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NCM 214 A > Unit 4: Nursing Care of Male and Female Clients with General and Specific Problems in Reproductive Ability to Produce > Flashcards

Unit 4: Nursing Care of Male and Female Clients with General and Specific Problems in Reproductive Ability to Produce Flashcards

1
Q

This reproductive organ produces cells necessary for production?

A

Gonads

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2
Q

Becomes testes

A

Mesonephric (Wolffian) ducts

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3
Q

Becomes ovaries

A

Paramesonephric (Mullerian) ducts

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4
Q

It is the stage were secondary sex characteristics starts to change

A

Puberty

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5
Q

What does the hypothalamus produces that stimulates the anterior pituitary?

A

GnRH

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6
Q

What does the anterior pituitary releases?

A

LH and FSH

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7
Q

This is known as the closure of growth of the long bones?

A

Adrenarche

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8
Q

This is the stage of breast development?

A

Thelarche

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9
Q

It is the first menstruation

A

Menarche

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10
Q

This cell is produced in a cyclic pattern

A

Ova

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11
Q

This is produce in a continuous process

A

Spermatozoa

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12
Q

It is the study of male reproductive organ

A

Andrology

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13
Q

Support the testes and regulate temperature

A

Scrotum

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14
Q

manufacture spermatozoa

A

testes

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15
Q

It is the most abundant male sex hormone

A

testosterone

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16
Q

It expels urine from bladder and deposit sperm to the woman’s vagina

A

Penis

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17
Q

Stores sperm and transports it from the testes

A

Epididymis

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18
Q

How long does the sperm remain in the epididymis?

A

2-10 days

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19
Q

how long does it take for the sperm to travel?

A

12-20 days

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20
Q

How long does it take for the sperm to fully mature?

A

65 - 75 days

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21
Q

What are the other terms for vas deferens?

A

Ductus deferens or spermatic cord

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22
Q

It is where the sperms fully mature where it travels.

A

vas deferens

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23
Q

What protects the sperm from the acidic environment of the vagina?

A

accessory gland

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24
Q

What composes the accessory glands?

A

seminal fluid, bulbourethral gland and prostate gland

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25
Q

What are the other function of accessory gland apart from protecting the sperm from the acidic environment?

A

enhance motility and nourish sperm

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26
Q

Hollow tube leading from the base of the bladder to the shaft and glans.

A

Urethra

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27
Q

Study of female reproductive organ

A

Gynecology

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28
Q

It is responsible for the production of estrogen and progesterone which stimulates ovum maturation.

A

Ovaries

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29
Q

What is the shape and size of the ovaries?

A

almond shape and walnut size

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30
Q

What are the other terms used as substitute for fallopian tube?

A

Oviducts or uterine tube

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31
Q

How long is the fallopian tube in cm and inches?

A

8 - 13.5 cm or 3 - 5.3 inches

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32
Q

This part of the fallopian tube extends in uterine cavity and lies to the top of the uterus,

A

Interstitial portion

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33
Q

It is the part of the fallopian tube which is a narrow area near that connects ampulla to the nearest portion of the uterus.

A

Isthmus

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34
Q

It is the wider area of the fallopian tube which is a site for fertilization.

A

Ampulla

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35
Q

It is the funnel like distal end of the fallopian tube.

A

Infundibulum

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36
Q

It is a hallow area where fertilized egg is implanted, an embryo forms and a fetus develop.

A

Uterus

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37
Q

What is the mass and length of a nonpregnant uterus?

A

60 grams and 7.5 cm long

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38
Q

What are the 3 parts of the uterus?

A

fundus, corpus and cervix

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39
Q

It is the most contractile part of the uterus where fallopian tube enter uterus on side.

A

Fundus

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40
Q

It is the middle portion of the uterus which has an active role in menstruation and pregnancy.

A

Corpus

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41
Q

It is a narrow tubular opening to the vagina.

A

Cervix

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42
Q

What are different layers of the uterus?

A

Perimetrium
Myometrium
Endometrium

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43
Q

It is the inner and mucosal layer of the uterus that is functional. It is where IUD is applied.

A

Endometrium

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44
Q

It connects the external genitalia to uterus.

A

Vagina

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45
Q

What is the normal pH of the vagina?

A

4 to 5

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46
Q

What are the 3 main functions of the vagina?

A
  • acts as organ of intercourse to convey sperm to cervix
  • drainage of menstrual flow and secretion
  • passageway for infant birth
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47
Q

It occupies the lower portion of the trunk of the body.

A

Pelvis

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48
Q

Access organ of reproduction (mammary).

