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Nursing 531 (Womens Health) > Week 1: Women's Health (Lecture 1) > Flashcards

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

1
Q

Average life expectancy for women is

A

80 years old

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2
Q

causes of death are related to ___ & ___

A

age and race

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3
Q

What is the cause of death in 15-24 y/o’s?

A

Accidents & Violence

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4
Q

Cause of death in 25-44 y/os”s

A
  1. heart disease
  2. cancer
  3. suicide
  4. accidents
  5. violence
  6. HIV (6th 25-34), 5th (35-44)
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5
Q

Cause of death in 45-64 y/os?s

A
  1. heart disease
  2. cancer
  3. CVA
  4. COPD
  5. liver disease
  6. DM
  7. accidents
  8. suicide
  9. violence
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6
Q

Cause of death 65 & up?

A
  1. heart disease
  2. cancer
  3. CVA
    4.COPD
    5.pneumonia
  4. accidents
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7
Q

Disease in White Women

A
  1. heart disease
  2. cva
  3. copd
    4.all cancers except respiratory
    5.pneumonia
  4. flu
  5. accidents
  6. adverse events
  7. suicide
  8. hiv
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8
Q

Disease in Black women

A
  1. lung cancer
  2. liver cancer
  3. HIV (leading cause of death in women 25-34)
  4. homicide
  5. legal interventions
  6. DM
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9
Q

Teens

A

-Critical period in human development

-Complete physical growth and development changes

-Complete psychosocial development

-High risk behaviors

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10
Q

-In 2022, 16% of population 10-19

-14% of adolescents are pregnant before age 18

-51% of 12th grade students admit to sexual intercourse past three months

-Condom usage decreases by age

-Of the 30K + New HIV cases in the US, 51% were adults and adolescents in the south

A

Females begin puberty about 2 years earlier than males

Puberty is a response of the HPG axis

After puberty, the mature ovary takes over as the driving force of hormonal control in females.

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11
Q

Puberty

A

Rapid physical growth begins start of puberty; menarche is the end point

Spans 8-14 years of age

Duration 18 months to 5 years

Growth spurt between 8-17, with peak time at age 12

Average duration 3 years

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12
Q

Puberty

A

Females grow about 2 ½ to 5 inches and gain

8-20 pounds per year

Growth slows down after menarche

Weight gain is attributed to estrogen

Growth spurt precedes thelarche by 1 year

Thelarche and adrenarche are concurrent

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13
Q

Puberty

A

External and internal genitalia develop into adult female proportions

Menarche final landmark of puberty

Begins 1-3 years after thelarche and with tanner stage 3 or 4

Early on menarche is anovulatory

Cycle is set within 3-4 years

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14
Q

Development for teens 11-13

A

Peer acceptance and conformity important

Normal with peer group

Concrete thinking

^interest in sexual processes but no desire

Sexual fantasies are common- guilt

Expresses through dress, body language, and curiosity

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15
Q

Development for teens 14-16

A

Most turbulent

Egocentric but self-esteem in relation to peers

Rebellion and mood swings to independence

Abstract reasoning but also immortality

Sexual energy is high with emphasis on physical contact

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16
Q

Development for teens 17-21

A

Full sexual maturity

Development of a sense of self and purpose

Relationships are becoming monogamous and intimate

Abstract reasoning skills fully developed

Achieves sociological maturity

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17
Q

Teens Health Issues & Risks: Nutrition & Eating Disorders

A

Needs increase due to the metabolic demand

Need sources of PRO, CA, Zinc, Fe

Eating disorders are compulsive overeating, anorexia nervosa, and bulimia

Overeating results in obesity, 1 out of 10

Eating disorders frequently begin subsequent to a emotional trauma

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18
Q

Menstrual disorders

A

Abnormal bleeding- Acute adolescent menorrhagia. Usually results from anovulatory cycle. Can progress to life threatening hemorrhage

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19
Q

Menstrual disorders

A

Dysmenorrhea: most common complaints of adolescence. Usually associated with onset of ovulatory cycles.

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20
Q

Sexually Transmitted Diseases

A

HPV – most common
Chlamydia – 28%
Gonorrhea – 22%
HIV – 7% are 13 - 24

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21
Q

Sexually Transmitted Diseases

A

Among teens with HIV diagnosis – 81% are male and 19% female.

Most are sexually active by the time they ever see a health care provider.

