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NURS ADN004 Maternity > Week 7 Final Reproductive Ch 4/5 > Flashcards

Week 7 Final Reproductive Ch 4/5 Flashcards

1
Q

Women’s health is ________ area of health care

A

Evolving

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2
Q

Role of the nurse in women’s health care

A

Education, assessment, nursing care

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3
Q

Women’s emphasis on

A

Health promotion and health education

Health maintenance
- Diet
- Exercise
- Prevention
- Tx
- Healthy eating

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4
Q

Primary female sex hormone is

A

Estrogen

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5
Q

When is estrogen in high levels?

A

Childbearing age

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6
Q

Estrogen in high levels in males

A

False

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7
Q

Estrogen is responsible for

A

Development of secondary sex characteristics

Helps regulates menstrual cycle by?
- Stimulating proliferation of endometrial lining in preparation of pregnancy

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8
Q

Primary male hormone is

A

Testosterone

Made in testes - men- ovaries- females

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9
Q

Hormone responsible for the development of the male genital tract and the secondary sex characteristics

A

Testosterone

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10
Q

In both genders what does testosterone do?

A

Enhances libido
Increases energy
Boosts immune function
Helps protect against osteoporosis

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11
Q

Menstrual hx and hx of pregnancies
Hx of exposure of medications
Pain with menses or intercourse
Vaginal discharge, odor, itching
Urinary and bowel function
Sexual history, including abuse of sexual and physical
Hx of STDs. STIs, surgeries or procedures
Chronic illness or disabilities
Family or genetic hx

A

Health Hx and Sexual Assessment

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12
Q

Pelvic Smear
Pap Smear
Colposcopy and cervical biopsy
Cryotherapy and laser therapy
Cone biopsy and LEEP
Endometrial biopsy
Dilation and Cuerttage
Laparoscopy( Pelvic Peritoneoscopy) and hysteroscopy

A

Diagnostic Examinations and tests

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13
Q

Method of cervical screening used to detect potentially precancerous and cancerous tissues in the cervix ( opening of the uterus or womb)

A

Pap Smear

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14
Q

Examination of the vagina or cervix using has camera attached for photographs; used to document findings and for follow up treatments

A

Colposcopy

Views cervix with beam of light

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15
Q

What are the 3 methods of doing cone biopsy of cervix?

A

LEEP

Cold knife excision

Laser Surgery

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16
Q

Uses a thin wire loop heated by electricity to remove cervical tissue

A

Loop electrosurgical excision procedure

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17
Q

Uses a surgical knife to remove cervical tissue

A

Cold Knife excision

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18
Q

Uses a laser 9 intense narrow beam of light to remove the cervical tissue

A

Laser Surgery

Laser Excision

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19
Q

Method of destroying tissue by freezing, used for treating cervical dysplasia and early cancers

A

Cryosurgery

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20
Q

Inspection of the abdominal or pelvic cavity with a laparoscope, which is an endoscope used to examine the abdominal and pelvic regions

A

Laparoscopy

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21
Q

Procedure used to examine inside of the womb(uterus)

A

Hysteroscopy

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22
Q

Carried out using a hysteroscope

A

Hysteroscopy
- Narrow telescope with a light and camera at the end

Images are sent to a monitor so the physician or specialist can see inside the womb

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23
Q

Broad term that includes abuse, elder abuse, and the abuse of women and men

A

Domestic Violence

Abuse can be
- Emotional
- Physical
- Sexual
- Economic

Asking about the abuse is part of comprehensive assessment

Reporting and abuse guidelines

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24
Q

Physical, sexual, or psychological harm or social isolation

A

IPV

Perpetrated by a current or former partner

Occurs in intimate dating or relationship

Intended to instill fear and to intimidate and control the victim

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25
Q

Worldwide affects 1 in every 3 women

11 million women affected
5 million men affected

Women have 1 in 4 risk of being IPV in their lifetime

A

IPV

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26
Q

Male abuser with past hx of violence

Violent behaviors occurs early in relationship and progressively worsens

Used to handle conflicts

Used to exert feelings of powerlessness

A

IPV Characteristics

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27
Q

Affects persons, regardless of: status, ethnicity, educational level, or religious status

