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Nursing Semester 2 > Toni - Week 8 - Final > Flashcards

Toni - Week 8 - Final Flashcards

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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
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2
Q

what is the longest possible fertile period?

A

8 days

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3
Q

sperm survive _______ and ovum survive ______

A

7 days; 24 hrs

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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

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5
Q

what are the 5 different barrier contraceptives?

A
  • male condom
  • female condom
  • spermicide
  • diaphragm
  • cervical cap
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6
Q

a male condom is ____ effective, while a female condom is ____ effective

A

85%; 79%

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7
Q

spermicide _____ condom effectiveness

A

increases

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8
Q

diaphragm and cervical cap are both _____ effective.

A

84%

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9
Q

diaphragms should be replaced every ____.

A

1 - 2 years

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10
Q

when should a diaphragm be inserted? taken out?

A

inserted 4 hrs before intercourse; take out 6 hours after.

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11
Q

what are hormonal contraceptives? what are the 2 different types?

A

ingested hormones

  • estrogen and progestin
  • progestin alone
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12
Q

how do hormonal contraceptives work?

A
  • inhibits ovum release

- thickens cervical mucus

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13
Q

T/F: hormonal contraceptives are available in 21, 28, 91, and 365 day regimens

A

TRUE

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14
Q

what is the effectiveness of hormonal contraceptives? the benefits?

A

92% effective; reduced PMS, cramps, and menstrual flow

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15
Q

hormonal contraceptives protect against ____ _____.

A

bone loss

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16
Q

what are the disadvantages of hormonal contraceptives?

A
  • no STI protection

- ↑ risk of thromboembolism

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17
Q

what are the 2 hormonal contraceptives that avoid first pass? what is their effectiveness?

A
  • transdermal patch
  • vaginal ring

**effectiveness: 92%

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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

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19
Q

what are the characteristics of the ring?

A

releases estrogen and progestin; in for 3 weeks and then removed

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20
Q

what are the 3 methods of sterilization?

A

vasectomy, tubal ligation, transcervical sterilization

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21
Q

what is the effectiveness of sterilization?

A

> 99%

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22
Q

what is depo-provera?

A
  • progestin IM injection q 12 weeks
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23
Q

how does depo-provera work?

A

inhibits ovulation and stimulates thick cervical mucus

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24
Q

what is the effectiveness of depo-provera?

A

97%

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25
Q

what are 4 other characteristics of depo provera?

A
  • 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
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26
Q

what is a IUD?

A

plastic device placed in uterus that can remain 5-10 years

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27
Q

how does IUD work?

A
  • some release progestin

- triggers inflammation of endometrium preventing fertilization and implantation

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28
Q

how effective is UTI? what is important to teach?

A

99% effective; teach to check for string ends between periods; test for STI before insertion

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29
Q

what is emergency contraception?

A

high dose OCs given within 72 hrs of unprotected intercourse; Two doses 12hrs apart

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30
Q

how does EC work?

A

may prevent ovulation, fertilization, and implantation

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31
Q

EC is ____ effective

A

80%

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32
Q

what are the disadvantages of EC?

A

nausea; advise to take antiemetics

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33
Q

what is also important when someone requests EC?

A

counseling and discuss risky sexual behaviors

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34
Q

T/F Paragard IUD can also be used within 5 days of unprotected sex

A

T

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35
Q

what is a therapeutic abortion?

A

intentional pregnancy interruption before 20 weeks

  • elective: woman’s request
  • therapeutic: maternal or fetal health
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36
Q

what are the 5 characteristics of TAB?

A 
– Legalized 1970
– 1st trimester abortions legal
– Late abortion legality left to individual states
– Catholic-run hospitals forbid
– RN may refuse abortion care assignment
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37
Q

what is a surgical abortion?

A

• Vacuum aspiration up to 16
weeks after LMP
• Dilation & evacuation used
after 16 weeks

38
Q

what are complications of a surgical abortion?

A

Complications: perforation,
hemorrhage, cervical
lacerations, infection ***prophylactic antibiotics are used

39
Q

what is the cost of a surgical abortion?

A

$1,500 aspiration; more for D&E

40
Q

what is a medical abortion?

A

PO within 7 weeks of LMP

  • Mifepristone (RU-486)
  • Misoprostol 2 days later
41
Q

what are 2 characteristics of medical abortion?

A
  • most woman terminate pregnancy in 5 hrs

- return to MD to confirm

42
Q

what are the complications of a medical abortion?

A
  • cramping, fatigue, nausea, heavy bleeding
43
Q

what is the cost of a medical abortion?

A

up to $800

44
Q

Highest STI rates are in ____ _____ _____

A

sexually active adolescents

45
Q

T/F STIs can bring significant complications

A

T

46
Q

how can STIs be prevented?

A
  • abstinence
  • monogamy
  • latex condoms
  • prompt diagnosis and tx
  • educate regarding risky behaviors
47
Q

what are the 5 bacterial STIs

A 
chlamydia
gonorrhea
syphilis 
pelvic inflammatory disease
bacterial vaginosis
48
Q

what are the 4 required reportable diseases?

A

chlamydia
gonorrhea
syphilis
PID

49
Q

what are the 2 viral STIs

A

genital herpes and genital warts

50
Q

what is the parasite STI?

A

trichomoniasis

51
Q

what is the fungal STI?

A

candidiasis

52
Q

what is the most common bacterial STI?

A

chlamydia

53
Q

how is chlamydia transmitted?

