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OB FINAL > Women's Health > Flashcards

Women's Health Flashcards

1
Q

Women’s Health

A

A holistic view of women and their health-related needs
within the context of their everyday lives.

Nursing Role
 Advocacy
 Collaboration
 Educator
 Manager of Care
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2
Q 
Health Promotion
Health history
Physical Assessment
Preventative counseling
Screening
A 
Health History
Risk factors 
Gender
Age
Family hx
Genetics
Environment
Assessment
Psychosocial assessment

Physical Assessment

Preventive Counseling
Self-care

Screening
Prevention
Early Diagnosis

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3
Q

Heart Disease

A

1 in 4 women die of heart disease
64% of women who die of heart disease have had no previous symptoms

Coronary heart disease
Ischemic stroke
Hypertension
Heart failure

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4
Q

Breast Disorders

A

Benign
Teens-20s
Fibroadenoma

20s-50s
Fibrocystic breast changes
Near/During menopause
Ductal ectasia
Intraductal papilloma

Malignant
Ductal Carcinoma in situ – Noninvasive
Invasive Ductal Carcinoma
Invasive Lobular Carcinoma

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5
Q

Breast Disorders: Malignant

Risk factors
Psychosocial Considerations

A

Major type of cancer among women of all races
Risk factors
Mutation of the BRCA1 and BRCA2 genes
Mutation of CHEK-2 gene in men and women

Changes in body image – mastectomy, hair loss, chemo
Effect on sexuality
Side effects of treatment

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6
Q

Menstruation

A

Secondary sex characteristics = 9/10 years
Menarche ~ 12 y/o

Amenorrhea
Primary – not established by age 16
Secondary – cessation of regular menses (pregnancy, hormonal/endocrine disorders, strenuous athletic activity)

Dysmenorrhea
Primary – cramps NOS

Secondary – pathology 
Polyps, Fibroids (Leimyomas), Cysts
Endometriosis
Polycystic Ovarian Syndrome
Infections
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7
Q

Endometriosis

A

Excessive endometrial production +
Reflux of blood and tissue to fallopian tubes

Dysmenorrhea
Dyspareunia

Tx
Oral contraceptive – decrease tissue can cause bleeding and bleeding can cause pain
Synthetic androgen

Invasive tx
Laparotomy with laser excision

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8
Q

Polycystic Ovarian Syndrome

A

Hyperinsulinism – increased androgen production
Follicular ovarian cysts dont mature – anovulation

Lack of ovulation
Increase in testosterone
Higher risk for infertility
Mustache, hair on cheeks, increased weight gain

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9
Q

Treatment for PCOS

A

Treatment
Oral contraceptive
Metformin

Spironaldactone to decrease hair growth
(antiandrogen)

Clomid for infertility

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10
Q

Health Promotion – Aging Women

A

Menopause

Perimenopause
Hormone replacement therapy (HRT) - Increase risk for breast cancer
Complementary/alternative therapy

Osteoporosis
Urinary incontinence
Pelvic floor dysfunction

Kegel exercises

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11
Q

Pelvic floor dysfunction

A

Cystocele – prolapsed bladder
Rectocele – prolapsed rectum
Prolapsed uterus

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12
Q

Infection and Inflammation
Not an STI
Complications of STI

A

Not an STI
Bacterial Vaginosis – fishy-smelling white discharge infection stemming from decrease in normal flora

Candidiasis – cottage cheese-like white discharge yeast infection from a change in vaginal ph

Function of changes that may occur over a certain time in a women’s reproductive system

Complication of an STI
Pelvic Inflammatory Disease – chronic inflammation from exposure to multiple microorganisms
Ectopic Pregnancy Infertility

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13
Q

Sexually Transmitted Infections

A 
Acquired immunodeficiency syndrome
Condylomata Acuminata
         (HPV & vaccine)
Chlamydia
Gonorrhea
Herpes genitalis
Syphilis
Trichomoniasis
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14
Q

Initial Assessment - Infertility

A

Sterility
Reproduction not possible

Infertility
Lack of conception after 12 mos (34 yrs and

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15
Q

Potential Effects of Infertility (4)

A

Emotional stress
Feelings of disappointment and failure
Sense of loss and grief
Intercourse changes to goal-oriented procedure

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16
Q

Challenges of Diagnostic Testing and Treatment (4)

A

Embarrassing
Ethics
Commitment
Expensive

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17
Q 
Diagnostic testing (5)
Male
A 
Semen analysis
Endocrine
P postcoital test
Ultrasonography
Testicular biopsy
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18
Q 
Diagnostic Testing (8)
Female
A 
Thyroid function test 
Glucose tolerance test 
Serum prolactin levels  
Specific hormonal assays 
Ultrasonography
Endometrial biopsy
Hysterosalpingography 
Laparoscopy
19
Q

Treatment Options—Infertility (4)

A 
Lifestyle Behavior 
Medications --- clomid
   Increase sperm count & motility
   Induce ovulation    
   Facilitate cervical mucous formation
   Reduce antibody concentration
   Suppress endometriosis

Surgical treatment
Repair of variocele, ducts
Repair of tubes

Advanced reproductive technologies (ART)
In vitro Fertilization

20
Q

Reproductive Alternatives

A 
Oocyte Donation
Embryo Donation 
Therapeutic Insemination
Surrogate Mother
    Surrogate mother’s egg
    Surrogate mother’s uterus
Adoption
21
Q

