Week 1: Women's Health (Lecture 1) Flashcards

Question

Illegal drug abuse

Answer 1

Substance free is increasing – 52% high school and 85% 8th graders were substance free 30 days. Marijuana – most common. 23% past thirty days; 1% 8th graders are daily users – 6% 12th graders Overall street drugs are declining but prescription drug abuse is increasing

Answer 2

Lifetime use - prescription drugs taken without a prescription (18%), inhalants (9%), hallucinogenics (7%), ecstasy/MDMA (7%), cocaine (6%), methamphetamine (3%), illegal steroids (3%), and heroin (2%) Act for youth.net

Answer 3

teen suicide

Answer 4

-Divorce of parents. -Violence in the home. -Inability to find success at school. -Feelings of worthlessness. -Rejection by friends or peers. -Substance abuse. -Death of someone close to the teenager. -The suicide of a friend or someone he or she "knows" online.

Answer 5

Talks about death and/or suicide (maybe even with a joking manner). Plans ways to kill him or herself. Expresses worries that nobody cares about him or her. Has attempted suicide in the past. Dramatic changes in personality and behavior.

Answer 6

Withdraws from interacting with friends and family. Shows signs of depression. Shows signs of a substance abuse problem. Begins to act recklessly and engage in risk-taking behaviors.

Answer 7

Begins to give away sentimental possessions. Spends time online interacting with people who glamorize suicide and maybe even form suicide pacts

Answer 8

Atherosclerosis begins in childhood Has a genetic and environmental factor HTN in teens associated with obesity

Answer 9

50% rape victims are 10-19 and perpetrator is known Can lead to self-blame and doubt Longstanding effects on self-worth and identity

Answer 10

Health promotion – at schools or health fairs or in pediatrics office Sexual behavior decisions – schools or during routine visits Pelvic examination Confidentiality and trust

Answer 11

Cigarette smoking Substance abuse Medication overuse sedentary life Nutritional concerns Unsafe driving Violence Blood borne disease

Answer 12

Lack of personal care Lack of sleep Environmental Stress Family crisis Poor/absent support Mood disorders Unrealistic value

Answer 13

Lack of recreational activities Poverty Familial disease Race Ethnic, cultural, religious factors

Answer 14

Communicate with the patient by: Maintain professionalism Client terminology Open ended questions Watch nonverbal cues Let client to speak freely Provide a private and quiet place Have realistic time frame Remain supportive, concerned, and nonjudgmental Value honesty and encourage from client

Answer 15

McMaster family assessment device Family apgar Nutritional assessment Fitness assessment Stress assessment Sexual assessment

Answer 16

Generic exam components Breast and Pelvic components Pap smear

Answer 17

Squamous cell abnormalities: ASCUS, LGSIL, HGSIL, Squamous cell cancer Gland cell abnormalities: Endometrial cells, cytologically benign, AGCUS, Adenocarcinoma

Answer 18

CIN 1 (cervical intraepithelial neoplasia) abnormal cells confined to lower third (mild dysplasia) CIN 2 Extending into middle third (moderate dysplasia) CIN 3 Into upper third (severe dysplasia) CIS (carcinoma in situ) full thickness involvement

Answer 19

1st pap smear at age 21 Ages 21-29: every 3 years Ages ≥ 30: every 3 years (pap only); pap plus HPV testing every 5 years

Answer 20

May discontinue ages 65 if - Negative history 3 negative paps in a row or 2 negative co-tests within 5 years No need to screen after hysterectomy for benign diseases ** Pregnant women ≤ 20: no pap ACOG guidelines 2017

Answer 21

Populations not appropriate to follow new guidelines HIV positive Immunosuppressed Exposed to DES in-utero Women previously treated for CIN 2, CIN 3, or cancer Remain at risk for recurrent or persistence for 20 years (after surgery or treatment) ACOG 2017

Answer 22

HPV testing Not recommended for women under 30 HPV vaccine Recommended for all women 11-24 Some physicians may get HPV testing with pap routinely.