A

• Transmitted via vaginal, anal, oral sex (to neonate during birth)

54
Q

what are the s/sx of chlamydia?

A

• S/Sx: often asymptomatic
– Women: mucopurulent discharge, cervicitis, urethritis, vaginal
bleeding
– Men: urethritis with clear or mucoid urethral discharge

55
Q

what can happen if chlamydia isn’t treated?

A

• If untreated
– Mom: PID, ectopic pregnancy, infertility
– Newborn: opthalmia neonatorum/blindness; pneumonia

56
Q

what is the tx for chlamydia?

A 
• Treatment
– Azithromicin PO x 1
– Ceftriaxone IM x 1 (empiric treatment of gonorrhea)
– Treat partners/abstain until cured
– Prevention counseling/education
– Reportable STI
57
Q

what is the nd most common bacterial STI?

A

gonorrhea

58
Q

how is gonorrhea transmitted?

A

Transmitted via vaginal, anal, oral sex (neonate during birth)

59
Q

what are the s/sx of gonorrhea?

A

– Women often asymptomatic; may have cervicitis/urethritis

– Men typically present dysuria & purulent penile discharge

60
Q

what occurs when gonorrhea is untreated?

A

If untreated
– Mom: PID, ectopic, infertility, preterm labor
– Newborn: opthalmia neonatorum/blindness

61
Q

what is the tx for gonorrhea?

A 
– Ceftriaxone IM x 1
– Azithromicin PO x 1 (empiric treatment of chlamydia)
– Treat partners/abstain until cured
– Prevention counseling/education
– Reportable STI
62
Q

how is syphilis transmitted?

A

Transmitted sexual contact; crosses placenta

63
Q

what are the s/sx of syphilis?

A

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
Q

what are the screening tests for syphilis?

A

VDRL and RPR

65
Q

what happens if syphilis is untreated?

A

Mom: SAB, stillbirth
Newborn: congenital syphilis (deformities; mental delay)

66
Q

what is the tx for syphilis?

A

– Penicillin 2.4 million units IM x 1
– Treat partners/abstain until cured
– Prevention counseling/education
– Reportable STI

67
Q

what is HPV do?

A

causes venereal warts; Incurable; vaccine available for common CA-causing types

68
Q

how is HPV transmitted?

A

Transmitted via sexual contact or during delivery

69
Q

what are the s/sx of HPV?

A

S/sx: fleshy painless growths on vagina, labia, cervix, or anus

70
Q

how is HPV diagnosed?

A

Diagnosis via Pap smear, visual exam

71
Q

what happens if HPV is untreated?

A

If untreated in pregnancy may obstruct birth canal &

newborn may develop laryngeal papillomas

72
Q

how can HPV be managed?

A

– May disappear without treatment
– Removal via cryotherapy, surgery, podophyllin, or acid
– Prevention counseling/education
– Sexual partner examination is not necessary

73
Q

what is bacterial vaginosis?

A
  • Sexually associated infection - not true STI

* Bacteria outnumber vaginal lactobacilli; alters vaginal pH

74
Q

what are risk factors for bacterial vaginosis?

A

multiple partners, douching, smoking

75
Q

what are the s/sx of BV?

A

thin, gray-white vaginal discharge; fishy odor

76
Q

how is BV diagnosed?

A

microscopic identification of clue cells; whiff test; vaginal
pH 4.5 or above

77
Q

what happens when BV is untreated?

A

If untreated in pregnancy: PROM, chorioamnionitis, PTL, PID

78
Q

what is the tx for BV?

A

– Metronidazole (Flagyl) PO bid x 7 days
– Abstain or use condom until antibiotics completed
– Treating partner not beneficial

79
Q

what is PID?

A

Acute infection of uterus & fallopian tubes (from STIs)

80
Q

what are the s/sx of PID?

A

dysuria, pelvic pain, fever, chills, nausea, anorexia,

abnormal vaginal discharge or bleeding

81
Q

how is PID diagnosed?

A

– STI +(chlamydia/gonorrhea), elevated WBC, CRP & ESR

– Pain in uterus & cervix when moved during exam

82
Q

what are the risk factors for PID?

A

hx STIs, young, low income, multiple
partners, recent IUD insertion, douching
**↑ risk ectopic pregnancy and infertility

83
Q

what is the tx for PID?

A

– Ceftriaxone IM, doxycycline PO, metronidazole PO
– Treat partners/abstain until cured
– Prevention counseling/education
– Reportable STI

84
Q

how is HSV transmitted?

A

• Transmitted: skin or sexual contact, & to neonate in vaginal
birth (viral shedding can occur in absence of visible sores)
• Highly contagious; incurable

85
Q

what are the s/sx of HSV?

A

S/sx: painful blisters vulva, perineum, & anus

86
Q

how is HSV diagnosed?

A

visual exam confirmed by viral culture

87
Q

what can HSV be associated with in pregnancy?

A

– Mom: SAB, stillbirth

– Neonatal herpes: CNS infection 50% mortality (risk greatest if mom gets virus 1st time in late pregnancy)

88
Q

what is the tx for HSV?

A

– Acyclovir & healthy lifestyle reduces symptoms

– C/S if active genital infection at time of birth

89
Q

what is trichamoiasis? transmission? s/sx? diagnosis? tx?

A

• 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
Q

what is genital candidiasis? transmission? s/sx? diagnosis? tx?

A

• 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

Nursing Semester 2 (21 decks)

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