Toni - Week 8 - Final Flashcards
1
Q
what are the 11 contraception decision factors??
A
- Effectiveness
- Safety
- Age
- Childbearing plans
- Contraindications
- Religious/moral beliefs
- Preference
- Lifestyle
- Partner cooperation
- Motivation
- Finances
2
Q
what is the longest possible fertile period?
A
8 days
3
Q
sperm survive _______ and ovum survive ______
A
7 days; 24 hrs
4
Q
In order to avoid pregnancy, when should women should abstain or use barrier method?
A
- 7 days before ovulation
- 3 days after ovulation
5
Q
what are the 5 different barrier contraceptives?
A
- male condom
- female condom
- spermicide
- diaphragm
- cervical cap
6
Q
a male condom is ____ effective, while a female condom is ____ effective
A
85%; 79%
7
Q
spermicide _____ condom effectiveness
A
increases
8
Q
diaphragm and cervical cap are both _____ effective.
A
84%
9
Q
diaphragms should be replaced every ____.
A
1 - 2 years
10
Q
when should a diaphragm be inserted? taken out?
A
inserted 4 hrs before intercourse; take out 6 hours after.
11
Q
what are hormonal contraceptives? what are the 2 different types?
A
ingested hormones
- estrogen and progestin
- progestin alone
12
Q
how do hormonal contraceptives work?
A
- inhibits ovum release
- thickens cervical mucus
13
Q
T/F: hormonal contraceptives are available in 21, 28, 91, and 365 day regimens
A
TRUE
14
Q
what is the effectiveness of hormonal contraceptives? the benefits?
A
92% effective; reduced PMS, cramps, and menstrual flow
15
Q
hormonal contraceptives protect against ____ _____.
A
bone loss
16
Q
what are the disadvantages of hormonal contraceptives?
A
- no STI protection
- ↑ risk of thromboembolism
17
Q
what are the 2 hormonal contraceptives that avoid first pass? what is their effectiveness?
A
- transdermal patch
- vaginal ring
**effectiveness: 92%
18
Q
what are characteristics of the hormonal patch?
A
a new patch once a week; patch free week’ not as effective in above 200 lb
19
Q
what are the characteristics of the ring?
A
releases estrogen and progestin; in for 3 weeks and then removed
20
Q
what are the 3 methods of sterilization?
A
vasectomy, tubal ligation, transcervical sterilization
21
Q
what is the effectiveness of sterilization?
A
> 99%
22
Q
what is depo-provera?
A
- progestin IM injection q 12 weeks
23
Q
how does depo-provera work?
A
inhibits ovulation and stimulates thick cervical mucus
24
Q
what is the effectiveness of depo-provera?
A
97%
25
what are 4 other characteristics of depo provera?
- safe for lactation
- risk of bone loss with prolonged use
- may be used for 2 years
- fertility delayed up to 18 months when d/c
26
what is a IUD?
plastic device placed in uterus that can remain 5-10 years
27
how does IUD work?
- some release progestin
| - triggers inflammation of endometrium preventing fertilization and implantation
28
how effective is UTI? what is important to teach?
99% effective; teach to check for string ends between periods; test for STI before insertion
29
what is emergency contraception?
high dose OCs given within 72 hrs of unprotected intercourse; Two doses 12hrs apart
30
how does EC work?
may prevent ovulation, fertilization, and implantation
31
EC is ____ effective
80%
32
what are the disadvantages of EC?
nausea; advise to take antiemetics
33
what is also important when someone requests EC?
counseling and discuss risky sexual behaviors
34
T/F Paragard IUD can also be used within 5 days of unprotected sex
T
35
what is a therapeutic abortion?
intentional pregnancy interruption before 20 weeks
- elective: woman's request
- therapeutic: maternal or fetal health
36
what are the 5 characteristics of TAB?
```
– Legalized 1970
– 1st trimester abortions legal
– Late abortion legality left to individual states
– Catholic-run hospitals forbid
– RN may refuse abortion care assignment
```
37
what is a surgical abortion?
