Reproductive, Contraception Flashcards

1
Q

What are curable STIs?

A

Syphilis
Gonorrhea
Chlamydia
Trichomoniasis

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2
Q

What are non-curable STIs?

A

Hep B
Herpes
HIV/AIDS
HPV

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3
Q

What are pregnancy/NB complications of STIs?

A

PROM
stillbirth
Spontaneous abortion
Small gestational age
Damage to brain, eyes, ears
Death

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4
Q

Which STIs are nurses legally responsible to report?

A

Chlamydia is most states
Gonorrhea, syphilis, HIV/AIDS in ALL states

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5
Q

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

A. The kit has detected an increased presence of luteinizing hormone (LH) in the urine

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6
Q

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

A

C. A failure to ovulate

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7
Q

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

A

D. Fertility testing usually begins with ovulation monitoring in the woman

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8
Q

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

A

C. The feeling of being male or female

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9
Q

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

A

B. Explain that because of her low body fat, it is not unusual for menstruation not to have begun yet

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10
Q

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

A

D. 43-year old who doesn’t smoke cigarettes

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11
Q

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

A

B. Your current medications will reduce the effectiveness of the pill

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12
Q

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

A. Synthetic progestin

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13
Q

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

A. Spinnbarkeit mucus

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14
Q

Can a patient with Herpes Simplex breastfeed?

A

Yes

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15
Q

Incubation period of Syphillis

A

10-90 days

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16
Q

Syphillis transmission

A

Sex
Perinatal

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17
Q

Stages of Syphillis

A

Primary
Secondary
Latent (can last a long time, 20 years)
Tertiary

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18
Q

Primary stage of Syphillis

A

Painless ulcer or chancre
Painless bilateral adenopathy

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19
Q

Secondary stage of Syphillis

A

Flu-like symptoms
Maculopapular rash on the trunk, palms, soles
Alopecia
Adenopathy
Weight loss
Fever
Fatigue

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20
Q

Latent stage of Syphillis

A

No signs and symptoms but serology and can last 20 years

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21
Q

Tertiary stage of Syphillis

A

life-threatening heart disease and neurologic disease that destroys heart, eyes, brain, CNS, and skin

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22
Q

Syphillis diagnostics

A

Non-treponemal test, treponemal test (RPR)
VDRL

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23
Q

Syphillis effects on NB

A

spontaneous abortion
Low birth weight
Prematurity
Stillbirth
Multi-system failure
Mental retardation
Increased risk of HIV
Fetal death
Fetal blindness, hearing loss

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24
Q

Prevention of Syphillis

A

Condoms

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25
Q

Management of Syphillis

A

Benzathine penicillin IM, IV at all stages
Re-test at 6, 12, 24 months after treatment

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26
Q

Incubation period of gonorrhea

A

2-7 days

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27
Q

Gonorrhea transmission

A

Sex
Perinatal

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28
Q

Risk factors of gonorrhea

A

Poor socioeconomic status
Urban area
Single
Inconsistent use of barrier conctraceptives
Age <20
Multiple sex partners

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29
Q

Signs & symptoms of gonorrhea

A

Profuse watery foul-smelling discharge
Burning when peeing
Itching
Vaginal bleeding
Dysuria
PID
Neonatal conjunctivitis (NB)
Often asymptomatic

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30
Q

Gonorrhea effects on pregnancy/NB

A

Ophthalmia neonatorum
Conjunctivitis
Chorioamnionitis
fetal growth restriction
Premature labor
PROM
PP endometriosis
Ectopic pregnancy
PID
PP sepsis

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31
Q

Prevention of gonorrhea

A

Condoms
Annual Pap smear
Erythromycin ophthalmic ointment (NB)

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32
Q

Management of gonorrhea

A

Azithromycin & ceftriaxone

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33
Q

Incubation period of chlamydia

A

7-21 days

34
Q

Transmission of chlamydia

A

Sex
Perinatal

35
Q

Risk factors of chlamydia

A

Age <25
Multiple sex partners
Recent change of sex partners
Poor socioeconomic status
prostitution
Non-white
Single
Lack of barrier contraception

36
Q

Signs and symptoms of chlamydia

A

Mucopurulent vaginal discharge
Salpingitis
Ophthalmia neonatorum
Conjunctivitis
Often Asymptomatic

37
Q

Effects of chlamydia on pregnancy/NB

A

Ophthalmia neonatorum
Conjunctivitis
Infertility
Ectopic pregnancy
PID
PP endometriosis
Pre-term labor

38
Q

Management of chlamydia

A

Doxycycline PO
Azithromycin PO

39
Q

Incubation period of trichomoniasis

A

5-28 days

40
Q

Transmission of trichomoniasis

A

Sex
Perinatal

41
Q

Signs & symptoms of trichomoniasis

A

70% asymptomatic
Bad-smelling foamy yellow/green/gray vaginal discharge
Vulvar itching, soreness
Dyspareunia (pain with intercourse)
Pain when peeing

