Unit 4: Nursing Care of Male and Female Clients with General and Specific Problems in Reproductive Ability to Produce Flashcards
1
Q
This reproductive organ produces cells necessary for production?
A
Gonads
2
Q
Becomes testes
A
Mesonephric (Wolffian) ducts
3
Q
Becomes ovaries
A
Paramesonephric (Mullerian) ducts
4
Q
It is the stage were secondary sex characteristics starts to change
A
Puberty
5
Q
What does the hypothalamus produces that stimulates the anterior pituitary?
A
GnRH
6
Q
What does the anterior pituitary releases?
A
LH and FSH
7
Q
This is known as the closure of growth of the long bones?
A
Adrenarche
8
Q
This is the stage of breast development?
A
Thelarche
9
Q
It is the first menstruation
A
Menarche
10
Q
This cell is produced in a cyclic pattern
A
Ova
11
Q
This is produce in a continuous process
A
Spermatozoa
12
Q
It is the study of male reproductive organ
A
Andrology
13
Q
Support the testes and regulate temperature
A
Scrotum
14
Q
manufacture spermatozoa
A
testes
15
Q
It is the most abundant male sex hormone
A
testosterone
16
Q
It expels urine from bladder and deposit sperm to the woman’s vagina
A
Penis
17
Q
Stores sperm and transports it from the testes
A
Epididymis
18
Q
How long does the sperm remain in the epididymis?
A
2-10 days
19
Q
how long does it take for the sperm to travel?
A
12-20 days
20
Q
How long does it take for the sperm to fully mature?
A
65 - 75 days
21
Q
What are the other terms for vas deferens?
A
Ductus deferens or spermatic cord
22
Q
It is where the sperms fully mature where it travels.
A
vas deferens
23
Q
What protects the sperm from the acidic environment of the vagina?
A
accessory gland
24
Q
What composes the accessory glands?
A
seminal fluid, bulbourethral gland and prostate gland
25
What are the other function of accessory gland apart from protecting the sperm from the acidic environment?
enhance motility and nourish sperm
26
Hollow tube leading from the base of the bladder to the shaft and glans.
Urethra
27
Study of female reproductive organ
Gynecology
28
It is responsible for the production of estrogen and progesterone which stimulates ovum maturation.
Ovaries
29
What is the shape and size of the ovaries?
almond shape and walnut size
30
What are the other terms used as substitute for fallopian tube?
Oviducts or uterine tube
31
How long is the fallopian tube in cm and inches?
8 - 13.5 cm or 3 - 5.3 inches
32
This part of the fallopian tube extends in uterine cavity and lies to the top of the uterus,
Interstitial portion
33
It is the part of the fallopian tube which is a narrow area near that connects ampulla to the nearest portion of the uterus.
Isthmus
34
It is the wider area of the fallopian tube which is a site for fertilization.
Ampulla
35
It is the funnel like distal end of the fallopian tube.
Infundibulum
36
It is a hallow area where fertilized egg is implanted, an embryo forms and a fetus develop.
Uterus
37
What is the mass and length of a nonpregnant uterus?
60 grams and 7.5 cm long
38
What are the 3 parts of the uterus?
fundus, corpus and cervix
39
It is the most contractile part of the uterus where fallopian tube enter uterus on side.
Fundus
40
It is the middle portion of the uterus which has an active role in menstruation and pregnancy.
Corpus
41
It is a narrow tubular opening to the vagina.
Cervix
42
What are different layers of the uterus?
Perimetrium
Myometrium
Endometrium
43
It is the inner and mucosal layer of the uterus that is functional. It is where IUD is applied.
Endometrium
44
It connects the external genitalia to uterus.
Vagina
45
What is the normal pH of the vagina?
4 to 5
46
What are the 3 main functions of the vagina?
- acts as organ of intercourse to convey sperm to cervix
- drainage of menstrual flow and secretion
- passageway for infant birth
47
It occupies the lower portion of the trunk of the body.
Pelvis
48
Access organ of reproduction (mammary).
