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IM 6 Test 3 > Women's Health > Flashcards

Women's Health Flashcards

1
Q

what is the number one killer of women and why

A

cardiac disease d/t atypical symptoms

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2
Q

symptoms of female heart attacks

A

pain/pressure in the chest, discomfort in neck, arm or jaw

pain in upper back and/or stomach

unusual fatigue

N/V

loss of appetite

lightheadedness, dizziness palpitations

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3
Q

stroke warning signs

A

sudden onset of:
-numbness/weakness of face arm or leg

trouble seeing out of one or both eyes

trouble walking, dizziness, loss of balance or coordination

severe headache

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4
Q

what is the golden hour

A

within 1 hour from onset of stroke symptoms

admin of tPA

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5
Q

ACS clinical breast exam ages

A

19-39 y/o - every 3 year

> 40 - annually

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6
Q

what to ask a patient if a lump appears

A

ask where they are in their cycle - fibrocystic women can have lumps appear close to period

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7
Q

mammorgram ages

A

every 1-2 years after age 40

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8
Q

montly vulvar self exam ages

A

all women 18 y/o or younger if sexually active

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9
Q

ACS cervical screening recommendations

A

21-29 y/o - every 3 years

30-65 y/o - every 5 years

> 65 - stop pap if no pre-cancerous w/n last 20 years

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10
Q

when is a pelvic exm schedule

A

5 days after last menstrual period

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11
Q

colposcopy

A

microscopic exam of vaginal and cervical tissue

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12
Q

colposcopy indications

A

abnormal pap, treat condyloma

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13
Q

cervical biopsy

A

extensive surgical biopsy

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14
Q

cervical biopsy indications

A

abnormal pap - atypical or abnormal cells

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15
Q

when is a cervical biopsy performed

A

early phase of menstrual cycle

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16
Q

endometrial biopsy

A

endometrial tissue aspirated from uterus

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17
Q

endometrial biopsy

A

abnormal or postmenopausal bleeding

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18
Q

hysterosalpingography

A

cervix, uterus and fallopian tubes are visualized by x-ray after injecting contrast dye

