Flashcards in Lecture 15A Health assessment and health promotion Deck (44):
1. Transverse folds in the mucosal lining of the vagina - allow the vagina to expand during childbirth.
2. After childbirth, during lactation, and at menopause - *estrogen* deprivation causes dryness and thinning of the vaginal walls and *smoothing of the rugae*.
The highly vascular lining of the uterine wall - the outer two of its three layers are shed during menstruation.
Cells from _ are scraped for the Papanicolaou (Pap) test.
The squamocolumnar junction or transformation zone *just inside the cervical os*.
Three hormones produced by the ovaries
Estrogen, progesterone, and androgen.
Estrogen is dominant in the first half of the menstrual cycle and progesterone is dominant in the second half.
The periodic uterine bleeding that begins approximately *14 days after ovulation* (the release of a mature ovum from the ovary).
1. Oxygenated fatty acids classified as hormones; produced by most organs of the body (including the uterus); exert a marked effect on metabolism, particularly on glycolysis.
2. Affect smooth muscle contractility and modulation of hormonal activity; cause sloughing of the endometrium, resulting in menstruation.
3. Increase myometrial response to oxytocin stimulation, enhance uterine contractions, and cause cervical dilation.
1. Refers only to the last menstrual period; can be dated with certainty only 1 year after menstruation ceases.
2. Occurs on average at 51.4 years, with an age range of 35 to 60 years.
A period preceding menopause that lasts about 4 years, in which ovarian function and estrogen production gradually decline.
Period of critical fetal organ development
Between 17 and 56 days after fertilization.
Supplemental folic acid
*600 mcg* taken during pregnancy to reduce the incidence of neural tube defects such as spina bifida and anencephaly.
Most women seeking health care during the perimenopausal period do so because of _
Lesbians who have never had children may still be at risk for _
Breast, ovarian, and endometrial cancer.
Leading causes of death in women in the United States
1. Heart disease.
Current guidelines suggest that the Pap test should begin _
At age 21 (regardless of a young woman's sexual activity).
1. The leading cause of preventable death and illness.
2. Smoking during pregnancy is known to cause a *decrease in placental perfusion* and is one cause of *LBW in infants*.
Recent research suggests that _ during pregnancy may lessen the effects of prenatal alcohol exposure in the children of women who are unable or unwilling to curtail their alcohol abuse when pregnant.
Multivitamin supplement use.
Research suggests that eating disorders are often associated with _
Difficulties in intimate relationships.
A screening tool for eating disorders; used by nurses to determine whether an eating disorder is likely and whether the woman needs further assessment and possibly psychiatric and medical intervention.
Preferred exercises for women
*Weight-bearing aerobic exercises* such as walking, running, racquet sports, and dancing.
1. Positioning for a *pelvic examination* - hips and knees are flexed, with buttocks at the edge of the table, and feet supported by heel or knee stirrups.
2. Avoid asking questions while the woman is in this position; wait until she is upright again.
Menarche occurs between _
8 and 16 years of age.
Ovarian function ceases between _
40 and 55 years of age.
Vaginal screening after hysterectomy
The Pap test is not recommended; sampling of the *vaginal walls* may still be practiced, every 1-3 years - important for HPV screening.
The CDC recommends testing people who were born in 1945 through 1965 for _
Pap test important points
1. No douching, use of vaginal medications, or sexual intercourse for 24-48 hours before test.
2. Midcycle is the best time for the test; the woman should not be menstruating.
3. The cytologic specimen is obtained before any digital examination of the vagina is made or endocervical bacterial specimens are taken.
4. Lubrication is *not* used for the test.
Pap test age/frequency recommendations
1. Age 21-29: Every 3 years.
2. Age 30-65 with previous negative Pap test *and* negative HPV test: Every 5 years.
3. High risk women (DES exposure in utero, previous treatment for cervical cancer, HIV positive) should be tested more frequently.
4. May stop screening: After age 65 + 3 negative tests + no risks and after total hysterectomy for benign disease.
Young women who have been treated with excisional procedures for cervical dysplasia have an increase in _
MyPlate healthy eating guidelines
Each plate of food should be composed of:
- 1/2 fruits and vegetables
- 1/4 grains
- 1/4 protein
Folic acid (maternal intake)
Helps reduce high levels of homocysteine, an amino acid that damages the heart and blood vessels and increases the risk of heart disease, stroke, and dementia.
*Citrus fruits, broccoli, spinach, asparagus, peas, lettuce, beans, whole grains, and orange juice.*
Thought to be effective in helping to prevent oxidative damage in the body such as cancer, heart disease, and stroke.
*Vitamins C and E, selenium, beta-carotenes - fruits, vegetables, and whole grains.*
Best formulation is calcium carbonate with vitamin D (contains the most elemental calcium); prevents fractures in premenopausal women but is associated with a small risk of developing renal stones.
Pelvic examination frequency
Annually from the beginning of sexual activity until age 70.
An endometrial biopsy is generally conducted _
At menopause for women at risk for endometrial cancer, repeated as needed.
Exercise during pregnancy
1. An ongoing exercise regimen can be continued, but *intensity and duration should be decreased*.
2. Sedentary women should obtain medical clearance to initiate exercise during pregnancy and should begin with low-intensity and low-impact workouts.
1. Strengthen the muscles of the pelvic floor, providing support for the pelvic muscles and control of the muscles surrounding the vagina and urethra; reduce incontinent urine loss.
2. Teaching: Have the woman pretend she is trying to prevent the passage of intestinal gas or stop the flow of urine in midstream; the pelvic muscles are moved upwards and inward. Hold each contraction *for at least 10 seconds* and rest for *10 seconds or more* between contractions.
How would the physiologic process of the sexual response best be characterized?
Myotonia (increased muscular tension) and vasocongestion (resulting in engorgement of the genitals and vaginal lubrication).
Which female reproductive organ(s) is (are) responsible for cyclic menstruation?
Uterus. [The uterus is responsible for cyclic menstruation and also houses and nourishes the fertilized ovum and the fetus. The ovaries are responsible for ovulation and the production of estrogen.]
Which hormone is responsible for the maturation of mammary gland tissue?
Progesterone. [Progesterone causes maturation of the mammary gland tissue, specifically acinar structures of the lobules. Estrogen increases the vascularity of the breast tissue.]
1. At least 30 minutes of moderate-intensity aerobic activity at least 5 days per week for a total of 150 minutes/week; OR
2. At least 25 minutes of vigorous aerobic activity at least 3 days per week for a total of 75 minutes/week; OR
3. A combination of the two.
*AND* Moderate to high intensity muscle-strengthening activity at least 2 or more days per week for additional health benefits.
Exercise suggestion for lowering blood pressure and cholesterol
An average of 40 minutes of moderate- to vigorous-intensity aerobic activity 3 or 4 times per week.
The 5 As of smoking cessation
1. Gardisil (quadrivalent) and Cervarix (bivalent); available *between the ages of 9 and 26* and recommended routinely for females at 11 or 12 years of age.
2. Administered in 3 doses over a 6-month period.
Pap test results - ASCUS
Atypical squamous cells of uncertain significance.