A

IPV Victims

Most often affected are
- Young women

Economically challenged individuals
- No means getting away

  • Children living in homes with IPV
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28
Q

Contributing social factors include

A

Personal family violence
Poverty
Oppression
Unemployment
Difficulty with relationships
Single parent families

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29
Q

Individual risk factors of IPV

A

Young age
Low self esteem
Low academic achievement
Heavy drugs use
Social isolation
History of abuse
Prior injury from same partner
Economic stress
Tobacco and alcohol
Depression

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30
Q

Relationship risk factors include

A

Maternal conflict, instability
Relationship dominance by one partner
Poor family functioning
Economic stress

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31
Q

Name IPV indicators

A

Overuse of health services
Vague complaints
Unexplainable injuries, delay in care
Multiple injuries in various healing stages
Intimate partner refuses to leave, insists on explaining cause of the injury

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32
Q

Forced participation, use of force
Refusal to use condoms
Increased exposure to STDs
Forced undesired pregnancy

A

Sexual Violence

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33
Q

Maternal injury, increased infections and hospitalizations with pregnant women

Increased preterm births

Low birth weight infants, neonatal death

A

IPV and Childbearing

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34
Q

Threats and stalking

Involves property and pet destruction

Abuser

Blames the victim for the violence

Seeks to convince children to view victim as instigator of violence

Attempts to convince others of victim’s incompetence

A

Psychological and Emotional Violence

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35
Q

Social abuse may include

A

Total isolation from family, friends

Requiring permission to leave home and accounting for all time spent away from home

Denying access to medical care

Forbidding employment or school

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36
Q

Control of victim’s finances
Refusal to share money
Forced accounting for money spent
Forbidding victim employment or taking action to jeopardize the job

A

Financial abuse

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37
Q

The financial abuse is often what in elder abuse cases?

A

Taking control of the victim’s money and finances, clearing accounts or incurring large credit bills

May include obtaining power of attorney over victim affairs

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38
Q

ANA endorses universal screening, assessment, documentation in all health settings

Conducting IPV interview

Provide safe setting

Establish trust

Maintain therapeutic communication

Consider use of validated assessment tools

Properly document and report

A

Screening for Abuse

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39
Q

Nursing Interventions for Abuse

A

Education and counseling

Support in decision making

Strategies to protect from harm in the home environment

Strategies to facilitate escape to a safe place

Establishment of a victim referral system

Provision for long term follow up

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40
Q

Premenstrual Syndrome
Premenstrual Dysphoric Disorder
Dysmenorrhea- Painful periods
Amenorrhea- No periods
Abnormal uterine bleeding
Menorrhagia- Heavy menstrual bleeding
Metrorrhagia- break through bleeding, spotting

Postmenopausal bleeding- Bleeding that occurs 6 or more months after menopause

A

Menstrual Disorders

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41
Q

Meno

A

Menstrual related

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42
Q

Metro

A

Time

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43
Q

Oligo

A

Few

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44
Q

A

A

Without

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45
Q

Rhagia

A

Excess or abnormal

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46
Q

Dys

A

Not or pain

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47
Q

Rhea

A

Flow

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48
Q

Absence of menses by age 14 with the absence of secondary sexual characteristics or absence of menses by age 16 with normal development of secondary sex characteristics

A

Primary amenorrhea

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49
Q

Absence of menses for 3 cycles or 6 months in women who have previously menstruated

A

Secondary Amenorrhea

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50
Q

Nursing Care of the Patient with PMS

A

Assessment: Health hx, nutritional hx, recording of symptoms

Assess for potential for violence, suicide, and refer

Identify pt goals: Improved coping, reduction of anxiety, improved relationships

Interventions and pt teaching

Social support, counseling, and stress reduction

Diet and exercise
Medications

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51
Q

Name PMS Characteristics

A

Physical, emotional, behavioral changes

Occur during luteal phase

Cease at menses- usually 4 days after onset

Key: Timing of symptoms

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52
Q

Diagnostic Criteria for PMS

A

Symptoms occur in cyclic pattern

Look for symptoms not caused by underlying physical/ mental condition

Symptoms cause considerable disruption in the woman’s life

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53
Q

Diagnostic criteria for PMS must have one of the following in the luteal phase

A

Affective Symptoms- confusion, depression, anger, irritability, sleep disturbances

Somatic symptoms or physiologic- Bloating, headache, breast tenderness, weight gain, appetite changes

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54
Q

PMS may be related to what?