A

Breast

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49
Q

This type of hormone is needed for the production of milk.

A

prolactin

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50
Q

This hormone stimulates contraction of myoepithelial cells surrounding the alveoli that causes milk ejection.

A

oxytocin

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51
Q

What are the common problems of couple with infertility?

A

Violence, Social Stigma, Divorce and Anxiety

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52
Q

What are the 5 criteria in order for a couple to get pregnant?

A
  1. Woman must release egg from 1 ovary
  2. Ovulation
  3. Fertilization
  4. Fertilized egg should proceed from the fallopian tube to the uterus
  5. Implantation
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53
Q

It is the inability to conceive a child or sustain pregnancy to birth.

A

Infertility

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54
Q

How would you consider if a couple is infertile?

A

If the couple practiced unprotected sex for 1 year and did not get pregnant (Reproductive age lesser than 35); while 6 months for woman more than 5 years of age

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55
Q

This type of subfertility refers to no previous conception.

A

Primary subfertility

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56
Q

This refers to subfertility that has previous pregnancy but unable to conceive.

A

Secondary subfertility

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57
Q

It refers to the inability to conceive because of certain conditions.

A

Sterelity

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58
Q

It is the chance to achieve pregnancy with 1 menstrual cycle.

A

Fecundity

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59
Q

It refers to the difficulty of getting pregnant or carry child to term.

A

Impaired fecundity

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60
Q

It is the ability to produce life.

A

Fertility

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61
Q

What is the recommended number of intercourse per week?

A

4 times

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62
Q

What are included in fertility assessments?

A
  • if Female partner is younger than 35 years, evaluate if subfertile after 1 year
  • If older than 35 years, evaluate after 6 months
  • Fertility testing is no before 18 or after 45 years of age
  • Age and emotional status of couple considered
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63
Q

What are the 3 assessments considered for subfertility?

A
  • Semen analysis (M)
  • Ovulation monitoring (F)
  • Tubal patency (F)
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64
Q

What other tests are used for Male?

A
  • Urinalysis
  • CBC
  • Blood Typing including RH factors
  • Testing of syphilis
  • HIV
  • Erythromycin Sedimentation Rate
  • Protein bound iodine
  • Cholesterol level, FSH, LH and testosterone level
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65
Q

What other tests are considered for female?

A
  • Rubella titer
  • Serological test for syphilis
  • HIV evaluation
  • Thyroid uptake
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66
Q

What are the factors affecting Man’s feritility?

A
  • Disturb spermatogenesis
  • Inadequate FSH and LH which stimulates the production of sperm
  • Obstruction in seminiferous tubules, ducts, vessels which prevent movement of sperm
  • Qualitative and quantitative changes in seminal fluid which prevent sperm motility
  • Development of autoimmunity, immobilize sperm
  • Problems of ejaculation or deposition
  • General ill health
  • poor diet
  • stress
67
Q

This refers to the number of sperm at single ejaculation.

A

Sperm count

68
Q

What are the criteria for a healthy sperm?

A
  • 33 million to 36 million sperm per mL of seminal fluid, over 50 million per ejaculation
  • 50% are motile
  • 30% are normal shape and form
69
Q

What other factors are considered for a sperm?

A
  • volume
  • motility
  • shape (morphology)
  • ability to pass strong mucus at cervix
  • acrosome reaction
  • zona pellucida binding
  • nuclear decondensation
70
Q

What are the 2 kinds of sperm according to their motility?

A

Progressive motility and non-progressive motility

71
Q

It travels mostly in straight line or large circle.

A

Progressive motility

72
Q

Sperm that do not travel in straight lines or that swim in tight circle.

A

non-progressive motility

73
Q

What are the indications for a healthy sperm motility?

A
  • forward progression
  • 25 micrometers/second
74
Q

< 32% of sperm are able to move efficiently

A

Poor sperm motility or asthenozoospermia

75
Q

It refers to the absence of sperm cells in the semen.

A

Azoospermia

76
Q

It refers to the absence of seminal fluid

A

Aspermia

77
Q

It refers to a condition in which there are < 20 million sperm

A

Oligospermia

78
Q

What are the risk factors for the abnormality of sperm?

A
  • increase body temperature condition
  • cryptorchidism
  • varicocele
  • past trauma to the testes
  • surgery near or on testes
  • endocrine imbalance, thyroids, pancreas, pituitary gland
  • drug use or excessive alcohol
  • environmental factors
79
Q

What are use for testing of the sperm number?

A

Analysis of Pituitary hormone
Semen Analysis
Sperm Penetration Assay and Antisperm Antibody testing

80
Q

It is a basic test of subfertility, which is repeated every 2-3 months.

