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Nursing 113 > Sexuality/std > Flashcards

Sexuality/std Flashcards

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0
Q

Chapter 5 nursing diagnosis

A 
HSBC r/t reproductive functioning
Anxiety
Pain 
Body image disturbance r/t 2nd sex 
Sexual dysfunction 
Self esteem disturbance 
Altered sexuality patterns
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1
Q

Nonverbal cues

A

Over modest
Inappropriate jokes
Any funny effects of medication?

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2
Q

Androgens

A

Adrenal cortex and gonads

Physical, muscles, sebaceous, body hair

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3
Q

Progesterone

A

Decreases mucous permeability
Decreases ovum transport
Decreases proliferation

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4
Q

Estrogen

A

Develops reproductive tract
Stops growth
Fat placement
Suppresses FSH/LH suppressing ovulation

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5
Q

Testes

A

Descend at 34-38 weeks

Undescended increases cancer risk

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6
Q

GnRH

A

Released by hypothalamus and influences pituitary

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7
Q

Pituitary

A

Releases FSH and LH that control ABP

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8
Q

LH

A

Promotes testosterone release

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9
Q

ABP

A

Androgen binding protein

Promotes sperm formation

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10
Q

Vulvar blood and nerves

A

Pudendal V&A

Pudendal, ilioinguinal, genitofemoral nerves

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11
Q

Ovary palpation

A

Can’t because so low but pain indicates problem in lower quadrants

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12
Q

Nonfunctional ovaries

A

No breasts

Male like body hair

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13
Q

Estrogen

A

Prevents osteoporosis

Keeps cholesterol low

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14
Q

Ovary anatomy

A

Epithelium
Cortex (hormone production)
Medulla

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15
Q

How eggs transport

A

Mucous
Cilia
Muscular peristalsis

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16
Q

Uterus

A

Doesn’t mature until 17 (LBW of newborns)

Stays 33% bigger after birth

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17
Q

Isthmus

A

Enlarges greatly for fetus

Part typically cut for CS

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18
Q

Cervical Os

A

Relation to is ischial spine determining fetal position

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19
Q

Pap smear

A

Sample taken between lower cervix and lower cervical canal

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20
Q

Myometrium

A

Prevents hemorrhaging during menstruation
Keeps Os closed in pregnancy
Contracts equally to expel
Contracts to close vessels postpartum

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21
Q

Uterine nerves

A

Sensory nerves lower than motor

Epidural stops pain but not contractions

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22
Q

Uterus septums

A

Present during formation but are supposed to rescind

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23
Q

Vagina

A

Elastic, strong, vascular
Glycogen rich feeding bacteria that creates lactic acid
Higher pH after menopause

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24
Q

Breast exams

A

Self Not indicated

Q12months

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25
Q

Breasts

A

20 lobes and nipple openings
Ampulla provides reservoir
Vascular

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26
Q

Proliferative phase

A

Immediately after menstruation completes
Rapid cell expansion
1-14

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27
Q

Secretory

A

Spongy velvet appearance
Glycogen rich
15-22

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28
Q

Ischemic

A

Pro and Est decrease
Endometrium sloughs off
23-24

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29
Q

Menses

A

30-80 mL blood
200 mL total
25-end

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30
Q

Cervical changes

A

During ovulation, mucous becomes thinner
Fern test positive before ovulation
Negative after

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31
Q

Spinnbarkeit test

A

Estrogen is high so vaginal mucous is stretchy between fingers

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32
Q

Menopause symptoms

A

Hot flashes, vaginal dryness, osteoporosis, bladder incontinence

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33
Q

HR therapy

A

Correlation with CVA and cancer

Short term with acute symptoms

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34
Q

Menopause therapies

A 
Low dose estrogen vaginal ring
Kegels
Calcium nasal spray
Calcitonin 
1200mg Ca and 400-800U Vit D
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35
Q

Osteoporosis risk factors

A 
Asian
Low BMI
Genetics
Nutrition 
Cigarettes 
Age
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36
Q