A

Social, cultural, biological, and psychological factors

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55
Q

Condition is estimated to affect up to 75% of women during their childbearing years

A

PMS

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56
Q

This occurs more often in women between their late 20s and early 40s who have at least one child with a personal or family history of major depression, ppd, or affective mood disorder

A

PMS

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57
Q

> 80% of women report PMS Symptoms

Become more worse in late 30s and 40s with menopause approaching

As many as 50-60% of women with severe PMS have PMDD ( premenstrual dysphoric disorder, a psych disorder

A

PMS

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58
Q

When does PMS begin usually?

A

14 days after the start of menstrual cycle

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59
Q

When does PMS end?

A

4-7 days after the cessation of the menstrual period

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60
Q

Symptoms of PMS

A

Include bloating, gas, breast tenderness, clumsiness, constipation or diarrhea, food craving, headache, light or noise sensitivity and irritability

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61
Q

Most severe form of PMS

A

PMDD

Premenstrual Dysphoric Disorder

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62
Q

Common Symptoms of PMDD

A

Abdominal bloating
Tension, anxiety, crying episodes
Depression, fatigue, difficulty concentrating

Appetite changes, swelling of extremities

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63
Q

Primary emotional symptoms of PMDD

A

Anxiety
Depression
Anger
Sadness
Despair
Suicidal ideation
Panic attacks
Extreme sensitivity
Chronic fatigue
Binge eating
Insomnia or hypersomnia
Extreme disruption of personal relationships

64
Q

Physical Symptoms may include breast tenderness, heart palpitations, headaches, joint pain, bloating, and weight gain

A

PMDD

65
Q

Causes of PMDD include

A

Multifactorial: genetic predisposition plus biological, psychosocial, sociocultural factors

Increased sensitivity to cyclic hormonal changes

66
Q

Diagnostic Criteria of PMDD

A

At least 5 symptoms occurring 1-2 weeks premenstrual with relief by day 4 of menses

Major symptom categories at least 1

Anger, anxiety, depression, moodiness

Plus 5 additional symptoms
Difficulty concentrating, fatigue, insomnia, overeating

67
Q

Treatment of PMS/ PMDD

A

Healthy lifestyle ( diet, exercise, rest)

Pharmacologic
- Continuous combined oral contraceptives, Depo- Provera

  • Spironolactone
    SSRIs (PMDD)
    ( Fluoxetine, sertraline, paroxetine, escitalopram oxalate)

Monophasic oral contraceptives containing drospirenone (progestin) (PMDD)

68
Q

Treatment Options for PMS and PMDD

A

Lifestyle changes
Reduce Stress
Exercise 3-5x
Eat balanced diet and increase water intake
Decrease caffeine
Stop smoking and limit intake of alcohol
Attend a PMS or women’s support group
Vitamin and Mineral supplements
Multivitamin daily
Vitamin E 400 units
Calcium 1200- 1600
Magnesium 200- 400

Medications
- NSAIDs taken week prior to menses
- OCs low dose
- SSRIs
- Anxiolytics
- Diuretics to remove excess fluid
- Progestins
- GnRH agonists
- Danazol ( androgen hormone inhibits estrogen production)

69
Q

Permanent physiologic cessation of menses associated with declining ovarian function

A

Menopause

70
Q

Changes in menstruation
Clinical manifestations
Psychological considerations
Medical management : HRT; risks and benefits
Alternative therapy for hot flashes

