Women's Health Test 1-Overview

Front 1

Menarche begins at what time in life?

Back 1

12-13 years

Front 2

What is perimenopause?

Back 2

Regression in ovarian function
Has a loss of estrogen, hot flashes, emotional changes, and wt gain
Cyclical symptoms every 20-30min

Front 3

What is menopause?

Back 3

cessation of menses
concerns with: loneliness, depression, and financial stress

Front 4

Chance of breast cancer in women

Back 4

1 in 7 women

Front 5

*Signs of Breast Cancer

Back 5

*lump
*pain in breast
*discharge
*skin changes

Front 6

Breast Cancer Screening

Back 6

BSE Q1mo starting at age 20
Clinical Exam:
20-40 Q3yrs
>35 yearly if at risk
>40 yearly
Mammogram >39 Q 1yr

Front 7

Cervical CA is most often related to _________

Back 7

sexual history-HPV

Front 8

What is the most common kind of gynecological CA?
greatest risk?
sign?

Back 8

Uterine
often the greatest risk is age
vaginal bleeding esp post menopausal

Front 9

Most fatal gynecological CA is what?

Back 9

Ovarian

Front 10

What is the leading cause of death in women?

Back 10

CVD

Front 11

Woman's chance of dying from CVD

Back 11

1 in 3 women

Front 12

*S&S of MI in women

Back 12

*unspecified pain
vague symptoms
back pain
fatigue
SOB and weakness
diabetes

Front 13

Risk factors of osteoporosis

Back 13

smoking, alcohol, small thin frame, soft drinks and coffee, inactivity, low Ca, Hysterectomy b4 50

Front 14

Cycles of Abuse: Sunshine

Back 14

shower with kindness, bonding intensified, begs for forgiveness

Front 15

Cycles of Abuse: Clouds

Back 15

Tension build, batterer becomes possessive, woman accepts responsibility, isolation and threats, arguments

Front 16

Cycles of Abuse: Storm

Back 16

Acute battering, shock and denial after attack, rationalization of abuse

Front 17

Estrogen

Back 17

controls 2ndary sex characteristics
assists in maturing ovarian follicle
proliferates endometrial mucus

Front 18

Progesterone

Back 18

effects and cotnrols uterine endometrium to prepare for implantation
Related to temp at ovulation

Front 19

PGE

Back 19

vasodilator

Front 20

PGF

Back 20

vasoconstrictor

Front 21

GnRH

Back 21

signals anterior pituitary to secrete FSH and LH

Front 22

FSH

Back 22

matures ovarian follicle and influences estrogen

Front 23

LH

Back 23

final maturation of follicle
*peak prod causes ovulation

Front 24

What are the two ovarian cycle phases?

Back 24

The follicular phase and the luteal phase

Front 25

What happens during the follicular phase?

Back 25

immature follicles mature as a result of FSH

Front 26

What occurs during the luteal phase?

Back 26

Ovum leaves the follicle
Corpus luteum develops from the ruptured follicle(will degenerate if not fertilized)

Front 27

What is the average blood loss during the menstrual cycle? and Iron loss?

Back 27

30mL
0.5 to 1mg daily

Front 28

What are the four phases of the menstrual cycle?

Back 28

Menstrual phase
Proliferative phase
Secretory phase
Ischemic phase

Front 29

What hormones are the ovaries sensitize to?

Back 29

FSH and LH

Front 30

What hormones are the uterus and breast sensitive to?

Back 30

Estrogen and progesterone

Front 31

What hormones change to maintain pregnancy after the ovum has been fertilized?

Back 31

Estrogen and progesterone

Front 32

What is the fertility period for ova and sperm?

Back 32

Ova- 12-24 hours
Sperm- 24 hours most fertile up to 72hrs

Front 33

What is the acrosomal reaction?

Back 33

When millions of sperm surround the ovum, releasing enzymes to breakdown the outer layer of the ovum's shell

Front 34

What is the reaction that prevents additional sperm from entering the single ovum?

Back 34

Cortical reaction

Front 35

Different in zygotes between fraternal and identical twins

Back 35

Fraternal- dizygotic
Identical- monozygotic

Front 36

Implantation occurs when?

Back 36

7-10 days after fertilization

Front 37

What hormone causes thickening of the endometrium after implantation changing the endomentrium to the decidua?

Back 37

Progesterone

Front 38

The embryonic membranes are called what?

Back 38

The amnion and chorion

Front 39

What is the function of the placenta?

Back 39

metabolic and nutrient exchange between mother and embryo
Secretes estradiol to maintain pregnancy

Front 40

*Umbilical Cord

Back 40

*Two arteries and one vein- AVA

Front 41

*Wharton's Jelly

Back 41

*CT that surrounds vessels of umbilical cord and prevents compression

Front 42

*Umbilical Vein

Back 42

*carries O2 to the fetus

Front 43

*2 umbilical arteries

Back 43

*carries deoxygenated blood to the placenta

Front 44

What are the three stages of human development?