Preschool identity

A

Can identify but don’t care

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37
Q

School age identification

A

Strict M and F separation

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38
Q

Adolescent identity

A

Strong M or F
Educate
High suicide rate among sexually confused

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39
Q

Spinal cord injuries and sex

A

Men can achieve both

Woman can typically get pregnant

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40
Q

Homosexual sti risk factors

A

MwM highest
MwW next
WwW lowest risk

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41
Q

Megan’s Law

A

Notifying a community of registered sex offenders in the area

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42
Q

Quid pro quo harassment

A

Sex for personal gain

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43
Q

Hostile work environment

A

Discomfort or exploited worker

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44
Q

Inhibited sexual desire causes

A 
Medicines
Disease
Age
Depression
Menopause
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45
Q

Maternal Unintended pregnancy risk factors

A

Unmarried
Stalled education
Financially less stable

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46
Q

Child unintended pregnancy risk factors

A 
LBW
Abuse
Abortion
Mortality rate
Insufficient resources
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47
Q

Reproductive health tests

A

Pap
Preg test
Sti screen
CBC

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48
Q

Reproductive health history assessments

A

PT HX and FX
OB history
Sti history
Sexual history

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49
Q

Reproductive psychological assessment

A

Knowledge
Desires
Needs
Body image and self esteem

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50
Q

Reproductive ND

A 
HSB
Deficient knowledge
Spiritual distress
Low self esteem
Decision all conflict RT pregnancy/choice of contraception
Powerlessness/fear/anxiety
Ineffective sexuality pattern
RF ineffective health maintenance
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51
Q

1st three things for nurse to assess in reproductive health

A

Nurses own feelings
PT knowledge
Where PT gained knowledge

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52
Q

Contraception assessment

A 
Personal values
Clients values
HX and future
Ability to use correctly
Side effects 
Cost
PT relationships
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53
Q

Reproductive education benefits

A

Fewer unwanted pregnancies
Fewer STI
Fewer abortions

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54
Q

Contraception desired outcomes

A 
Safe
100% effective
All aspects are compatible with PT
No S/E before, during, or after
Easily used and obtained
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55
Q

Rhythm method plan

A

6 month cycle evaluation

  • 18 from shortest cycle
  • 11 from longest
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56
Q

BBT method plan

A 
Take temp each morning when waking
Temp drops .5 before and rises 1 during ovulation
Avoid sex for 3 days
75% effective
Meds and exercise affect baseline temp
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57
Q

Mucus method

A

Mucus thick and sparse until ovulation

Must monitor daily and before sexual activity

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58
Q

Symptomthermal method

A

Mucus and temp method
3 days after temp
4 days after mucus thinning

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59
Q

Ovulation detection

A

Detect LH in urine
98%+ accurate
Expensive

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60
Q

Lactation amenorrhea

A

Natural ovulation suppression while breastfeeding

Use < 3 months

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61
Q

Natural method throughout the lifespan

A

Committed relationships
Adolescents aren’t as disciplined or regular
Elder women temp and mucus change

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62
Q

Oral contraception

A

Estrogen/progesterone based
Estrogen suppresses gonadotropins
Progesterone keeps mucus thick and decreases tubal transport

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63
Q

Biphasic coc

A

Steady estrogen until increasing progestin during last 11 days

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64
Q

Triphasic

A

Estrogen and progestin vary throughout

Mimics natural cycle

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65
Q

Coc non-contraceptive decreases:

A 
Dysmenorrhea
PMS 
Acne
Fe deficiency 
PID
Cancer
Osteoporosis and endometriosis
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66
Q

Coc instructions

A

Start 2 weeks postpartum
Not effective for first week
21 active/ 7 placebo
Take at the same time everyday

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67
Q

Coc side effects

A 
Weight gain
Metrorrhagia 
Depression
Hypertension
Breast tenderness 
Nausea
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68
Q

Coc contraindications

A 
Thromboembolic disease
CvA or cardiovascular accidents
Smoking/over 35 increases clotting risks
Cancer
Pregnant/Breastfeeding/< 6 weeks postpartum
Hypertension
Hyperlipidemia
Liver problems
Diabetes
Not regular for at least 2 years
Younger adolescent
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69
Q