42
Q

Effects of trichomoniasis on pregnancy/NB

A

Preterm birth
PP endometritis
PROM
Low birth weight

43
Q

Prevention of trichomoniasis

A

Condoms

44
Q

Management of trichomoniasis

A

Metronidazole PO
Tinidazole

*avoid ETOH and sexual activity while treating

45
Q

Bacterial vaginosis incubation, transmission

A

Unknown

46
Q

Risk factors of bacterial vaginosis

A

Douching
Multiple sex partners
Lack of lactobacili

47
Q

Signs & symptoms of bacterial vaginosis

A

Thin, white homogenous vaginal discharge
Stale fish odor
Burning when peeing
Itching

48
Q

Effects of bacterial vaginosis on pregnancy/NB

A

Preterm labor
PROM
Chorioamnionitis
PP endometritis
PID
Ectopic pregnancy
Infertility
Spontaneous abortion
Neonatal sepsis

49
Q

Prevention of bacterial vaginosis

A

No douching
Condoms

50
Q

Management of bacterial vaginosis

A

Metronidazole PO, gel
Clindamycin cream

51
Q

Incubation period of Herpes (HSV)

A

2-14 days

52
Q

Transmission of herpes

A

Mucous membranes via breaks in the skin, kissing, sex
Perinatal

53
Q

Signs and symptoms of herpes

A

Primary:
Painful vesicular lesions
Mucopurulent discharge
Genital irritation
Malaise

Recurrent:
Tingling
Itching
Pain
Unilateral genital lesions

54
Q

Herpes triggers

A

Fever
Stress
UV radiation
Immunosuppression
Menses
Sex

55
Q

Management of herpes

A

Acyclovir
Famciclovir
Valacyclovir

c-section with active outbreak
BF okay with no active lesion

56
Q

Incubation period of HPV

A

3 weeks - 8 months

57
Q

Transmission of HPV

A

Sex
Perinatal

58
Q

Risk factors of HPV

A

Everyone, but especially age 15-25
Multiple partners
First sexual encounter age <16

59
Q

Signs and symptoms of HPV

A

Visible genital warts
Mostly asymptomatic
Lesions increase when pregnant

60
Q

Effects of HPV on pregnancy/NB

A

Maternal dystocia (with large lesions)

61
Q

Prevention of HPV

A

Serial Pap smears
HPV vaccine at age 11 preferably

62
Q

Management of HPV

A

Trichloroacetic acid topical
Liquid nitrogen cryotherapy
Surgical excision

63
Q

In vitro fertilization (IVF)

A

Oocytes fertilized in lab, bypasses Fallopian tube and implanted into uterus

64
Q

Gamete intrafallopian transfer (GIFT)

A

“Gift and zift”

Oocytes and sperm combined and placed into Fallopian tube for natural fertilization to occur

65
Q

Donor Oocytes or sperm

A

Eggs or sperm from donor and eggs are inseminated, embryos transferred via IVF

66
Q

Gestational carrier (surrogacy)

A

Lab fertilization takes place and the embryos are transferred into another woman via gamete treatment or articulated insemination

67
Q

Behavioral methods of contraception

A

Abstinence
Fertility awareness based methods
Withdrawal (“pull out”)
Lactation amenorrhea (during breastfeeding)

68
Q

Fertility awareness-based methods

A

Cervical mucus
BBT
Symptothermal method
Standard days
2-day method

69
Q

Barrier methods of contraception

A

Condoms
Diaphragms
Cervical caps
Contraceptive sponge

70
Q

Chemical barriers of contraception

A

*should be paired with barrier method

Spermicide

71
Q

Hormonal methods of contraception

A

Oral
Injectible
Implant
Intrauterine
Vaginal ring
Transdermal patch
Emergency oral

72
Q

Depo-provera

A

Injectable

Progesterone only; Q3 month IM

SE: menstrual cycle disturbance, depression, acne, weight gain, loss of bone mineral density

73
Q

Nexplanon

A

Implant

3 years of continuous effective contraception

SE: irregular bleeding, HA, weight gain, acne, increased appetite, breast tenderness, depression

74
Q

IUC

A

T-shaped object in uterus

Inflammatory reaction to inhibit sperm & ovum from meeting; lasts 3-7 years

75
Q

Potential complications of IUC method - PAINS

A

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

76
Q

NuvaRing

A

Vaginal ring in vagina

Flexible ring with ethinyl estradiol and etonogestrel; applied for 3 weeks, then 1 week without for bleeding

77
Q

Transdermal patch

A

Place on skin

Continuous progesterone, estrogen; applied for 3 weeks, then 1 week without

78
Q

Emergency contraceptive

A

Oral

used within 72-hours of unprotected intercourse, prevents embryo creation and uterine implantation

79
Q

Permanent methods of contraception

A

Sterilization
Vasectomy
Tubal ligation

80
Q

Vasectomy considerations

A

Cut into vas deferens; Must undergo 8-16 weeks of test until 2 (-) sperm counts