Ch. 11 nurses role in women's health Flashcards
(230 cards)
1
Q
Screening test are
A
not diagnostic, identify if more test are needed
2
Q
what screening is done for detection of breast cancer
A
- monthly self exam
- annual professional exam
- mammography as needed
3
Q
Who should perform BSE
A
all women after 20
4
Q
When is the best time for BSE
A
1 week after start period
5
Q
when should professional breast exams be done
A
yearly for all women over 20
6
Q
How are mammograms performed
A
very low doses of x-ray
7
Q
what can reduce the discomfort of mammograms
A
having them done after menstrual period
8
Q
Who should get mammograms
A
all women 40 or older
9
Q
Who should do vulvar self exams
A
women over 18
10
Q
What should women do before pelvic exams
A
don’t douche or have sex for at least 48 hrs before
11
Q
What do pelvic exams check for
A
- tumors
- discharge
- infections
- unusual pain
12
Q
How often should women get pap smears:
- age 21-39
- age 30-65
- over 65
A
- every 3 years
- every 5 years
- not needed if normal for past 10 years
13
Q
Amenorrhea
A
no periods
14
Q
when is amenorrhea normal
A
- before menarche
- during pregnancy
- after menopause
15
Q
Primary amenorrhea
A
don’t menstruate by age 16 or by age 14 if no secondary sex characteristics have developed
16
Q
Secondary amenorrhea
A
no period for at least 3 cycles or 6 months
17
Q
what increases risk of polycystic ovaries
A
obese teens
18
Q
why would women who have low body fat experience amenorrhea
A
fat is needed to make estrogen
19
Q
Metrorrhagia
A
normal bleeding but happens irregularly
20
Q
Menorrhagia
A
bleeding a lot
21
Q
how much blood does the average woman lose
A
35 mL
22
Q
what is considered an excessive amount of blood
A
> 80 mL/month
23
Q
How does menorrhagia manifest
A
- soaking through a pad or tampon in 1 hour sever times
- clots the size of a quarter
- gushing sensation that leaks through protection
24
Q
Common causes of abnormal bleeding
A
- bleeding disorders
- pregnancy complications
- lesions
- breakthrough bleeding from oral contraceptives
- endocrine disorders
- failure to ovulate or respond to hormones
25
laser ablation
permanently removes uterine lining without hysterectomy
26
mefenamic acid
- what drug class
- what does it treat
- NSAID
| - menorrhagia
27
Tranexamic acid
- what drug class
- what does it treat
- when is it used
- antifibrinolytic
- menorrhagia
- when hormones are contraindicated
28
what can reduce menstrual flow when taken daily
NSAIDs
29
Mittelschmerz
pain around ovulation near the middle of the cycle
30
Dysmenorrhea
painful cramps
31
when does dysmenorrhea occur
after period starts
32
nulliparas
never been pregnant
33
Primary dysmenorrhea
no evidence of abnormality
34
Secondary dysmenorrhea
pathological condition found
35
when does the pain from dysmenorrhea start and how long does it last
- starts no more than a few hours before period
| - last no more than 72 hours
36
secondary dysmenorrhea common causes
- endometriosis
- IUD
- pelvic inflammatory disease
- uterine polyps
- ovarian cyst
37
what hormones effect dysmenorrhea
Vasopressin and Prostoglandins
38
drugs that reduce prostaglandin secretion
- include
- used for
- ibuprofen
- naproxen
- oral contraceptives
- dysmenorrhea
39
endometriosis
tissue that resembles endometrium outside the uterus
40
what can endometriosis cause
- pain
- pressure
- inflammation to adjacent organs
41
dyspareunia
painful sex
42
what meds treat endometriosis
- danazol
- agonsit of ganadotropin (nasal)
- lupron (IM)
43
what are women with endometriosis at increased risk for
osteoporosis
serum lipid changes
infertility
44
what are surgical treatments for endometriosis
hysterectomy
| laser ablation
45
what causes PMS and PMDD
serotonin responses to normal changes in estrogen
46
Symptom criteria used for PMDD
