Reproductive, Contraception Flashcards
What are curable STIs?
Syphilis
Gonorrhea
Chlamydia
Trichomoniasis
What are non-curable STIs?
Hep B
Herpes
HIV/AIDS
HPV
What are pregnancy/NB complications of STIs?
PROM
stillbirth
Spontaneous abortion
Small gestational age
Damage to brain, eyes, ears
Death
Which STIs are nurses legally responsible to report?
Chlamydia is most states
Gonorrhea, syphilis, HIV/AIDS in ALL states
A woman calls into the ambulatory care center. She reports that her at-home ovulation predictor test strip results were positive. She asks what this means; which should the nurse explain?
A. The kit has detected an increased presence of luteinizing hormone (LH) in the urine
B. The kit has determined that our cervical mucous is receptive to sperm
C. The kit has detected an increase in free estrogen in the urine
D. The kits had detected that ovulation will take place within the next 6-8 days
A. The kit has detected an increased presence of luteinizing hormone (LH) in the urine
A woman is using a basal body temperature (BBT) graph to monitor fertile periods. She calls to report that she did not see any temperature change during her past monthly cycle; to which does the nurse attribute this?
A. An elevated estrogen level
B. An elevated FSH level
C. A failure to ovulate
D. An elevated progesterone level
C. A failure to ovulate
In counseling a couple who have experienced sub-fertility for 14 months, which of the following true statement does the nurse base the initial information given to them?
A. Transrectal and scrotal ultrasound testing is routinely performed in the male
B. Semen analysis is usually not performed until all the tests in the female partner are negative
C. Testing for tubal latency is performed during the same time period as ovulation monitoring is being done
D. Fertility testing usually begins with ovulation monitoring in the woman
D. Fertility testing usually begins with ovulation monitoring in the woman
Which of the following statements defines gender identity?
A. The chosen activities a person uses to express masculinity or feminists
B. The male or female characteristics determined genetic factors
C. The feeling of being male or female
D. The male or female characteristics encourage the culture
C. The feeling of being male or female
The school nurse conducts a sports physical exam on a 14-year old gymnast, who voices a concern that she has not begun menstruation, even though most of her friends have. Which is the best nursing action?
A. Advise her to share her concerns with her family doctor because this certainly is an abnormal occurrence
B. Explain that because of her low body fat, it is not unusual for menstruation not to have begun yet
C. Report these findings immediately to her physician for further evaluation
D. Encourage the use of hormone supplements to promote puberty
B. Explain that because of her low body fat, it is not unusual for menstruation not to have begun yet
Which woman is a safe candidate for oral contraceptives?
A. 39-year old with a history of thrombophlebitis
B. 16-year old with a benign liver tumor
C. 20-year old who suspects she may be pregnant
D. 43-year old who doesn’t smoke cigarettes
D. 43-year old who doesn’t smoke cigarettes
A woman who has a seizure disorder and takes barbiturates and phytonutrients sodium daily asks the nurse about the pill as a contraceptive choice. What is the nurse’s most appropriate response?
A. This is a highly effective method, but it has some side effects
B. Your current medications will reduce the effectiveness of the pill
C. The pill will reduce the effectiveness of your seizure medication
D. This is a good choice for a woman of your age and personal history
B. Your current medications will reduce the effectiveness of the pill
A patient is to receive an implantable contraceptive. The nurse describes this contraceptive as containing which of the following?
A. Synthetic progestin
B. Combined estrogen and progestin
C. Concentrated spermicide
D. Concentrated estrogen
A. Synthetic progestin
A woman using the cervical mucus ovulation method of fertility awareness reports that her method of fertility awareness reports that her cervical mucus looks like egg whites. The nurse interprets this as which kind of mucus?
A. Spinnbarkeit mucus
B. Purulent mucus
C. Post-ovulatory mucus
D. Normal pre-ovulation mucus
A. Spinnbarkeit mucus
Can a patient with Herpes Simplex breastfeed?
Yes
Incubation period of Syphillis
10-90 days
Syphillis transmission
Sex
Perinatal
Stages of Syphillis
Primary
Secondary
Latent (can last a long time, 20 years)
Tertiary
Primary stage of Syphillis
Painless ulcer or chancre
Painless bilateral adenopathy
Secondary stage of Syphillis
Flu-like symptoms
Maculopapular rash on the trunk, palms, soles
Alopecia
Adenopathy
Weight loss
Fever
Fatigue
Latent stage of Syphillis
No signs and symptoms but serology and can last 20 years
Tertiary stage of Syphillis
life-threatening heart disease and neurologic disease that destroys heart, eyes, brain, CNS, and skin
Syphillis diagnostics
Non-treponemal test, treponemal test (RPR)
VDRL
Syphillis effects on NB
spontaneous abortion
Low birth weight
Prematurity
Stillbirth
Multi-system failure
Mental retardation
Increased risk of HIV
Fetal death
Fetal blindness, hearing loss
Prevention of Syphillis
Condoms
Management of Syphillis
Benzathine penicillin IM, IV at all stages
Re-test at 6, 12, 24 months after treatment
Incubation period of gonorrhea
2-7 days
Gonorrhea transmission
Sex
Perinatal
Risk factors of gonorrhea
Poor socioeconomic status