Back 44

Preembryonic stage
Embryonic stage
Fetal stage

Front 45

Preembryonic Stage

Back 45

first 14 days of human development
Establishes the endoderm, mesoderm, and ectoderm

Front 46

Embryonic Stage

Back 46

15 days after conception to 8 weeks
Extreme vulnerability to teratogens

Front 47

Fetal Stage

Back 47

8 weeks until birth

Front 48

What is the major cause of mental retardation in the US

Back 48

Fetal Alcohol Syndrome

Front 49

Marijuana's effect on pregnancy

Back 49

no teratogenic effects

Front 50

What is toxoplasmosis?

Back 50

from toxoplasma gondii
contracted by eating raw or poorly cooked meat, drinking unpasteurized goat's milk,or contact with infected cat feces

Front 51

Rubella

Back 51

can be contracted by MMR vaccine

Front 52

CMV

Back 52

is asymptomatic in women so can be transmitted to fetus unbeknown to woman
NO TREATMENT

Front 53

HSV

Back 53

from herpes
meds can help decrease viral shredding but has NO TREATMENT

Front 54

Purpose of braxton-hicks contractions

Back 54

stimulate blood flow through the intervillous spaces of the placenta

Front 55

What hormone maintains the corpus luteum during early pregnancy?

Back 55

hCG

Front 56

Amount of air increase during pregnancy

Back 56

30-40%

Front 57

Blood volume increase during pregnancy

Back 57

40-45%

Front 58

Vital sign changes during pregnancy

Back 58

Pulse increase 10-15bpm
BP decreases slightly

Front 59

Supine Hypotension/Vena Caval Syndrome/Aortocaval Compression

Back 59

uterus puts pressure on vena cava when woman is supine resulting in decreased BP

Front 60

Avg WBC count during pregnancy

Back 60

5000-12000

Front 61

Normal Wt gain overall

Back 61

norm wt- 25-35 lbs
overwt- 15-25 lbs
underwt- ideal + 25-35 lbs

Front 62

Wt gain by trimester

Back 62

3.5-5
12-15
12-15

Front 63

What hormone is responsible for initial lactation

Back 63

Prolactin

Front 64

Oxytocin

Back 64

affects uterine contractility and milk ejection from breasts

Front 65

*hCG

Back 65

*stimulates progesterone and estrogen production by the Corpus Luteum until placenta takes over

Front 66

hPL

Back 66

acts against insulin so that maternal metabolism of glucose to favor fetal growth

Front 67

*Estrogen

Back 67

*stimulates uterine development
develops ductal system of breasts to prepare for lactation

Front 68

*Progesterone

Back 68

*MOST CRUCIAL HORMONE IN MAINTAINING PREGNANCY
*Maintains endometrium
*inhibits spontaneous uterine contractility
*develops breasts for lactation

Front 69

*Relaxin

Back 69

*Inhibits uterine contractility
*diminishes strength of uterine contractions

Front 70

*signs of pregnancy: Subjective/Presumptive

Back 70

*amenorrhea
N&V
*excessive fatigue
*urinary frequency
*breast tenderness

Front 71

*signs of pregnancy: Objective/Probably

Back 71

*changes in pelvic organs
*goodell's sign(softening of cervix)
*Chadwick's sign(blue coloration of cervix)
*Hegars sign: softening of isthmus of cervix
*McDonalds signs: easing of flexing of body of uterus against the cervix

Front 72

Goodell's sign

Back 72

softening of the cervix

Front 73

Chadwick's sign

Back 73

deep red to purple/blue coloration of cervix, mucus membranes, and vagina

Front 74

Hegar's Sign

Back 74

Softening of the isthmus of the cervix

Front 75

McDonalds sign

Back 75

easing of flexing of body of uterus against cervix

Front 76

Ballotment test

Back 76

touches cervix, something moves off and comes back

Front 77

Prime example of objective sign of pregnancy

Back 77

Pregnancy tests(measures hCG)

Front 78

Positive signs of pregnancy

Back 78

FHB, Fetal mvmnt, visualization of fetus by ultrasound

Front 79

definition of gestation

Back 79

number of weeks since the 1st day of LMP

Front 80

Definition of abortion

Back 80

birth that occurs befre the endof 20 weeks gestation

Front 81

Normal "Term" of pregnancy

Back 81

38-42 weeks

Front 82

Definition of preterm/premature birth

Back 82

After 20 weeks and before 37

Front 83

Definition of Gravida

Back 83

Any pregnancy, regardless of duration, including present pregnancy

Front 84

Nulligravida

Back 84

woman who has never been pregnant

Front 85

Primigravida

Back 85

Woman pregnant for the first time

Front 86

Multigravida

Back 86

Woman in her second or subsequent pregnancy

Front 87

Definition of Para

Back 87

birth after 20 weeks, regardless of outcome

Front 88

Nullipara

Back 88

Woman who has not given birth at more than 20 weeks EGA

Front 89

Stillbirth

Back 89

Fetus born dead after 20 weeks gestation

Front 90

Nagele's Rule

Back 90

1st day of LMP-3months+7days

Front 91

Fundal Ht

Back 91

corresponds in cm measurement between 22-34 weeks

Front 92

What is quickening?