• Vacuum aspiration up to 16
weeks after LMP
• Dilation & evacuation used
after 16 weeks
38
what are complications of a surgical abortion?
Complications: perforation,
hemorrhage, cervical
lacerations, infection ***prophylactic antibiotics are used
39
what is the cost of a surgical abortion?
$1,500 aspiration; more for D&E
40
what is a medical abortion?
PO within 7 weeks of LMP
- Mifepristone (RU-486)
- Misoprostol 2 days later
41
what are 2 characteristics of medical abortion?
- most woman terminate pregnancy in 5 hrs
| - return to MD to confirm
42
what are the complications of a medical abortion?
- cramping, fatigue, nausea, heavy bleeding
43
what is the cost of a medical abortion?
up to $800
44
Highest STI rates are in ____ _____ _____
sexually active adolescents
45
T/F STIs can bring significant complications
T
46
how can STIs be prevented?
- abstinence
- monogamy
- latex condoms
- prompt diagnosis and tx
- educate regarding risky behaviors
47
what are the 5 bacterial STIs
```
chlamydia
gonorrhea
syphilis
pelvic inflammatory disease
bacterial vaginosis
```
48
what are the 4 required reportable diseases?
chlamydia
gonorrhea
syphilis
PID
49
what are the 2 viral STIs
genital herpes and genital warts
50
what is the parasite STI?
trichomoniasis
51
what is the fungal STI?
candidiasis
52
what is the most common bacterial STI?
chlamydia
53
how is chlamydia transmitted?
• Transmitted via vaginal, anal, oral sex (to neonate during birth)
54
what are the s/sx of chlamydia?
• S/Sx: often asymptomatic
– Women: mucopurulent discharge, cervicitis, urethritis, vaginal
bleeding
– Men: urethritis with clear or mucoid urethral discharge
55
what can happen if chlamydia isn't treated?
• If untreated
– Mom: PID, ectopic pregnancy, infertility
– Newborn: opthalmia neonatorum/blindness; pneumonia
56
what is the tx for chlamydia?
```
• Treatment
– Azithromicin PO x 1
– Ceftriaxone IM x 1 (empiric treatment of gonorrhea)
– Treat partners/abstain until cured
– Prevention counseling/education
– Reportable STI
```
57
what is the nd most common bacterial STI?
gonorrhea
58
how is gonorrhea transmitted?
Transmitted via vaginal, anal, oral sex (neonate during birth)
59
what are the s/sx of gonorrhea?
– Women often asymptomatic; may have cervicitis/urethritis
| – Men typically present dysuria & purulent penile discharge
60
what occurs when gonorrhea is untreated?
If untreated
– Mom: PID, ectopic, infertility, preterm labor
– Newborn: opthalmia neonatorum/blindness
61
what is the tx for gonorrhea?
```
– Ceftriaxone IM x 1
– Azithromicin PO x 1 (empiric treatment of chlamydia)
– Treat partners/abstain until cured
– Prevention counseling/education
– Reportable STI
```
62
how is syphilis transmitted?
Transmitted sexual contact; crosses placenta
63
what are the s/sx of syphilis?
S/Sx vary depending on infection stage:
– Primary: painless chancre
– Secondary: fever, lymphadenopathy, HA, anorexia, rash
– Latent: asymptomatic
– Tertiary: irreversible multi organ damage & death
64
what are the screening tests for syphilis?
VDRL and RPR
65
what happens if syphilis is untreated?
Mom: SAB, stillbirth
Newborn: congenital syphilis (deformities; mental delay)
66
what is the tx for syphilis?
– Penicillin 2.4 million units IM x 1
– Treat partners/abstain until cured
– Prevention counseling/education
– Reportable STI
67
what is HPV do?
causes venereal warts; Incurable; vaccine available for common CA-causing types
68
how is HPV transmitted?
Transmitted via sexual contact or during delivery
69
what are the s/sx of HPV?
