Exam 2 Flashcards by carleigh fraze

Genital Fistulas

Perforation between genital tract organs

*surgery does not always fix

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When does urinary incontinence become increased

Increased number or pregnancies

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What do ovarian cysts depend on

Hormonal influences associated with the menstrual cycle

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What are the most common cysts in young normal ovaries

Follicular cysts

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What causes polycystic ovarian syndrome (PCOS)

Endocrine issue
Increased estrogen, increased testosterone, increased LH
Decreased FSH

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S/s of PCOS

Obesity 
Hirsutism (hair growth)
Irregular menses
Infertility 
Glucose intolerance 
Hyperinsulinemia

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Where do uterine polyps originate

Endometrial tissue

Cervix

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What are the nursing interventions for post op removal of uterine polyps

No tampons
No sex for a week
Bleeding
Infection

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informed consent (BRAIDED) includes

Benefits
Risks
Alternatives
Inquiries (let them ask)
Decisions
Explanations
Documentation

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what is the cornerstone of the nursing care for planned interventions

Education

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what type of barrier methods can cause toxic shock syndrome (TSS)

diaphragms
cervical caps
sponges

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how do oral contraceptives work

inhibit ovulation by preventing formation of a follicle and suppressing LH

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what are some warnings/side effects that can occur when on contraceptives (ACHES)

abdominal pain
chest pain/SOB
headaches (sudden/persistent)
eye problems (HTN/vascular accident)
severe leg pain (thrombosis)

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Progestin Only (mini pill) is good for who

moms who are breastfeeding

won’t affect milk supply

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what is an important reminder with the mini pill

must be taken every day at the same time

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what can happen after depo is ended

fertility may be delayed for 3 months

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what can too much progesterone cause

recurrent yeast infections and acne

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what can injectable progestins cause

irregular bleeding/spotting
decreased libido
weight gain
depression
mood changes

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when is the start dose best to start

first day of menses

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if a patient does a quickstart, what is important to educate them on

they can start at any time

use backup contraception for 7 days

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if there is one missed dose for combos, what should the patient do

take next tablet and next scheduled pill at the same time

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what should the patient do if more than 3 pills are missed

discontinue the pack, allow for withdrawal bleeding, start new pack after

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if a patient misses a dose of the progestin only pill, what should the patient do

take the pill as soon as they notice

backup contraception needed for 48 hours after

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when is the lactational amenorrhea method not effective

if mom is pumping

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where does implantation occur

endometrium

what are the first layers developed of the fetal membranes

chorion | amnion

what is amniotic fluid good for

space for movement/protection thermoregulation nutrients/fluid

what does the amniotic fluid prevent

adhering of the amnion to the fetus | umbilical cord compression

what is Polydramnios and what can it indicate

too much amniotic fluid (>2,000) can indicate GI malformation TWINS

what is Oligohydramnios and what can it indicate

too little amniotic fluid (<300) | can indicate renal malformations of fetus

what can amniotic fluid be tested for

genetic disorders

what is the umbilical cord protected by

Whartons jelly

what do the arteries do in the umbilical cord

carry deoxygenated blood and waste AWAY from the fetus

what does the vein do in the umbilical cord

carry oxygenated nutrient rich blood TO fetus

what is the placenta considered

endocrine gland

what hormones does the placenta regulate

HCG Progesterone Estrogen HPL (needed for fetal growth/development)

what does the placenta regulate the transport of

gases nutrients wastes

what is different about fetal circulation

blood is shunted from the lungs while in utero

if there is a decrease in fetal heart rate, what can this mean

there is a problem with perfusion

how can the fetal heart rate be increased

by doing things with the mom such as turning the mom

what is produced during week 20-24 weeks to reduce sticking of the lungs and reduce surface tension

surfactant

what is L/S (Lecithin/Sphingomyelin)

2 chemicals in the lungs

what should be the L/S ratio and what does it indicate

2:1 | indicates lung maturity

what is gravidity/gravida

pregnancy

what is term birth

birth after 37 weeks

what is preterm birth

birth before 37 weeks

what is considered abortion

spontaneous (natural) or medical/therapeutic

nulligravida

no pregnancies

premigravida

pregnant for the first time

what are presumptive signs (what patient feels) of pregnancy

``` amenorrhea fatigue breast changes (heaviness, dark areola) nausea frequency quickening (movement of fetus) ```

what are probable signs of pregnancy (observed by the examiner)

``` Goodell Sign (softening of the cervix) Chadwicks Sign (blueish purple color of cervix) Hegar Sign (softening of the lower segment of the uterus) pregnancy test (can have false positives) Ballottment Sign (fetus bounces when cervix is tapped) ```

what are positive signs of pregnancy (definite evidence)

ultrasound fetal heart rate palpation of fetal movement

what is the Mucous Plugs purpose and when it leaves the uterus does it mean water has broke

acts as barrier against infection for the baby | no, can leave uterus weeks or days before birth

does the heart remain in its normal position during pregnancy

no | displaced to the left

when does the BP drop during pregnancy and is this normal

usually drops around 20 weeks | normal

what can occur if a women remains too sedentary during pregnancy and why

can increase the risk for blood clots | body is in a hypercoaguable state (increased clotting factors, protective mechanism)

what can occur in the nose during pregnancy

nasal stuffiness espistaxis (bloody nose) more vascular due to estrogen

what is Melasma

blotchy brown "mask of pregnancy" | common in darker complected females

Linea Negra

fades after birth

what is exaggerated Lordosis

slopping of the back | normal

what is pica and what can it indicate

craving something that isn't food | usually gives clues to what she is defficient in

what hormone maintains pregnancy

Progesterone

what hormone causes morning sickness

HCG

how does the baby get glucose

relies on the maternal glucose

during the first trimester, what occurs with the mother in regards to glucose

results in decreased maternal BGL

During the 2nd trimester, what occurs with the mother

maternal tissue has decreased sensitivty to insulin

Because the mother has decreased sensitivity to insulin, what 2 important things does this do to the mother and baby

stimulates pancreas of healthy women to produce more insulin | makes more glucose for fetal energy needs

why should the babies BGL be monitored

they are used to high glucose, can become hypoglycemic

what is the most important adaptation for a women to make during pregnancy

accepting the pregnancy, verbalizing the pregnancy | acceptance

what is Couvade Syndrome

dad experiences pregnancy like symptoms

what are the 5 things screened on EVERY pregnant women (need consent)

``` HIV Syphilis Gonorrhea Chlamydia GBS (Group B Strep) ```

what can Group B Strep do in pregnancy

pass to the baby, baby can become septic not an STD changes with each pregnancy

what should the patients do if the baby isn't active after 20 weeks

notify the HCP

what are abnormal discomforts for pregnant women

bright red bleeding uterine contractions changes in fetal movement

what are the two immunizations that are NOT okay for pregnant women

MMR | Varicella