Back 92

fetal movements felt by mother-occurs around 20 weeks

Front 93

FHB detected when?

Back 93

10-12 weeks w/ doppler
16-20 w/ fetoscope

Front 94

Fetal heart activity seen when?
Fetal breathing movement seen when?

Back 94

6-7weeks
10-11weeks

Front 95

Discomforts of Pregnancy: N&V

Back 95

due to increased hCG, gastric overload, slowed peristalsis
usually resolves by 16th week

Front 96

Discomforts of Pregnancy: Urinary Frequency(patient teaching)

Back 96

maintain adequate fluid intake!
void q2hrs wheen awake
Kegel exercises help

Front 97

Discomforts of Pregnancy: Fatigue

Back 97

Not as bad 2nd trimester and bad again the 3rd
due to change in metabolic rate

Front 98

Discomforts of Pregnancy: Nasal stuffiness

Back 98

due to estrogen engorged mucus membranes
teach cool air vaporizers/saline spray

Front 99

Discomforts of Pregnancy: Heartburn

Back 99

Due to increased progesterone causing relaxation of sphincter to esophagus, GI motility, increased uterine size
worse in 2nd and 3rd trimesters

Front 100

Discomforts of Pregnancy: Dependent Edema

Back 100

uterus causes impaired venous return
teach avoidance of constricting clothing, elevate legs and feet every 2-3hours
lie on side instead of back

Front 101

Discomforts of Pregnancy: Hemorrhoids

Back 101

Due to constipation, pressure of the uterus on the bowel, relaxing effects of progesterone

Front 102

Discomforts of Pregnancy: Constipation

Back 102

due to decreased peristalsis from progesterone, displacement and compression of bowel
can be side effect of Fe tabs

Front 103

Upper backache can be treated w/ what?

Back 103

good support bra. pain is from enlarged breasts

Front 104

Discomforts of Pregnancy: Leg Cramps

Back 104

due to enlarged uterus
treat w/ straightening legs and exercise +elevation
calcium phosphorous

Front 105

Discomforts of Pregnancy: SOB

Back 105

uterus puts pressure on diaphragm

Front 106

Discomforts of Pregnancy: Round Ligament Pain

Back 106

Tx: flex knees into abdomen, warm baths, heating paid, support uterus w/ pillow, change positions

Front 107

Classifications of Anemia

Back 107

levels of Hgb <12 in nonpregnant and <11 in pregnant client

Front 108

What is the most common medical complication of pregnancy?

Back 108

Iron deficiency anemia

Front 109

Prevention/Tx of IDA

Back 109

27mg/day to prevent, 60-120mg/day if diagnosed

Front 110

Common SE of Iron supplements

Back 110

tarry stools

Front 111

Prevention/Tx of Folic Acid Deficiency Anemia

Back 111

.4mg folate
1mg folate

Front 112

Sickle Cell Anemia

Back 112

Normal adult hGB and abnormal HbA
RBCs become crescent shaped
clog capillaries esp in spleen, bone marrow,and placenta

Front 113

Sickle Cell Anemia can cause what in Maternal client?

Back 113

high temp, dehydration, infection, acidosis, low o2 pressure, vaso-occlusive crisis

Front 114

Vaso-occlusive crisis

Back 114

Sudden attacks of pain secondary to ischemia from occluded capillaries

Front 115

Fetal/Neonatal risk of Sickle Cell Anemia

Back 115

Prematurity and IUGR, perinatal mortality

Front 116

Sickle Cell Anemia Tx

Back 116

folic acid supplements, prevent dehydration, administer o2, analgesics and antibiotics
Monitor fetal HR!!!!!