Coc complications

A

Angina
SHoB
Acute headache/leg pain
Changes in vision

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70
Q

Mini pills

A

Progestins thicken mucus

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71
Q

Coc and adolescents

A

Regular cycle for at least 2 years and done growing
Low compliance
High cost

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72
Q

Discontinuing COC

A

Pituitary needs 1-8 months to effectively release gonadotropins
Clomiphene restores fertility

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73
Q

Postcoital contraception

A

Morning after pill
High estrogen inhibits implantation
Causing vomiting

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74
Q

Emergency contraceptive kit

A 
Prevent
After sexual assault
Urine test and then estrogen/progesterone
Up to 5 days after
NOT PRIMARY USE
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75
Q

Plan B

A

Prescription needed under 18
75-85% effective
Started within 72 hrs and repeated in 12
Not common

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76
Q

Subdermal implant benefits

A

Used during breast feeding
No compliance
3-5 year length

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77
Q

Subdermal disadvantages

A

Long term

Teratogenic

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78
Q

Injection benefits

A 
Every 12 weeks
99% effective by suppressing ovulation
Reduces ectopic, cancer, endo, and sickle cell
Breastfeeding
Amenorrhea may occur after 12 months
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79
Q

Injection disadvantages

A

Glucose and Ca malabsorption
Not for adolescents
6-12 month to become fertile again

80
Q

IUD disadvantages

A 
Doctor needs to implant
Dysmenorrhea and heavier flow for first 3-6 months
Metrorrhagia 
TSS risk
Spontaneous abortion risk
Not for adolescent
Can take 6-12 months to become fertile
81
Q

IUD contraindications

A

Adolescent/never pregnant
Abnormal uterus
HX of ectopic, dysmenorrhea, menorrhagia, carditis, anemia
Multiple partners

82
Q

Chemical barrier disadvantages

A

Leaking
Irritating
20% failure rate
Must prepare

83
Q

Diaphragm disadvantages

A 
Compliance
Left in for 6 hours 
Healthy/normal uterus needed
No adolescent 
Dislodges
Weight loss/gain needs refitting
84
Q

Diaphragm can cause

A

TSS
UTI
Allergic reaction
Irritation

85
Q

Vasectomy disadvantages

A

Not always reversible
Risk for kidney stones
Body may form antibodies to sperm
Not for adolescents/obese

86
Q

Tubal ligation disadvantages

A

Cancer risk increases
Surgical pain/risks
Still have cycle
Symptoms similar to PDD

87
Q

Elective termination reasons:

A

Threatens moms life
Fetal defect
Rape/incest
Unwanted

88
Q

Pre-termination tests

A 
Pregnancy
CBC w/ typing
Gon/Syph 
Urinalysis
Amnio
Pap
89
Q

Federal termination guidelines

A

< 12 weeks

90
Q

State termination rules can include:

A

Regulate/forbid 2nd 3rd trimester
24 hr waiting
Counseling
Parental approval in adolescents

91
Q

Mifepristone

A 
Progesterone antagonist preventing implantation
Reduces leiomyomas
Induces labor
Cocaine detox
90-95%
92
Q

Mifepristone administration procedure

A

Single dose
Rh- woman receives RhO immune globulin
Misoprostol administered 3 days later causing contractions

93
Q

Medical termination contraindications

A 
Ectopic
IUD
Adrenal failure
Long term corticosteroids
Blood disorder
Anticoagulant therapy
Allergies
94
Q

Medical termination advantages

A

Decreased uterine damage

No anesthesia

95
Q

Medical termination disadvantages

A

Return visit for confirmation
NVD
Acute cramping

96
Q

Menstrual extraction facts

A

5-7 LMP

Vacuum extraction of uterine lining

97
Q

Menstrual extraction procedure:

A 
Voids
Peri-cleanse
Speculum
Tenaculum stabilizes cervix
Catheter inserted
Suction
Possible oxytocin
Lay supine for 15 min
98
Q

Dilatation and Curettage procedure

A 
<13 weeks
Voids
Peri-cleanse
Para cervical block
Cervix dilated
Curette scrapes
Oxytocin
1-4 hour stay at hospital
99
Q

D&C risks

A

Uterine perforation

Infection

100
Q

Dilatation and Vacuum extraction procedure

A 
12-16 weeks
Dilatation with seaweed or misoprostol
Vacuum over 15 min
Oxytocin
Supine for 15 min
101
Q