Breast
49
This type of hormone is needed for the production of milk.
prolactin
50
This hormone stimulates contraction of myoepithelial cells surrounding the alveoli that causes milk ejection.
oxytocin
51
What are the common problems of couple with infertility?
Violence, Social Stigma, Divorce and Anxiety
52
What are the 5 criteria in order for a couple to get pregnant?
1. Woman must release egg from 1 ovary
2. Ovulation
3. Fertilization
4. Fertilized egg should proceed from the fallopian tube to the uterus
5. Implantation
53
It is the inability to conceive a child or sustain pregnancy to birth.
Infertility
54
How would you consider if a couple is infertile?
If the couple practiced unprotected sex for 1 year and did not get pregnant (Reproductive age lesser than 35); while 6 months for woman more than 5 years of age
55
This type of subfertility refers to no previous conception.
Primary subfertility
56
This refers to subfertility that has previous pregnancy but unable to conceive.
Secondary subfertility
57
It refers to the inability to conceive because of certain conditions.
Sterelity
58
It is the chance to achieve pregnancy with 1 menstrual cycle.
Fecundity
59
It refers to the difficulty of getting pregnant or carry child to term.
Impaired fecundity
60
It is the ability to produce life.
Fertility
61
What is the recommended number of intercourse per week?
4 times
62
What are included in fertility assessments?
- if Female partner is younger than 35 years, evaluate if subfertile after 1 year
- If older than 35 years, evaluate after 6 months
- Fertility testing is no before 18 or after 45 years of age
- Age and emotional status of couple considered
63
What are the 3 assessments considered for subfertility?
- Semen analysis (M)
- Ovulation monitoring (F)
- Tubal patency (F)
64
What other tests are used for Male?
- Urinalysis
- CBC
- Blood Typing including RH factors
- Testing of syphilis
- HIV
- Erythromycin Sedimentation Rate
- Protein bound iodine
- Cholesterol level, FSH, LH and testosterone level
65
What other tests are considered for female?
- Rubella titer
- Serological test for syphilis
- HIV evaluation
- Thyroid uptake
66
What are the factors affecting Man's feritility?
- Disturb spermatogenesis
- Inadequate FSH and LH which stimulates the production of sperm
- Obstruction in seminiferous tubules, ducts, vessels which prevent movement of sperm
- Qualitative and quantitative changes in seminal fluid which prevent sperm motility
- Development of autoimmunity, immobilize sperm
- Problems of ejaculation or deposition
- General ill health
- poor diet
- stress
67
This refers to the number of sperm at single ejaculation.
Sperm count
68
What are the criteria for a healthy sperm?
- 33 million to 36 million sperm per mL of seminal fluid, over 50 million per ejaculation
- 50% are motile
- 30% are normal shape and form
69
What other factors are considered for a sperm?
- volume
- motility
- shape (morphology)
- ability to pass strong mucus at cervix
- acrosome reaction
- zona pellucida binding
- nuclear decondensation
70
What are the 2 kinds of sperm according to their motility?
Progressive motility and non-progressive motility
71
It travels mostly in straight line or large circle.
Progressive motility
72
Sperm that do not travel in straight lines or that swim in tight circle.
non-progressive motility
73
What are the indications for a healthy sperm motility?
- forward progression
- 25 micrometers/second
74
< 32% of sperm are able to move efficiently
Poor sperm motility or asthenozoospermia
75
It refers to the absence of sperm cells in the semen.
Azoospermia
76
It refers to the absence of seminal fluid
Aspermia
77
It refers to a condition in which there are < 20 million sperm
Oligospermia
78
What are the risk factors for the abnormality of sperm?
- increase body temperature condition
- cryptorchidism
- varicocele
- past trauma to the testes
- surgery near or on testes
- endocrine imbalance, thyroids, pancreas, pituitary gland
- drug use or excessive alcohol
- environmental factors
79
What are use for testing of the sperm number?
Analysis of Pituitary hormone
Semen Analysis
Sperm Penetration Assay and Antisperm Antibody testing
80
It is a basic test of subfertility, which is repeated every 2-3 months.