Answer 23

If HPV negative – repeat pap in 12 months If HPV positive – colposcopy If after colposcopy CIN negative – pap at 6 and 12 months or HPV testing at 12 months CIN positive – manage according to cytology

Answer 24

Colposcopy for all LSIL If no lesion or no CIN Repeat at 6 and 12 months, HPV 12 months If lesion or + CIN Biopsy and manage according to cytology Usually either a LEEP or follow-up every 4 months

Answer 25

ASCUS or LSIL Colposcopy preferred Can defer initial until 6 weeks pp No ECC If no CIN 2, 3, or cancer – pp follow-up recommended

Answer 26

HPV testing Colposcopy Repeat pap smear at 6 and 12 months

Answer 27

colposcopy for all HSIL No lesion Repeat at 4 or 6 months (6 or 12) Lesion LEEP Repeat every 4 or 6 months (6 or 12)

Answer 28

Colposcopy with ECS (endocervical sampling) Do HPV if not already done Add endometrial sampling If > 35 to all subcategories IF < 35 with unexplained vaginal bleeding or chronic anovulation Treat based on cytology

Answer 29

CIN 2 43 % will regress 35 % will persist as CIN 2 22% will progress CIN 3 32% will regress 52% will persist as CIN 3 14% will progress

Answer 30

Women’s movement Sexual beings No guilt Can enjoy sexuality Sexual health defined as: WHO-State of physical, emotional, mental, and social well-being in relation to sexuality, not merely the absence of disease dysfunction or infirmity

Answer 31

Sexuality-Unique human quality that reflects our need for closeness from others Response is physical Sexual desire-The urge for sex Varies across life-span Learned behavior

Answer 32

Excitement: vaginal lubrication Plateau: vaginal engorgement and clitoral retraction Orgasm: the peak of uterine vasocongestion and myotonia Resolution: body returns to the pre-excitement phase

Answer 33

Issues that affect sexuality for women include what? How does she view herself as female How does she present herself as female

Answer 34

Adolescence Reproductive years Midlife Older adulthood Disabled Other orientation

Answer 35

Heterosexual monogamous marriage Serial heterosexual monogamy Swingers Living together Single Lesbianism/Bisexual Celibacy

Answer 36

Diabetics Cancer survivors Disabled

Answer 37

Women’s needs are second to men’s Women take longer to become aroused A women who initiates sex is immoral Women must have an orgasm to like sex Don’t discuss sex with your daughters Older women have no sexual desire Older women are sexually undesirable Older women who enjoy sex are shameful

Answer 38

Loss of identity Family influence Relationship discord Religious/cultural beliefs

Answer 39

Definition: impaired, incomplete, or absent expression of normally recurring human sexual desire Characteristics: physical-any phase Categories: life-long or after trauma

Answer 40

Hyposexual sexual desire -persistent absence or deficiency of sexual feelings, fantasies or desire for sex Sexual Aversion disorder- extreme repulsion, loathing and avoidance of all genital sexual contact with a partner

Answer 41

Sexual arousal disorders- partial or total lack of physical response as evidenced by lack of vaginal lubrication and vasocongestion in the excitement phase.

Answer 42

Inhibited female orgasm- persistent delay or absence of orgasm following a normal excitement phase during sexual activity.

Answer 43

Dyspareunia- recurring genital pain before, during or after vaginal intercourse Vaginismus- recurrent spasms of the outer 1/3 of the vagina which interferes or prevents coitus

Answer 44

FNP must be aware of his/her sexuality Components of sexual assessment Do’s and don'ts

Answer 45

Find a private place Confidentiality Allow time for trust and rapport Monitor your responses Open ended questions May use several interview sessions Progress from simple to complex Use client terminology

Answer 46

Act surprised Demean the client Laugh at a myth Fidget because you are uncomfortable

Answer 47

Physical Psychological Sociocultural

Answer 48

Separate form or part of complete history form If part of complete form, keep brief and expand if needed Sexual problem history When to perform history and any lab? Sample questions (see handout)

Answer 49

lesbiens, teens, disabled

Answer 50

Be aware of bias Remember barriers to care Special barriers Create a safe environment Assess coping status Common problems STD’s Cancer Body image Heart disease/stroke Suicide Mental health disorders Violence

Answer 51

Body image Views on sex and sexuality Peer pressure Not enough knowledge Psychological issues Self-concept

Answer 52

Common concerns for all disabled women Spinal cord injuries Joint inflexibility/pain Multiple sclerosis Epilepsy Urinary/bowel appliances

Week 1: Women's Health (Lecture 1) Flashcards

(79 cards)