Women's Health Flashcards
1
Q
what is the number one killer of women and why
A
cardiac disease d/t atypical symptoms
2
Q
symptoms of female heart attacks
A
pain/pressure in the chest, discomfort in neck, arm or jaw
pain in upper back and/or stomach
unusual fatigue
N/V
loss of appetite
lightheadedness, dizziness palpitations
3
Q
stroke warning signs
A
sudden onset of:
-numbness/weakness of face arm or leg
trouble seeing out of one or both eyes
trouble walking, dizziness, loss of balance or coordination
severe headache
4
Q
what is the golden hour
A
within 1 hour from onset of stroke symptoms
admin of tPA
5
Q
ACS clinical breast exam ages
A
19-39 y/o - every 3 year
> 40 - annually
6
Q
what to ask a patient if a lump appears
A
ask where they are in their cycle - fibrocystic women can have lumps appear close to period
7
Q
mammorgram ages
A
every 1-2 years after age 40
8
Q
montly vulvar self exam ages
A
all women 18 y/o or younger if sexually active
9
Q
ACS cervical screening recommendations
A
21-29 y/o - every 3 years
30-65 y/o - every 5 years
> 65 - stop pap if no pre-cancerous w/n last 20 years
10
Q
when is a pelvic exm schedule
A
5 days after last menstrual period
11
Q
colposcopy
A
microscopic exam of vaginal and cervical tissue
12
Q
colposcopy indications
A
abnormal pap, treat condyloma
13
Q
cervical biopsy
A
extensive surgical biopsy
14
Q
cervical biopsy indications
A
abnormal pap - atypical or abnormal cells
15
Q
when is a cervical biopsy performed
A
early phase of menstrual cycle
16
Q
endometrial biopsy
A
endometrial tissue aspirated from uterus
17
Q
endometrial biopsy
A
abnormal or postmenopausal bleeding
18
Q
hysterosalpingography
A
cervix, uterus and fallopian tubes are visualized by x-ray after injecting contrast dye
19
Q
hysterosalpingography indications
A
evaluating for fibroids, tumors, fistulas or fertility
20
Q
dilation and cutterage
A
dilate cervix and scrape endometrial tissue
21
Q
D&C diagnostic
A
malignancy, fertility, dysfunctional uterine bleeding
22
Q
D&C therapeutic indications
A
heavy iterine bleeding, incomplete abortion
23
Q
endometrial ablation
A
removal of endometrial tissue
24
Q
laparoscopy
A
laparoscope inserted for visualization and surgery
25
laparoscopy dx
fertility, ectopic, adhesions, cysts, endometriosis or PID
26
laparoscopy therapeutic indications
tubal ligation, IUD or adhesion removal, egg retrival
27
hysterectomy
surgical removal of the uterus
28
hysterectomy indications
cancer
fibroid tumors
endometriosis
genital prolapse
PID
29
total hysterectomy
cervix and uterus removed
30
subtotal or supracervical hysterectomy
above the cervix - rare
| pap smears still done
31
hysterectomy with salpingo-oophorectomy
total with ovaries and tubes out too
32
radical hysterectomy
everything + part of vagina + lymph nodes
33
breast pain and Ca
10% of breast cancer presents with pain
34
fibrocystic breast changes before menopause
thickeing of breast tissue with the formation of cysts
35
symptoms of fibrocystic breast disorders
biltaeral pain and tenderness that occurs around the menstrual cycle
36
fibrocystic breast disorder tx
supportive bra
avoid caffeine
danazol
37
what does danazol do
androgenic medication that suppresses estrogen
38
primary amnorrhea
periods begin 2 years after breast development
no menses and no secondary sex characteristics by 14
no menses with secondary sex characteristics by 16
39
secondary amenorrhea
cessation of menstruation 6 months following normal cycles
underlying cause
40
menorrhagia
prolonged or ehavy menstrual bleeding
41
metorrhagia
irregular bleeding which often occurs between period or after menopause
42
menometrorrhagia
prolonged or excessive bleeding that occurs irregular and more frequent
43
menopause
permanent cessation of menstrual cycles
44
when does menopause occur
35-58 y/o w/ average age of 51
45
3 stages of menopause
perimenopause
menopause
post-menopause
46
perimenopause
s/s about 1 year before last menses
47
menopause
year after last menses
48
post-menopause
after menopause
49
vasomotor menopause changes
irregular periods
hot flashes
night sweats
50
GU menopause changes
incontinence/vaginal changes
increased pH
dryness
painful sex
51
psychological menopause changes
mood swings
sleep changes
decreased REM
fatigue
52
skeletal menopause changes
decreased bone density
53
CV menopause changes
irregular heart beat
palpitations
decreased HDL
increased LDL
54
dermatologic menopause changes
decreased skin elasticity
| hair loss
55
reproductive menopause changes