A

Menopause

71
Q

Average age for menopause

A

51.4 years

Age range is 40- 58 years

72
Q

Last normal menstrual period

Results from decreased ovarian hormone secretion

A

Menopause

73
Q

Time period preceding menopause, usually 2-8 years before final menses

A

Perimenopause

74
Q

Onset age of perimenopause

A

Range 39-51 years

Average lasts 4 years

75
Q

Characterized by hormonal fluctuations, sporadic ovulation, physical symptoms

A

Perimenopause

76
Q

Changes in menstrual cycle

A

Changes in bleeding patterns

Result from a lack of ovulation

Bleeding may be heavy, prolonged, irregular

Important to rule out other causes

Leiomyomas

Cancer- Cervical

77
Q

Fibroid aka called

A

Leiomyomas

78
Q

Hormonal changes are related to declining ovarian function are which two

A

Decreased estrogen and progesterone

79
Q

What physiological feedback loop is lost

A

Ovaries- hypothalamus- pituitary gland stops

80
Q

Hormonal changes include increased conversion of

A

Androgens to estrogens

81
Q

Physiological changes in menstrual include

A

Skin, mucous membranes become drier

Shrinkage of fatty layer beneath skin

Decreased elasticity decreased moisture in skin, more wrinkling

Increased body hair growth, scalp hair loss

Shrinkage of breast glandular tissue

82
Q

Urogenital changes include

A

Related to estrogen deficiency

Worsen with advancing age

Vaginal symptoms include: itching, burning, bleeding, soreness, atrophic vaginitis

Urinary symptoms: dysuria, frequency, stress incontinence, UTIs more common

Loss of mechanical support of pelvic diaphragm

Bones: Bone density loss; increased risk of osteoporosis

83
Q

Urogenital changes are related to?

A

Estrogen deficiency
Worsen with age

84
Q

Urogenital changes include what vaginal symptoms

A

Itching, burning, soreness, atrophic vaginitis

85
Q

Urogenital urinary symptoms include?

A

Dysuria
Frequency
Stress incontinence
UTIs more common

Loss of mechanical support of pelvic diaphragm

86
Q

Bones in urogenital changes include what?

A

Bone density loss
Increased risk of osteoporosis

87
Q

Vasomotor changes in menopause include

A

Hot flashes and night sweats

88
Q

Most common menopausal symptom
Sweeping waves of heat

A

Hot Flashes

89
Q

Profuse perspiration and heat radiating from the body at night

A

Night Sweats

90
Q

Ways to promote comfort for menopause patients

A

CAM medicine
Exercise
Dietary strategies
Consumption of “cool” foods
Avoidance of triggers
Clothing strategies

91
Q

View life as natural change and new phase for potential growth and new activities

Promote general health with diet and exercise

Note fatigue and stress may worsen hot flashes

Nutrition

Address sexual activity and prevention or management of common problems

A

Nursing teaching for pt approaching Menopause

92
Q

What is the nutrition for Menopause patients?

A

Calcium and vitamin D supplementation may be helpful

Decrease fat and calories and increase calcium, whole grains, fiber, fruit, and veggies.

93
Q

Name two abortions

A

Spontaneous Abortion

Habitual Abortion

94
Q

Abortions should include

A

Medical management
Nursing support for patient
Grief process and dysfunctional grief

95
Q

Pre abortion counseling

Pelvic examination and lab tests

Use Rhogam and Rh -

A

Elective Abortion

Different types

Patient teaching instruction with follow up care and information on contraception

96
Q

Couple’s inability to achieve a pregnancy a pregnancy after 1 year of unprotected intercourse

A

Infertility

97
Q

Primary infertility refers to couple who have never had a child

A

True

98
Q

At least one conception has occurred but the couple can not achieve pregnancy

A

Secondary Infertility

99
Q

Cervical causes of infertility in women include

A

Abnormal cervical mucous production
Cervical surgery or damage

100
Q

Causes of infertility in Women

A

Damage to fallopian tubes
PID
Surgical Intervention
Endometriosis
Hormonal Causes

Failure to synchronize the hormonal factors that lead to preparation of the uterine lining or maturation and release of the ovum

Failure to produce adequate estrogen and progesterone to maintain the pregnancy

101
Q

Name Uterine causes of Infertility in women

A

Polyps.
Myomas
Leiomymas- Fibroids
- Uterine Malformation
- Bicornuate uterus

102
Q

Treatment of Infertility includes

A

Fertility drugs

Regulate or induce ovulation

103
Q

How do fertility drugs work?