A

Semen Analysis

81
Q

What should be the minimum amount of semen and sperm produce for semen analysis?

A

1.4 mL to 1.7 mL , minimum of 33 to 46 million spermatozoa per milliliter of fluid.

82
Q

This test determine the ability of the sperm to undergo capacitation. This include fusion of egg and sperm in the cytoplasm of the oocyte.

A

Sperm Penetration Assay or Zona-free hamster

83
Q

This test looks for special proteins that fight against blood, vaginal fluid and semen as this can cause immune response.

A

Antisperm Antibody Testing

84
Q

What are the therapy for increasing sperm count and motility?

A
  • Man should abstain from coitus for 7 to 10 days
  • ligation of varicocele
  • changes in lifestyle
  • maintain ideal body weight (18.5 to 24.9 BMI)
85
Q

What are the factors for the obstruction or impaired sperm motility?

A
  • mumps orchitis
  • epididymitis
  • gonorrhea, ascending urethral infection
  • pressure from enlarge gland at vas deferens
  • Infected prostate gland
  • congenital stricture of sperm duct
  • vasectomies develop autoimmune reaction
  • hypospadias
  • epispadias
  • peyronie disease (bent penis)
  • extreme obesity
86
Q

What are the therapy included for obstruction or impaired sperm motility?

A
  • surgery to relieve obstruction
  • extracting sperm from a point above blockage and injecting into vagina or uterus of the woman.
  • administration of corticosteroid to a woman
87
Q

What are the different type of ejaculation problems?

A

Erectile dysfunction
- primary
- secondary
Premature ejaculation

87
Q

Able to experience before but is difficult now

A

Secondary

87
Q

This type of erectile dysfunction involve never achieving errection.

A

Primary

88
Q

What are the causes of ejaculation problems?

A
  • psychological problems
  • cerebrovascular accident
  • diabetes
  • parkinson disease
  • Use of certain antihypertensive agents
  • discontinuation of finasteride
89
Q

Ejaculation before penetration which may interfere with proper deposition of sperm.

A

Premature ejaculation

90
Q

What are the therapy for premature ejaculation?

A
  • Psychological or social counseling
  • Assessment of phosphodiesterase inhibitor
  • Dapoxetine (taken 1 hour before coitus)
91
Q

What are the female factors that may affect subfertility?

A
  • limited production of FSH and LH
  • Anovulation
  • Problem of ova transport
  • uterine factors such as tumors or poor endometrial development
  • Cervical and vaginal factors which can immobilize sperm
  • poor nutrition
  • increase body weight
  • lack of exercise
92
Q

Condition in which there is absence of ovulation or release of ova from ovary. This is a naturally recurring variations in ovulatory patterns or PCOS.

A

Anovulation

93
Q

What are the causes of anovulation?

A
  • genetic abnormality
  • hormonal imbalance
  • ovarian tumors or PCOS
  • chronic or excessive exposure to x-ray
  • radioactive substances
  • general ill health
  • poor diet
  • stress
  • blood glucose/ insulin imbalance
94
Q

What are the tests used for anovulation?

A

Ovulation monitoring and Ovulation determined by test strip

95
Q

During this exam, serum progesterone is altered during the luteal phase (21-28 days: ovum occur).

A

Ovulation Monitoring

96
Q

What are the therapy included for anovulation?

A
  • maintain BMI
  • Nutrition, body exercise, body weight
  • administration of GnRH
  • therapy with clomiphene citrate (clomid) or letrozole (femara)
  • administer combination of FSH and LH in conjunction with human chorionic gonadotrophin
  • relieve clomiphene citrate
97
Q

Why does tubal transport problem happens?

A
  • scarring has developed in fallopian tube which is caused by chronic salpingitis
98
Q

What are the 3 test for tubal patency?

A

Sonohysterosalpingogram
Hysterosalpingogram
Trahnvaginal Hydrolaparoscopy

99
Q

This is a condition which infects the pelvic organ including fallopian tube, uterus, ovaries and supporting structure.

A

PID

100
Q

Why does PID cause fertility problem?

A

scarring leads to stricture of fallopian tube

101
Q

This test examines the fallopian tube and the uterus using an ultrasound contrasting agent.

A

Sonohysterosalpingogram

102
Q

It is similar to Sonohysterosalpingogram but instead uses a radiopaque contrast medium, fallopian tube is revealed by x-ray.

A

Hysterosalpingogram

103
Q

It is an alternative to Hysterosalpingogram and laparoscopy, this allows direct visualization of female peritoneal cavity.

