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Flashcards in Sexuality/std Deck (198):
0

Nonverbal cues

Over modest
Inappropriate jokes
Any funny effects of medication?

1

Chapter 5 nursing diagnosis

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

2

Androgens

Adrenal cortex and gonads
Physical, muscles, sebaceous, body hair

3

Progesterone

Decreases mucous permeability
Decreases ovum transport
Decreases proliferation

4

Estrogen

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

5

Testes

Descend at 34-38 weeks
Undescended increases cancer risk

6

GnRH

Released by hypothalamus and influences pituitary

7

Pituitary

Releases FSH and LH that control ABP

8

LH

Promotes testosterone release

9

ABP

Androgen binding protein
Promotes sperm formation

10

Vulvar blood and nerves

Pudendal V&A
Pudendal, ilioinguinal, genitofemoral nerves

11

Ovary palpation

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

12

Nonfunctional ovaries

No breasts
Male like body hair

13

Estrogen

Prevents osteoporosis
Keeps cholesterol low

14

Ovary anatomy

Epithelium
Cortex (hormone production)
Medulla

15

How eggs transport

Mucous
Cilia
Muscular peristalsis

16

Uterus

Doesn't mature until 17 (LBW of newborns)
Stays 33% bigger after birth

17

Isthmus

Enlarges greatly for fetus
Part typically cut for CS

18

Cervical Os

Relation to is ischial spine determining fetal position

19

Pap smear

Sample taken between lower cervix and lower cervical canal

20

Myometrium

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

21

Uterine nerves

Sensory nerves lower than motor
Epidural stops pain but not contractions

22

Uterus septums

Present during formation but are supposed to rescind

23

Vagina

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

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