- happens between ovulation and period
- improves after period
- 5 of the common symptoms occur
47
common symptoms of PMDD
- depression
- anxiety
- irritable
- difficulty concentrating
- lethargy
- food cravings
- change in sleep
- breast tenderness
- bloating
- weight gain
- headache
48
treatment for PMDD
- diet high in complex carbs and fiber
- stress management
- exercise
49
meds for PMDD
- oral contraceptives
- diuretics during luteal phase
- NSAIDs
- SSRIs 2 weeks before period and stopped when it starts
50
Vaginal epithelium at birth
- controlled by
- rich in
- pH
- estrogen from the mother
- glycogen
- 3.7 to 6.3 (low)
51
Vaginal epithelium during childhood
- atrophies
- contains little glycogen
- pH 7
52
When does estrogen influence come back after the mothers leaves
puberty
53
Interactions of glycogen and estrogen in the vaginal epithelium results in
growth of lactobacilli
54
what does lactobacilli do
produces bacteriostatic action and drops pH to 3.5-4.5
55
what factors predispose vagina to infection
- antibiotics
- douching
- sex
- uncontrolled diabetes
56
normal vaginal secretions are made up of
- creamy white epithelial cells
| - mucus from cervix, skene glands and bartholin glands
57
what is mucus like during ovulation
clear and slippery with spinnbarkeit
58
spinnbarkeit
stretching without breaking
59
what is mucus like after ovulation
cloudy and sticky
60
what can temporarily change the vagina's pH
- deodorant soap
- perfumed toilet tissue
- douching
- spermicides
- tampons
- hot tubs or swimming pools
- tight synthetic clothes
61
what are the classes of gynecological infections
- toxic shock
- STI
- pelvic inflammatory disease
62
what micro-organism causes toxic shock
staphylococcus aureus
63
what does staphylococcus aureus cause if it enters the blood
- shock
- coagulation defects
- tissue damage
64
what factors increase the risk for TSS
- high-absorbency tampons for prolonged periods
| - diaphragm or cervical caps esp. after childbirth
65
symptoms of TSS
- sudden fever
- flulike symptoms
- hypotension
- sunburn like rash
- skin peeling on palms and soles 1 to 2 weeks after illness
66
how often should tampons be changed
q4h
67
what is the treatment for TSS
hospitalization
- vasopressor drugs
- antimicrobial meds
- fluid replacement
68
Candidiasis
yeast infection
69
symptoms of candidiasis
- itching
- burning on urination
- inflammation
- cottage cheese discharge
70
how is candidiasis diagnosed
id of spores
71
How does candidiasis effect babies
can infect them at birth
72
what is the treatment for candidiasis
- monistat (miconazole nitrate)
- gyne-lotrimin (clotrimazole)
- mycostatin (nystatin)
- diflucan (fluconazole)
73
Symptoms of Trichomoniasis
- discharge green, thin, smelly
- itching
- edema
- redness
74
Trichomoniasis is diagnosed by, how long does it take
- under microscope
| - 10 min
75
How does Trichomoniasis effect baby
doesn't but, can cause postpartum infection
76
Treatment for Trichomoniasis
=Flagyl (metronidazole) not during 1st trimester
| -Gyne-lotrimin (clotrimazole) symptoms during first trimester
77
what kind of enviorment is best for trichomoniasis
alkaline
78
How is trichomoniasis spread
sex
79
what should be avoided during treatment with Flagyl
alcohol
80
symptoms of bacterial vaginosis
thin, fishy, grayish discharge
81
how is BV diagnosed
microscope and rapid detection tests
82
How does BV effect baby
preterm delivery
83
what is the treatment for BV
- Flagyl (metronidazole) for symptoms
| - restore normal flora
84
What STI are all pregnant women screened for
BV
85
Chlamydia symptoms
- yellowish discharge
- painful urination
- often asymptomatic in women
86
Diagnosis of chlamydia
- culture
- DNA from urine
- NAAT
87
how does chlamydia effect baby
- transmitted via birth
- conjunctivitis
- pneumonia
88