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19
Q

hysterosalpingography indications

A

evaluating for fibroids, tumors, fistulas or fertility

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20
Q

dilation and cutterage

A

dilate cervix and scrape endometrial tissue

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21
Q

D&C diagnostic

A

malignancy, fertility, dysfunctional uterine bleeding

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22
Q

D&C therapeutic indications

A

heavy iterine bleeding, incomplete abortion

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23
Q

endometrial ablation

A

removal of endometrial tissue

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24
Q

laparoscopy

A

laparoscope inserted for visualization and surgery

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25
Q

laparoscopy dx

A

fertility, ectopic, adhesions, cysts, endometriosis or PID

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26
Q

laparoscopy therapeutic indications

A

tubal ligation, IUD or adhesion removal, egg retrival

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27
Q

hysterectomy

A

surgical removal of the uterus

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28
Q

hysterectomy indications

A

cancer

fibroid tumors
endometriosis
genital prolapse
PID

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29
Q

total hysterectomy

A

cervix and uterus removed

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30
Q

subtotal or supracervical hysterectomy

A

above the cervix - rare

pap smears still done

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31
Q

hysterectomy with salpingo-oophorectomy

A

total with ovaries and tubes out too

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32
Q

radical hysterectomy

A

everything + part of vagina + lymph nodes

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33
Q

breast pain and Ca

A

10% of breast cancer presents with pain

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34
Q

fibrocystic breast changes before menopause

A

thickeing of breast tissue with the formation of cysts

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35
Q

symptoms of fibrocystic breast disorders

A

biltaeral pain and tenderness that occurs around the menstrual cycle

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36
Q

fibrocystic breast disorder tx

A

supportive bra

avoid caffeine

danazol

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37
Q

what does danazol do

A

androgenic medication that suppresses estrogen

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38
Q

primary amnorrhea

A

periods begin 2 years after breast development

no menses and no secondary sex characteristics by 14

no menses with secondary sex characteristics by 16

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39
Q

secondary amenorrhea

A

cessation of menstruation 6 months following normal cycles

underlying cause

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40
Q

menorrhagia

A

prolonged or ehavy menstrual bleeding

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41
Q

metorrhagia

A

irregular bleeding which often occurs between period or after menopause

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42
Q

menometrorrhagia

A

prolonged or excessive bleeding that occurs irregular and more frequent

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43
Q

menopause

A

permanent cessation of menstrual cycles

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44
Q

when does menopause occur

A

35-58 y/o w/ average age of 51

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45
Q

3 stages of menopause

A

perimenopause
menopause
post-menopause

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46
Q

perimenopause

A

s/s about 1 year before last menses

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47
Q

menopause

A

year after last menses

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48
Q

post-menopause

A

after menopause

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49
Q

vasomotor menopause changes

A

irregular periods
hot flashes
night sweats

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50
Q

GU menopause changes

A

incontinence/vaginal changes
increased pH
dryness
painful sex

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51
Q

psychological menopause changes

A

mood swings
sleep changes
decreased REM
fatigue

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52
Q

skeletal menopause changes

A

decreased bone density

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53
Q

CV menopause changes

A

irregular heart beat
palpitations
decreased HDL
increased LDL

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54
Q

dermatologic menopause changes

A

decreased skin elasticity

hair loss

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55
Q

reproductive menopause changes

A

breast changes

decreased interest in sex

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56
Q

therapy for menopause

A

HRT and ERT

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57
Q

HRT

A

estrogen progesterone

requires uterus

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58
Q

ERT

A

estrogen

uterus CANNOT

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59
Q

primary dysmenorrhea

A

painful cramping 12-24 hours before menses

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60
Q

primary dysmenorrhea is caused by

A

excessive endometrial production of prostaglandin

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61
Q

secondary dysmenorrhea

A

painful menses with known anatomic factors/pelvic pathology

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62
Q

second dysmenorrhea is caused by

A

endometriosis, adhesions, cervical stenosis, fibroids

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63
Q

endometriosis

A

presence of endometrial tissue outside the uterus

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64
Q

endometriosis s/sx

A 
cyclic pelvic and low back pain
infertility
dysparaunia
IBS
fixed/retroverted uterus
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65
Q

endometriosis med mgmt

A

NSAIDS
hormone therapy
biopsy
surgery (D&C)

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66
Q

endometriosis education

A

pain mgmt

emotional support r/t infertility

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67
Q

PCOS

A

increase in estrogen, testosterone and LH w/ a decrease of FSH lead to multiple cysts on ovaries and over production of estrogen

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68
Q

risks for PCOS

A 
diabetes/metabolic syndrome
dyslipidemia/HTN
cardiac dz
Ca
infertility
sleep apnea
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69
Q

PCOS s/s

A 
menstrual disorders
infertility
pelvic pain
ovarian cysts
obesity
oily skin
acne
hirsutism
male pattern baldness
70
Q

hirsutism

A

facial hair on women

71
Q

PCOS medical mgmt

A

lifestyle modification - diet/exercise
hormone therapy
fertility therapy
diabetic meds (metformin)

72
Q

PCOS nursing interventions

A

education:

  • Risk factors for PCOS
  • Weight reduction

treatment for:

  • hirsutism
  • acne
  • oily skin

emotional support:

  • infertility
  • psychological effects
73
Q

vaginal wall prolapse

A

loss of support to pelvic organs

74
Q

vaginal wall prolapse RF

A 
childbirth trauma
family hx
low estrogen
menopause
obesity
pelvic trauma
stress/strain
75
Q

cystocele

A

bulging of bladder into anterior vaginal wall

76
Q

cystocele s/s

A 
vaginal fullness
activity increases the bulge
stress incontinence
difficulty voiding
bladder infection
dysparenuia
sexual dysfunction
77
Q

rectocele

A

bluging mass in posterior vaginal wall

78
Q

rectocele s/s

A 
straining increases bluge
irritation of vaginal mucose
constpation
uncontrolled flatus
hemorrhoids
79
Q

uterine prolapse

A

uterus protrudes into vagina

80
Q

uterine prolapse s/s

A

heavy sensation in pelvis or vagina
low backache
painful intercourse
uterus falls out

81
Q

pelvic floor dysfunction mgmt

A

intravaginal estrogen
vaginal pessary
A/P repair

82
Q

pelvic floor dysfunction nursing ints

A

pessary insertion, removal, cleaning
pelvic exercises
urinary incontinence
prevention of constipation