Front 117

*Fetal risks with Maternal HIV

Back 117

transmission 15-25% W/out medicine
<2% if treated with zidovudine and delivered via C/S

Front 118

*Fetal risks for infant AIDS

Back 118

encephalopathy characterized by delayed developmental milestones or loss of skills
found in 50-90% of children w/ AIDS

Front 119

Heart disease classifications

Back 119

Class I-IV- from uncompromised to severely compromised

Front 120

Clinical signs of ectopic pregnancy

Back 120

one sided lower abdominal pain
vasomotor disturbances
referred rt shoulder pain
adnexcal tenderness
bleedling
abdomen rigid and tender
lower hCG levels

Front 121

*Abruptio Placenta

Back 121

premature separation of a normally implanted placenta from the uterine wall

Front 122

*Gestational Diabetes screening

Back 122

1 hour glucose tolerance test @24-28 weeks
if 130-140 or above, 3 hour diagnostic test is ordered

Front 123

PROM

Back 123

spontaneous rupture of membranes prior to the onset of labor <37 weeks

Front 124

Tests to determine PROM

Back 124

fern test, ultrasound, nitrazine paper,

Front 125

Number one cause of neonatal mortality in the US

Back 125

prematurity

Front 126

Risk factors for preterm labor

Back 126

Uterine/cervical problems, low wt, chronic illness, previous preterm labor/birth, febrile illness, substance abuse

Front 127

fFN

Back 127

presence of this between 20-34 weeks shown to be strong indicator of preterm delivery

Front 128

Tocolysis

Back 128

use of medication to stop labor
delays birth 2-7 days
does not improve neonatal outcome but allows time for administration of bethamethasone

Front 129

Pregnancy Induced Hypertension

Back 129

preeclampsia/eclampsia

Front 130

Preeclampsia

Back 130

increase in BP after 20 weeks gestation w/ proteinuria

Front 131

Characteristics of preeclampsia

Back 131

increased viscosity of blood, hyperreflexia, HA, subcapsular hematoma of liver

Front 132

HTN effects on fetus

Back 132

SGA, fetal hypoxia, death related to abruption, prematurity

Front 133

Mild Preeclampsia

Back 133

BP 140/90, proteinuria 1+ to 2+

Front 134

S&S of worsening preeclampsia

Back 134

increased edema, worsening HA, visual disturbances, decreased urinary output, N&V, bleeding gums, overall not feeling well

Front 135

Severe preeclampsia

Back 135

BP 180/110 or higher, proteinuria 3+

Front 136

S&S of Severe preeclampsia

Back 136

HA or visual disturbances, pulmonary edema, epigastric pain, impaired liver fxn, fetal growth restriction

Front 137

Eclampsia

Back 137

onvulsion or coma occuring before, during or early postpartum

Front 138

* What do you administer to prevent seizures of eclampsia?

Back 138

magnesium sulfate!

Front 139

HELLP syndrome

Back 139

hemolysis, elevated liver enzymes, low platelet count

Front 140

Rh incompatibility

Back 140

Rh+ father and Rh- mother, fetus Rh+
can result in CHF

Front 141

Amniotic Fluid Index

Back 141

<5 is a red flag

Front 142

Non-Stress Test

Back 142

electronic fetal monitor to obtain tracing of FHR, observing accelerations of the FHR w/ movement
REACTIVE IS GOOD

Front 143

Amniocentesis

Back 143

used to test biochemical determinations and fetal lung maturity

Front 144

Chorionic Villi Sampling

Back 144

used to test for DNA abnormalities

Front 145

*Folic acid deficiency is linked to what?

Back 145

Neural Tube Defects

Front 146

*Amino Acid Deficits can cause what?

Back 146

Mental Retardation and growth restrictions

Front 147

*Maternal Wt Gain Distribution

Back 147

11lbs-placenta/fetus/amniotic fluid
2lbs-uterus
4lbs-increased blood volume
3lbs-breast tissue
5-10 lbs-maternal stores

Front 148

*kcal increase during pregnancy

Back 148

300kcal increase during 2nd and 3rd trimesters only

Front 149

Mother's calcium needs

Back 149

>19yrs-1000mg/day
<18yrs-1300mg/day

Front 150

Phosphorous RDA during pregnancy

Back 150

DOES NOT CHANGE

Front 151

RDA for Iron during pregnancy

Back 151

27mg/day

Front 152

Effects of Vit A Deficiency

Back 152

preterm birth, IUGR, low birth weight

Front 153

Mercury in Fish can cause what?

Back 153

neurotoxic effects of mercury

Front 154

What do spermicides use?

Back 154

nonoxynol-9

Front 155

Oral contraceptives can also cause what?

Back 155

decreased menstrual flow, more regularity, decreased formation of ovarian cysts, less cramps, less risk of ovarian and endometrial cancer and ectopics, decrease hirsutism and acne

Front 156

Depo-provera

Back 156

IM injection of progestin lasts for 3mo

Front 157

Female Tubal Ligation

Back 157

fallopian tubes are cut

Front 158

Essure method of permanent sterilization

Back 158

no surgery. insert into fallopian tubes under hysteroscopy
after 3 mo the inserts will cause occlusion

Front 159

Clinical Interruption of Pregnancy

Back 159

up to 49 days following first day of LMP
surgical interruption safer in 1st trimester