Treatment for chlamydia
- Azithomycin
- doxycycline
- erythromycin
- eye care for all newborns
89
what are the complications of chlamydia
scarring of Fallopian tubes
90
Gonorrhea symptoms
- purulent discharge
- painful urination
- dyspareunia
91
diagnosis of gonorrhea
- culture
- NAAT
- results in hours
92
how does gonorrhea effect baby
transmits to eyes during birth causing blindness
93
treatment for gonorrhea
- eye care for all newborns
- cefriaxone
- azithromycin
94
complications of gonorrhea
pelvic inflammatory disease with tubal scarring
95
Symptoms for primary stage syphilis
painless chancre on genitals, anus, lips
96
symptoms of secondary syphilis
- 2 months after primary
- enlarged spleen and liver
- headache
- anorexia
- rash
- warlike growths
97
symptoms of tertiary syphilis
- may be years after secondary
- heart dmg
- blood vessel dmg
- nerve dmg
98
diagnosis of primary syphilis
- scrapings of chancre
| - serology tests
99
diagnosis of secondary or tertiary syphilis
- serology test
- rapid plasma reagin
- FTA-ABS
100
how does syphilis effect baby
- crosses placenta
- congenital syphilis
- stillbirth
- miscarriage
101
Treatment for syphilis
- Benzathine penicillin G
- tetracycline (not in pregnancy)
- erythromycin
102
how is syphilis spread
- most contagious in primary or secondary
- sex
- sharing needles
103
Herpes genitalis is caused by what
herpes simplex virus 1 and 2
104
Symptoms of Herpes
- clusters of painful vesicles
- vesicles rupture after 1-7 days
- Heal in 12 days
105
Herpes is diagnosed by
viral culrture antibodies
| DNA rapid test
106
How does herpes effect babies
- miscarraige
- stillbirth
- active infection needs C-section
- CNS problems
107
Treatment for herpes
- no cure
- Zovirax (acyclovir)
- Valtrex (valacyclovir)
- sitz baths
- wearing loose cotton underwear
108
Condylomata acuminatat
HPV
109
what are the symptoms of Condolyomata acuminatat
-dry warlike growths
110
What HPV cause warts
6 & 11
111
What HPV cause cervical disorders
16 & 18
112
how does hpv effect babies
- obstruct birth canal
| - laryngeal papillomas
113
At what age is the HPV vaccine given
11-26
114
Treatment for HPV
cryotherapy
electrocautery
laser
podophyllin
115
Diagnosis of HPV
Pap test
116
HIV early symptoms
- no symptoms at first
- weight loss
- night sweats
- fever and chills
- fatigue
- enlarged lymph nodes
- rash
- diarrhea
117
HIV late symptoms
- immune suppression
- infections
- malignancies
118
Test for HIV
- serology test
- ELISA
- positive western blot test
119
How does HIV effect babies
- transmitted before birth
| - must be bottle fed
120
Treatment for HIV
- no cure
| - antiretrovirals
121
How is HIV transmitted
- blood
- sex
- mother to child
122
Who is at higher risk for HPV
women who douche
123
How is Hep B transmitted
sex (especially anything rectal)
124
Symptoms of Hep B
- malaise
- anorexia
- nausea
- fatigue
- liver failure
125
when is the hep B vaccine given
if you are exposed
126
what is pelvic inflammatory disease
infection of the upper reproductive tract
127
What is the most common cause of PID
- asymptomatic STIs
- N. gonnorrheae
- chlamydia trachomatis
128
What are the complications of PID
- Scarring of fallopian tubes
- ectopic pregnancy
- infertility
129
Symptoms of PID
- vary by effected area
- fever
- chronic pain
- abnormal discharge
- nausea
- anorexia
- irregular bleeding
- tenderness
- elevated leukocytes
- elevated sedimentation rate
130
Treatment for PID
antibiotics
| antimicrobias
131
what does douching increase the risk of
- PID
- bacterial vaginosis
- ectopic pregnancy
- infection
132
what is the optimum timing between pregnancy
12-24 months
133
Natural family planning is
using protection or not having sex while fertile
134
Ovum is viable for how long
24 hrs after ovulation
135
How long is sperm viable
48-72 hours