breast changes
| decreased interest in sex
56
therapy for menopause
HRT and ERT
57
HRT
estrogen progesterone
| requires uterus
58
ERT
estrogen
| uterus CANNOT
59
primary dysmenorrhea
painful cramping 12-24 hours before menses
60
primary dysmenorrhea is caused by
excessive endometrial production of prostaglandin
61
secondary dysmenorrhea
painful menses with known anatomic factors/pelvic pathology
62
second dysmenorrhea is caused by
endometriosis, adhesions, cervical stenosis, fibroids
63
endometriosis
presence of endometrial tissue outside the uterus
64
endometriosis s/sx
```
cyclic pelvic and low back pain
infertility
dysparaunia
IBS
fixed/retroverted uterus
```
65
endometriosis med mgmt
NSAIDS
hormone therapy
biopsy
surgery (D&C)
66
endometriosis education
pain mgmt
| emotional support r/t infertility
67
PCOS
increase in estrogen, testosterone and LH w/ a decrease of FSH lead to multiple cysts on ovaries and over production of estrogen
68
risks for PCOS
```
diabetes/metabolic syndrome
dyslipidemia/HTN
cardiac dz
Ca
infertility
sleep apnea
```
69
PCOS s/s
```
menstrual disorders
infertility
pelvic pain
ovarian cysts
obesity
oily skin
acne
hirsutism
male pattern baldness
```
70
hirsutism
facial hair on women
71
PCOS medical mgmt
lifestyle modification - diet/exercise
hormone therapy
fertility therapy
diabetic meds (metformin)
72
PCOS nursing interventions
education:
- Risk factors for PCOS
- Weight reduction
treatment for:
- hirsutism
- acne
- oily skin
emotional support:
- infertility
- psychological effects
73
vaginal wall prolapse
loss of support to pelvic organs
74
vaginal wall prolapse RF
```
childbirth trauma
family hx
low estrogen
menopause
obesity
pelvic trauma
stress/strain
```
75
cystocele
bulging of bladder into anterior vaginal wall
76
cystocele s/s
```
vaginal fullness
activity increases the bulge
stress incontinence
difficulty voiding
bladder infection
dysparenuia
sexual dysfunction
```
77
rectocele
bluging mass in posterior vaginal wall
78
rectocele s/s
```
straining increases bluge
irritation of vaginal mucose
constpation
uncontrolled flatus
hemorrhoids
```
79
uterine prolapse
uterus protrudes into vagina
80
uterine prolapse s/s
heavy sensation in pelvis or vagina
low backache
painful intercourse
uterus falls out
81
pelvic floor dysfunction mgmt
intravaginal estrogen
vaginal pessary
A/P repair
82
pelvic floor dysfunction nursing ints
pessary insertion, removal, cleaning
pelvic exercises
urinary incontinence
prevention of constipation
83
genital fistulas
abnormal connection between vagina and bladder, urethra or rectum
84
RF for genital fistulas X3
trauma
hysterectomy
pelvic radiotherapy
85
genital fistuals s/s
urine/fecal leakage from vagina
foul vaginal odor
vaginal mucose irritation
86
genital fistula med mgmt
pelvic, rectal and perineal exam
| determine location and severity
87
genital fistula nursing int
care of fistula
| pre op/post op care
88
small genital fistual tx
at home resolution
89
large genital fistulas tx
require surgical repair
90
urinary incontinencetx
estrogen cream/anticholinergic drugs
91
cervical polyps
small tumors caused by proliferation of cervical mucose
92
s/s of cervical polyps
intermittent vaginal bleeding
93
uterine leiomyomas (fibroids)
develop from uterine smooth muscle
estrogen dependent
94
follicular ovarian cysts
mature follicle fails to rupture
95
follicular ovarian cyst s/s
asymptomatic
96
luteal ovarian cyst
corpus luteum becomes cystic and fails to reabsorb
97
luteal ovarian cyst s/s
acute pain, delays next menstrual cycle, may rupture
98
cyst tx
depends on type of cyst
99
cervical Ca early s/s
vaginal discharge, abnormal vaginal bleeding
100
cervica ca late s/s
weight loss, fatigue, pelvic pain, vaginal leakage of feces/urine
101
cervical ca RF
```
HPV
early onset sexual activity
multiple sex partners
inadequate cervical screening
high parity
```
102
cervical dx
pap smear
colposcopy
cervical cone biopsy
103
cervical ca mgmt
tx depends on stage and desire for future pregnancies
| chemo and target drug therapy
104
endometrial cancer s/s
postmenopausal or abnormal bleeding
abnormal discharge
difficult or painful urination
pelvic pain or pain with intercourse
105
endometrial RF X4
HRT
menopause after age 52
nulliparity
diabetes, obesity, PCOS
106
endometrial ca diagnosis
endometrial biopsy
107
endometrial ca mgmt
based on size, stage, tumor grade and estrogen effect
108
ovarian cancer s/s
vague
bloating or swollen abdomen
pelvic or abdominal pain
difficulty eating or feeling full quickly
