Part IV Flashcards
(25 cards)
What are some Breast Cancer Risk Factors?
Breast Cancer Risk Factors
o Age (incidence increases with age)
o Female gender
o History of breast cancer
o BRCA1 or BRCA2 gene mutation
o Family history (first degree relative)
o Overweight or obese after menopause
o Alcohol consumption
o No pregnancy (nullipara)
o First pregnancy after age 30
o Never breastfeeding a child
o Longer reproductive phase (early menarche and/or late menopause
o High dose radiation to the chest
o Physical inactivity
o Smoking
What is Perimenopause?
Perimenopause: the time before menopause during which a woman moves from normal ovulatory cycles to the cessation of menses.
o On average, lasts around 5 years.
During this time women may experience:
o Menstrual irregularities
o Changes in hormones
o Vasomotor symptoms (hot flashes)
o Mood changes
o Difficulties with memory
o Contraception is a major concern!
true or false - One full year without menstruation is true menopause.
true
When does menopause typically happen?
Usually occurs between 45 and 58 years of age (51 is the average age in the US).
o Onset is influenced by overall health, weight, nutrition, lifestyle, culture, and genetic factors.
What are some physical changes with menopause?
Menopause: Physical Changes
o Breasts lose density
o Vasomotor changes (hot flashes & night sweats)
o Increased risk of osteoporosis
o Increased risk for CVD, HTN & stroke
o Changes in cognitive function
o All reproductive structures atrophy
o Vaginal mucosa loses elasticity & becomes thinner
o Vagina itchy and dry
________ is #1 killer of women in the US.
Cardiovascular Disease CVD
Changes in what puts women at risk for:
o Cardiovascular Disease
o Hypertension
o Hyperlipidemia
o Stroke
Change in lipid and lipoprotein levels during/after menopause
How does Menopause affect bones?
Menopause and Osteoporosis
o Diminished bone density and bone quality leads to decreased bone strength.
o Major health concern for women, AFTER menopause, because of the decreased in estrogen.
o Women who go through menopause at a younger age will have the most bone loss.
o Osteoporosis causes an increased risk for fractures.
What are some Risk Factors for Osteoporosis?
Risk Factors for Osteoporosis
o History of fracture after age 50
o Low bone mass
o Weight less than 127 pounds and/or having a small frame
o Advanced age
o Family History
o Use of certain medications
o Early onset of menopause
o Low intake of calcium
o Vitamin D deficiency
o Cigarette smoking
o Excessive alcohol use
o Inactive lifestyle
o Being Caucasian or Asian
There is a direct relationship between the lack of estrogen and the development of osteoporosis. Osteoporosis is largely preventable, so what are some ways to prevent bone breakdown?
o Calcium
o Vitamin D
o Regular weight bearing exercises
o Smoking cessation
o Moderate intake of alcohol
o Fall prevention strategies
What is Ohio’s law on reporting Domestic Abuse?
o Ohio does not have an explicit law requiring healthcare providers to report suspected instances of domestic violence. Health care providers only need to contact law enforcement at the patient’s request.
o If the victim presents with felony-level injuries, such as gunshot wounds, stabbings, second- or third-degree burns, or other serious injuries, healthcare workers providing aid to these victims are required to report these injuries to law enforcement.
How can the nurse best facilitate family bonding and attachment?
Overall - Keep the baby near the family!
*Other good ideas: encourage skin-to-skin and breastfeeding
What is a Version? Describe goals, criteria, and risks.
VERSION-External rotation of baby
Goals:
- Convert the baby to a cephalic presentation for a vaginal delivery
- Maintain stable mother and fetus throughout procedure
- No adverse outcomes from procedure
Criteria:
- Singleton fetus (ONE baby)
- 36+ weeks gestation minimum
- has to have enough fluid
- CANNOT be done with a mom with previous C-section
RISKS:
- Fetal heart changes, cord accidents, blood mixing
- Abruption
- Emergency cesarean
Define: Induction
Induction = start of labor
Define: Augmentation
Augmentation = helping ineffective labor to become effective
What are the ideal frequency of contractions?
every 2 to 3 minutes (beginning to beginning)
How long (duration) do we want contractions to last?
1 minute
How long do we want contraction intervals to last?
at least 1 minute
What are some reasons labor is induced or augmented?
Indications for induction/augmentation:
* Fetal demise
* Fetal compromise (BUT stable fetus)
* Post-term pregnancy
* PROM, Chorioamnionitis
* Preeclampsia (no Pitocin), mild abruption placentae
* A variety of maternal medical conditions
* Risks versus Benefits must be weighed
What are some contraindications for induction/augmentation?
Contraindications for induction/augmentation:
* Placenta previa
* Malpresentation
* Cord prolapse
* Hx. Classical incision
* Active Herpes infection
* NRFHT, unexplained vaginal bleeding
* Previously diagnosed conditions indicating a cesarean is indicated
What is a Bishop Score for? What is a favorable multipara and primipara score?
BISHOP SCORE- How favorable the cervix will react to labor stimulating medications/procedures; Likelihood of labor induction success by considering five cervical and fetal factors. (Higher the score, the better!)
*A favorable score = 5 or higher in multipara
*A favorable score =7 or higher in a primipara
What is a Ballard Score?
Nurse compares a baby’s due date to how they physically look (go off of how they look)
What are some cervical ripening (or softening) agents?
Cytotec (prostaglandin agent)
- Tablet taken PO, sublingually, or placed vaginally to produce labor
- Softens cervix, induces contractions
Cervidil/Prepidil (prostaglandins-both contain dinoprostone)
- Dinoprostone acts on myometrial fibers to cause contractions, and relaxes smooth cervical muscle to soften cervix
- Prepidil placed intracervically by a small catheter - Cervidil insert placed in the posterior vagina (12-hour slow release)
*Removed by a retrieval string attached to insert-Anadvantage if side effects are severe
What are some risks with using cervical ripening/softening agents?
RISKS: Tachysystolic labor (more than 5 contractions in 10 minutes), NRFHT, N&V, fever, diarrhea,uterine rupture if previous cesarean
