repro / womens health (exam 2)

Question 1

what are the 2 primary repro hormones in women?

Answer 1

estrogen and progesterone

Question 2

where are estrogen and progesterone made?

Answer 2

mostly ovaries, also adrenal cortex

Question 3

what are estrogen nd progesterone synthesized by?

Answer 3

cholesterol

Question 4

what are the 3 ovarian estrogens?

Answer 4

-estradiol
-estrone
-estriol

Question 5

when you’re __________, progesterone si secreted by corpus leutem last half of cycle

Answer 5

not pregnant

Question 6

when you’re _____, progesterone maintains pregnancy and prepares for lactation

Answer 6

pregnant

Question 7

days 1-14 of menstrual cycle = ____ phase

Answer 7

follicular

Question 8

days 15-28 of menstrual cycle are the _____ phase

Answer 8

luteal

Question 9

what are extreme PMS symptoms?

Answer 9

premenstrual dysphoric disorder (PMDD)

Question 10

what is characterized by chronic pelvis pain and is a common GYN problem

Answer 10

endometriosis

Question 11

what anti-depressants are used for PMS/PMDD

Answer 11

SSRIs or SNRIs

Question 12

what is the first line treatments for PMS/PMDD

Answer 12

anti-depressants

Question 13

what is the second-line therapy for PMS/PMDD

Answer 13

oral contraceptives (progestins)

Question 14

what is the treatment of PMS/PMDD if the symptoms are anxiety / insomnia?

Answer 14

benzodiazepines (alprazolam)

Question 15

what kinds of meds are used to manage symptoms of endometriosis

Answer 15

-NSAIDS
-hormonal contraceptives
-GnRH agonists

Question 16

what is the drug therapy for menopause?

Answer 16

hormone replacement therapy (estrogen)

Question 17

example of hormone replacement estrogen in women

Answer 17

conjugated estrogen

Question 18

pharmacokinetics of conjugated estrogen?

Answer 18

oral = slow release
patch = avoid first-pass

Question 19

what are the actions of estrogens?

Answer 19

-circulate to target cell (ovary)
-affects primarily the reproductive system

Question 20

what are uses of estrogens?

Answer 20

-birth control
-menopause
-replacement therapy
-slow bone loss in osteoporosis
-palliative care for breast cancer / prostate cancer

Question 21

what are adverse effects of of estrogens?

Answer 21

-thromboembolic conditions

Question 22

what are black box warnings of estrogens?

Answer 22

-cancer
-clots
-dementia

Question 23

what are contraindications of estrogens?

Answer 23

-thromboembolic disorders
-CV disease
-tobacco use
-hx. of breast/repro cancer

Question 24

what is sued to prevent hyperplasia of the endometrial lining

Answer 24

progestins

Question 25

what is our example progestin?

Answer 25

medroxyprogesterone acetate

Question 26

routes of administration for medroxyprogesterone acetate?

Answer 26

oral, IM, topical

Question 27

what med acts on endometrial lining to suppress pituitary hormones to inhibit ovulation

Answer 27

progestins

Question 28

what med prevents spontaneous uterine contraction

Answer 28

progestins

Question 29

what are uses of progestins?

Answer 29

-contraceptives -treat amenorrhea and uterine bleeding -fertility programs -oncology -plan B

Question 30

adverse effects of progestins?

Answer 30

-CV comp. -Thromboembolic conditions

Question 31

black box warnings of progestins

Answer 31

-pregnancy -CV -thromboembolic -dementia

Question 32

contraindications of progestins?

Answer 32

preg/lac CV disease thromboembolic disorder

Question 33

nursing implications of estrogens and progestins

Answer 33

-identify high risk women (medical history, vitals, weight, weight, mammo) -patch may be applied weekly or bi-weekly

Question 34

education of estrogen and progestins

Answer 34

-monitor weight -smoking cessation -report vaginal bleeding -teach signs of thromboembolism

Question 35

why are estrogen-progestin combos used?

Answer 35

smaller doses of both instead on 1 large does decreases symptoms

Question 36

example of estrogen-progestin combination drug

Answer 36

conjugated estrogen-medroxyprogesterone

Question 37

what are admin routes of est-progestin combos?

Answer 37

PO, IM, implant, IUD

Question 38

how does the estrogen part of combo drugs prevent pregnancy?

Answer 38

-inhibit ovulation -suppress FSH/LH -stabilize endometrium

Question 39

how does the progestin part of combo drugs prevent pregnancy?

Answer 39

-thin endometrium -slow sperm transport -thicken cervical mucous -suppress LH surge

Question 40

uses of estrogen/progestin combos

Answer 40

-contraception -treatment of PMS/PMDD -HRT

Question 41

adverse effects of estrogen-progestin combos?

Answer 41

-CV complications -thromboembolic conditions -irregular vag bleeding

Question 42

what are black box warnings for estrogen-progestin combos

Answer 42

-smoking -osteoporosis -thromboembolic events

Question 43

contraindications of estrogen-progestin combos

Answer 43

-smoking -women older than 35 -hx of thromboembolic probs

Question 44

nurse prescribes estrogen replacement therapy to relieve severe menopausal symptoms of hot flashes, which are a result of... -insufficient gonadotropin secretion -vasomotor instability -high estrogen levels -decreased progesterone

Answer 44

vasomotor instability

Question 45

after teaching ab warning signs associated with combo hormonal contraception, what statement results in additional education -breakthrough bleeding is sign of uterine abnormality -i should go to ER if i get sudden, severe HA that is not relieved with analgesic -severe leg pain / swelling should immediately be reported -CV probs are most severe adverse effects associated with oral contraceptives

Answer 45

-breakthrough bleeding is sign of uterine abnormality -its an adverse effect