A

Like natural hormone
FSH and L trigger ovulation

104
Q

Risks of infertility include

A

Multiple gestations
Ovarian Hyperstimulation Syndrome

105
Q

This syndrome includes enlarged ovaries, pain, GI problems, and SOB

A

Ovarian Hyperstimulation Syndrome

106
Q

Name the infertility drugs that stimulate ovulation and stimulate release of FSH and LH and growth of ovarian follicle

A

Clomiphene Citrate
- Clomid, Serophene

107
Q

Name drugs that may be used with intrauterine insemination

A

Gonadotropins

108
Q

These drugs are used to stimulate ovary directly rather than stimulating pituitary

A

HMG- Repronex, Meonpur

109
Q

This drug is used when insulin resistance is known or suspected making ovulation more likely to occur

A

Glucophage

110
Q

Lentrozole may induce what?

A

Ovulation and treat breast cancer

also called Femara

111
Q

Name surgical interventions for infertility

A

Tissue removal
Removal of endometrial tissue or pelvic adhesions
Tubal reversal surgery
Tubal surgery to repair obstructive disorders
Remove adhesions, dilate tubes, create new opening in tubes
Salpingectomy

112
Q

Removal of tube used with Invitro fertilization to improve chances of pregnancy

A

Salpingectomy

113
Q

Involves retrieving mature eggs from woman’s ovaries, fertilization with man’s sperm in a dish in a lab, and transfer to the embryos 3 to 5 days after fertilization

A

Vitro Fertilization

114
Q

What method increases the chance of multiples?

A

Vitro

Requires frequent blood tests and daily hormone injections

115
Q

Name the two hormones responsible for stimulating ovulation

A

Estrogen and Progesterone

116
Q

Which hormones are produced by the pituitary gland in a specific pattern during the menstrual cycle

A

FSH and LH

117
Q

What can disrupt fertility and can affect ovulation?

A

Excess physical or motional stress
Very high or low body weight
Recent substantial weight gain or loss - 10%
Disrupt pattern and ovulation

Main sign is irregular or absent period

118
Q

What is much less common, specific diseases of the pituitary, usually associated with other hormone deficiencies or with the excess production of ?

A

Hormonal factors

Production of prolactin

119
Q

Complex changes occur in the hypothalamus, pituitary, and ovary which results in overproduction of males hormones (androgens) which affects ovulation

A

Polycystic Ovary Syndrome

Associated with insulin resistance and obesity

120
Q

What defect occurs when the ovary does not produce enough of the hormone progesterone after ovulation.

A

Luteal Phase Defect

121
Q

__________________ is vital in preparing the uterine lining for fertilized egg

A

Progesterone

122
Q

Disorder is usually caused by autoimmune response, where your body attacks ovarian tissue

Results in loss of eggs in the ovary, as well as decrease in estrogen production

A

Premature Ovarian Failure

123
Q

Name Male factors of infertility

A

Blockage in a man’s reproductive system

Certain medicines

Low sperm count

Sperm abnormally shaped or doesn’t move correctly

Undescended testicles - Due to Temp.

Infections

Underlying medical conditions

124
Q

Other factors of infertility include

A

Tobacco smoking, excessive alcohol consumption ad abuse of other illegal drugs, emotional stress, obesity and age- Fertility gradually decreases in men who are older than 35

Sometimes the cause of infertility may not be identified- May be genetic problem

125
Q

Treatment of Male Infertility

A

More than half can be corrected and may help couple get pregnant through normal intercourse

Even if can’t, you may not need expensive or invasive treatments to get pregnant

If man needs surgery it can often be done in outpatient

126
Q

Name common causes of female infertility with Ovulation Disorders

A

Aging
Diminished Ovarian Reserve
Premature Ovarian Failure
Endocrine disorders

127
Q

Tubal causes of infertility disorders include

A

PID
Tubal Surgery
Previous ectopic pregnancy
Salpingectomy

128
Q

Uterine and Cervical causes of female infertility include

A

Congenital uterine anomaly
Fibroids
Endometriosis
Poor cervical mucous quantity and quality
Infection

129
Q

Breast Disorders

A

Overview anatomy of the breast
Major health problem
215000 women
1450 men

40000 die anually

130
Q

Surgical management of Breast Cancer

A

Breast Conservation Treatment or lumpectomy

Total Mastectomy

Modified radical mastectomy

Sentinel node biopsy and axillary lymph node dissection

Breast reconstruction surgery

131
Q

External beam for breast cancer that is nonpharmacological

A

Radiation Therapy

132
Q

Insert a sealed source of radiation right in tumor sight

A

Brachytherapy

133
Q

Stop hormones from helping cancer cells grow
Suppress production of hormones that encourage cancer cell growth

