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Nursing 113 > Sexuality/std > Flashcards

Sexuality/std Flashcards

0
Q

Chapter 5 nursing diagnosis

A 
HSBC r/t reproductive functioning
Anxiety
Pain 
Body image disturbance r/t 2nd sex 
Sexual dysfunction 
Self esteem disturbance 
Altered sexuality patterns
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1
Q

Nonverbal cues

A

Over modest
Inappropriate jokes
Any funny effects of medication?

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2
Q

Androgens

A

Adrenal cortex and gonads

Physical, muscles, sebaceous, body hair

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3
Q

Progesterone

A

Decreases mucous permeability
Decreases ovum transport
Decreases proliferation

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4
Q

Estrogen

A

Develops reproductive tract
Stops growth
Fat placement
Suppresses FSH/LH suppressing ovulation

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5
Q

Testes

A

Descend at 34-38 weeks

Undescended increases cancer risk

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6
Q

GnRH

A

Released by hypothalamus and influences pituitary

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7
Q

Pituitary

A

Releases FSH and LH that control ABP

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8
Q

LH

A

Promotes testosterone release

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9
Q

ABP

A

Androgen binding protein

Promotes sperm formation

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10
Q

Vulvar blood and nerves

A

Pudendal V&A

Pudendal, ilioinguinal, genitofemoral nerves

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11
Q

Ovary palpation

A

Can’t because so low but pain indicates problem in lower quadrants

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12
Q

Nonfunctional ovaries

A

No breasts

Male like body hair

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13
Q

Estrogen

A

Prevents osteoporosis

Keeps cholesterol low

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14
Q

Ovary anatomy

A

Epithelium
Cortex (hormone production)
Medulla

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15
Q

How eggs transport

A

Mucous
Cilia
Muscular peristalsis

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16
Q

Uterus

A

Doesn’t mature until 17 (LBW of newborns)

Stays 33% bigger after birth

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17
Q

Isthmus

A

Enlarges greatly for fetus

Part typically cut for CS

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18
Q

Cervical Os

A

Relation to is ischial spine determining fetal position

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19
Q

Pap smear

A

Sample taken between lower cervix and lower cervical canal

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20
Q

Myometrium

A

Prevents hemorrhaging during menstruation
Keeps Os closed in pregnancy
Contracts equally to expel
Contracts to close vessels postpartum

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21
Q

Uterine nerves

A

Sensory nerves lower than motor

Epidural stops pain but not contractions

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22
Q

Uterus septums

A

Present during formation but are supposed to rescind

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23
Q

Vagina

A

Elastic, strong, vascular
Glycogen rich feeding bacteria that creates lactic acid
Higher pH after menopause