Dilatation and Vacuum risks

A

Rare uterine perforation

Infection

102
Q

Prostaglandin/Saline induction procedure

A 
16-24 weeks
Misoprostol/laminaria for dilatation
Prostaglandin administration
Oxytocin for induction
Expulsion
Oxytocin for hemorrhaging 
Examination of expelled
103
Q

Saline induction procedure

A

Voids
Abdominal anesthesia
Needle into uterus with 100-200mL 20%
12-36 hours until contractions

104
Q

Hypernatremia symptoms and treatment

A

Increased pulse
Flushed face
Acute headache

5% dextrose

105
Q

Hysterotomy when these aren’t working:

A

Oxytocin
Prostaglandin
Saline

106
Q

Hysterotomy

A

> 16 weeks
C-section
< 1% of all abortions

107
Q

Partial birth is indicated when:

A

Last trimester
Encephalocele
High meningocele
Other congenital anomalies

108
Q

Chapter 47 nursing diagnosis

A 
R/F infection
Pain RT
Disturbed body image RT breast mass
Anxiety
Fear
109
Q

Pelvis exam across the lifespan

A

Not indicated in preadolescent (Use otoscope or ear tip)
Begins when sexually active
18-20 if not sexually active

110
Q

1st phase of reproductive development

A

Reproductive differentiation In utero at 8 weeks

111
Q

2nd period of reproductive development

A

Maturation and development of sex organs and characteristics

112
Q

Congenital adrenocortical syndrome

A

Adrenal gland produces androgen instead of cortisone causing female to look male

113
Q

Ambiguous genitalia assessment

A

Karyotyping
Laprascoping abdomen for ovaries
Surgery

114
Q

Therapeutic considerations for ambiguous genitalia:

A

Will removal of X affect them later?
Should the surgery be delayed for the child to make or to mature?
Does non working part need to be removed?

115
Q

Precocious puberty origins:

A

Tumor
Hypothalamus
Gonads

116
Q

Precocious puberty signs:

A

Increased skeletal development
Increased breast development
Menstruation with few other secondary traits
Abnormal growth of male genitals

117
Q

Precocious puberty treatment:

A

Leuprolide daily SubQ desensitizes GnRH receptors

D/c at 12-13

118
Q

Testicular cancer

A

< 1%
15-35 yr old
Enlargement, heaviness, weight loss, abdominal and back pain

119
Q

Testicular cancer therapy

A

Sperm banking if needed
Removal and prosthesis
Chemo or radiation

120
Q

Mittelschmerz signs

A

Pain in lower quadrant by ovary
NVD
Scant spotting

121
Q

Dysmenorrhea signs

A 
Bloating
Cramping 
Pain in LQ
Aching in legs, vulva
Breast tenderness
122
Q

Menorrhagia signs

A

Saturating a tampon an hour or 200mL per flow

123
Q

Metrorrhagia > 1 cycle can signal:

A

Cancer or ovarian cyst

124
Q

Endometriosis causes:

A

Genetic
Deficient immune response
Excess estrogen
Failed luteal phase

125
Q

Endometriosis symptoms

A

Dysmenorrhea
Dyspareunia if culdesac
No/irregular ovulation

126
Q

Estrogen and endometriosis

A

Estrogen level stays high and blood gets forced back into Fallopian tubes by tissue

127
Q

Endometriosis therapies

A

Coc
Androgen shrinks tissue
GnRH
Laparotomy is last resort

128
Q

Amenorrhea causes

A

Extreme dieting
Extreme excercise
Low body fat
Pregnancy

129
Q

PDD symptoms

A 
Decreased ovary blood supply
Vit B deficiency
Excess estrogen
Water retention
Hypoglycemia
130
Q

Instructions to PT who think they have PDD

A

Diary of symptoms
Diet high in Vit and Ca
Low salt

131
Q

Imperforate hymen

A

Occluded vagina preventing flow

132
Q

Imperforate hymen symptoms

A

None until menstruation
Pressure building in vagina/uterus
Abdominal pain
Mass palpable in lower abdomen

