advise patients to keep a journal while on
fertility drugs

44
Q

A woman has not taken her oral contraceptive since
Monday morning. It is now Thursday morning. What
should she do now to prevent pregnancy?

A

Start over witha newmonthlypack of oral
contraceptives. use a second form of contraceptions

45
Q

Testosterone

A

Responsible for normal development and maintenance of
primary and secondary male sex characteristics
🞑 Development of bone and muscle tissue
🞑 Inhibition of protein catabolism (metabolic breakdown)
🞑 Retention of various electrolytes - Nitrogen, phosphorus Na & K

46
Q

adrogen

A

Several synthetic derivatives of testosterone
 Long-term dosage forms can last from 2 to 3 days to
2 to 4 weeks
 Oral forms have a high first-pass effect - usually not given orally
 Transdermal forms available
🞑 Patches and gel

47
Q

testosterone precautions

A

 Precautions: not for use in prostate cancer, male
breast cancer, heart, liver and kidney disease

48
Q

testosterone teaching considerations

A

keep clean oil buildup can cause acne. May experience mild fluid retention.
🞑 Possible stimulation of prostate tissue growth (hypertrophy), with
perhaps some increased urination symptoms such as a
decreased stream or frequency.
🞑 Pt is at risk for increased risk of developing
prostate cancer

49
Q

Anabolic steroid

A

Schedule III. may give to men who aren’t growing

50
Q

Androgens: Mechanism of Action

A

Stimulation of normal growth and development of the
male sex organs
🞑 Development and maintenance of male secondary sex
characteristics
🞑 Stimulate increased synthesis of body proteins, aiding
in the formation of muscular and skeletal proteins

51
Q

Androgen Inhibitors

A

5-Alpha-reductase inhibitors
 Alpha1-adrenergic blockers
 Androgen receptor blockers
 Gonadotropin-releasing hormone (Gn-RH)
Analogs

52
Q

Finasteride (Proscar, Propecia®) and Dutasteride (Avodart®)**

A

unsafe. Inhibits enzyme converting testosterone to DHT more potent
form of testosterone stimulates prostate growth.

53
Q

Alpha1
-Adrenergic Blockers**

A

1mg= Alopecia
- 5mg= BPH

54
Q

Drugs to Treat Erectile Dysfunction

A

sildenafil - board will usually use this name, not viagra. (Viagra®)
🞑 First oral drug for tx of ED
Longer Duration
 vardenafil (Levitra®)
 tadalafil (Cialis®)

55
Q

Drugs to Treat Erectile Dysfunction

A

Prolonged erection >4 hrs= medical emergency - priatism - NO NITRATES - causes severe hypotension and we can’t get it back up and then have heart attack.

56
Q

Men’s Health Drugs: Adverse Effects

A

5-alpha-reductase inhibitors
Finasteride
🞑 Loss of libido, loss of erection,
ejaculatory dysfunction, other effects
🞑 May cause PSA concentrations to decrease
🞑 PSA- Serum “Prostate Specific Antigen” Inc S/sx
of prostate CA
🞑 Normal 2.5 – 3 ng/mL (just know these value)

57
Q

general list of

A

what nitrates look like - patch, pill, etc.

58
Q

Nursing Implications - Men’sHealth Drugs: -

A

get baseline psa and digital rectal exam - it’s hasn’t been evidenced based yet. GI upset
🞑 Headache
🞑 Back pain
🞑 Dysuria
weight, renal functions,
do IM deep it hurts when it leaks out

59
Q

Transdermal Androderm® patches / gel are
applied to the skin on the body, never to scrotal
skin

A

Transdermal Androderm® patches / gel are
applied to the skin on the body, never to scrotal
skin

60
Q

Pregnant women should not handle crushed or
broken finasteride tablets,

A

can cause
teratogenesis

61
Q

Finasteride can be used to treat baldness in both
men and women.

A

false

XIO (393 decks)

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