Women's Health Flashcards
(39 cards)
A NP suspects ovarian cancer in a patient. What should be ordered before referral?
- Transvaginal U/S
2. Order Lab: Cancer Antigen (CA-125)
As a NP working with women’s health, a NP knows the leading cause of death in maternal patient in the first trimester of pregnancy ____________.
Ectopic Pregnancy
A NP suspects ectopic pregnancy, what is the pain-pattern for ectopic pregnancy?
Patient will report pain for 6-7 weeks. The pain will be located in the lower-abdominal area or right-shoulder. The aggravation factors will be laying supine. It will be described as jarring.
A NP is reviewing a patient’s medical history, what diagnoses will place concern for ectopic pregnancy for the NP.
- History of PID
- History tubal ligation
- Previous ectopic pregnancy
A NP has a follow-up with a patient. The NP suspects ectopic pregancy. What labs need to be ordered? What is the interpretation?
- Quantitative HCG (Beta HCG) - with 48 hours the HCG level should double in a normal pregancy
- Progesterone- 5-20 % , if it is less than 5 it is considered abnormal
- Ultrasound
- CBC
A 30 year old patient is receiving a cervical screen on this visit. How should it be ordered?
In the same collection,
- PAP
- HPV DNA test
- F/U 5 years if patient has negative results
A NP diagnosed patient with pelvic inflammatory disease. Given no contraindication, what should be ordered?
- Rocephin
- Doxycycline
- Flagyl
- F/U in 48-72 hours
What are the strains of HPV that cause cervical cancer? What are the top two?
Top Two:
- most common 16
- 18
What is the gold standard for diagnosing cervical cancer? What is the procedure called?
- Gold: Cervical biopsy
2. Procedure: Colposcopy (viewing of the cervix) with biopsy
According to USPTF, when do you start and stop breast cancer screening for patient without risk factors.
Mammogram
Start at 50
Stop at 75
According to the USPTF, when do you start cervical screenings and stop without any risk factors.
Pap Smear and /or HPV DNA testing starts at 21 and stops at 65
Which vaccine pregnant patients cannot have?
- Live Vaccines
- HPV
- MMR
- Live influenza (Nasal Flu-mist)
- Varicella
A pregant patient wants to travel out the country. She ask about vaccines for travel. What should the NP teach?
The patient cannot have yellow-fever, typhoid fever, and Jan encephalitis vaccine are travel vaccines, BUT pregnant women cannot have because they are live vaccines.
A newly diagnosed pregnant patient ask about vaccines. Which ones should be recommended?
It is encourage for a pregancy patient to have a up-to-date influenza and COVID-19 vaccine.
She will also received TDaP every pregancy at 27-36 weeks of gestation.
If a pregnant patient is not immune to varicella, when will she take the vaccine?
Varicella is live. She will not take it during pregancy. She can have it after giving birth.
The two doses will 4-8 weeks apart
A NP palpates a ovary in a post-menopausal woman, what is the suspected diagnosis? What needs to be ordered?
- Ovarian Cancer
- Transvaginal U/S
- Order BRCA 1 and BRCA 2
- Oncology or OB-GYN referral
What medications are contraindicated in pregnant women?
- Diflucan
- ACEI (even during breastfeeding)
- ARBS (even during breastfeeding)
- Live vaccines
- HPV Vaccine
- Tetracyclines
- Macrolids
- Fluoroquinolones ( even during breastfeeding)
Pregnant patient has a UTI. What is used to treat UTI in pregnant women?
Amoxicillin or Cephalexin
A new patient comes into your office. She informs you that she is positive for BRCA mutations. How would you care this patient?
- Referral to Breast Specialist
- Screen them using Mammogram and MRI
- Genetic counseling
- Monitor or ovarian cancer
When does the NP know a female pediatric patient is starting puberty? Which stage on Tanner?
Breast buds
Tanner Stage 2
Ends at Stage 5
What are the three phases of menstruation?
Follicular Phase Day 1-14
Mid-Cycle Day 14
Luteal Phase 14-28
A NP is education a patient about the window of fertility and the Mid-cycle stage. What facts are important?
Mid-Cycle stage is day 14 out 28. This is called the Ovulatory Phase. During this stage, the LH hormone is secreted by the anterior pituitary gland. This hormone induces ovulation of the dominant follicles. The follicles migrates to the fimbriae of the Fallopian tube.
Coitus is best 1-2 days before ovulation.
A NP knows that a patient younger than 21 years of age cannot have a cervical screening. Which patient can have cervical screening ( PAP ) before the age of 21?
HIV patients
A NP is treating a patient for their annual gynecological exam. She is due for a PAP smear. She has been diagnosis with a infection on this visit. What should the NP do?
Treat the infection.
Bring patient back in for PAP after the infection clears.