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24
Breast exams
Self Not indicated | Q12months
25
Breasts
20 lobes and nipple openings Ampulla provides reservoir Vascular
26
Proliferative phase
Immediately after menstruation completes Rapid cell expansion 1-14
27
Secretory
Spongy velvet appearance Glycogen rich 15-22
28
Ischemic
Pro and Est decrease Endometrium sloughs off 23-24
29
Menses
30-80 mL blood 200 mL total 25-end
30
Cervical changes
During ovulation, mucous becomes thinner Fern test positive before ovulation Negative after
31
Spinnbarkeit test
Estrogen is high so vaginal mucous is stretchy between fingers
32
Menopause symptoms
Hot flashes, vaginal dryness, osteoporosis, bladder incontinence
33
HR therapy
Correlation with CVA and cancer | Short term with acute symptoms
34
Menopause therapies
``` Low dose estrogen vaginal ring Kegels Calcium nasal spray Calcitonin 1200mg Ca and 400-800U Vit D ```
35
Osteoporosis risk factors
``` Asian Low BMI Genetics Nutrition Cigarettes Age ```
36
Preschool identity
Can identify but don't care
37
School age identification
Strict M and F separation
38
Adolescent identity
Strong M or F Educate High suicide rate among sexually confused
39
Spinal cord injuries and sex
Men can achieve both | Woman can typically get pregnant
40
Homosexual sti risk factors
MwM highest MwW next WwW lowest risk
41
Megan's Law
Notifying a community of registered sex offenders in the area
42
Quid pro quo harassment
Sex for personal gain
43
Hostile work environment
Discomfort or exploited worker
44
Inhibited sexual desire causes
``` Medicines Disease Age Depression Menopause ```
45
Maternal Unintended pregnancy risk factors
Unmarried Stalled education Financially less stable
46
Child unintended pregnancy risk factors
``` LBW Abuse Abortion Mortality rate Insufficient resources ```
47
Reproductive health tests
Pap Preg test Sti screen CBC
48
Reproductive health history assessments
PT HX and FX OB history Sti history Sexual history
49
Reproductive psychological assessment
Knowledge Desires Needs Body image and self esteem
50
Reproductive ND
``` HSB Deficient knowledge Spiritual distress Low self esteem Decision all conflict RT pregnancy/choice of contraception Powerlessness/fear/anxiety Ineffective sexuality pattern RF ineffective health maintenance ```
51
1st three things for nurse to assess in reproductive health
Nurses own feelings PT knowledge Where PT gained knowledge
52
Contraception assessment
``` Personal values Clients values HX and future Ability to use correctly Side effects Cost PT relationships ```
53
Reproductive education benefits
Fewer unwanted pregnancies Fewer STI Fewer abortions
54
Contraception desired outcomes
``` Safe 100% effective All aspects are compatible with PT No S/E before, during, or after Easily used and obtained ```
55
Rhythm method plan
6 month cycle evaluation - 18 from shortest cycle - 11 from longest
56
BBT method plan
``` Take temp each morning when waking Temp drops .5 before and rises 1 during ovulation Avoid sex for 3 days 75% effective Meds and exercise affect baseline temp ```
57
Mucus method
Mucus thick and sparse until ovulation | Must monitor daily and before sexual activity
58
Symptomthermal method
Mucus and temp method 3 days after temp 4 days after mucus thinning
59
Ovulation detection
Detect LH in urine 98%+ accurate Expensive
60
Lactation amenorrhea
Natural ovulation suppression while breastfeeding | Use < 3 months
61
Natural method throughout the lifespan
Committed relationships Adolescents aren't as disciplined or regular Elder women temp and mucus change
62
Oral contraception
Estrogen/progesterone based Estrogen suppresses gonadotropins Progesterone keeps mucus thick and decreases tubal transport
63
Biphasic coc
Steady estrogen until increasing progestin during last 11 days
64
Triphasic
Estrogen and progestin vary throughout | Mimics natural cycle
65
Coc non-contraceptive decreases:
``` Dysmenorrhea PMS Acne Fe deficiency PID Cancer Osteoporosis and endometriosis ```
66
Coc instructions
Start 2 weeks postpartum Not effective for first week 21 active/ 7 placebo Take at the same time everyday
67
Coc side effects
``` Weight gain Metrorrhagia Depression Hypertension Breast tenderness Nausea ```
68
Coc contraindications
``` Thromboembolic disease CvA or cardiovascular accidents Smoking/over 35 increases clotting risks Cancer Pregnant/Breastfeeding/< 6 weeks postpartum Hypertension Hyperlipidemia Liver problems Diabetes Not regular for at least 2 years Younger adolescent ```
69
