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Nursing Health Promotion > Unit 3 > Flashcards

Unit 3 Flashcards

1
Q

What are the two phases of the ovarian cycle?

A

Follicular (first 7 days) and Luteal phase

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2
Q

What are the predominant gonadotropic hormone levels in each phase of the ovarian cycle?

A

Follicular: FSH Luteal: LH

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3
Q

Describe the ovarian hormone levels in the ovarian cycle

A

During follicular phase, estrogen levels rise and peak around day 13 During luteal phase, progesterone levels rise and peak around day 20 (and inhibin peaks around day 22)

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4
Q

Describe the endometrial changes during the ovarian cycle

A

Days 1-7: Menses Days 8-14: Repair and regeneration Days 15-28: Secretion of endometrial glands

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5
Q

Describe changes in basal body temperature during the ovarian cycle

A

BBT rises approximately 1 degree (0.3 C) during luteal phase

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6
Q

Menarche

A

Age of first period

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7
Q

Menopause

A

Amenorrhea for one year (average age 51.9)

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8
Q

Metrorrhagia

A

Off-schedule bleeding

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9
Q

Menorrhagia

A

Excessive, profuse menstrual flow

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10
Q

Dysmenorrhea

A

Painful menstruation Primary: Cramping w/o prostaglandin disease Secondary: Associated pathology

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11
Q

Dyspareunia

A

Pain with intercourse

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12
Q

Amenorrhea

A

Absence of menstruation Primary: Not started by age 14/16 Secondary: Ceases for 6 months

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13
Q

When does PMS occur?

A

During luteal phase (resolves with menses)

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14
Q

What bacteria causes toxic shock syndrome?

A

S. aureus

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15
Q

What is endometriosis?

A
  • Endometrial tissue found outside of uterus - Chronic and progressive - Causes infertility, dyspareunia, pain
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16
Q

What is polycystic ovarian syndrome?

A

Multiple inactive ovarian follicles that interrupt ovarian function (irregular periods)

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17
Q

At what time would one best measure their basal body temperature?

A

When first waking up

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18
Q

What are the most effective (99%) birth control methods?

A

Sterilization, IUD, implant

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19
Q

What are “very effective” (90-99%) birth control methods?

A

OCP, injectables, patch, ring

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20
Q

What are “moderately effective” (80-90%) birth control methods?

A

Condoms (M or F), sponge, diaphragm

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21
Q

What are “effective” (80%) birth control methods?

A

Fertility awareness, cervical cap, spermicide

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22
Q

What is transcervical sterilization?

A

Essure - flexible springs in proximal ends of fallopian tubes

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23
Q

What is the warning acronym for IUD/IUC devices?

A

PAINS P - period late, pregnancy, spotting or bleeding A - Abdominal pain, dyspareunia I - Infection exposure, abnormal discharge N - Not feeling well, fever, chills S - String length (check if missing)

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24
Q

What is the warning acronym for oral contraceptives?

A

ACHES A - Abdominal pain (liver or gallbladder) C - Chest pain or SOB H - Headaches E - Eye problems S - Severe leg pain

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25
Q

How soon must the emergency contraceptive be used?

A

Within 72 hours

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26
Q

What type of medications might reduce the effectiveness of OCP?

A

Seizure medications and antibiotics

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27
Q

Who should not use OCP?

A

Smokers - increased risk of MI, stroke, HTN

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28
Q

Who should not use the weekly patch?

A

Women over 198 pounds

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29
Q

How long after a vasectomy will a man be sterile?

A

About 36 ejaculations (recheck at 6 and 12 months)

30
Q

For what ages does the USPTSTF recommend mammograms?

A

50-74

31
Q

Who should not use HRT?

A

Hx of breast cancer, blood coagulation disorders, smokers, HTN, diabetics, CAD, renal or liver disease

32
Q

What are risk factors for osteoporosis?

A

Increased age, small frame, white/asian, family hx, rheumatoid arthritis

33
Q

What are some ways to manage osteoporosis?

A

Weight bearing exercises, no smoking or alcohol, calcium, vitamin D, medications (calcitonin, HRT, SERMS, bisphosphonates)

34
Q

Infections characterized by vaginal/penile discharge

A

Trichomoniasis, bacterial vaginosis

35
Q

Infections characterized by cervicitis

A

Chlamydia, gonorrhea

36
Q

Infections characterized by genital ulcers

A

Herpes, syphilis

37
Q

Vaccine preventable STIs

A

Hep A/B, HPV

38
Q

Describe system for naming parity

A

GTPAL Gravida Term births (38-42 weeks) Preterm births (20-37 weeks and viable) Abortions (<20 or viability) Living children

39
Q

What is Nagele rule?

