Week 1 Flashcards
What is the primary risk for cervical cancer?
Recommended for what age?
HPV
Vaccine is available
Girls age 9-26 and boys age 11-21
When checking the lab report, what should you ensure that is present?
Endocervical Component.
This tells you that the correct cells were collected for the pathologist to evaluation. This is collected by scraping or sweeping in the internal/external os. (Transformation zone. Squamous/columnar junction). Also want to see that the report states there is no malignancy seen.
Bimanual palpation
Palpation for tenderness, lesions, and nodules. Screening used for ovarian cancer.
Dysmenorrhea (pg. 105)
Painful menstruation that interferes with daily activities.
What is a common pharmacologic tx for various of pain including dysmenorrhea?
Non-Steroidal Anti-inflammatory drugs (NSAIDS)
Testicular Cancer Screening
Most common cancer men aged 20-34 yrs, and second most cancer in 35-39 years old.
What can we do?
Teach Testicular Self-Exam
Mittelschmerz (pg. 108)
Pain during ovulation
On the 14th day with a 28 day menstrual cycle
Risk Factors Associated With Breast Cancer (Box 4-6)
- Defects in breast cancer gene 1 or breast cancer gene 2
- Gender: 100x more likely to occur in females
- Age: Increasing age, with 50% appearing by age 50
- Personal hx of breast cancer in at least one breast
- Family hx of breast cancer
- Exposure to radiation
- Excess weight
- Exposure to estrogen: early onset of menarche, late menopause, or use of hormonal therapy
- Race: Caucasians more likely to develop breast cancer than Hispanics or African Americans
- Smoking
- Exposure to carcinogens
- Excessive use of alcohol
- Diagnosis of precancerous breast changes
- Increased breast density revealed on mammography
Pelvic Floor Dysfunction: (pg. 120)
Cystocele
Bladder presses into the vagina
Pelvic Floor Dysfunction: (pg. 120)
Rectocele
Rectum presses into the vagina
Pelvic Floor Dysfunction: (pg. 120)
Pessary
Device inserted into the vagina to support a prolapsed bladder or uterus. Can be difficult to take out and clean.
Natural Family Planning (NFP) (pg. 162)
A contraceptive method that involves identifying the fertile time periods and avoiding intercourses during that time every cycle. It is the only method of contraception acceptable to the Roman Catholic Church.
Fertility Awareness-Based methods (FAMs)
Identify the fertile time during the cycle and use abstinence or other contraceptive methods during the fertile periods. These methods require motivation and considerable counseling to be used effectively. They may interfere with sexual spontaneity and require several months of Sx/cycle charting before they may be used effectively.
Basal Body Temperature (pg. 163)
Take temperature each morning and look for a rise of 0.5-1 degrees F. The rise in temperature is an evidence that ovulation has occurred about 1 day (24-36 hours) prior.
Sterilization
Male vasectomy/ female
Partner or spousal consent in the U.S is not legally required. Patients using federal or state funds for sterilization must be 21 or older and mentally competent, and they must wait 30 days after signing the consent before receiving a sterilization procedure.
Critical Nursing Action Recognizing Contraindications to Oral Contraceptive Use:
- Cigarette smoking (at least 15 cigarettes/day) and age greater than 35 years
- Uncontrolled HTN
- Undiagnosed abnormal vaginal bleeding
- Diabetes of more than 20 years duration or with vascular complications
- Hx of pulmonary embolism or deep venous thrombosis or congestive HF
- Cerebrovascular disease or coronary artery disease
- Severe migraine headaches
- Estrogen-dependent neoplasia
- Known or suspected breast cancer
- Active liver disease
- Known or suspected pregnancy
- Hx of complications from organ transplants or presently preparing for transplant surgery
- Kidney or adrenal gland insufficiency/liver disease (drospirenone [fourth generation progestin] use only)
What should you teach the patient taking oral contraceptives to report?
ACHES
- Abd pain (problem with liver or gallbladder)
- Chest pain or SOB (blood clot in lungs or heart)
- Headaches: Sudden or persistent (HTN or cardiovascular accident)
- Eye Problems (HTN or vascular accident)
- Severe leg pain (thromboembolism)
Termination of Pregnancy (pg. 176)
Elective abortion
Per patient request
What can teenage girls benefit from taking OCPs?
To treat dysmenorrhea, anovulatory cycling, or acne.
The adolescent’s physical development will not be affected nor her growth in height.