Need counseling regarding safe sex
Act for youth.net

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22
Q

Teen Pregnancy

A

Pregnancy rate (15-19) 17.4 per 1,000 females in 2018

16.7 per 1,000 females in 2019

Abortion rate (15-19) In 2020, 5.5 per 1000

Birth rate (15-19) 24 births/1000

Majority are unintentional (82%), minority intentional

60% in live birth, 26% abortion, and 14% miscarriage (2010)

Adolescents are at increased risk for perinatal complications

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23
Q

Smoking

A

-6000 experiment and 3000 become smokers
-Don’t like it but want to fit in
-Know of risk factors but unconcerned

-Adolescent smoking has a negative correlation with academic achievement and a positive correlation with drugs and ETOH usage

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24
Q

Alcohol usage

A

-Still a problem but reached lowest levels in 2014

-35% reported one drink in the past thirty days (before survey)

-21% binge drinking

-Drunk driving has declined by 50% since 1991

2013 – 10% reported driving drunk and 22% rode with someone who was drunk (hss)

Caucasian – more likely to drive drunk
Act for youth.net

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25
Q

Illegal drug abuse

A

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

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26
Q

Illegal drug abuse

A

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

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27
Q

___ is the 3rd cause of death after accidents in 15-24 year olds

A

suicide

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28
Q

___teens attempt suicide 4 times more than males

A

female

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29
Q

___ is associated with anger & depression

A

teen suicide

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30
Q

contributing factors for teen suicide?

A

-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.

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31
Q

signs a teen may attempt suicide

A

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.

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32
Q

signs a teen may attempt suicide

A

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.

33
Q

signs a teen may attempt suicide

A

Begins to give away sentimental possessions.

Spends time online interacting with people who glamorize suicide and maybe even form suicide pacts

34
Q

Cardiovascular disease

A

Atherosclerosis begins in childhood

Has a genetic and environmental factor

HTN in teens associated with obesity

35
Q

Sexual Assault

A

50% rape victims are 10-19 and perpetrator is known

Can lead to self-blame and doubt

Longstanding effects on self-worth and identity

36
Q

Care of a Teen

A

Health promotion – at schools or health fairs or in pediatrics office

Sexual behavior decisions – schools or during routine visits

Pelvic examination

Confidentiality and trust

37
Q

Leading health risks of a teen

A

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

38
Q

Leading health risks of a teen

A

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

39
Q

Leading health risks of a teen

A

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

40
Q

How to know risk factors?

A

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

41
Q

special assessment guides

A

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

42
Q

physical assessment

A

Generic exam components

Breast and Pelvic components

Pap smear

43
Q

Bethesda System Nomenclature

A

Squamous cell abnormalities: ASCUS, LGSIL, HGSIL, Squamous cell cancer

Gland cell abnormalities: Endometrial cells, cytologically benign, AGCUS, Adenocarcinoma

44
Q

Terms

A

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

45
Q

Guidelines for pap smears

A

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

46
Q

Guidelines for pap smears

A

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

47
Q

Pap guidelines

A

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

48
Q

Pap

A

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.

49
Q

Abnormal Initial ASC-US

A

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

50
Q

LSIL

A

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

51
Q

Pregnant non-teen

A

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

52
Q

Postmenopausal LSIL

A

HPV testing
Colposcopy
Repeat pap smear at 6 and 12 months

53
Q

HSIL

A

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)

54
Q

HPV HR testing

A

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

55
Q

Natural history of CIN

A

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

56
Q

women & sexuality

A

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

57
Q

women & sexuality

A

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

58
Q

sexual response cycle

A

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

59
Q

sexuality

A

Issues that affect sexuality for women include what?

How does she view herself as female
How does she present herself as female

60
Q

Presentation of self as female: How does she behave in public?

A

Adolescence
Reproductive years
Midlife
Older adulthood
Disabled
Other orientation

61
Q

sexual lifestyles

A

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

62
Q

sexual concerns

A

Diabetics

Cancer survivors

Disabled

63
Q

sexual myths

A

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

64
Q

Interference with a positive view of sexuality

A

Loss of identity

Family influence

Relationship discord

Religious/cultural beliefs

65
Q

sexual dysfunction

A

Definition: impaired, incomplete, or absent expression of normally recurring human sexual desire

Characteristics: physical-any phase

Categories: life-long or after trauma

66
Q

sexual desire disorders

A

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

67
Q

sexual arousal disorders

A

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

68
Q

sexual orgasm disorder

A

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

69
Q

sexual pain disorders

A

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

70
Q

sexual health care assessment

A

FNP must be aware of his/her sexuality

Components of sexual assessment

Do’s and don’ts

71
Q

sexual health care assessment do’s

A

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

72
Q

sexual health assessment donts

A

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

73
Q

What are the components of sexual history & assessment?

A

Physical

Psychological

Sociocultural

74
Q

Sexual history

A

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)

75
Q

special women groups?

A

lesbiens, teens, disabled

76
Q

Healthcare for lesbians

A

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

77
Q

Teens healthcare

A

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

78
Q

disabled women

A

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

79
Q
A

Nursing 531 (Womens Health) (10 decks)

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