Semen Analysis
81
What should be the minimum amount of semen and sperm produce for semen analysis?
1.4 mL to 1.7 mL , minimum of 33 to 46 million spermatozoa per milliliter of fluid.
82
This test determine the ability of the sperm to undergo capacitation. This include fusion of egg and sperm in the cytoplasm of the oocyte.
Sperm Penetration Assay or Zona-free hamster
83
This test looks for special proteins that fight against blood, vaginal fluid and semen as this can cause immune response.
Antisperm Antibody Testing
84
What are the therapy for increasing sperm count and motility?
- Man should abstain from coitus for 7 to 10 days
- ligation of varicocele
- changes in lifestyle
- maintain ideal body weight (18.5 to 24.9 BMI)
85
What are the factors for the obstruction or impaired sperm motility?
- mumps orchitis
- epididymitis
- gonorrhea, ascending urethral infection
- pressure from enlarge gland at vas deferens
- Infected prostate gland
- congenital stricture of sperm duct
- vasectomies develop autoimmune reaction
- hypospadias
- epispadias
- peyronie disease (bent penis)
- extreme obesity
86
What are the therapy included for obstruction or impaired sperm motility?
- surgery to relieve obstruction
- extracting sperm from a point above blockage and injecting into vagina or uterus of the woman.
- administration of corticosteroid to a woman
87
What are the different type of ejaculation problems?
Erectile dysfunction
- primary
- secondary
Premature ejaculation
87
Able to experience before but is difficult now
Secondary
87
This type of erectile dysfunction involve never achieving errection.
Primary
88
What are the causes of ejaculation problems?
- psychological problems
- cerebrovascular accident
- diabetes
- parkinson disease
- Use of certain antihypertensive agents
- discontinuation of finasteride
89
Ejaculation before penetration which may interfere with proper deposition of sperm.
Premature ejaculation
90
What are the therapy for premature ejaculation?
- Psychological or social counseling
- Assessment of phosphodiesterase inhibitor
- Dapoxetine (taken 1 hour before coitus)
91
What are the female factors that may affect subfertility?
- limited production of FSH and LH
- Anovulation
- Problem of ova transport
- uterine factors such as tumors or poor endometrial development
- Cervical and vaginal factors which can immobilize sperm
- poor nutrition
- increase body weight
- lack of exercise
92
Condition in which there is absence of ovulation or release of ova from ovary. This is a naturally recurring variations in ovulatory patterns or PCOS.
Anovulation
93
What are the causes of anovulation?
- genetic abnormality
- hormonal imbalance
- ovarian tumors or PCOS
- chronic or excessive exposure to x-ray
- radioactive substances
- general ill health
- poor diet
- stress
- blood glucose/ insulin imbalance
94
What are the tests used for anovulation?
Ovulation monitoring and Ovulation determined by test strip
95
During this exam, serum progesterone is altered during the luteal phase (21-28 days: ovum occur).
Ovulation Monitoring
96
What are the therapy included for anovulation?
- maintain BMI
- Nutrition, body exercise, body weight
- administration of GnRH
- therapy with clomiphene citrate (clomid) or letrozole (femara)
- administer combination of FSH and LH in conjunction with human chorionic gonadotrophin
- relieve clomiphene citrate
97
Why does tubal transport problem happens?
- scarring has developed in fallopian tube which is caused by chronic salpingitis
98
What are the 3 test for tubal patency?
Sonohysterosalpingogram
Hysterosalpingogram
Trahnvaginal Hydrolaparoscopy
99
This is a condition which infects the pelvic organ including fallopian tube, uterus, ovaries and supporting structure.
PID
100
Why does PID cause fertility problem?
scarring leads to stricture of fallopian tube
101
This test examines the fallopian tube and the uterus using an ultrasound contrasting agent.
Sonohysterosalpingogram
102
It is similar to Sonohysterosalpingogram but instead uses a radiopaque contrast medium, fallopian tube is revealed by x-ray.
Hysterosalpingogram
103
It is an alternative to Hysterosalpingogram and laparoscopy, this allows direct visualization of female peritoneal cavity.