A

Transvaginal Hydrolaparoscopy

104
Q

What are the therapy for pelvic inflammatory disorder?

A
  • prescribe diathermy or steroid administration
  • canalization of fallopian tube and plastic surgical repair (microsurgery)
  • laparoscopy or later surgery
  • reopening of ligated fallopian tube
105
Q

What are the most common uterine concerns?

A
  • tumors such as fibromas
  • a congenitally deformed uterine cavity (separate uterus)
  • Endometriosis
  • Poor secretion of estrogen and progesterone
106
Q

What are use for testing of uterine concerns?

A
  • hysteroscopy
  • Uterine Endometrial Biopsy
  • Laparoscopy
107
Q

It is use for the visualization of uterus.

A

Hysteroscopy

108
Q

In this test forceps are introduce to cervix to check if the endometrium is ready for implantation.

A

Uterine Endometrial Biopsy

109
Q

It is the introduction of lighted tube through small abdomen incision which is used to examine the fallopian tube and ovaries.

A

Laparoscopy

110
Q

This are type of myomas in which when it resembles a seedling is undetectable, but when bulky can distort enlarged uterus.

A

Leiomyomas

111
Q

This type of leiomyomas are attached to the muscular uterine wall.

A

Intramural fibroids

112
Q

This type of leiomyomas is a bulge in the uterine wall.

A

Submucosal

112
Q

It projects outside of the uterus, what type of leiomyomas?

A

Sub serosal fibroid

113
Q

What are the causes of Leiomyomas?

A
  • Genetic Changes
  • hormones
  • insulin like growth factor
  • extracellular matrix
114
Q

What are the risk factor of leiomyomas?

A
  • reproductive age
  • race
  • heredity
  • menstruation at an early age
  • obesity
  • diet higher in red meat and lower vegetable and fruits
  • alcohol
115
Q

What is the treatment for leiomyomas?

A

Myomectomy or surgical removal of tumor and adhesions

116
Q

It refers to the implantation of uterine endometrium or nodules that have spread from the interior to outside.

A

Endometriosis

117
Q

What are the most common sites for endemetriosis?

A

Fallopian tubes
Ovaries
Uterine ligament
Cul-de-sac of douglas
surface of uterus
bowel

118
Q

What are the manifestations of endometriosis?

A
  • pelvic pain
  • painful periods (dysmenorrhea)
  • pain with intercourse
  • pain with bowel movement or urination
  • excessive bleeding
  • infertility
  • fatigue, diarrhea
  • constipation
  • bloating or nausea especially during menstruation
119
Q

What is the treatment for endometriosis?

A

medical and surgical treatment

120
Q

It is a deformity of the uterus, which happens during fetal development. The septum divide inner uterus which leads to implant problem. This is also considered as the most common abnormal uterine development.

A

Septate Uterus

121
Q

This is a condition where in the entire uterus tips far forward.

A

Anteversion

122
Q

This is a condition where the uterus tips far back

A

Retroversion

123
Q

This is a condition where the body of the uterus is bent sharp forward at the junction with the cervix

A

Anteflexion

124
Q

It is a condition where the body of the uterus is bent sharp back above cervix

A

Retroflexion

125
Q

What are the causes of vaginal and cervical concerns?

A
  • Cervical mucus too thick which does not allow the sperm to penetrate the cervix.
  • Inflamed cervix
  • Stenotic cervical or obstruction of os by a polyp
  • Has undergone D&C - dilatation and curettage
  • infected vagina
  • sperm immobilizing or sperm-agglutinating bodies
126
Q

What are the testing and therapy for cervical and vaginal concern?

A
  • low-dose estrogen therapy to increase mucus production among days 5 to 10 of the cycle
  • vaginal infection will be treated according to the causative organism based on culture reports
  • partner needs antibiotic therapy
  • administer metronidazole (flagyl) for trichomonas infection
127
Q

What are other active support to help find alternative solutions for unexplained subfertility?

A
  • continue to try to conceive
  • use an assisted reproductive technique
  • choose to adopt
  • agree to a child free life
128
Q

What are the most common nursing diagnosis for subfertility?

A
  • Situational low self-esteem
  • anticipatory grieving
  • Hopelessness
129
Q

These treatment involves handling both eggs and sperms. In general it involves removing eggs, fertilize eggs in lab and return as embryo or surrogate carrier.

A

Assisted Reproductive Technique

130
Q

What are the different types of assisted reproductive technique?