Coc complications
Angina SHoB Acute headache/leg pain Changes in vision
70
Mini pills
Progestins thicken mucus
71
Coc and adolescents
Regular cycle for at least 2 years and done growing Low compliance High cost
72
Discontinuing COC
Pituitary needs 1-8 months to effectively release gonadotropins Clomiphene restores fertility
73
Postcoital contraception
Morning after pill High estrogen inhibits implantation Causing vomiting
74
Emergency contraceptive kit
``` Prevent After sexual assault Urine test and then estrogen/progesterone Up to 5 days after NOT PRIMARY USE ```
75
Plan B
Prescription needed under 18 75-85% effective Started within 72 hrs and repeated in 12 Not common
76
Subdermal implant benefits
Used during breast feeding No compliance 3-5 year length
77
Subdermal disadvantages
Long term | Teratogenic
78
Injection benefits
``` Every 12 weeks 99% effective by suppressing ovulation Reduces ectopic, cancer, endo, and sickle cell Breastfeeding Amenorrhea may occur after 12 months ```
79
Injection disadvantages
Glucose and Ca malabsorption Not for adolescents 6-12 month to become fertile again
80
IUD disadvantages
``` Doctor needs to implant Dysmenorrhea and heavier flow for first 3-6 months Metrorrhagia TSS risk Spontaneous abortion risk Not for adolescent Can take 6-12 months to become fertile ```
81
IUD contraindications
Adolescent/never pregnant Abnormal uterus HX of ectopic, dysmenorrhea, menorrhagia, carditis, anemia Multiple partners
82
Chemical barrier disadvantages
Leaking Irritating 20% failure rate Must prepare
83
Diaphragm disadvantages
``` Compliance Left in for 6 hours Healthy/normal uterus needed No adolescent Dislodges Weight loss/gain needs refitting ```
84
Diaphragm can cause
TSS UTI Allergic reaction Irritation
85
Vasectomy disadvantages
Not always reversible Risk for kidney stones Body may form antibodies to sperm Not for adolescents/obese
86
Tubal ligation disadvantages
Cancer risk increases Surgical pain/risks Still have cycle Symptoms similar to PDD
87
Elective termination reasons:
Threatens moms life Fetal defect Rape/incest Unwanted
88
Pre-termination tests
``` Pregnancy CBC w/ typing Gon/Syph Urinalysis Amnio Pap ```
89
Federal termination guidelines
< 12 weeks
90
State termination rules can include:
Regulate/forbid 2nd 3rd trimester 24 hr waiting Counseling Parental approval in adolescents
91
Mifepristone
``` Progesterone antagonist preventing implantation Reduces leiomyomas Induces labor Cocaine detox 90-95% ```
92
Mifepristone administration procedure
Single dose Rh- woman receives RhO immune globulin Misoprostol administered 3 days later causing contractions
93
Medical termination contraindications
``` Ectopic IUD Adrenal failure Long term corticosteroids Blood disorder Anticoagulant therapy Allergies ```
94
Medical termination advantages
Decreased uterine damage | No anesthesia
95
Medical termination disadvantages
Return visit for confirmation NVD Acute cramping
96
Menstrual extraction facts
5-7 LMP | Vacuum extraction of uterine lining
97
Menstrual extraction procedure:
``` Voids Peri-cleanse Speculum Tenaculum stabilizes cervix Catheter inserted Suction Possible oxytocin Lay supine for 15 min ```
98
Dilatation and Curettage procedure
``` <13 weeks Voids Peri-cleanse Para cervical block Cervix dilated Curette scrapes Oxytocin 1-4 hour stay at hospital ```
99
D&C risks
Uterine perforation | Infection
100
Dilatation and Vacuum extraction procedure
``` 12-16 weeks Dilatation with seaweed or misoprostol Vacuum over 15 min Oxytocin Supine for 15 min ```
101
Dilatation and Vacuum risks
Rare uterine perforation | Infection
102
Prostaglandin/Saline induction procedure
``` 16-24 weeks Misoprostol/laminaria for dilatation Prostaglandin administration Oxytocin for induction Expulsion Oxytocin for hemorrhaging Examination of expelled ```
103
Saline induction procedure
Voids Abdominal anesthesia Needle into uterus with 100-200mL 20% 12-36 hours until contractions
104
Hypernatremia symptoms and treatment
Increased pulse Flushed face Acute headache 5% dextrose
105
Hysterotomy when these aren't working:
Oxytocin Prostaglandin Saline
106
Hysterotomy
> 16 weeks C-section < 1% of all abortions
107
Partial birth is indicated when:
Last trimester Encephalocele High meningocele Other congenital anomalies
108
Chapter 47 nursing diagnosis
``` R/F infection Pain RT Disturbed body image RT breast mass Anxiety Fear ```
109
Pelvis exam across the lifespan
Not indicated in preadolescent (Use otoscope or ear tip) Begins when sexually active 18-20 if not sexually active