A
  • First day of LMP – 3 mo + 7 days + 1 year = EDD - Margin of error is +/- two weeks – any birth within this timeframe is considered a normal range
40
Q

What are presumptive signs of pregnancy?

A
  • Presumptive (subjective) – signs that the mother can see
    • Absence of menstruation (most obvious sign), nausea, fatigue, breast tenderness, and urinary frequency
41
Q

What are probable signs of pregnancy?

A
  • Probable (objective) – can be detected upon physical examination by a provider
    • Hegar’s sign – Softening of the lower uterine segment or isthmus
    • Goodell’s sign – softening of the cervix
    • Chadwick’s sign – a blueish-purple coloration of the vaginal mucosa and cervix
    • Pregnancy test – tests for human chorionic gonadotropin (hCG) in serum
      • 5% test positive by day 8
      • 98% test positive by day 11
      • hCG levels double every 48-72 hours and peak 60-70 days after fertilization, then decrease and plateau around 100-130 days of pregnancy
      • Low levels of hCG are associated with ectopic pregnancies
      • Higher levels are associated with molar or multiple gestational pregnancies
      • Elevated hCG corresponds to morning sickness of 6-12 weeks
42
Q

What are positive signs of pregnancy? (How many are there?)

A
  • Three positive signs of pregnancy
  • Positive – performed by healthcare professional
    • Visualizing fetus by ultrasound
    • Palpating for fetal movements
    • Hearing a fetal heartbeat
43
Q

When do Braxton-Hicks contractions start?

A

They can start the first trimester, but get stronger towards the end of pregnancy. “Practice” contractions that help efface (thin) cervix.

44
Q

Would white discharge from the vagina be concerning during pregnancy?

A

Only if painful/itching

45
Q

What causes ovulation to cease during pregnancy?

A

Elevated estrogen and progesterone levels

46
Q

What does the corpus luteum secrete and for how long after fertilization? What takes over?

A

Progesterone - for the first trimester then the placenta takes over

47
Q

What does progesterone do to the intestine?

A

Causes smooth muscle relaxation –> constipation

48
Q

What happens to blood pressure during pregnancy?

A

Typically goes down - any increase should be reported

(Progesterone causes vasodilation)

49
Q

What are the psychological changes during pregnancy?

A
  • Ambivalence – 1st trimester
  • Introversion – 1st and 3rd trimesters
  • Acceptance – 2nd trimester
  • Mood swings/Emotional liability – common throughout pregnancy
  • Changes in body image – common and vary from woman to woman
50
Q

What is it called when the man experiences pregnancy symptoms? What are the most common symptoms he experiences?

A

Couvade syndrome - nausea, vomitting, and weight gain

51
Q

What are milemarkers for the fundus during pregnancy?

A
  • 12 weeks can be palpated and is at symphysis pubis
  • 16 weeks midway to umbilicus
  • 20 weeks at the umbilicus
  • 36 weeks just below xyphoid process
52
Q

Discuss assessment of edema during pregnancy

A
  • May indicate gestational hypertension if noted early in pregnancy
  • Dependent edema normal in third trimester
  • Ask about pain with ambulation, which can indicate DVT (increased risk caused by increased estrogen levels)
53
Q

What are factors for a high risk pregnancy?

A
  • Previous child with congenital anomaly
  • Hx of gestational diabetes or polyhydramnios
  • Family hx of diabetes
  • Corticosteroids or antipsychotics
  • Age 35+
  • Polycystic ovarian syndrome
  • Multiple pregnancy (twins, triplets)
  • Previous infant over 9 pounds
  • Previous unexplained neonatal death
  • Maternal obesity (BMI >30)
  • HTN before or during early pregnancy
  • Hispanic, Native American, Pacific Islander, or African American
  • Recurrent non-responsive monilial infections
  • Polyuria, polyphagia, polydipsia, fatigue (signs of glucose intolerance)
  • Glycosuria or proteinuria
54
Q

What vaccine cannot be given while pregnant?

A

Rubella (will be given after birth)

55
Q

What are the FDA recommendations for eating fish during pregnancy?

A
  • Avoid fish with moderate to high mercury 6-12 months before conception
  • Avoid shark, swordfish, king mackerel, orange roughy, ahi tuna, and tilefish (high mercury levels)
  • Eat up to 12 ounces (two meals) weekly of low-mercury fish – shrimp, canned tuna, salmon, pollock, and catfish
56
Q

What are best practices for a woman to avoid listeria during pregnancy?

