Maternity 7-1 Flashcards by Amanda S.

Standard of Care - on test

that level of practice that a reasonably prudent nurse would provide in the same or similar circumstances.

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Mons Pubis

Mons Pubis: Fatty tissue over symphysis pubis (pubic bone)

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Vulva (C LUV vulva)

Vulva: Collective term for labia, head of clitoris, urethral & vaginal openings

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uterus - parts (uterus at CCF)

Cervix, Fundus, Corpus

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Fundus

Fundus superior muscular portion of uterus

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Corpus (corpse)

the body of organ

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Uterine layers (end my peri)

endometrium, myometrium, perimetrium

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Fallopian Tubes - what is the lumen like?

Fallopian Tubes- location of fertilization, tube which transports ova to uterus, narrow lumen easily scarred

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Ovary-contains - and how many mature each month?

400,000 immature oocytes- usually one matures each month

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3 phases of puberty (thelma, adrene, and mench are going through phases)

Thelarche, Adrenarche, Menarche

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female puberty initated by (what structures)

the hypothalamus, anterior pituitary gland, and ovaries

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Female Reproductive Cycle (over every reproductive cycle)

Ovarian Cycle
Endometrial Cycle
Regulating Hormonal Cycle
Cyclic Breast Changes

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GnRH: (gonad is friends with fish)

GnRH: Released by hypothalamus. Targets anterior pituitary to release FSH and LH.

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FSH (fish is mature) and produced where?

FSH: Produced by Anterior Pituitary. Responsible for egg maturation in the ovary.

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LH (the luetenant releases prisoners)

Responsible for release of egg from ovary.

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Estrogen (Estradiol) (estrogen liners) and produced where?

Estrogen (Estradiol): Responsible for maintaining uterine lining. Produced by Ovaries.

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Progesterone (lining for progeria)

Responsible for maintaining uterine lining.

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Hypothalamic-Pituitary-Ovarian Axis - the cycle of menses - the order of it

Hypothalamus- releases GnRH (gonadotropin-releasing hormone) which stimulates the

Anterior pituitary first releases FSH (follicle stimulating hormone) which stimulates graafian primordial follicles to mature

Anterior pituitary then releases LH (luteinizing hormone) which releases the ovum from one follicle

Empty follicle then becomes corpus luteum

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Ovarian Cycle:
3 Phases (the ovaries fol)

Follicular Phase (1), Ovulatory Phase (2), Luteal Phase (3)

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Endometrial/Uterine Cycle:
4 Phases (menstruate proliferatively w/ secretary ishmael)

Menstrual Phase (1), Proliferative Phase (2), Secretory Phase (3), Ischemic Phase (4)

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Uterine Cycle - 3rd phase (the secretary ovulates and hormones increase)

Secretory Phase (3)
Begins with ovulation

Continued endometrial 	growth (estrogen)

Increase in progesterone = 	endometrial growth + gland 	growth

Increased vascularity If PREGNANCY occurs here, 	process stops

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uterine cycle - 4th stage

Ischemic Phase (4) (if no fertilization):
Corpus luteum degenerates and becomes corpus albicans

Decrease in estrogen, 	progesterone

Necrosis under epithelial 	lining, small blood vessels 	rupture, arteries constrict 

Return to menstrual phase

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2nd half of cycle - which hormone is more dominant?

more progesterone dominant

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1st half of cycle

more estrogen dominant

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LH - when does it start, and what does it do? (the leutenant triggers ava after 24 hours)

triggers ovulation - surge is 24 -36 hours before ovulation

corpus leutium - what does it make? (progesterone corpse)

shell - that makes progesterone

progesterone only around

after ovulation, bc it comes from the corpus luteum, which is the shell after ovulation.

Prostaglandins (prostie clots)

Lipids w/ hormone-like action. Many roles in body functions including immune/clotting actions.

Cancers of the Reproductive Tract

Ovarian Cancer Uterine/Endometrial Cancer Cervical Cancer Vaginal Cancer Vulvar Cancer

Ovarian Cancer Symptoms: “Silent Stalker” - symptoms (what about gi?)

General abdominal discomfort/pain GI disturbance: nausea, diarrhea, constipation Frequent urination Feeling of fullness Weight loss or gain Vaginal bleeding Back pain and fatigue Painful intercourse

Ovarian Cancer: Risk Factors (ava cancer is all about the hormones) (ava is early and late)

Advancing age Early menarche and late menopause Having a first child after age 30

nursing care - ovarian cancer

indentify high risk, encourage regular GYN visits, provide emotional and phychological support, prepare for surgery, post surgery follow up care

Endometrial cancer - prognosis?

more frequent than cervical, but better prognosis. Most common malignancy of reproductive system Slow-growing and has a good prognosis if diagnosed at a localized stage

Endometrial cancer - risk factors (end the cancer w/ obesity with no children)

Obesity Nulliparity

Endometrial Cancer: Signs and Symptoms - just one

Abnormal Uterine bleeding.

Endometrial Cancer: Diagnosis & Treatment

Endometrial biopsy Total abdominal hysterectomy: uterus/cervix (TAH) Bilateral salpingo (fallopian tubes) -oophorectomy (BSO) Radiation Radical hysterectomy tissue)chemotherapy

Cervical cancer - what causes it? (cervical cancer is hip)

Cancer that occurs in the cells of the cervix Various strains of the human papillomavirus (HPV) play a role in causing most cervical cancer.

Human Papilloma Virus (HPV) - which types cause cancer?