Transvaginal Hydrolaparoscopy
104
What are the therapy for pelvic inflammatory disorder?
- prescribe diathermy or steroid administration
- canalization of fallopian tube and plastic surgical repair (microsurgery)
- laparoscopy or later surgery
- reopening of ligated fallopian tube
105
What are the most common uterine concerns?
- tumors such as fibromas
- a congenitally deformed uterine cavity (separate uterus)
- Endometriosis
- Poor secretion of estrogen and progesterone
106
What are use for testing of uterine concerns?
- hysteroscopy
- Uterine Endometrial Biopsy
- Laparoscopy
107
It is use for the visualization of uterus.
Hysteroscopy
108
In this test forceps are introduce to cervix to check if the endometrium is ready for implantation.
Uterine Endometrial Biopsy
109
It is the introduction of lighted tube through small abdomen incision which is used to examine the fallopian tube and ovaries.
Laparoscopy
110
This are type of myomas in which when it resembles a seedling is undetectable, but when bulky can distort enlarged uterus.
Leiomyomas
111
This type of leiomyomas are attached to the muscular uterine wall.
Intramural fibroids
112
This type of leiomyomas is a bulge in the uterine wall.
Submucosal
112
It projects outside of the uterus, what type of leiomyomas?
Sub serosal fibroid
113
What are the causes of Leiomyomas?
- Genetic Changes
- hormones
- insulin like growth factor
- extracellular matrix
114
What are the risk factor of leiomyomas?
- reproductive age
- race
- heredity
- menstruation at an early age
- obesity
- diet higher in red meat and lower vegetable and fruits
- alcohol
115
What is the treatment for leiomyomas?
Myomectomy or surgical removal of tumor and adhesions
116
It refers to the implantation of uterine endometrium or nodules that have spread from the interior to outside.
Endometriosis
117
What are the most common sites for endemetriosis?
Fallopian tubes
Ovaries
Uterine ligament
Cul-de-sac of douglas
surface of uterus
bowel
118
What are the manifestations of endometriosis?
- pelvic pain
- painful periods (dysmenorrhea)
- pain with intercourse
- pain with bowel movement or urination
- excessive bleeding
- infertility
- fatigue, diarrhea
- constipation
- bloating or nausea especially during menstruation
119
What is the treatment for endometriosis?
medical and surgical treatment
120
It is a deformity of the uterus, which happens during fetal development. The septum divide inner uterus which leads to implant problem. This is also considered as the most common abnormal uterine development.
Septate Uterus
121
This is a condition where in the entire uterus tips far forward.
Anteversion
122
This is a condition where the uterus tips far back
Retroversion
123
This is a condition where the body of the uterus is bent sharp forward at the junction with the cervix
Anteflexion
124
It is a condition where the body of the uterus is bent sharp back above cervix
Retroflexion
125
What are the causes of vaginal and cervical concerns?
- Cervical mucus too thick which does not allow the sperm to penetrate the cervix.
- Inflamed cervix
- Stenotic cervical or obstruction of os by a polyp
- Has undergone D&C - dilatation and curettage
- infected vagina
- sperm immobilizing or sperm-agglutinating bodies
126
What are the testing and therapy for cervical and vaginal concern?
- low-dose estrogen therapy to increase mucus production among days 5 to 10 of the cycle
- vaginal infection will be treated according to the causative organism based on culture reports
- partner needs antibiotic therapy
- administer metronidazole (flagyl) for trichomonas infection
127
What are other active support to help find alternative solutions for unexplained subfertility?
- continue to try to conceive
- use an assisted reproductive technique
- choose to adopt
- agree to a child free life
128
What are the most common nursing diagnosis for subfertility?
- Situational low self-esteem
- anticipatory grieving
- Hopelessness
129
These treatment involves handling both eggs and sperms. In general it involves removing eggs, fertilize eggs in lab and return as embryo or surrogate carrier.
Assisted Reproductive Technique
130
What are the different types of assisted reproductive technique?