136
Failure rate of natural family planning
20%
137
When is basal body temp taken
on waking up before activity
138
How does basal temperature change during ovulation and how long does it last
raises about 0.2 C (0.4 F) and remains higher for the last half of cycle
139
What can interfere with the accuracy of BBT
- poor sleep
- illness
- jet lag
- sleeping late
- alcohol evening before
- heated blankets or water beds
140
Billings method uses
the character or amount of mucus
141
What factors interfere with billings method
- antihistamines
- infection
- contraceptive foams or jellies
- sexual arousal
- sex
142
What is the benefit of Billings method
can be used in women whose cycles are irregular
143
When does ovulation occur
days before period
144
How long is a woman fertile
5 days before and 1 day after ovulation
145
Contraceptive effects
- prevent ovulation
- makes mucus thick and resistant to spern
- makes uterus less hospitable
146
The pill contains
estrogen and progestin
147
the mini pill contains
only progestin
148
who should avoid the mini pill
hispanic women with gestational diabetes who are breast feeding
149
How long after delivery can the pill be taken
3 weeks, but the mini pill helps with lactation
150
How are multiphasic pills different
the hormones change during the cycle to mimic natural hormone activity
151
induced amenorrhea are
extended-dose contraception
152
with extended-dose pills how is the period effected
only have one once every 3 months
153
what form of the pill is most effective
extended-dose
154
Common side effects of birth control pills
- nausea
- headache
- breast tenderness
- weight gain
- spotting
- amenorrhea
155
Who should be not take birth control pills
- blood clots
- heart problems
- estrogen dependent cancer
- breast cancer
- smokes more than 15 cigarettes a day and older than 35
- poor liver function
- pregnant
- undiagnosed vaginal bleeding
156
Why shouldn't birth control be given after delivery
- high risk for blood clots
| - can cause problems with lactation
157
how does breast feeding effect ovulation
women who feed 10x per day don't ovulate for 10 weeks after labor
158
ACHES is used for
| -what does it mean
- warning signs that need to be reported for birth control
- Abdominal pain (severe)
- Chest pain, dyspnea, bloody sputum
- Headache (severe). weakness or numbness of limbs
- Eye problems
- Severe leg pain or swelling, speech disturbance
159
what reduces the effectiveness of birth control pills
- antibiotics
- anticonvulsants
- rifampin
- barbiturates
160
Implanon does not affect
bone density
161
failure rate of implanon
0.05%
162
Medroxyprogesterone acetate
depo-provera
163
how long does depo last how long can you take it
3 months for 2 years
164
how long does it take for fertility to return with depo
1 year
165
failure rate of depo
6%
166
what are the benefits of depo
- can be taken with antiseizure meds
| - reduces blood loss for those with coagulation problems or sickle cell
167
How effective is the IUD
98%
168
What is Paragard
small T-shaped copper containing plastic device with no hormones
169
how long is ParaGard good for
12 years
170
How does ParaGard work
makes a hostile enviorment
171
What is Mirena
IUD with progestin or levonorgestrel
172
How does Mirena work
makes the mucus too thick and sometimes prevents ovulation
173
How often does Mirena get replaced
every 3 to 6 years
174
How long til fertility last after IUD removal
rapidly
175
What are the side effects of IUD
- cramping and bleeding on insertion
- increased menstuation
- dysmenorrhea
176
What is important for he woman with an IUD
check the string weekly for the first 4 weeks then monthly
177
Who should use an IUD
only those without infection and in monogamous relationships
178
Ortho-Evra
transdermal patch containing norelgestromin/ethinyl-estadiol