83
Q

genital fistulas

A

abnormal connection between vagina and bladder, urethra or rectum

84
Q

RF for genital fistulas X3

A

trauma
hysterectomy
pelvic radiotherapy

85
Q

genital fistuals s/s

A

urine/fecal leakage from vagina
foul vaginal odor
vaginal mucose irritation

86
Q

genital fistula med mgmt

A

pelvic, rectal and perineal exam

determine location and severity

87
Q

genital fistula nursing int

A

care of fistula

pre op/post op care

88
Q

small genital fistual tx

A

at home resolution

89
Q

large genital fistulas tx

A

require surgical repair

90
Q

urinary incontinencetx

A

estrogen cream/anticholinergic drugs

91
Q

cervical polyps

A

small tumors caused by proliferation of cervical mucose

92
Q

s/s of cervical polyps

A

intermittent vaginal bleeding

93
Q

uterine leiomyomas (fibroids)

A

develop from uterine smooth muscle

estrogen dependent

94
Q

follicular ovarian cysts

A

mature follicle fails to rupture

95
Q

follicular ovarian cyst s/s

A

asymptomatic

96
Q

luteal ovarian cyst

A

corpus luteum becomes cystic and fails to reabsorb

97
Q

luteal ovarian cyst s/s

A

acute pain, delays next menstrual cycle, may rupture

98
Q

cyst tx

A

depends on type of cyst

99
Q

cervical Ca early s/s

A

vaginal discharge, abnormal vaginal bleeding

100
Q

cervica ca late s/s

A

weight loss, fatigue, pelvic pain, vaginal leakage of feces/urine

101
Q

cervical ca RF

A 
HPV
early onset sexual activity
multiple sex partners
inadequate cervical screening
high parity
102
Q

cervical dx

A

pap smear
colposcopy
cervical cone biopsy

103
Q

cervical ca mgmt

A

tx depends on stage and desire for future pregnancies

chemo and target drug therapy

104
Q

endometrial cancer s/s

A

postmenopausal or abnormal bleeding

abnormal discharge

difficult or painful urination

pelvic pain or pain with intercourse

105
Q

endometrial RF X4

A

HRT

menopause after age 52

nulliparity

diabetes, obesity, PCOS

106
Q

endometrial ca diagnosis

A

endometrial biopsy

107
Q

endometrial ca mgmt

A

based on size, stage, tumor grade and estrogen effect

108
Q

ovarian cancer s/s

A

vague

bloating or swollen abdomen
pelvic or abdominal pain
difficulty eating or feeling full quickly
urinary symptoms

109
Q

ovarian cancer RF

A 
menses started earlier than 12 y/o
nulliparity or 1st child after age 30
late menopause
infertility/drugs
family history of ovarian, breast or colorectal cancer
personal history of breast cancer
110
Q

ovarian cancer diagnosis

A

transvaginal ultrasound
CT scan/MRI
PET scan
barium enema x ray

111
Q

ovarian ca mgmt

A

total abdominal hysterectomy
biopsy lymph nodes, pelvic and abdominal tissues
chemotherapy and or radiation

112
Q

pelvic inflammatory disease

A

acute inflammation of the upper female genital tract

113
Q

PID consequences

A

ectopic pregnancy
chronic pelvic pain
infertility

114
Q

PID symptoms

A

asymptomatic or

severe abdominal pain
dyspareunia
purulent vagina discharge
nausea
irregular vaginal bleeding
fever
115
Q

PID mgmt

A

treat STI
analgesia
hospitilization

116
Q

PID nursing interactions

A

medication education
s/s and consequences of PID
risk reduction

117
Q

TSS

A

caused by toxin producing strain of S. Aureus

118
Q

TSS s/s

A

flu like
hypotension
generalized rash
skin peeling form palms and soles of feet

119
Q

TSS tx

A

stabilize hypotension

antimicrobial therapy

120
Q

TSS nursing considerations

A

change tampon every 4 hours
avoid superabsorbent tampons
use pad at night

121
Q

vaginitis

A

vaginal inflammation

122
Q

candidasis vaginitis

A

yeast infection

123
Q

yeast infection RF

A 
abx therapy
immunosuppression
diabetes
pregnancy
menopause
124
Q

yeast infection s/s

A

itching and irritation of the vulva
white, cheesy vaginal discharge
burning on urination