110
1st phase of reproductive development
Reproductive differentiation In utero at 8 weeks
111
2nd period of reproductive development
Maturation and development of sex organs and characteristics
112
Congenital adrenocortical syndrome
Adrenal gland produces androgen instead of cortisone causing female to look male
113
Ambiguous genitalia assessment
Karyotyping Laprascoping abdomen for ovaries Surgery
114
Therapeutic considerations for ambiguous genitalia:
Will removal of X affect them later? Should the surgery be delayed for the child to make or to mature? Does non working part need to be removed?
115
Precocious puberty origins:
Tumor Hypothalamus Gonads
116
Precocious puberty signs:
Increased skeletal development Increased breast development Menstruation with few other secondary traits Abnormal growth of male genitals
117
Precocious puberty treatment:
Leuprolide daily SubQ desensitizes GnRH receptors | D/c at 12-13
118
Testicular cancer
< 1% 15-35 yr old Enlargement, heaviness, weight loss, abdominal and back pain
119
Testicular cancer therapy
Sperm banking if needed Removal and prosthesis Chemo or radiation
120
Mittelschmerz signs
Pain in lower quadrant by ovary NVD Scant spotting
121
Dysmenorrhea signs
``` Bloating Cramping Pain in LQ Aching in legs, vulva Breast tenderness ```
122
Menorrhagia signs
Saturating a tampon an hour or 200mL per flow
123
Metrorrhagia > 1 cycle can signal:
Cancer or ovarian cyst
124
Endometriosis causes:
Genetic Deficient immune response Excess estrogen Failed luteal phase
125
Endometriosis symptoms
Dysmenorrhea Dyspareunia if culdesac No/irregular ovulation
126
Estrogen and endometriosis
Estrogen level stays high and blood gets forced back into Fallopian tubes by tissue
127
Endometriosis therapies
Coc Androgen shrinks tissue GnRH Laparotomy is last resort
128
Amenorrhea causes
Extreme dieting Extreme excercise Low body fat Pregnancy
129
PDD symptoms
``` Decreased ovary blood supply Vit B deficiency Excess estrogen Water retention Hypoglycemia ```
130
Instructions to PT who think they have PDD
Diary of symptoms Diet high in Vit and Ca Low salt
131
Imperforate hymen
Occluded vagina preventing flow
132
Imperforate hymen symptoms
None until menstruation Pressure building in vagina/uterus Abdominal pain Mass palpable in lower abdomen
133
Imperforate hymen treatment
Use pictures to describe procedure Local anesthesia Incision/removal of hymen Mild analgesia and warm bath for pain
134
TSS symptoms
``` Temp > 102 NVD Hypotension Shock Impaired kidneys/liver/cognition Headache Severe pain ```
135
TSS assessments
Pelvic and removal of debris | Culture for S aureus
136
TSS treatment
``` Iv fluids Dopamine to elevate BP Removal of debris Penicillanase-resistant antibiotics (Not penicillin) Avoid tampon use ```
137
Vulvovaginitis signs
``` Inflammation Pain Odor Pruritus Discharge Possibly bleeding ```
138
Vulvovaginitis in preadolescent
``` Discharge but no bleeding Vaginal exam Ointment/bath to clean Rule out sexual abuse/precocious puberty/pinworm Culture Staph/EColi ```
139
Vulvovaginitis in adolescents
Discharge Irritation Odor
140
PID causes
Chlamydia and Gonorrhea
141
PID symptoms
Acute abdominal/ovarian/cervical pain Purulent discharge Fever Peritoneal edema
142
Untreated PID
``` Scarring Dysmenorrhea Dyspareunia Scarring Metrorrhagia ```
143
PID therapies
Analgesia Broad spectrum Limit activity Drain abscesses
144
Advice to post PID PT
High risk of reoccurrence No sex with infected partner Non sex while menstruating Have kids early
145
Fibrocystic breast disease treatment
Analgesia Aspiration Ultrasound Mammogram
146
STI preventative measures
``` Education Condom Voiding post Washing with soap and water Choose partners wisely ```
147
HPV and women
Most likely to contract Adolescents reviewed for abuse Yearly Pap recommended Correlated with cancer
148
Hpv vaccine
Teenage girls | Shot, 2months, 6 months
149
Hpv and pregnancy
Warts get bigger and can get infected | No effect on fetus
150
Herpes symptoms
Vesicles Painful draining Lesions Flulike symptoms
151
Herpes flair up causes:
``` Illness Prior to menstruation Fever Excessive sunlight/tanning Stress ```
152
Herpes treatment
Antiviral ointment | Sitz for comfort
153
Herpes and pregnancy
Crosses placenta if contracted while pregnant Given during birth Vaginal birth preferred if no active lesions
154
Gonorrhea in males
``` 2-7 day incubation Urethritis Thick yellow green discharge Itching Urination/rectal/testicular pain Can spread and cause sterility ```