Termination of Pregnancy (pg. 176)
Therapeutic abortion
For maternal or fetal health or disease
Termination of Pregnancy (pg. 176)
Spontaneous abortion
Also used to describe a miscarriage. Please be sensitive when using this term as it would be offensive to many families.
Infertility (pg. 178)
Preconception
Prior to pregnancy, but during the childbearing years.
Infertility (pg. 178)
Periconception
Period immediately before conception and through organogenesis.
Infertility (pg. 178)
Interconception
Period between the end of one pregnancy and the beginning of the next pregnancy.
2 Genetics Screening During Pregnancy (Table 10-1)
Sickle Cell Disease
Common in African Americans, and persons of Mediterranean descent
Patho: RBC assume abnormal, sickle shape in response to triggers, including hypoxia, infection, dehydration. Results in inability to oxygenate tissues.
Pregnancy and Newborn Complications: Spontaneous abortion, Preterm labor, Intrauterine growth restriction (baby doesn’t grow to normal weight during pregnancy), Stillbirth
2 Genetics Screening During Pregnancy (Table 10-1)
Tay-Sachs disease
Common in Jewish people from eastern or Central Europe, French Canadians, Cajuns
Patho: Lipid storage disorder that results from a deficiency in the enzyme beta-hexosaminidase A. Both parents must carry and pass on the trait to the child.
Pregnancy and Newborn Complications: Infants appear normal at birth, until about 3-6 months of age.
Nerve cells become distended with fatty material; muscles atrophy; neurological system deteriorates. Death usually occurs between the ages of 2 and 4 years.
How much should a women gain during pregnancy if she is underweight (BMI <18.5)?
28-40 lbs
How much should a women gain during pregnancy if she is normal weight (BMI 18.5-24.9)?
25-35 lbs.
How much should a women gain during pregnancy if she is overweight (25.0-29.9)?
15-25 lbs.
How much should a women gain during pregnancy if she is obese (<30.0)?
11-20 lbs.
Pica
An eating disorder where the individual consumes nonnutritive substances or food.
Believed to include nutritional deficiencies (deficiencies in iron, calcium, zinc, thiamine, niacin, vit C, and vit D), cultural and familial factors, stress, low socioeconomic status, and biochemical disorders.
Consumption of clay and starch is most commonly seen in southern, rural, African American communities, and believed this practice was 1st initiated to alleviate discomfort of nausea in early pregnancy.
What is the tx for pica?
Tx focuses on the diagnosis and tx of underlying nutritional deficiencies. The practice usually subsides after the birth of the baby.
Absolute Contraindications to Aerobic Exercise During Pregnancy:
- Hemodynamically significant heart disease
- Restrictive lung disease
- Cervical insufficiency/incompetence
- Multiple gestation at risk for premature labor
- Persistent 2nd or 3rd trimester bleeding
- Placenta Previn after 26 weeks of gestation
- Premature labor during the current pregnancy
- Ruptured membranes
- Preeclampsia/pregnancy-induced HTN
Safety Guidelines for Muscle Strengthening Exercise During Pregnancy:
- Use lighter weights and more repetitions (heavy weights may overload the “loosened” joints)
- Avoid walking lunges (lunges may injure connective tissue in the pelvic area)
- Use caution with free weights, to avoid hitting the abdomen (use resistance bands instead)
- Avoid lifting from a supine position (to prevent vena caval syndrome and decreased placental perfusion- tilt the bench to an incline)
- Avoid heavy weightlifting and reduce the frequency of workouts if fatigue or muscle strain develop
Primary Prevention
Health Promotion, activities meant to prevent disease from occuring
Secondary Prevention
Early identification and prompt tx of a health problem before it has an opportunity to spread or become more serious.
Screening
Ex: Papsmear for cervical cancer. Gestational Diabetes
Tertiary Prevention
Restore health to the highest functioning state possible.
Prevent end organ damage
They already have the disease
Ecomap
Diagram that helps to document different systems that interact with a family
Papanicolaou Test
Collection and examination of cervical cells to screen for cervical cancer.
When is it best to collect a Pap smear?
Mid-cycle Not menstruating No infection No intercourse x24 hrs No douch x24 hrs
Recommended age for 1st Pap smear?
Age 21, then q 2yrs from 21-29, after 30 and 3 consecutive negative Pap smears- may be reduced to q 3yrs per health provider
Age 65-70 with 3 or more negatives and no abnormal in 10 yrs, may choose to stop screening