133
Q

Imperforate hymen treatment

A

Use pictures to describe procedure
Local anesthesia
Incision/removal of hymen
Mild analgesia and warm bath for pain

134
Q

TSS symptoms

A 
Temp > 102
NVD
Hypotension
Shock
Impaired kidneys/liver/cognition
Headache
Severe pain
135
Q

TSS assessments

A

Pelvic and removal of debris

Culture for S aureus

136
Q

TSS treatment

A 
Iv fluids
Dopamine to elevate BP
Removal of debris
Penicillanase-resistant antibiotics (Not penicillin)
Avoid tampon use
137
Q

Vulvovaginitis signs

A 
Inflammation
Pain
Odor
Pruritus
Discharge 
Possibly bleeding
138
Q

Vulvovaginitis in preadolescent

A 
Discharge but no bleeding
Vaginal exam
Ointment/bath to clean
Rule out sexual abuse/precocious puberty/pinworm
Culture Staph/EColi
139
Q

Vulvovaginitis in adolescents

A

Discharge
Irritation
Odor

140
Q

PID causes

A

Chlamydia and Gonorrhea

141
Q

PID symptoms

A

Acute abdominal/ovarian/cervical pain
Purulent discharge
Fever
Peritoneal edema

142
Q

Untreated PID

A 
Scarring
Dysmenorrhea
Dyspareunia
Scarring
Metrorrhagia
143
Q

PID therapies

A

Analgesia
Broad spectrum
Limit activity
Drain abscesses

144
Q

Advice to post PID PT

A

High risk of reoccurrence
No sex with infected partner
Non sex while menstruating
Have kids early

145
Q

Fibrocystic breast disease treatment

A

Analgesia
Aspiration
Ultrasound
Mammogram

146
Q

STI preventative measures

A 
Education 
Condom
Voiding post
Washing with soap and water
Choose partners wisely
147
Q

HPV and women

A

Most likely to contract
Adolescents reviewed for abuse
Yearly Pap recommended
Correlated with cancer

148
Q

Hpv vaccine

A

Teenage girls

Shot, 2months, 6 months

149
Q

Hpv and pregnancy

A

Warts get bigger and can get infected

No effect on fetus

150
Q

Herpes symptoms

A

Vesicles
Painful draining Lesions
Flulike symptoms

151
Q

Herpes flair up causes:

A 
Illness
Prior to menstruation
Fever
Excessive sunlight/tanning
Stress
152
Q

Herpes treatment

A

Antiviral ointment

Sitz for comfort

153
Q

Herpes and pregnancy

A

Crosses placenta if contracted while pregnant
Given during birth
Vaginal birth preferred if no active lesions

154
Q

Gonorrhea in males

A 
2-7 day incubation
Urethritis 
Thick yellow green discharge
Itching
Urination/rectal/testicular pain
Can spread and cause sterility
155
Q

Gonorrhea in females

A 
May be asymtomatic
Slight discharge
Itching
Pain after sex/rectal
Can cause sterility through tubal scarring
156
Q

Gonorrhea assessment

A

Urine, vaginal, urethral culture

157
Q

Gonorrhea therapy timeline

A

Oral/IV treatment
Not contagious in 24 hours
Return in 7 days for follow up

158
Q

Gonorrhea and antepartum and delivery

A

Spontaneous miscarriage
Preterm birth
Endometritis postpartum
Can cause blindness if present at birth and not treated

159
Q

Progression of syphylis

A

Chancre for 6 weeks then fades
Rash and mucous lesions appears 2-4 weeks later then fades
Latent for years-decades
Finally blindness, paralysis, and cognitive failure

160
Q

Syphilis tests

A 
Serologic serum
Ven Dis Research Lab
Automated reagin test
Rapid plasma reagin test
Fluorescent treponemal antibody absorption tests (confirms VDRL)
161
Q

Syphilis treatment

A

Benzathine penicillin IM X2
Oral erythromycin 10-15 days
Cyclines

162
Q

Jarisch Herxheimer reaction

A 
Caused in adolescents post syphilis treatment
Hypotension
Fever
Tachycardia
Muscle aches
163
Q