155
Gonorrhea in females
``` May be asymtomatic Slight discharge Itching Pain after sex/rectal Can cause sterility through tubal scarring ```
156
Gonorrhea assessment
Urine, vaginal, urethral culture
157
Gonorrhea therapy timeline
Oral/IV treatment Not contagious in 24 hours Return in 7 days for follow up
158
Gonorrhea and antepartum and delivery
Spontaneous miscarriage Preterm birth Endometritis postpartum Can cause blindness if present at birth and not treated
159
Progression of syphylis
Chancre for 6 weeks then fades Rash and mucous lesions appears 2-4 weeks later then fades Latent for years-decades Finally blindness, paralysis, and cognitive failure
160
Syphilis tests
``` Serologic serum Ven Dis Research Lab Automated reagin test Rapid plasma reagin test Fluorescent treponemal antibody absorption tests (confirms VDRL) ```
161
Syphilis treatment
Benzathine penicillin IM X2 Oral erythromycin 10-15 days Cyclines
162
Jarisch Herxheimer reaction
``` Caused in adolescents post syphilis treatment Hypotension Fever Tachycardia Muscle aches ```
163
Pregnancy and syphilis
Crosses at 18th week | Causes miscarriage, preterm, stillbirth, congenital anomalies
164
Pregnancy and syphilis tests
Woman tested at 36 weeks | Baby tested with cord blood
165
Newborns and syphilis
``` Copper rash on face, palms, feet Rhinitis Pegged teeth Easy tooth decay Same as final stage for adult ```
166
Strep and pregnancy
Screened at 35-38 weeks | Babies develop sepsis, pneumonia, meningitis, rds
167
Erectile dysfunction causes:
``` Disease- diabetes, neuropathy Injury Substances Low T Decreased nerves sensitivity Hypogonadism ```
168
Erectile disfunction risk factors
Age Trauma Disease Substances
169
Erectile dysfunction drugs:
Viagra and levitra PRN Cialis daily No nitrates/cardiac/bottom out
170
IUD advantages
Long term Possibly have amenorrhea after 12 Can take ibuprofen 99% effective
171
Sonohysterography
Saline injected into uterus Ultrasound inserted vaginally for inspection Can be done anytime
172
Hysterosalpingonography
Iodine/radiopaque dye introduced into cervix | If patent, flows through to ovaries and outlines
173
Hysterosalpingonography disadvantages
Rare infection/allergy Must be done post menses Can cause acute cramping
174
Hysterosalpingonography benefits
Can break up masses | Can increase patency
175
Male sperm facts
20-200 mil sperm/mL 2.5-5 mL > 50% mobile > 30% normal shape
176
Sex 4 times/week for 6 and 12 months:
6- 50% pregnancy | 12- 85%
177
Subfertility assessments:
Semen analysis Ovulation analysis Tubal patency
178
Sterility
From known condition like absent testicles or uterus
179
Subfertile causes
Disease Semen Ovulation Patency
180
Male subfertile causes:
``` Pancreas, thyroid, pituitary imbalance Substances Thermoregulation/blood flow Long sitting Infection Autoimmune ```
181
Female subfertile causes
``` Nutrition Weight Exercise High Glucose/insulin Stress Poly cystic ovary disease Plumbing ```
182
Endometrial biopsy
``` 3 days before menses Anesthesia block Inserted through cervix Sample should look like corkscrew indicating progesterone Call back with next menses ```
183
Biopsy contraindications
Current infection Current STI Pregnant
184
Biopsy complications
Bleeding Infection Uterine perforation
185
Pre-therapeutic insemination tasks:
Mucus, BBT, ovulation kit | Blood type/rH factor of donor
186
IVF procedure
``` GnRH hormones administered Ultrasound daily to view eggs HCG to cause ovulation in 36-48 hrs Extraction 8 hr incubation Sperm introduced 40 hr incubation 1-2 zygotes introduced back ```
187
Al states must report within 24 hours
Gonorrhea Syphilis HIV-Aids Confirmed chlamydia in most states by 7 days
188
When to get STI tested
Stopping sex relationship and before starting another Regularly with multiple partners Any STI symptoms
189
3 categories of STI
Bacterial Viral Parasitic
190
Candidiasis symptoms
``` White discharge Itching Burning Dry skin Occasional dsyurea ```
191
Chlamydia symptoms
Runny grayish white discharge and dsyurea | Inflammation
192
Hpv treatments
Gardasil (quadrivalent) | Cervarix (Bivalent)
193
Gardasil
HPV vaccine mostly in teens | Homosexual men can get until 26
194
Ed nursing dx
Knowledge deficit Situational low self esteem Sexual dysfunction
195
Coc drug interactions
Acetaminophen Anti coagulants Antibiotics Seizure meds
196
Depo
Q12 weeks | Im
197
Permanent birth control methods
Vasectomy Ligation Essure block

Nursing 113 (10 decks)

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