Women Health Flashcards
(45 cards)
1
Q
Contraception Methods
A
- abstinence
- withdrawal
- natural family planning
- hormonal
- barrier
- permanent sterilization
2
Q
Vasectomy
A
- scalpel technique: cut and ligate/cauterize vas deferens
- no-scalpel technique: puncture scrotum to deliver vas deferens then ligate or cauterize
3
Q
Traditional tubal occlusion
A
- ligating
- blocking with clips or rings
- cauterizing
4
Q
Newer tubal occlusion
A
- brand name: essure
- micro-inserts placed into proximal fallopian tubes
- no reported pregnancies to date
5
Q
IUD’s
A
- most effective
- NOT for patient with current STD, PID, or uterine anomalies
6
Q
ParaGard T
A
- releases copper
- causes inflammation of endometrium and decreased sperm motility
- placed for 10 years
7
Q
Mirena & Skyla
A
- releases levonorgestrel
- creates inhospitable environment
- decreased ovulation
- Mirena placed up to 5 years
- Skyla up to 3 years
8
Q
IUD decreases…
A
risk of ectopic pregnancy compared to patients no using birth control
9
Q
Nexplanon
A
- most effective
- contains progestin
- implanted in inner upper arm
NOT for:
- hx of clot
- hx of br cancer
- liver dz
- smoker
10
Q
Combination Oral Contraceptives
A
- very effective
- administration of estrogen and progesterone prevents ovulation
- come in various forms and combo’s
- very effective if used as directed
General risks: hypercoagulability
11
Q
How to take contraceptives
A
-usually, active pills are taken for 21 days, then 7 days inactive pills
12
Q
Monophasic
A
- fixed ratio estrogen/progesterone
prototype: Lo/Ovral
13
Q
Biphasic
A
- estrogen stays same, progesterone increased in 2nd half
prototype: mircette
14
Q
triphasic
A
- estrogren and progesterone increase in 3 phases
prototype: ortho tricylcen Lo
15
Q
Combo pills serious side effects
A
- thrombosis
- accelerated breast tumor growth
16
Q
Patient teaching oral contraceptives
A
A: abnormal liver fx C: CP - SOB H: HA E: eye problems S: severe leg pain (thromboembolic process)
17
Q
Progestin-only products
A
- mini pill
- work more by creating inhospitable environment than preventing ovulation
- less effective, more breakthrough
- safer is a smoker, heart dz, breastfeeding
- all 28 pills are active
Prototype: Micronor
18
Q
Depo
A
- lasts 3 months
- safe postpartum
- must stay on schedule
- side effects: irregular spotting at first, eventually may have amenorrhea
- wt gain, HA, decreased libido, depression, hair loss, delayed return to fertility
- loss of bone mineral density
19
Q
Xulane: The Patch
A
- 1 combo patch q wk x3, then 1 wk off
- advantages: easier to remember
- not effective if over 198lbs, skin rxns common
- other side effects similar to combo pills, greater risk for VTE compared to pills
- not for pt with hx of VTE
20
Q
NuvaRing
A
- combo hormone
- indwelling ring placed against the cervix
- remains for 3 wks, then removed for 1 wk to allow meses
- need backup for 1 wk after ring placed for first time
- side effects similar to combo pill
- other issues: client comfort with use
21
Q
Barrier Method
A
- moderately effective
- male/female condoms
- vaginal sponge
- diaphragm
22
Q
Cervical Cap
A
- FemCap
- more effective for nulliparous women
23
Q
Spermicide
A
- effective
- available as creams, gels, film, foam, and suppositories containing nonoxynol-9
- used alone or with a barrier method
24
Q
Fertility Awareness
A
- effective
- rhythm method
- standard days method (cycle beads)
- BBT Method
- Billings ovulation method
- Symptothermal method
25
Emergency Contraception
- prevents pregnancy after sex
- not the same as abortion pill
- methods: plan B, Ella, Copper T IUD
26
Abortion
Spontaneous vs. Elective
- purposeful interruption of pregnancy before 20 wks gestation (elective, therapeutic)
- legal and moral issues
27
Concurrent use of spermicides and latex condoms...
provides protection against STIs
28
Tubal ligations and vasectomies are...
permanent sterilization methods
29
Induced abortion performed in the ____ trimester is safer and less coplex
first
30
most common complications of induced abortion
- infection
- retained products of conception
- excessive vaginal bleeding
31
Infertility
defined as a lack of conception with unprotected SI x12 months
-increases with age
32
Sterility
inability to conceive
33
Contributing factors to infertility
- 1/3 female issue
- 1/3 male issue
- 1/3 related to a combination of both male and female problems or unknown
34
Causes of female infertility
- hormone imbalance
- structural: endometriosis, scar tissue, congenital anomalies
- polycystic ovarian syndrome
- infections
- genetics
- weight
- age
- environment
35
PCOS
- 4-12% of women in US
- abnormal metabolism of androgen and estrogen leading to a hormone imbalance that impedes ovulation
- small cysts form in the ovaries rather than producing a mature egg (anovulatory)
- peripheral insulin resistance and hyperinsulinemia
- dyslipidemia
- increased clotting factors
- obesity
36
PCOS Symptoms
- abnormal menstrual patterns
- male pattern hair growth
- increased muscle mass, deepened voice
- infertility
- obesity
- DM
- acanthosis nigricans
- apple shape
- HTN
37
PCOS Infertility Tx
- weight loss
- metformin
- ovulation induction using agents like clomiphene (Clomide)
38
Metformin
regulates insulin resistance and improves hormone balance, thus reducing symptoms after 2 or 3 months of use in many patients
39
Assistive Reproductive Technologies
IVF-may include donor egg or sperm costs for this is very high with no guarantees for success
- gestational surrogacy
- adoption
40
Menopause
- climacteric period
- permanent cessation of menstrual flow with mean age of 51 years
- just one event occurring over months when ovarian function and hormone production decline call peri-menopausal period
- decreasing levels of estrogen and progesterone result in many of the classic symptoms
41
Labs for menopause
- FSH
| - LH
42
Symptoms of menopause
- vasomotor symptoms "hot flashes" r/t low levels of estrogen and increased levels of LH
- sleep disturbances
- urogenital atrophy leading to vaginal thinning, incontinence, cystocele and rectoceles
- osteoporosis and kyphosis
- hair loss and hair growth in annoying places
43
Menopause Key Points
- alt in thermoregulation
- alteration in comfort
- trauma, risk for r/t bone loss
- sleep pattern disturbance
- altered urinary elimination
- knowledge deficit
44
HRT
most beneficial in minimizing vasomotor symptoms, bone loss, and maintaining higher levels of high density lipoproteins (HDL) lipids
45
Herbal Approaches
soy: may help...more research needed
black cohosh, red clover, ginseng probably don't help
