Women's Health Flashcards

(43 cards)

1
Q

Women’s Health

A

A holistic view of women and their health-related needs
within the context of their everyday lives.

Nursing Role
 Advocacy
 Collaboration
 Educator
 Manager of Care
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2
Q
Health Promotion
Health history
Physical Assessment
Preventative counseling
Screening
A
Health History
Risk factors 
Gender
Age
Family hx
Genetics
Environment
Assessment
Psychosocial assessment

Physical Assessment

Preventive Counseling
Self-care

Screening
Prevention
Early Diagnosis

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3
Q

Heart Disease

A

1 in 4 women die of heart disease
64% of women who die of heart disease have had no previous symptoms

Coronary heart disease
Ischemic stroke
Hypertension
Heart failure

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4
Q

Breast Disorders

A

Benign
Teens-20s
Fibroadenoma

20s-50s
Fibrocystic breast changes
Near/During menopause
Ductal ectasia
Intraductal papilloma

Malignant
Ductal Carcinoma in situ – Noninvasive
Invasive Ductal Carcinoma
Invasive Lobular Carcinoma

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5
Q

Breast Disorders: Malignant

Risk factors
Psychosocial Considerations

A

Major type of cancer among women of all races
Risk factors
Mutation of the BRCA1 and BRCA2 genes
Mutation of CHEK-2 gene in men and women

Changes in body image – mastectomy, hair loss, chemo
Effect on sexuality
Side effects of treatment

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6
Q

Menstruation

A

Secondary sex characteristics = 9/10 years
Menarche ~ 12 y/o

Amenorrhea
Primary – not established by age 16
Secondary – cessation of regular menses (pregnancy, hormonal/endocrine disorders, strenuous athletic activity)

Dysmenorrhea
Primary – cramps NOS

Secondary – pathology 
Polyps, Fibroids (Leimyomas), Cysts
Endometriosis
Polycystic Ovarian Syndrome
Infections
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7
Q

Endometriosis

A

Excessive endometrial production +
Reflux of blood and tissue to fallopian tubes

Dysmenorrhea
Dyspareunia

Tx
Oral contraceptive – decrease tissue can cause bleeding and bleeding can cause pain
Synthetic androgen

Invasive tx
Laparotomy with laser excision

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8
Q

Polycystic Ovarian Syndrome

A

Hyperinsulinism – increased androgen production
Follicular ovarian cysts dont mature – anovulation

Lack of ovulation
Increase in testosterone
Higher risk for infertility
Mustache, hair on cheeks, increased weight gain

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9
Q

Treatment for PCOS

A

Treatment
Oral contraceptive
Metformin

Spironaldactone to decrease hair growth
(antiandrogen)

Clomid for infertility

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10
Q

Health Promotion – Aging Women

A

Menopause

Perimenopause
Hormone replacement therapy (HRT) - Increase risk for breast cancer
Complementary/alternative therapy

Osteoporosis
Urinary incontinence
Pelvic floor dysfunction

Kegel exercises

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11
Q

Pelvic floor dysfunction

A

Cystocele – prolapsed bladder
Rectocele – prolapsed rectum
Prolapsed uterus

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12
Q

Infection and Inflammation
Not an STI
Complications of STI

A

Not an STI
Bacterial Vaginosis – fishy-smelling white discharge infection stemming from decrease in normal flora

Candidiasis – cottage cheese-like white discharge yeast infection from a change in vaginal ph

Function of changes that may occur over a certain time in a women’s reproductive system

Complication of an STI
Pelvic Inflammatory Disease – chronic inflammation from exposure to multiple microorganisms
Ectopic Pregnancy Infertility

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13
Q

Sexually Transmitted Infections

A
Acquired immunodeficiency syndrome
Condylomata Acuminata
         (HPV & vaccine)
Chlamydia
Gonorrhea
Herpes genitalis
Syphilis
Trichomoniasis
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14
Q

Initial Assessment - Infertility

A

Sterility
Reproduction not possible

Infertility
Lack of conception after 12 mos (34 yrs and

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15
Q

Potential Effects of Infertility (4)

A

Emotional stress
Feelings of disappointment and failure
Sense of loss and grief
Intercourse changes to goal-oriented procedure

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16
Q

Challenges of Diagnostic Testing and Treatment (4)

A

Embarrassing
Ethics
Commitment
Expensive

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17
Q
Diagnostic testing (5)
Male
A
Semen analysis
Endocrine
P postcoital test
Ultrasonography
Testicular biopsy
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18
Q
Diagnostic Testing (8)
Female
A
Thyroid function test 
Glucose tolerance test 
Serum prolactin levels  
Specific hormonal assays 
Ultrasonography
Endometrial biopsy
Hysterosalpingography 
Laparoscopy
19
Q

Treatment Options—Infertility (4)

A
Lifestyle Behavior 
Medications --- clomid
   Increase sperm count & motility
   Induce ovulation    
   Facilitate cervical mucous formation
   Reduce antibody concentration
   Suppress endometriosis