A
  • Hot dogs, lunch meat, and deli meat should be reheated until steaming hot – do not eat cold
  • Avoid getting fluids from the above on cooking surfaces, utensils, etc.
  • Do not eat soft cheeses such as feta, Brie, Camembert, and blue-veined cheeses
  • It is safe to eat hard cheeses and semi-soft cheeses (mozzarella, processed cheese slices and spreads, cream cheese, and cottage cheese)
  • Do not eat refrigerated pate or meat spreads
  • Do not eat refrigerated smoked seafood unless it is an ingredient in a casserole
  • It is safe to eat canned fish or shelf-stable smoked seafood
  • Use all refrigerated perishables as soon as possible
  • Use a refrigerator thermometer to ensure temperature is 40F (5C) or below
  • Do not eat store-bought salads such as ham salad, chicken salad, egg salad, tuna salad, or seafood salad
  • Clean your refrigerator regularly
57
Q

Nursing interventions for urinary frequency or incontinence

A
  • Pelvic floor exercises
  • Empty bladder when you first feel full
  • Avoid caffeinated drinks, which stimulate voiding
  • Reduce fluid intake after dinner to reduce nighttime urination
58
Q

Nursing interventions for fatigue during pregnancy

A
  • Attempt to get a full night’s sleep
  • Eat a healthy and balanced diet
  • Schedule a nap in the early afternoon daily
  • When you feel tired, rest
59
Q

Nursing interventions for nausea and vomiting during pregnancy

A
  • Avoid an empty stomach always
  • Eat crackers/toast in bed before getting up
  • Eat several small meals
  • Don’t brush teeth immediately after eating to avoid gag reflex
  • Acupressure wristbands
  • Drink fluids between meals not with meals
  • Avoid greasy/fried foods and strong-smelling foods (cabbage, Brussels sprouts)
60
Q

Nursing interventions for sore back during pregnancy

A
  • Change positions often
  • Heating pad
  • Back pillows
  • Proper body mechanics
  • Avoid excessive bending/lifting/walking
  • Avoid high heels
  • Stand with shoulders back
61
Q

What are common discomforts for each trimester

A
  • First Trimester
    • Urinary frequency and incontinence
    • Fatigue
    • Nausea and vomiting
    • Breast tenderness
    • Constipation
    • Nasal stuffiness and bleeding gums (bleeding nose)
    • Cravings
    • Leukorrhea (increased vaginal discharge – should not burn or itch)
  • Second Trimester
    • Backache
    • Leg cramps
    • Varicosities of the vulva and legs
    • Hemorrhoids
    • Flatulence with bloating
  • Third Trimester
    • Shortness of breath and dyspnea
    • Heartburn and indigestion
    • Dependent edema
    • Braxton Hicks Contractions
62
Q

What are warning signs for each trimester?

A
  • First Trimester
    • Spotting or bleeding (miscarriage)
    • Painful urination (infection)
    • Severe persistent vomiting (hyperemesis gravidarum)
    • Lower abdominal pain with dizziness and shoulder pain (ruptured ectopic pregnancy)
  • Second Trimester
    • Regular uterine contractions (preterm labor)
    • Pain in calf, often increased with foot flexion (DVT)
    • Sudden gush or leakage of fluid from vagina (premature rupture of membranes)
    • Absence of fetal movement for more than 12 hours (possible fetal distress or demise)
  • Third Trimester
    • Sudden weight gain, facial edema, severe upper abdominal pain, or headache with visual changes (gestational hypertension or preeclampsia)
    • Decrease in fetal daily movement for more than 24 hours (possible demise)
    • Any previous warning signs can also be present in the third trimester
63
Q

What type of exam is performed when confirming endometriosis?

A

Laparoscopy

64
Q

What hormone is contained in the implantable contraceptive?

A

Synthetic progestin

65
Q

What type of scan is done for osteoporosis?

A

DEXA scan

66
Q

What are some benefits of oral contraceptives?

A
  • Reduced risk of endometrial cancer (uterine)
  • Protection against pelvic inflammatory disease
  • Improvement if acne
67
Q

What transmits syphilis to a fetus?

A

The placenta

68
Q

What are symptoms of secondary syphilis?

A

Rash, sore throat, and flu-like symptoms

69
Q

How long should infants be in rear-facing car seats?

A

2 years old or outgrow the seat

70
Q
A

Nursing Health Promotion (5 decks)

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