Most common STI, More than 100 types – 5 cause warts, 8 of which may cause cancer, Types 16 and 18 responsible for almost all cervical cancers, Most times resolves spontaneously

CDC recommends routine HPV vaccination for adolescents***on test - what ages can you give it?

CDC recommends routine HPV vaccination for adolescents at age 11 or 12 years. Vaccination can be started as early as age 9 years, and up to 26 years old for females.

HPV

males ages 13 through 21 years, * females ages 13 through 26 years gay, bisexual, and other men who have sex with men, transgender people, persons with certain immunocompromising conditions ages 22 through 26 years

HPV (16, 18)

HPV (16, 18) – responsible for 70-80% of cervical cancers

risk factors of cervical cancer (cervi and birthy control)

Sexually active during adolescence Multiple sexual partners STI infections Using Birth Control > 5 years HIV Smoking

Signs and Symptoms of Cervical Cancer

may be asymptomatic, abnormal vaginal discharge, bleeding, pap smear screens for abnormal cervical tissue detects 90% of early cervical changes

Pap screening - do what before the exam?

between menses. 48 hours prior to the scheduled Pap smear, the nurse advises the woman not to: have intercourse use tampons use intravaginal medication douche

PID is caused by what?

an acute infection of the reproductive organs, generally caused by STIs. Most commonly caused by Chlamydia and Gonorrhea

Pelvic Inflammatory Disease - infertility?

Affects ~ 1 million women annually 1 incidence of PID ~20% of women become infertile

Predisposing Factors for PID - (Pitt has STDs and infections)

Hx untreated STD Hx of PID Chronic vaginal infection

Signs and Symptoms of PID - temp and discharge?

( vary according to severity) Temperature > 38.3 C (100.9 F) Abnormal vaginal discharge

PID treatment

Antibiotics Treatment of sexual partner(s) Comfort measures Good perineal care Semi-fowlers for drainage Education and prevention Safer sex Avoid IUD contraception only if pt. has Hx of PID

cervix

Cervix “neck” effaces and dilates to allow fetus to pass into vagina

fundus

Fundus superior muscular portion of uterus

corpus

Corpus the body of organ

uterine layers

endometrium, myometrium, perimetrium

ovaries produce what? (3 things) ovaries are your enemy

estrogen, progesterone, and androgens

Thelarche

breast buds

Adrenarche

axillary/pubic hair

Menarche

menstruation, average age is 12 in U.S.

GnRH - stimulates what?

Indirectly stimulates progesterone/estrogen production feedback system

progesterone - fluctuations in levels (progeria rises to the leutenant)

Low levels in follicular phase, rises in luteal phase

where is progesterone produced? (2 places)

Produced in ovary (corpus luteum) and small amount from adrenals.

ovarian cycle - Follicular Phase (follicles first) when does it occur?

Pre-ovulatory first two weeks (on average)

ovarian cycle - ovulatory phase - what day?

Ovulation occurs Day 14 (varies by individual)

ovarian cycle - luteal phase - what days? (leutenant is last)

Post-ovulatory Day 14-28

endometrial cycle - menstrual phase

1-5 days Endometrial cells shed

endometrial cycle - Proliferative Phase (2) - growth? (proliferative growth 68 times)

Endometrial growth 6-8x

prostaglandins - released how?

Released by tissues throughout body.

prostaglandin - hormonal changes do what? (prostie contracts)

Respond to hormonal changes of menstrual cycle. Cause muscle contraction during menstrual cycle.

ovarian cancer - risk factors (ava at risk w/ breast and colon)

Personal or familial history of breast or colon cancer

endometrial cancer - risk factors (end the cancer w/ DM and HTN hormones)

DM HTN Family History Hormone imbalance*

endometrial cancer - risk factors (end the cancer with late menopause and Infertility)

Late onset Menopause Infertility

PID - Increased incidence of

ectopic pregnancy

PID - does what to the body?

scar tissue both outside and inside the fallopian tubes that can lead to tubal blockage; Long-term pelvic/abdominal pain.

s/sx of PID - pain? (Pitt is low)

Lower abdominal tenderness/pain  menstrual cramping Dyspareunia (vaginal pain)

PID - smell?

Foul smelling menstrual flow Malaise

PID - cramping? (Pitt gets crampy once in awhile)

Sub acute: dull intermittent cramping

proliferative phase - glands and mucus (the pH?)

Glands enlarge (estrogen) Cervical mucus-thin, watery, alkaline, elastic

endometrial cancer - late signs (ending late due to pain)

vaginal discharge low back pain pelvic pain

ovarian cancer - risk factors - (ava is early and late w/ drugs and fat)

History of fertility drugs High fat diet

predisposing factors for PID (Pitt has multiple partners)

IV drug use Multiple sexual partners or partner with multiple sexual partners Increased incidence in young women (sexually active and 25 years or younger

predisposing factors PID (Pitt is a douche who uses IUD)

Douche After IUD placement (3 weeks)

vestibule

area inside inner labia

what hormone triggers puberty?

gnrh

fsh and lh

fish matures and lh releases the prisoner

hgc

tells corpus luteum to keep producing progesterone. if no hgc, progesterone signals gnrh to start the cycle again bc there is no fetus.

Endometrial biopsy

goes through the cervix

Radical hysterectomy

hysterectomy + ligaments, part of vagina, surrounding

Most common STI

HPV

HPV vaccine for males - what ages

13-21

HPV screening

21-24, no screening. 25-29 - every 5 years, age 30-65 - every 5 years, over 65 - no screening, hysterectomy - no screening.

does genital warts cause cervical cancer?

Maternity 7-1 Flashcards

(90 cards)