125
Q

yeast infection dx

A

wet mount and whiff test (negative)

126
Q

bacterial vaginosis RF

A 
multiple sex partners
new sexual partner
sharing sex toys
douching
antibiotic therapy
127
Q

bacterial vaginitis s/s

A

thin, white, milky discharge

fishy discharge

128
Q

bacterial vaginosis complication

A

chorioamnioitis
PROM
premature labor
premature delivery

129
Q

bacteral vaginosis med mgmt

A

metronidazole

clindamycin

130
Q

bacterial vaginosis dx

A

wet point and positive whiff test

131
Q

Chlamydia s/s

A

most asymptomatic

fever
Nausea
spotting
urethritis
mucopurulent cervical discharge
lower abd pain
dyspareunia
132
Q

chlamydia RF

A

PID
infertility
ectopic pregnancies
preemie birth

133
Q

chlamydia dx

A

genital culture

134
Q

chlamydia tx

A

azithromycin
amoxicillin/erythromycin/doxycycline

retest in 3 weeks

135
Q

chlamydia during pregnancy

A

infertility
ectopic pregnancies
preemie birth

136
Q

chlamydia and newborns

A

ophthalmia neonatorum

137
Q

Gonorrhea s/s

A

women - asymptomatic usually

purulent yellow/green discharge
spotting
low backache
dysuria
dyspareunia
anal itching
138
Q

gonorroea complications

A

PID

139
Q

gonorrhea dx

A

genital or cervical culture

140
Q

gonorrhea tx

A

ceftriaxone

azithromycin

141
Q

gonorrhea during pregnancy

A

infertility, ectopic pregnancies

142
Q

gonorrhea and newborns

A

ophthalmia neonatorum, sepsis

143
Q

trichomonas s/s

A

women - asymptomatic

erythema/edema of external genitalia
profuse frothy yellow discharge
foul odor
dyspareunia
strawberry spots on cervix
144
Q

trich complications

A

PID

145
Q

trich dx

A

wet mount and positive whiff test

146
Q

trich tx

A

metronidazole

no alcohol for 24 hours

147
Q

trich and pregnancy

A

infertility

PROM, labor or delivery

148
Q

trich newborn

A

LBW

149
Q

herpes s/s

A

primary infection:
flu like
painful lesion
2-4 weeks

recurrent symptoms:
5-10 days

150
Q

herpes complications

A

sepsis

151
Q

herpes dx

A

history and exam

152
Q

herpes tx

A

antiviral
oral analgesia
comfort measures

153
Q

herpes pregnancy

A

c-section if active

154
Q

herpes newborn

A

primary exposure - 50-60% mortality
neurological complications
sepsis

155
Q

hep B RF

A

IV users

HCW with needle stick

156
Q

Hep B s/s

A

appear 90 days after exposure
fever, fatigue, dark urine
abdominal pain

157
Q

hep b dx

A

physical exam and blood work

158
Q

hep b tx

A

antiviral and prophylactic immunization

159
Q

hep B newborn

A

90% infected in chronic infections - cirrhosis of liver

160
Q

HPV s/s

A

painless genital warts

161
Q

HPV complications

A

cervical/penile cancer

162
Q

HPV dx

A

hx and pap smear

163
Q

HPV tx

A

podophyllin
trichloroacetic acid
electrocautery

164
Q

HPV prevention

A

gardasil immunizaiton

165
Q

HPV pregnancy

A

c-section

166
Q

HPV newborn

A

respiratory papillomatosis

167
Q

syphilis s/s

A

primary:
-single painless chancre, fever, weight loss, malaise

secondary:
fever, fatigue, sore throat, weight loss

tertiary:
CNS and multi organ damage

168
Q

syphilis risk

A

PID

169
Q

syphilis dx

A

RPR or VDRL

170
Q

syphilix tx

A

PCN G

171
Q

syphilis pregnancy

A

infertility, ectopic pregnancies

172
Q

syphilis newborn

A

congenital syphilis
preemie birth
neurological complications
still births

IM 6 Test 3 (4 decks)

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