Ethical/Legal

Considerations

A

Factual information—advantages and limitations
Informed consent for donor sperm and donor eggs.
Donor confidentiality
Ongoing education and counseling

22
Q

Promoting Sexual & Reproductive Health

A 
Assess
Establish trust
Obtain sexual history
Nursing diagnosis and Outcome identification
Plan
Implement care
Evaluate
23
Q

Teaching About Contraception

The role of the nurse

A 
Types of contraception available
Risks and benefits of each
Proper use of each method
What to do if an error is made
Emergency contraception (EC)
Backup methods
Change of methods
Questions and concerns
24
Q

Hormonal

ACHES

A 
Oral contraceptives – combined and; mini
   Monophasic, biphasic, triphasic
   Low-dose progestin-only
Subdermal implant, injection
Vaginal contraceptive ring
Transdermal patch

Abdominal pain – severe
Chest pain – severe, with cough, SOB, or on deep inspiration
Headache – severe, dizziness, numbness, esp if one side
Eye – vision loss, blurring, speech problems
Severe leg pain – calf or thigh

25
Q

Contraindications - BCP (5)

A

Smoking and age greater than 35 years
Moderate/severe hypertension (BP 160/100)
Undiagnosed uterine bleeding
Diabetes of more than 20 years’ duration or with vascular complications
History of embolism or thrombosis

26
Q

Contraindications – subdermal, injection (5)

A 
Breast cancer, current or previously
Undiagnosed uterine bleeding
Liver disease
History of embolism or thrombosis
Breastfeeding (Category 2) – ok after 6th wk
27
Q

Side Effects - BCP (7)

A 
Diminished menstrual flow
Breast tenderness
Irritability
Nausea
Headaches
Cyclic weight gain
Increased vaginal yeast infections
28
Q

Adverse Effects - BCP

3

A

Hypertension
Myocardial infarction
Thrombophlebitis

29
Q

Side Effects – subdermal, injection (9)

A

Irregular menstruation or amenorrhea
Acne
Headaches
Depression
Weight gain
Increased vaginal yeast infections
Scarring or injection at insertion site (subdermal)
Risk of decreased bone density (injection) – limit Rx to 2 yrs
Injection required q 3 months – reminders necessary

30
Q

Intrauterine Device (IUD) (4)

PAINS

A

No continued expense
No daily attention
No interference with intercourse
May decrease risk of endometrial CA

Period late
Abdominal pain, pain with intercourse
Infection exposure or vaginal discharge
Not feeling well, fever, or chills
String – missing, shorter, or longer
31
Q

Contraindications/Side Effects for IUD

A

Current STI
Genital tract cancer
Uterine anomalies, fibroids

Side Effects
Irregular bleeding
Amenorrhea
Pelvic infections

32
Q

Barrier Methods

A

Diaphragm, cervical cap
Risk for Toxic Shock Syndrome; Rare; Staphylococcus aureus

Condoms (male and female)
Latex allergies
Contraceptive sponge
Spermicides

Sterilization
Female
Tubal ligation, c/s or hysteroscopic
Essure

Male
Vasectomy

33
Q

“Natural Family Planning”

Fertility Awareness

A 
Methods:
Periodic Abstinence
Menstrual bleeding
Cervical mucus
Basal body temperature
Calendar Rhythm

Symptothermal
Cervical mucus
Basal body temperature

Secondary sx -> increased libido, mittelschmerz, midcycle spotting, pelvic tenderness, vulvar fullness.

34
Q

Emergency Postcoital Contraception

A

“Morning After” pill
Plan B

Copper-releasing intrauterine device IUD

35
Q

Clinical Termination of Pregnancy

A

Therapeutic Abortion = elective procedure
Medical
Medication inducing uterine contractions (RU-486)
Up to 63 days of gestation

Surgical  
Menstrual extraction, endometrial aspiration
 5 to 7 weeks gestation
Vacuum aspiration
 Up to 12 weeks gestation
Dilatation extraction (D/E)
 2nd trimester – up to 16 weeks

Spontaneous Abortion = “miscarriage” at any gestation

36
Q

Nursing Care for abortion

A 
Assessment
Emotional support
Observe for complications
Common: excessive bleeding, cramping
Rare: hemorrhage, incomplete abortion, infection, 
Postabortal Syndrome (a form of PTSD)
   Asherman syndrome: uterine adhesions
Schedule follow-up visits
Ultrasonography
hCG levels
37
Q

AIDS

A

asymptomatic
Not cured
antiretroviral

38
Q

Chlamydia

A

Asymptomatic or yellow discharge, painful urination
Cured
Azithromycin, coxycycline

39
Q

Condylomata

A

HPV warts
Not cured
TCA, cryotherapy

40
Q

Gonorrhea

A

Purulent discharge, painful urination
Cured
Azithromycin, coxycycline

41
Q

Herpes

A

Painful vesicles
No
Acyclovir

42
Q

Syphillis

A

Painless chancre
Yes
Penicillin

43
Q

Trichomoniasis

A

Discharge/pain
Yes
Metronidazole

OB FINAL (8 decks)

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