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55 Cards in this Set
- Front
- Back
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What is an STI? What is the recommended barrier?
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infections or infectious disease syndromes transmitted primarily by sexual contact
male or female condom |
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What is the most frequently reported STI? What are characteristics of it? Symptoms?
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chlamydia
PID most serious complication; women < 20 most likely to be infected; increase occurences in African Americans 15-19 infection usually asymptomatic but may have spotting, postcoital bleeding, mucoid or purulent discharge, or dysuria |
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What happens to an infant born to mom with chlamydia?
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will develop conjunctivitis or pneumonia
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What is the recommended management for chlamydia?
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doxycycline or azithromycin
azithromycin is rx when compliance is a problem because only one dose is needed women treated with either do not need to be retested unless symptoms continue |
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What is the oldest communicable disease? What are characteristics? Symptoms and Treatment?
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gonorrhea - "The Clap"
drug resistant cases is increasing; caused by bacteria; age is most important risk factor (< 20 y.o.) women often asymptomatic; may have yellow, green purulent endocervical discharge or may experience menstrual irregularities culture should be obtained for dx Treatment - IM injection of Rocephin with concomitant tx for chlamydia due to high incidence of coinfection most treatment failures are due to reinfection |
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What are perinatal complications of gonorrhea?
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premature rupture of membranes, preterm birth, chorioamnionitis, neonatal sepsis, intrauterine growth restriction, maternal postpartum sepsis
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What is the earliest described STI? Symptoms?
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syphilis (RPR) - complex disease that can lead to serious systemic disease and even death when untreated
entry through microscopic abrasions in the subq tissue, can also be transmitted through kissing, biting, or oral-genital sex rates decreased in women in 2010, rates for African American women account for almost one-half of the cases manifests itself in distinct stages (primary (lesion), secondary (widespread, symmetric, maculopapular rash), tertiary (effects cardiac, neuro, musculoskeletal, or multiorgan systems) |
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What is the risk to the fetus if maternal syphilis dx?
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transplacental transmission may occur at any time
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How is syphilis dx?
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depends on microscopic exam of primary and secondary lesion tissue and serology during latency and late infection
false-positive results are not unusual |
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What is the treatment for syphilis?
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Penicillin G is preferred drug
doxycycline (contraindicated in pregnancy), tetracycline (contraindicated in pregnancy), and erythromycin (unlikely to cure fetal infection) are alternative treatments |
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What STI is legally required to be reported?
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gonorrhea
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What is Jarisch-Herxheimer reaction?
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an acute febrile rxn often accompanied by headache, myalgias, and arthralgias that develop within the first 24 hours after treatment for syphilis
treated with analgesics and antipyretics women in the second half of pregnancy who exhibit this are at an increased risk of preterm labor or birth |
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What is PID? What causes it?
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pelvic inflammatory disease is an infectious process that most commonly involves the uterine tubes, casuing salpingitis; the uterus, causing endometriosis; and, more rarely, the ovaries and peritoneal surfaces
multiple organisms have been found to cause PID; most cases are associated with more then one organism |
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Women who have had PID are at increased risk for....
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ectopic pregnancy, infertility, and chronic pelvic pain
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What is the treatment for PID?
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treatment varies - generally broad spectrum antibiotics
preg women should be hospitalized and given parenteral antibiotics woman w/ acute PID shoud be on bed rest in a semi-fowlers position f/u labs should include endocervical culture for TOC |
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What is the most common viral STI? What causes it? How is it diagnosed?
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HPV - doubled stranded DNA virus known to cause genital warts and cervical cancer depending on strain
only definitive test is biopsy due to increased immune response in young women untreated warts may resolve on their own |
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What are symptoms of HPV?
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profuse, irritating vaginal discharge; itching; dyspareunia; or postcoital bleeding; may report "bumps" on vulva or labia
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What HSV? Who are most likely to be infected? Symptoms? Types?
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unknown until the 20th century - results in painful, recurrent ulcers; chronic, recurring disease with no cure (gift that keeps on giving); lesions being as vesicles and progress to ulcers; heavy, watery-to-purulent drainage common
women between 15 and 34 most likely to be infected HSV-1: not generally sexual and above the waist (fever blisters) HSV-2: generally sexual and below the waist |
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How is HSV diagnosed? How does it affect delivery?
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viral culture obtained from swabbing exudate during vesicular stage
if no lesions are visible, vaginal delivery okay; if lesions visible, c-section within four hours of labor begins or membranes rupture |
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Precautions for HSV:
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- nonantiviral ointments like cortisone should be avoided
- condoms may not prevent transmission - only plain soap and water need to be used to clean hands that have contacted lesions |
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How is Hepatitis A acquired? Diagnosed? Treated?
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acquired primarily through fecal-oral ingestions of contaminated food (milk, shellfish, polluted water, or person-to-person)
serologic testing for IgM to diagnose there is a vaccine |
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What is the most threatening STI to fetus and neonate?
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hepatitis b
vaccine during pregnancy is okay |
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What is Hepatitis B? Treatment? Diagnosis?
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often silent infection caused by large DNA virus that has been found in blood, saliva, sweat, tears, vaginal secretions and semen, amniotic fluid and breast milk
it is a disease of the liver no specific treatment recovery is usually spontaneous in 3 to 16 wks 3 (4 if needed) vaccine series in deltoid screening for active or chronic disease or disease immunity is based on testing for specific antigens and their antibodies |
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What is the most common bloodborne infection in the US?
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hepatitis c
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Symptoms of Hepatitis C? Treatment?