S/sx: fleshy painless growths on vagina, labia, cervix, or anus
70
how is HPV diagnosed?
Diagnosis via Pap smear, visual exam
71
what happens if HPV is untreated?
If untreated in pregnancy may obstruct birth canal &
| newborn may develop laryngeal papillomas
72
how can HPV be managed?
– May disappear without treatment
– Removal via cryotherapy, surgery, podophyllin, or acid
– Prevention counseling/education
– Sexual partner examination is not necessary
73
what is bacterial vaginosis?
* Sexually associated infection - not true STI
| * Bacteria outnumber vaginal lactobacilli; alters vaginal pH
74
what are risk factors for bacterial vaginosis?
multiple partners, douching, smoking
75
what are the s/sx of BV?
thin, gray-white vaginal discharge; fishy odor
76
how is BV diagnosed?
microscopic identification of clue cells; whiff test; vaginal
pH 4.5 or above
77
what happens when BV is untreated?
If untreated in pregnancy: PROM, chorioamnionitis, PTL, PID
78
what is the tx for BV?
– Metronidazole (Flagyl) PO bid x 7 days
– Abstain or use condom until antibiotics completed
– Treating partner not beneficial
79
what is PID?
Acute infection of uterus & fallopian tubes (from STIs)
80
what are the s/sx of PID?
dysuria, pelvic pain, fever, chills, nausea, anorexia,
| abnormal vaginal discharge or bleeding
81
how is PID diagnosed?
– STI +(chlamydia/gonorrhea), elevated WBC, CRP & ESR
| – Pain in uterus & cervix when moved during exam
82
what are the risk factors for PID?
hx STIs, young, low income, multiple
partners, recent IUD insertion, douching
**↑ risk ectopic pregnancy and infertility
83
what is the tx for PID?
– Ceftriaxone IM, doxycycline PO, metronidazole PO
– Treat partners/abstain until cured
– Prevention counseling/education
– Reportable STI
84
how is HSV transmitted?
• Transmitted: skin or sexual contact, & to neonate in vaginal
birth (viral shedding can occur in absence of visible sores)
• Highly contagious; incurable
85
what are the s/sx of HSV?
S/sx: painful blisters vulva, perineum, & anus
86
how is HSV diagnosed?
visual exam confirmed by viral culture
87
what can HSV be associated with in pregnancy?
– Mom: SAB, stillbirth
| – Neonatal herpes: CNS infection 50% mortality (risk greatest if mom gets virus 1st time in late pregnancy)
88
what is the tx for HSV?
– Acyclovir & healthy lifestyle reduces symptoms
| – C/S if active genital infection at time of birth
89
what is trichamoiasis? transmission? s/sx? diagnosis? tx?
• Causative agent: anaerobic, flagellated protozoan parasite
• Transmitted via sexual contact
• S/sx: may be asymptomatic
– Women: profuse yellow-green or frothy gray vaginal
discharge with foul odor. Vulvar pruritis/edema, dysuria,
cervicitis (strawberry cervix)
– Men: dysuria, thin, white penile discharge
• Diagnosis protozoa ID microscopically via “wet mount”
• If untreated in pregnancy: PPROM, PTL, stillbirth
• Treatment
– Metronidazole (Flagyl) po x 1 (avoid alcohol)
– Treat partners/abstain until cured
– Prevention counseling/education
90
what is genital candidiasis? transmission? s/sx? diagnosis? tx?
• Not true STI; overgrowth of vaginal yeast
• Curable with antifungal PO or vaginal suppository
• S/Sx vaginal/vulval itching, burning, vulva/vagina very red &
swollen; cottage cheese-like discharge
• If untreated: can infect newborn at birth: thrush, diaper rash,
meningitis, endocarditis, UTI, sepsis
• Oral yogurt common remedy (vaginal yoghurt also effective)
• Teach preventive measures: reduce dietary sugars, cotton
underwear, showers (no tubs), and avoid bubble bath,
douching, spandex, & super absorbent tampons/pads