179
When should ortho-evra be applied
once a week for 3 weeks then 1 week without
180
Who can use the patch
women who weigh less than 90 kg or 198 pounds
181
how does nuvaring work
releases estrogen and progestin
182
How long is nuvaring work
3 weeks with 1 week break
183
Failure rate of nuvaring
9%
184
Diaphragms and cervical caps
rubber domes that fit over cervix and use spermacide
185
failure rate of diaphragms and cervical caps
12%
186
How long should diaphragms be left in place
6 hours after sex
187
When should diaphragms be refitted
after each birth
| after weigh change of 10 lbs or more
188
When should the cap be refitted
yearly and after birth, abortion or surgery
189
FemCap
latex-free cap
190
Lea's shield
silicone reusable shield used with spermacide
191
how long can vaginal sponge be left in place
up to 24 hours after sex
192
What are adverse effects of vaginal sponge
dryness and irritation
193
Failure rate of condoms
18%
194
Bikini-panty style female condom
pouch that fits inside the vagina
195
how long before sex can the bikini-panty style female condom be inserted
up to 8 hours
196
Failure rate of female condoms
21%
197
how long are films and suppositories good for
1 hr
198
How long do you have to wait to douche if using spermicides
6-8 hrs
199
failure rate of spermicide
21%
200
spermicides may cause
irritation and increased risk of infection
201
Plan B
- contains
- most effective if used
- may be effective if used
- progestin levonorgestrel
- 72 hrs
- 120 hrs
202
who is plan b not effective for
women over 165 lbs
203
Ulipristal acetate
- requires
- how does it work
- taken within
Ella
- prescription
- prolonging ovulation
- 5 days
204
coitus interruptus
pull out method
205
how does vasectomy work
cutting each vas deferens
206
How long before sterile with vasectomy
1-3 months
207
how long does it take to do a vasectomy
20 minutes under local anesthetic
208
Tubal ligation
blocking or ligating the fallopian tubes via electrocautery or clips
209
Minilaparotomy
- AKA
- how does it work
- band-aid surgery
| - incision near belly button right after labor or above pubis other times
210
laparoscopic surgery
ligation through laparoscope
211
traditional approach tubal ligation
done during abd surgery usually a C-section
212
how long does it take to recuperate from tubal ligation
1-2 days
213
hysteroscope
saline fills uterus and essure microinsert is put in fallopian tubes through the vagina
214
How after hysteroscope before effective
3 months
215
depo can provide amenorrhea for how long
5 years
216
menopause
cessation of periods for 1 year because of changes in estrogen levels
217
Climacteric
the time before menopause last 2-8 years
218
when does menopause occur
age 45-50
219
decreased estrogen increases risk for
- osteoporosis
- arteriosclerosis
- increased cholesterol
220
menopause may be induced at any age by
- surgery
- pelvic irradiation
- extreme stress
221
what signs should be reported while on hormone replacement therapy
- headache
- vision changes
- signs of thrombophlebitis
- cardiac symptoms
222
contraindications to HRT
- estrogen dependent breast cancer
- endometrial cancer
- thromboembolic disease
- history of melanoma
- chronic liver disease
- severe hypertriglyceridemia
- gallbladder disease
- seizure disorders
223
Ginseng
helps relieve menopausal symptoms
224
Soy products
thought to reduce hot flashes and convert vit D into calcitonin
225
Vitamin E
stabilize estrogen lvls
226
Black cohosh
remifemin
| reduce luteinizing hormone
227
signs of osteoporosis
- height loss
- dowager's hump
- upper spine curve
- fractures
228
how much Vit D and calcium should women take for menopause
- 1200mg cal
| - 600 to 800 mg D
229
Fosamax (Alendronate)
prevents potential fractures
230
Prolia (Denosumab)
reduces bone loss