urinary symptoms
109
ovarian cancer RF
```
menses started earlier than 12 y/o
nulliparity or 1st child after age 30
late menopause
infertility/drugs
family history of ovarian, breast or colorectal cancer
personal history of breast cancer
```
110
ovarian cancer diagnosis
transvaginal ultrasound
CT scan/MRI
PET scan
barium enema x ray
111
ovarian ca mgmt
total abdominal hysterectomy
biopsy lymph nodes, pelvic and abdominal tissues
chemotherapy and or radiation
112
pelvic inflammatory disease
acute inflammation of the upper female genital tract
113
PID consequences
ectopic pregnancy
chronic pelvic pain
infertility
114
PID symptoms
asymptomatic or
```
severe abdominal pain
dyspareunia
purulent vagina discharge
nausea
irregular vaginal bleeding
fever
```
115
PID mgmt
treat STI
analgesia
hospitilization
116
PID nursing interactions
medication education
s/s and consequences of PID
risk reduction
117
TSS
caused by toxin producing strain of S. Aureus
118
TSS s/s
flu like
hypotension
generalized rash
skin peeling form palms and soles of feet
119
TSS tx
stabilize hypotension
| antimicrobial therapy
120
TSS nursing considerations
change tampon every 4 hours
avoid superabsorbent tampons
use pad at night
121
vaginitis
vaginal inflammation
122
candidasis vaginitis
yeast infection
123
yeast infection RF
```
abx therapy
immunosuppression
diabetes
pregnancy
menopause
```
124
yeast infection s/s
itching and irritation of the vulva
white, cheesy vaginal discharge
burning on urination
125
yeast infection dx
wet mount and whiff test (negative)
126
bacterial vaginosis RF
```
multiple sex partners
new sexual partner
sharing sex toys
douching
antibiotic therapy
```
127
bacterial vaginitis s/s
thin, white, milky discharge
| fishy discharge
128
bacterial vaginosis complication
chorioamnioitis
PROM
premature labor
premature delivery
129
bacteral vaginosis med mgmt
metronidazole
| clindamycin
130
bacterial vaginosis dx
wet point and positive whiff test
131
Chlamydia s/s
most asymptomatic
```
fever
Nausea
spotting
urethritis
mucopurulent cervical discharge
lower abd pain
dyspareunia
```
132
chlamydia RF
PID
infertility
ectopic pregnancies
preemie birth
133
chlamydia dx
genital culture
134
chlamydia tx
azithromycin
amoxicillin/erythromycin/doxycycline
retest in 3 weeks
135
chlamydia during pregnancy
infertility
ectopic pregnancies
preemie birth
136
chlamydia and newborns
ophthalmia neonatorum
137
Gonorrhea s/s
women - asymptomatic usually
```
purulent yellow/green discharge
spotting
low backache
dysuria
dyspareunia
anal itching
```
138
gonorroea complications
PID
139
gonorrhea dx
genital or cervical culture
140
gonorrhea tx
ceftriaxone
| azithromycin
141
gonorrhea during pregnancy
infertility, ectopic pregnancies
142
gonorrhea and newborns
ophthalmia neonatorum, sepsis
143
trichomonas s/s
women - asymptomatic
```
erythema/edema of external genitalia
profuse frothy yellow discharge
foul odor
dyspareunia
strawberry spots on cervix
```
144
trich complications
PID
145
trich dx
wet mount and positive whiff test
146
trich tx
metronidazole
| no alcohol for 24 hours
147
trich and pregnancy
infertility
| PROM, labor or delivery
148
trich newborn
LBW
149
herpes s/s
primary infection:
flu like
painful lesion
2-4 weeks
recurrent symptoms:
5-10 days
150
herpes complications
sepsis
151
herpes dx
history and exam
152
herpes tx
antiviral
oral analgesia
comfort measures
153
herpes pregnancy
c-section if active
154
herpes newborn
primary exposure - 50-60% mortality
neurological complications
sepsis
155
hep B RF
IV users
| HCW with needle stick
156
Hep B s/s
appear 90 days after exposure
fever, fatigue, dark urine
abdominal pain
157
hep b dx
physical exam and blood work
158
hep b tx
antiviral and prophylactic immunization
159
hep B newborn
90% infected in chronic infections - cirrhosis of liver
160
HPV s/s
painless genital warts
161
HPV complications
cervical/penile cancer
162
HPV dx
hx and pap smear
163
HPV tx
podophyllin
trichloroacetic acid
electrocautery
164
HPV prevention
gardasil immunizaiton
165
HPV pregnancy
c-section
166
HPV newborn
respiratory papillomatosis
167
syphilis s/s
primary:
-single painless chancre, fever, weight loss, malaise
secondary:
fever, fatigue, sore throat, weight loss
tertiary:
CNS and multi organ damage
168
syphilis risk
PID
169
syphilis dx
RPR or VDRL
170
syphilix tx
PCN G
171
syphilis pregnancy
infertility, ectopic pregnancies
172
syphilis newborn
congenital syphilis
preemie birth
neurological complications
still births