A
  • Alternative insemination
  • In vitro fertilization
  • Gamete intrafallopian and Zygote Intrafallopian transfer
  • Surrogate Embryo transfer
131
Q

This ASR involves installing sperm from masturbatory sample into a female reproductive system by means of cannula to aid conception at time of ovulation.

A

Alternative insemination (intrauterine insemination/ Artificial insemination/ Donor insemination)

132
Q

What are the 2 types of Alternative insemination?

A

Intrauterine Insemination and Intracervical Insemination

133
Q

What is the most important consideration when doing an Alternative Insemination?

A

The woman’s ovulation must be predicted and must occur during the treatment

134
Q

What are the advantages of artificial insemination?

A
  • to eliminate the chances for known genetic disorder that does not want to be transmitted to children
  • If woman does not have a male partner
  • If the partner has no sperm or inadequate sperm
135
Q

When is the best time to cryopreserve a sperm?

A
  • before radiation or chemotherapy and then used for alternative insemination afterward
136
Q

What are the important aspects of cryopreservation of sperm?

A

Constant temperature of -196 degrees centigrade and use of liquid nitrogen

137
Q

This treatment involves acquiring of woman’s egg, fertilizing it to the lab with sperm, then transfer it to the uterus after embryonic development.

A

In Vitro Fertilization

138
Q

What are the indications of in vitro fertilization?

A
  • absence of cervical mucus
  • sever male infertility
  • tubal disease or blockage
  • endometriosis
  • unexplained infertility
  • cervical anchor
  • immunologic infertility
139
Q

How many eggs are chosen for women who are below 35 who want to undergo IVF and what percentage is its overall live birth?

A

1-2 fertilized eggs; 52%

140
Q

How many eggs are chosen for women who are 40 who want to undergo IVF and what percentage is its overall live birth?

A

5 embryos; 11%

141
Q

It is a procedure which involves the removal of a section of the ovary or an entire ovary.

A

Ovarian Tissue Transplantation

142
Q

How is Ovarian Tissue transplantation done?

A

The removed ovarian tissue is frozen to be used at a future date, then it is transplanted to a non-functioning ovary or into the peritoneum near the ovary and uterus.

143
Q

This is a treatment where both ova and the sperm are instilled within a matter of hours using laparoscopic technique into open patent end of fallopian tube. Fertilization does not yet occur.

A

Gamete Intrafallopian Transfer

144
Q

What are the indications for Gamete intrafallopian transfer?

A
  • normal tubal anatomy
  • patency
  • absence of tubal disease
  • at least 1 fallopian tubeI
145
Q

This treatment involves transferring a fertilized egg into the waiting end of the fallopian tube.

A

Zygote intrafallopian tube transfer (ZIFT)

146
Q

It is an assisted reproductive technique for a woman who does not produce ova or if the inherited problem is one arising from the female partner.

A

Surrogate Embryo Transfer

147
Q

What is the most important consideration for surrogate embryo transfer?

A

The menstrual cycle of the mother and the surrogate mother must be synchronous. This is done using medications.

148
Q

What are the issues to be addressed by the infertile couples before treatment?

A
  • risk of multiple gestation
  • possible need for donor oocytes, sperm, or embryos or gestational carrier
  • whether or not to disclose facts of conception to offspring
  • freezing embryos for later use
  • possible risks of long term effects of medication and treatment on women, children and families
149
Q

What are the most important preimplantation genetic diagnosis?

A
  • specific genetic abnormalities such as down syndrome or hemophilia
  • sex of the children can be predetermined
150
Q

What are the alternatives to childbirth?

A
  • Surrogate Mother
  • Child free leaving
  • Adoption
151
Q

It is a woman who agrees to carry a pregnancy to term for a subfertile couple or an LGBT couple.

A

Surrogate Mother

152
Q

What are the conflicts of surrogacy?

A
  • is the surrogate mother decides to end the pregnancy and want to keep the fetus
  • child is born imperfect
153
Q

Taking in a child who is not their own biologically.

A

Adoption

154
Q

Acceptance because of rigors and frustrations of infertility.

A

Child-free living

155
Q

How long is the epididymis?

A

20 feet

156
Q

How many lobes are their in the breast?

A

20 lobes

157
Q

It is a distal form of treatment.

A

laparoscopic surgery

158
Q

It is a proximal form of treatment.

A

Assisted reproductive problem

159
Q

This drug is used to stimulate ovulation that has been associate with multiple births.

A

Clomid

160
Q

It is known as the pregnancy maintaining hormone.

A

Progesterone

161
Q

What is used to eliminate embryos not chosen by the couple?

A

Potassium chloride

NCM 214 A (8 decks)

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