- Alternative insemination
- In vitro fertilization
- Gamete intrafallopian and Zygote Intrafallopian transfer
- Surrogate Embryo transfer
131
This ASR involves installing sperm from masturbatory sample into a female reproductive system by means of cannula to aid conception at time of ovulation.
Alternative insemination (intrauterine insemination/ Artificial insemination/ Donor insemination)
132
What are the 2 types of Alternative insemination?
Intrauterine Insemination and Intracervical Insemination
133
What is the most important consideration when doing an Alternative Insemination?
The woman's ovulation must be predicted and must occur during the treatment
134
What are the advantages of artificial insemination?
- to eliminate the chances for known genetic disorder that does not want to be transmitted to children
- If woman does not have a male partner
- If the partner has no sperm or inadequate sperm
135
When is the best time to cryopreserve a sperm?
- before radiation or chemotherapy and then used for alternative insemination afterward
136
What are the important aspects of cryopreservation of sperm?
Constant temperature of -196 degrees centigrade and use of liquid nitrogen
137
This treatment involves acquiring of woman's egg, fertilizing it to the lab with sperm, then transfer it to the uterus after embryonic development.
In Vitro Fertilization
138
What are the indications of in vitro fertilization?
- absence of cervical mucus
- sever male infertility
- tubal disease or blockage
- endometriosis
- unexplained infertility
- cervical anchor
- immunologic infertility
139
How many eggs are chosen for women who are below 35 who want to undergo IVF and what percentage is its overall live birth?
1-2 fertilized eggs; 52%
140
How many eggs are chosen for women who are 40 who want to undergo IVF and what percentage is its overall live birth?
5 embryos; 11%
141
It is a procedure which involves the removal of a section of the ovary or an entire ovary.
Ovarian Tissue Transplantation
142
How is Ovarian Tissue transplantation done?
The removed ovarian tissue is frozen to be used at a future date, then it is transplanted to a non-functioning ovary or into the peritoneum near the ovary and uterus.
143
This is a treatment where both ova and the sperm are instilled within a matter of hours using laparoscopic technique into open patent end of fallopian tube. Fertilization does not yet occur.
Gamete Intrafallopian Transfer
144
What are the indications for Gamete intrafallopian transfer?
- normal tubal anatomy
- patency
- absence of tubal disease
- at least 1 fallopian tubeI
145
This treatment involves transferring a fertilized egg into the waiting end of the fallopian tube.
Zygote intrafallopian tube transfer (ZIFT)
146
It is an assisted reproductive technique for a woman who does not produce ova or if the inherited problem is one arising from the female partner.
Surrogate Embryo Transfer
147
What is the most important consideration for surrogate embryo transfer?
The menstrual cycle of the mother and the surrogate mother must be synchronous. This is done using medications.
148
What are the issues to be addressed by the infertile couples before treatment?
- risk of multiple gestation
- possible need for donor oocytes, sperm, or embryos or gestational carrier
- whether or not to disclose facts of conception to offspring
- freezing embryos for later use
- possible risks of long term effects of medication and treatment on women, children and families
149
What are the most important preimplantation genetic diagnosis?
- specific genetic abnormalities such as down syndrome or hemophilia
- sex of the children can be predetermined
150
What are the alternatives to childbirth?
- Surrogate Mother
- Child free leaving
- Adoption
151
It is a woman who agrees to carry a pregnancy to term for a subfertile couple or an LGBT couple.
Surrogate Mother
152
What are the conflicts of surrogacy?
- is the surrogate mother decides to end the pregnancy and want to keep the fetus
- child is born imperfect
153
Taking in a child who is not their own biologically.
Adoption
154
Acceptance because of rigors and frustrations of infertility.
Child-free living
155
How long is the epididymis?
20 feet
156
How many lobes are their in the breast?
20 lobes
157
It is a distal form of treatment.
laparoscopic surgery
158
It is a proximal form of treatment.
Assisted reproductive problem
159
This drug is used to stimulate ovulation that has been associate with multiple births.
Clomid
160
It is known as the pregnancy maintaining hormone.
Progesterone
161
What is used to eliminate embryos not chosen by the couple?
Potassium chloride