Surgical treatment
Repair of variocele, ducts
Repair of tubes

Advanced reproductive technologies (ART)
In vitro Fertilization

20
Q

Reproductive Alternatives

A
Oocyte Donation
Embryo Donation 
Therapeutic Insemination
Surrogate Mother
    Surrogate mother’s egg
    Surrogate mother’s uterus
Adoption
21
Q

Ethical/Legal

Considerations

A

Factual information—advantages and limitations
Informed consent for donor sperm and donor eggs.
Donor confidentiality
Ongoing education and counseling

22
Q

Promoting Sexual & Reproductive Health

A
Assess
Establish trust
Obtain sexual history
Nursing diagnosis and Outcome identification
Plan
Implement care
Evaluate
23
Q

Teaching About Contraception

The role of the nurse

A
Types of contraception available
Risks and benefits of each
Proper use of each method
What to do if an error is made
Emergency contraception (EC)
Backup methods
Change of methods
Questions and concerns
24
Q

Hormonal

ACHES

A
Oral contraceptives – combined and; mini
   Monophasic, biphasic, triphasic
   Low-dose progestin-only
Subdermal implant, injection
Vaginal contraceptive ring
Transdermal patch

Abdominal pain – severe
Chest pain – severe, with cough, SOB, or on deep inspiration
Headache – severe, dizziness, numbness, esp if one side
Eye – vision loss, blurring, speech problems
Severe leg pain – calf or thigh

25
Contraindications - BCP (5)
Smoking and age greater than 35 years Moderate/severe hypertension (BP 160/100) Undiagnosed uterine bleeding Diabetes of more than 20 years’ duration or with vascular complications History of embolism or thrombosis
26
Contraindications – subdermal, injection (5)
``` Breast cancer, current or previously Undiagnosed uterine bleeding Liver disease History of embolism or thrombosis Breastfeeding (Category 2) – ok after 6th wk ```
27
Side Effects - BCP (7)
``` Diminished menstrual flow Breast tenderness Irritability Nausea Headaches Cyclic weight gain Increased vaginal yeast infections ```
28
Adverse Effects - BCP | 3
Hypertension Myocardial infarction Thrombophlebitis
29
Side Effects – subdermal, injection (9)
Irregular menstruation or amenorrhea Acne Headaches Depression Weight gain Increased vaginal yeast infections Scarring or injection at insertion site (subdermal) Risk of decreased bone density (injection) – limit Rx to 2 yrs Injection required q 3 months – reminders necessary
30
Intrauterine Device (IUD) (4) PAINS
No continued expense No daily attention No interference with intercourse May decrease risk of endometrial CA ``` Period late Abdominal pain, pain with intercourse Infection exposure or vaginal discharge Not feeling well, fever, or chills String – missing, shorter, or longer ```
31
Contraindications/Side Effects for IUD
Current STI Genital tract cancer Uterine anomalies, fibroids Side Effects Irregular bleeding Amenorrhea Pelvic infections
32
Barrier Methods
Diaphragm, cervical cap Risk for Toxic Shock Syndrome; Rare; Staphylococcus aureus Condoms (male and female) Latex allergies Contraceptive sponge Spermicides Sterilization Female Tubal ligation, c/s or hysteroscopic Essure Male Vasectomy
33
“Natural Family Planning” | Fertility Awareness
``` Methods: Periodic Abstinence Menstrual bleeding Cervical mucus Basal body temperature Calendar Rhythm ``` Symptothermal Cervical mucus Basal body temperature Secondary sx -> increased libido, mittelschmerz, midcycle spotting, pelvic tenderness, vulvar fullness.
34
Emergency Postcoital Contraception
“Morning After” pill Plan B Copper-releasing intrauterine device IUD
35
Clinical Termination of Pregnancy
Therapeutic Abortion = elective procedure Medical Medication inducing uterine contractions (RU-486) Up to 63 days of gestation ``` Surgical Menstrual extraction, endometrial aspiration 5 to 7 weeks gestation Vacuum aspiration Up to 12 weeks gestation Dilatation extraction (D/E) 2nd trimester – up to 16 weeks ``` Spontaneous Abortion = “miscarriage” at any gestation
36
Nursing Care for abortion
``` Assessment Emotional support Observe for complications Common: excessive bleeding, cramping Rare: hemorrhage, incomplete abortion, infection, ``` ``` Postabortal Syndrome (a form of PTSD) Asherman syndrome: uterine adhesions Schedule follow-up visits Ultrasonography hCG levels ```
37
AIDS
asymptomatic Not cured antiretroviral
38
Chlamydia
Asymptomatic or yellow discharge, painful urination Cured Azithromycin, coxycycline
39
Condylomata
HPV warts Not cured TCA, cryotherapy
40
Gonorrhea
Purulent discharge, painful urination Cured Azithromycin, coxycycline
41
Herpes
Painful vesicles No Acyclovir
42
Syphillis
Painless chancre Yes Penicillin
43
Trichomoniasis
Discharge/pain Yes Metronidazole