Urban area
Single
Inconsistent use of barrier conctraceptives
Age <20
Multiple sex partners
Signs & symptoms of gonorrhea
Profuse watery foul-smelling discharge
Burning when peeing
Itching
Vaginal bleeding
Dysuria
PID
Neonatal conjunctivitis (NB)
Often asymptomatic
Gonorrhea effects on pregnancy/NB
Ophthalmia neonatorum
Conjunctivitis
Chorioamnionitis
fetal growth restriction
Premature labor
PROM
PP endometriosis
Ectopic pregnancy
PID
PP sepsis
Prevention of gonorrhea
Condoms
Annual Pap smear
Erythromycin ophthalmic ointment (NB)
Management of gonorrhea
Azithromycin & ceftriaxone
Incubation period of chlamydia
7-21 days
Transmission of chlamydia
Sex
Perinatal
Risk factors of chlamydia
Age <25
Multiple sex partners
Recent change of sex partners
Poor socioeconomic status
prostitution
Non-white
Single
Lack of barrier contraception
Signs and symptoms of chlamydia
Mucopurulent vaginal discharge
Salpingitis
Ophthalmia neonatorum
Conjunctivitis
Often Asymptomatic
Effects of chlamydia on pregnancy/NB
Ophthalmia neonatorum
Conjunctivitis
Infertility
Ectopic pregnancy
PID
PP endometriosis
Pre-term labor
Management of chlamydia
Doxycycline PO
Azithromycin PO
Incubation period of trichomoniasis
5-28 days
Transmission of trichomoniasis
Sex
Perinatal
Signs & symptoms of trichomoniasis
70% asymptomatic
Bad-smelling foamy yellow/green/gray vaginal discharge
Vulvar itching, soreness
Dyspareunia (pain with intercourse)
Pain when peeing
Effects of trichomoniasis on pregnancy/NB
Preterm birth
PP endometritis
PROM
Low birth weight
Prevention of trichomoniasis
Condoms
Management of trichomoniasis
Metronidazole PO
Tinidazole
*avoid ETOH and sexual activity while treating
Bacterial vaginosis incubation, transmission
Unknown
Risk factors of bacterial vaginosis
Douching
Multiple sex partners
Lack of lactobacili
Signs & symptoms of bacterial vaginosis
Thin, white homogenous vaginal discharge
Stale fish odor
Burning when peeing
Itching
Effects of bacterial vaginosis on pregnancy/NB
Preterm labor
PROM
Chorioamnionitis
PP endometritis
PID
Ectopic pregnancy
Infertility
Spontaneous abortion
Neonatal sepsis
Prevention of bacterial vaginosis
No douching
Condoms
Management of bacterial vaginosis
Metronidazole PO, gel
Clindamycin cream
Incubation period of Herpes (HSV)
2-14 days
Transmission of herpes
Mucous membranes via breaks in the skin, kissing, sex
Perinatal
Signs and symptoms of herpes
Primary:
Painful vesicular lesions
Mucopurulent discharge
Genital irritation
Malaise
Recurrent:
Tingling
Itching
Pain
Unilateral genital lesions
Herpes triggers
Fever
Stress
UV radiation
Immunosuppression
Menses
Sex
Management of herpes
Acyclovir
Famciclovir
Valacyclovir
c-section with active outbreak
BF okay with no active lesion
Incubation period of HPV
3 weeks - 8 months
Transmission of HPV
Sex
Perinatal
Risk factors of HPV
Everyone, but especially age 15-25
Multiple partners
First sexual encounter age <16
Signs and symptoms of HPV
Visible genital warts
Mostly asymptomatic
Lesions increase when pregnant
Effects of HPV on pregnancy/NB
Maternal dystocia (with large lesions)
Prevention of HPV
Serial Pap smears
HPV vaccine at age 11 preferably
Management of HPV
Trichloroacetic acid topical
Liquid nitrogen cryotherapy
Surgical excision
In vitro fertilization (IVF)
Oocytes fertilized in lab, bypasses Fallopian tube and implanted into uterus
Gamete intrafallopian transfer (GIFT)
“Gift and zift”
Oocytes and sperm combined and placed into Fallopian tube for natural fertilization to occur
Donor Oocytes or sperm
Eggs or sperm from donor and eggs are inseminated, embryos transferred via IVF
Gestational carrier (surrogacy)
Lab fertilization takes place and the embryos are transferred into another woman via gamete treatment or articulated insemination
Behavioral methods of contraception
Abstinence
Fertility awareness based methods
Withdrawal (“pull out”)
Lactation amenorrhea (during breastfeeding)
Fertility awareness-based methods
Cervical mucus
BBT
Symptothermal method
Standard days
2-day method
Barrier methods of contraception
Condoms
Diaphragms
Cervical caps
Contraceptive sponge
Chemical barriers of contraception
*should be paired with barrier method
Spermicide
Hormonal methods of contraception
Oral
Injectible
Implant
Intrauterine
Vaginal ring
Transdermal patch
Emergency oral
Depo-provera
Injectable
Progesterone only; Q3 month IM
SE: menstrual cycle disturbance, depression, acne, weight gain, loss of bone mineral density
Nexplanon
Implant
3 years of continuous effective contraception
SE: irregular bleeding, HA, weight gain, acne, increased appetite, breast tenderness, depression
IUC
T-shaped object in uterus
Inflammatory reaction to inhibit sperm & ovum from meeting; lasts 3-7 years
Potential complications of IUC method - PAINS
P = period late, pregnancy, abnormal spotting/bleeding
A = abdominal pain, pain with intercourse
I = infection exposure, abnormal vaginal discharge
N = not feeling well, fever, chills
S = string length shorter, longer or missing
NuvaRing
Vaginal ring in vagina
Flexible ring with ethinyl estradiol and etonogestrel; applied for 3 weeks, then 1 week without for bleeding
Transdermal patch
Place on skin
Continuous progesterone, estrogen; applied for 3 weeks, then 1 week without
Emergency contraceptive
Oral
used within 72-hours of unprotected intercourse, prevents embryo creation and uterine implantation
Permanent methods of contraception
Sterilization
Vasectomy
Tubal ligation
Vasectomy considerations
Cut into vas deferens; Must undergo 8-16 weeks of test until 2 (-) sperm counts
