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Maternity > Women's Health and Contraception > Flashcards

Women's Health and Contraception Flashcards

1
Q

Health Promotion

A

process of enabling people to increase control over, and to improve, their health

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2
Q

HPV Vaccine

A

initiated in 2006

Gardisil
Cervarix
Gardisil 9

should be offered to girls and boys ages 11-12 yo through age 26 for women

2-3 dose series

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3
Q

Breast Cancer Screening

A

clinical breast exam: evidence has not supported the benefit

mammogram annually starting at age 45 (sooner if family hx of early breast ca, do screening 10 years before age of diagnosis of first degree relative)

MRI for younger women at high risk of breast cancer d/t fam hx or gene mutations

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4
Q

Cervical Cancer Screening

A

start at age 21
21-29: every 3 years
30+: every 5 years w/ HPV test

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5
Q

Colonoscopy

A

every 10 years starting at age 45

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6
Q

BG Testing

A

every 3 years after age 45

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7
Q

Cholesterol

A

frequency based on health hx

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8
Q

Stages of Menopause

A

Perimenopause: years preceding menopause wehn woman has menopausal signs and symptoms, can last 2-10 years

Menopause: occurs 12 months afte last menstrual period, avg age 50-52

Postmenopause: the time after menopause

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9
Q

Menopause Management

A

Tx sx and discomforts

Lifestyle changes: adequate sleep, healthy diet, exercise, avoid caffeine/alcohol/smoking

Alternative medicine: phytoestrogens, herbal supplements, acupuncture, biofeedback, hypnosis

Menopausal hormone therapy (HT): estrogen only for women who don’t have uterus or estrogen/progesterone therapy

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10
Q

Hormone Replacement Therapy (HRT)

A
  • estrogen therapy
  • progesterone therapy
  • ET is never given alone to woman w/ uterus

Risk of HRT: thrombosis and breast cancer

Benefits of HRT: reduce osteoporotic fractures

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11
Q

Prevention of Osteoporosis

A
  • adequate calcium intake
  • vitamin D
  • estrogen
  • regular weight bearing exercise
  • stop smoking
  • moderate alcohol intake
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12
Q

Tx of Osteoporosis

A
  • bisphosphonates (first thing on empty stomach)
  • selective estrogen receptor modulators
  • salmon calcitonin
  • parathyroid hormone activates bone formation
  • ultra-low dose estrogen patches
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13
Q

Fertility Awareness-Based Methods

A

need regular menstrual cycles

takes into account sper can live up to 2-7 days and the ovum 1-3 days, max fertility for the woman occurs ~5days prior to ovulation

requires several months of tracking first before using

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14
Q

Situational Contraceptives

A

Abstinence
Coitus Interruptus
Douching

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15
Q

Spermicides

A

MOA: destroy sperm by disrupting cell membrane

Advantages: availability, no systemic effects

Disadvantages: minimally effective alone, use w/ barrier method increases effectiveness, not effective against STIs, increased risk of HIV since has negative effect on integrity of vaginal cells

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16
Q

Vaginal Sponge

A

soft, absorbent pillow-shaped device that has spermicide in it, has a cupped area to fit against cervix and a loop on it to remove it

wet sponge, then place in vagina against cervix

spermicide is released up to 24 hours, must be left in place for 6hrs after intercourse then discarded

multiple acts of intercourse is ok

has equal effectiveness as a diaphragm for nullips

17
Q

Barrier Methods

A

MOA: prevent transport of sperm to ovum, immobilize sperm or are lethal against them

Advantages: availability, non-hormonal, some STI protection, minimal SE

Disadvantages: possible lack of spontaneity, possible irritation, proper use and paying attention, risk of breakage, cost factor for some

Pt needs to be aware of s/sx of TSS (high fever, sore throat, vomiting, and/or diarrhea, faintness, weakness, muscle aches, and a rash)

18
Q

Diaphragm

A
  • used w/ spermicide
  • women is fitted for it and given Rx
  • not recommended if woman has hx recurrent UTI or hx of TSS
  • can be placed 6hrs ahead and NEEDS to be left in place 6-8hrs after intercourse
  • proper storage and care needed
19
Q

Intrauterine Contraceptives

A

exact MOA is not clearly understood but basically a spermicidal intrauterine environment

do not cause ectopic pregnancy of PID

Advantages: high rate of effectiveness, continuous contraceptive protection, relatively inexpensive over time

20
Q

IUD Contraindications

A 
current pregnancy
current STI or pelvic infection
undiagnosed bleeding disorder
abnormal uterine shape
caution w/ multiple sexual partners
21
Q

After IUD insertion

A

check for strings regularly, usually after menses

follow up exam 4-8 wks after insertion

call provider if you experience:

  • exposure to STI
  • late period, abnormal bleeding
  • dyspareunia or pelvic pain
  • s/sx of infection
  • missing strings

remove ASAP if pregnancy occurs

22
Q

COC

A

combined oral contraceptive
MOA: inhibit ovulation, create an atrophic endometrium, thicken cervical mucus
Methods of administration: day 1 start (no back up required), sunday start or quick start (back up required for 7 days)

23
Q

COC Education

A 
contact healthcare provider if:
-become depressed
-develop a breast lump
-become jaundiced
-experience "ACHES"
Abdominal pain
Chest pain
Headache
Eye changes
Severe leg pain
24
Q

Progestin Only Methods

A

good for breastfeeding moms, patients that have a contraindication to using estrogen

SE: amenorrhea or irregular bleeding

25
Q

Postcoital Emergency Contraception

A

emergency contraceptive (EC): available OTC w/o Rx

  • may cause n/v
  • initial w/in 72 hours of unprotected intercourse, may work up to 5 days!

Plan B: progestin only contraceptive

  • more effective than combined postcoital EC
  • initiate w/in 72 hours of unprotected intercourse

Copper IUD: place w/in 7 days of unprotected intercourse may reduce risk of pregnancy by up to 99%

26
Q

Sterilization

A

permanent birth control

operative: vasectomy, tubal ligation

27
Q

Medical Pregnancy Termination

A

mifepristone/misoprostol: first 10 wks of pregnancy

  • mifepristone blocks progesterone
  • misoprostol: causes uterus to contract

methotrexate (chemotherapy agent):

  • first 7 weeks of pregnancy
  • stops cell division
28
Q

Surgical Pregnancy Termination

A

first trimester: safest time to perform, vacuum aspiration for up to 8 wks, dilation/suction curettage up to 13wks

second trimester: medical induction, dilation and evacuation

risk: perforation to the uterus, cervical lacerations, hemorrhage, retained products of conception and infection

Maternity (13 decks)

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