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most people are asymptomatic or have general flu-like symptoms; transmission through breastmilk unreported
there is no vaccine Ribavirin for 6-12 months is main treatment |
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What is preterm labor?
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after 20th week before 37th weeks
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Contraindications to sex during pregnancy?
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- history of more than one miscarriage
- threatened miscarriage in 1st trimester - impending miscarriage in 2nd trimester - PROM, bleeding, or abd. pain in 3rd trimester |
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What is amenorrhea and the two types?
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amenorrhea is the absence of menstrual flow; often a sign of a disease
primary - absence by 16.5 y.o. secondary - a 6 month or more cessation (usually caused by pregnancy) |
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Circumstances that should generally be evaluated in regards to amenorrhea:
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1. the absence of both menarche and secondary sexual characteristics by age 13
2. absence of menses by 16.5 regardless of normal growth and development 3. a 6-month or more cessation of menses after a period of menstruation |
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What is hypogonadotropic amenorrhea?
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reflects a problem in the central hypothalamic-pituitary axis
stress, sudden-severe weight loss, eating disorders, strenuous exercise, or mental illness |
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What is dysmenorrhea? Two types?
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pain during or shortly before menstruation
primary - associated with ovulatory cycles; has biochemical basis secondary - associated with pelvic pathology |
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What is dyspareunia? What is it is symptom of?
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painful intercourse
endometriosis |
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What is PMS?
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complex, poorly understood condition that includes one or more of a large umber (more than 150) of physical and psychologic symptoms beginning in the luteal phase of the menstrual cycle, occurring to such a degree that lifestyle or work is affected, and followed by a symptom free period
affects all age groups; not dependent on presence of monthly menses |
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What is PMDD? What meds can be used to help?
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more severe variant of PMS - most common symptoms are those related to mood disturbances
lifestyle changes are often effective in its tx; if alternative interventions do not provide relief in 1-2 months, meds are added diuretics, NSAIDs, OCPs, SSRIs, progesterone - for physical symptoms |
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What is endometriosis? Management?
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presence and growth of endometrial tissue outside of the uterus
tissue grows during the proliferative and secretory phases of the cycle Management - GnRH agonists and androgen derivatives |
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What is oligomenorrhea?
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infrequent periods
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What is hypomenorrhea?
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scanty bleeding but at normal intervals
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What is menorrhagia?
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excessive bleeding - treatment depends on cause
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What is metrorrhagia?
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bleeding occurs between periods
warn against use of aspirin that could increase bleeding |
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What are a common cause of menorrhagia?
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leiomyomas - (fibroids or myomas) benign tumors of the smooth muscle of the uterus with an unknown cause
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What is a myomectomy?
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removal of tumors
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What is abnormal uterine bleeding? What causes it?
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any form of uterine bleeding that is irregular in amount, duration, or timing, and is not related to regular menstrual bleeding
can have organic causes (systemic diseases, repro. tract diseases) |
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What is dysfunctional uterine bleeding? Causes? Treatment?
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usually hormonally related - diagnosis made only when everything else has been ruled out
most commonly caused by anovulation most common treatment is oral or IV estrogen |
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What is a high risk neonate?
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a newborn, regardless of gestational age or birth weight, who has a greater-than-avg chance of morbidity or mortality because of conditions or circumstances associated with birth and the adjustment to extrauterine existence
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What is LGA? SGA?
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large for gestational - >90%
small for gestational - <10% |
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Preterm? Late preterm? Early term?
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preterm - born before 37 wks
late preterm - born between 34 0/7 and 36 6/7; at risk for respiratory distress, temp instability, hypoglycemia, apnea, feeding difficulties, and hyperbilirubemia early term - 37 0/7 - 38 6/7; at risk for long-term problems such as learning difficulties (ADHD) |
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Term? Postterm?
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term - between 37 and 42 wks
postterm - born after 42 wks |
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What is a thermistor probe?
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automatic sensor placed on the upper quadrant of the abdomen immediately below R) or L) costal margin (never over a bone)
designed to detect minor temp changes resulting from external environmental factors or neonatal factors before a dramatic change in core body temp develops |
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Signs to be reported to HCP in regards to temp, etc.
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increase or decrease in temperature with accompanying fussiness, lethargy, irritability, poor feeding, and excessive crying
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The two classifications of neonatal bacterial infection:
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early onset - (congenital sepsis) - manifests within the first 24-48 hours and progresses rapidly; acquired during the perinatal period; most common is E. Coli and GBS
late onset - occurs 7 to 30 days of age; considered primarily to be an infection acquired in the hospital or community |
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What is the Neonatal Abstinence Scoring System or Finnegan tool?
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developed to monitor infants in an objective manner and evaluate their response to clinical and pharmacologic interventions
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What is the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS)?
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comprehensive neurologic and behavioral assessment tool that may be used to identify NBs at risk as a result of intrauterine drug exposure
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Characteristics of preterm infants:
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- very small/scrawny due to minimal subq fat stores
- proportionately large head in relation to the body - skin is bright pink, translucent, smooth, shiny, with BV visible - fine lanugo hair is abundant - ear cartilage is soft and pliable - soles and palms have minimal creases - bones of skull and ribs feel soft - male infant: few scrotal rugae, testes undescended - female infant: labia and clitoris prominent |
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Clinical signs of hypoglycemia:
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can be transient or recurrent
jitteriness, lethargy, poor feeding, abnormal cry, hypotonia, temperature instability, respiratory distress, apnea, and seizures |
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What is the neutral thermal environment (NTE) for full-term NB?
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an environmental temp between 32 to 34 degress C
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