Pregnancy and syphilis

A

Crosses at 18th week

Causes miscarriage, preterm, stillbirth, congenital anomalies

164
Q

Pregnancy and syphilis tests

A

Woman tested at 36 weeks

Baby tested with cord blood

165
Q

Newborns and syphilis

A 
Copper rash on face, palms, feet
Rhinitis
Pegged teeth
Easy tooth decay
Same as final stage for adult
166
Q

Strep and pregnancy

A

Screened at 35-38 weeks

Babies develop sepsis, pneumonia, meningitis, rds

167
Q

Erectile dysfunction causes:

A 
Disease- diabetes, neuropathy
Injury
Substances
Low T
Decreased nerves sensitivity
Hypogonadism
168
Q

Erectile disfunction risk factors

A

Age
Trauma
Disease
Substances

169
Q

Erectile dysfunction drugs:

A

Viagra and levitra PRN
Cialis daily
No nitrates/cardiac/bottom out

170
Q

IUD advantages

A

Long term
Possibly have amenorrhea after 12
Can take ibuprofen
99% effective

171
Q

Sonohysterography

A

Saline injected into uterus
Ultrasound inserted vaginally for inspection
Can be done anytime

172
Q

Hysterosalpingonography

A

Iodine/radiopaque dye introduced into cervix

If patent, flows through to ovaries and outlines

173
Q

Hysterosalpingonography disadvantages

A

Rare infection/allergy
Must be done post menses
Can cause acute cramping

174
Q

Hysterosalpingonography benefits

A

Can break up masses

Can increase patency

175
Q

Male sperm facts

A

20-200 mil sperm/mL
2.5-5 mL
> 50% mobile
> 30% normal shape

176
Q

Sex 4 times/week for 6 and 12 months:

A

6- 50% pregnancy

12- 85%

177
Q

Subfertility assessments:

A

Semen analysis
Ovulation analysis
Tubal patency

178
Q

Sterility

A

From known condition like absent testicles or uterus

179
Q

Subfertile causes

A

Disease
Semen
Ovulation
Patency

180
Q

Male subfertile causes:

A 
Pancreas, thyroid, pituitary imbalance
Substances
Thermoregulation/blood flow 
Long sitting
Infection
Autoimmune
181
Q

Female subfertile causes

A 
Nutrition
Weight
Exercise
High Glucose/insulin
Stress
Poly cystic ovary disease 
Plumbing
182
Q

Endometrial biopsy

A 
3 days before menses
Anesthesia block
Inserted through cervix
Sample should look like corkscrew indicating progesterone
Call back with next menses
183
Q

Biopsy contraindications

A

Current infection
Current STI
Pregnant

184
Q

Biopsy complications

A

Bleeding
Infection
Uterine perforation

185
Q

Pre-therapeutic insemination tasks:

A

Mucus, BBT, ovulation kit

Blood type/rH factor of donor

186
Q

IVF procedure

A 
GnRH hormones administered
Ultrasound daily to view eggs
HCG to cause ovulation in 36-48 hrs
Extraction
8 hr incubation
Sperm introduced
40 hr incubation
1-2 zygotes introduced back
187
Q

Al states must report within 24 hours

A

Gonorrhea
Syphilis
HIV-Aids
Confirmed chlamydia in most states by 7 days

188
Q

When to get STI tested

A

Stopping sex relationship and before starting another
Regularly with multiple partners
Any STI symptoms

189
Q

3 categories of STI

A

Bacterial
Viral
Parasitic

190
Q

Candidiasis symptoms

A 
White discharge
Itching
Burning 
Dry skin
Occasional dsyurea
191
Q

Chlamydia symptoms

A

Runny grayish white discharge and dsyurea

Inflammation

192
Q

Hpv treatments

A

Gardasil (quadrivalent)

Cervarix (Bivalent)

193
Q

Gardasil

A

HPV vaccine mostly in teens

Homosexual men can get until 26

194
Q

Ed nursing dx

A

Knowledge deficit
Situational low self esteem
Sexual dysfunction

195
Q

Coc drug interactions

A

Acetaminophen
Anti coagulants
Antibiotics
Seizure meds

196
Q

Depo

A

Q12 weeks

Im

197
Q

Permanent birth control methods

A

Vasectomy
Ligation
Essure block

Nursing 113 (10 decks)

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