A

Estrogen and Progesterone Assay

134
Q

Infusion therapy is also known as

A

Chemotherapy

135
Q

Inhibit or enhance estrogen action in cells

A

SERMs

Selective Estrogen Receptor Modulators

136
Q

Non steroidal estrogen antagonist

A

Tamoxifen

137
Q

Name aromatase inhibitors

A

Anastrazole
Letrozole
Exemestane

138
Q

Which drugs block production of estrogen or block the action of estrogen on receptors

A

Aromatase Inhibitors

139
Q

What therapy blocks the GROWTH of cancer cells by interfering with specific targeted molecules needed for carcinogenesis and tumor growth

A

Targeted Therapy

140
Q

Nursing process assessment for patient undergoing Breast Cancer Surgery

A

How is this patient responding to diagnosis?

What coping mechanisms may be helpful?

What psychological or emotional supports does she have and use?

Is there support or assist in treatment making decisions?

What are her educational needs?

Is she experiencing any discomforts?

141
Q

Hand and Arm Care

A

Potential for lymphedema formation after ALND

Patient Education

Prevention is vital, follow guidelines for rest of life

No blood pressure, injections, or blood draws in affected arm

Perform exercise 3x per day for circulation increase and muscle strength. Prevents stiffness and contractures, and restores ROM

Initial limitation of lifting over 5-10 pounds and activity

142
Q

Risk Factors for Breast Cancer

A

Female Gender
age Greater than 50
Personal and family history
Genetic Mutations
Late or no pregnancy
Hormonal Factors
Starting Menopause after 55
Exposure to radiation
History of benign breast disease
Obesity
High fat diet
Alcohol Intake

143
Q

Other risk factors for breast cancer

A

Inactivity
Obesity after menopause
Dense breast tissue
Hrt for greater than 5 years after menopause
Certain types of birth control pills
Personal history of benign breast disorders
Women who took des

144
Q

Guidelines for Early Detection of Breast Cancer

A

20-30
- Breast exam every 3 years
- Then annual after 40

145
Q

When do we start for mammography?

A

Age 40

146
Q

Women at increased risk may have

A

Earlier initial screening
Shorter screening intervals
Additional screening procedures such as MRI and ultrasound

Beginning in 20s, teach women benefits and limitations of BSE

147
Q

When is self breast exam best performed?

A

5-7 days after 1st day of menses

Once a month for postmenopausal

Review the feel of normal breast tissue or identify changes

148
Q

Routine BSE will do what for patient?

A

Familiar with abnormalities of her own normal

149
Q

Demonstrate the exam technique

Learners should perform BSE demonstration on themselves or a breast model

A

Teaching BSE

150
Q

Part of BSE can be done ?

A

In shower with soapy hand to glide over the breast and focus on underlying tissue

151
Q

In BSE in is important to include what area?

A

Between the breast and underarm and underarm itself

Reporting any changes

152
Q

BSE Exam in 6 Steps

A
  1. Stand in mirror and examine the characteristics
  2. Raise arms and examine and turn
  3. Put hands on hips and examine
  4. Compress or squeeze nipple
  5. Start from collarbone begin to palpate by patting.
  6. Turn to lying position and examine in previous steps above
153
Q

Involves X ray tube x ray x ray cassette and compression paddle

A

Mammography

154
Q

Diseases that are sexually transmitted from partner to partner

A

STDs

Include
- Bacterial Vaginosis
- Chlamydia
- Gonorrhea
- Genital Herpes
- Hepatitis
- HIV/ AIDs
- HPV
- PID
- Syphilis
- Trichomoniasis

155
Q

What has increased by 45% in California?

A

STD/ STI

Prevention is critical
Oral sex is not a protection from STDs and STIs

156
Q

How can STD and STIs be passed

A

Breastfeeding, common use of needles, donor tissue or blood transfusion

157
Q
A

NURS ADN004 Maternity (11 decks)

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