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294 Cards in this Set
- Front
- Back
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Mothers who have a normal vaginal birth are typically discharged from the hosptial how many hours after birth?
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48 hours
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Mothers who give birth by cesarean section leave typically how many hours after birth?
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96 hours
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What are the characteristics of a traditional family aka nuclear family?
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Two married parents, their children
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What are characteristics of a single parent family?
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One parent, more likely to ahve an income below the poverty level, may be less prepared for illness
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What are characteristics of a blended family?
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Formed when divorced or widowed parents remarry and bring children from a previous marriage into the new relationship, "yours, mine, ours"
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What are characteristics of an extended family?
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Includes members from at least three generations living under one roof aka boomerang families
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How would the nurse care for a traditional family?
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Provide information as the need arises
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What does ehtnocentrism refer to?
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The belief that one cultures values and patterns of behavior are suprior to another.
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Your pt. is Asian, when speaking to her what should you avoid doing?
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Avoid prolonged eye contact
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What should the nurse be aware of when speaking with a hispanic pt. and her family?
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Men usually serve as head of house, women are the home makers, preliminary social interaction is improtant and may be insulted if a problem is addressed directly without taking time for small talk
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Hispanics often seek what before a U.S. health care worker is contacted?
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The Curandero, folk healer
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What should the nurse be aware of when speaking to an Islamic or muslim family?
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Obtaining health care information may be difficult, because Islam dictates that family affairs should be kept within the family. Personal information is shared only with personal friends and health assessment must be done gradually. Decisions are usually made by the male head of the household.
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What should the nurse know before planing a nutrition care plan for an Islamic pt.?
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Muslims do not eat pork and do not use alcohol. Most are vegetarians
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How do women of asian origin view health?
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balance between yin and yang
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How do african or haitian origin view health?
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Define health as harmony with nature
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How do people from mexico, central and south america and puerto rico often see health?
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They see health as a balance between hot and cold
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What do those of African origin do to facilitate labor?
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Consume nonfood substances (Pica) such as starch
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Asian women consume what daily?
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Rice
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What is dermabrasion?
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Rubbing or irritation of the skin to relieve discomfort
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What culture uses dermabrasion?
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Vietnam and Cambodia
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What is the most popular form of dermabrasion?
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Coining
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What is coining?
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An area is covered with an ointment and the edge of a coin is rubbed over the area, leaving a mark resembling a bruise or burn on the skin
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When does sexual development begin?
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It begins at conception when the genetic sex is determined by the union of an ovum and sperm
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At what time in the womb is the sex undifferentiated?
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During the first 6 weeks of prenatal life
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When does differentiation of the external sexual organs occur?
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At about 12 weeks gestational age
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What are primary sex characteristics of maturation?
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ova in the ovaries, sperm in the testes
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What occurs in the maturing child to induce puberty?
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The gradual increase of GnRH begining at 9-12 years
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Do boys or girls mature faster?
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The hormonal changes of puberty begin about 6 mo to one year earlier in girls than boys
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GnRh stimulales what two hormones?
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FSH and LH
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What is the result of the increase in FSH and LH
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They stimulate secretion of estrogens and progesterone by the ovary, resulting in maturation of the reproductive organs and breasts and development of secondary sex characteristics
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What is the first noticable change in girls, and how long after does mensturation begin?
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Development of breasts (8-13), menstruation occurs about 2-2.5 years after breast development (9-16)
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What appears at the time of menarche?
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Axillary hair
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When does the growth spurt begin for girls?
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It begins about 1 year after breast development
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What are the characteristics of the first menarche?
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Usually irregular and scant, usually not fertile
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When can a girl become pregnant?
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A sexually active girl can conceive even before her first menstrual period
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What do FSH and LH do in the male?
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They stimulate secretion of testosterone and eventually cause spermatogenesis in the maturing adolescent
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What is the first sign of puberty in the male?
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Growth of the testes (9.5)
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At what age is maturation complete in the male?
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16.5
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What should boys be taught about nocutrnal emissions?
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Often called wet dreams, is a normal occurance, boys should be taught about this because they may feel abnormal or ashamed
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What structures are in the vestibule?
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Urinary meatus, vaginal introitus, ducts of Skene's and Bartholin's glands
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What is the function of the ducts of SKene's?
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aka periurethral glans, provides lubrication for the urethra
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What is the function of Bartholin's glands?
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It provides lubrication for the vaginal introitus, during sexual arousal
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What is the normal position of the uterus?
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Anteverted (rotated forward over the bladder) and slightly anteflexed (flexed forward)
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Where does fertilization occur?
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In the fallopian tubes
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If a woman has had infection or scar tissue within the fallopian tube, what can result?
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Tubal blockage, which may result in sterility or a tubal pregnancy
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What happens to LH just before ovulation?
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There is a spike in LH and then a rapid decline
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When does the follicular phase begin and end?
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Begins on the first day of menstruation and ends 14 days later
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About how many days before ovulation does LH secretion rise?
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2 days before ovulation
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What marks the begining of the luteal phase?
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Ovulation marks the begining of the luteal phase, and occurs about 14 days before the next menstrual period
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What kind of mucus is present at the time of ovulation?
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Thin, stringy mucus, (aids entry of sperm into the uterus)
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During the menstrual cycle, about how much blood is lost?
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40 mL
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What does spinnbarkeit refer to?
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the elasticity of cervical mucus
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What are montgomery's tubercles?
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Sebaceous glands in the areola, inactive and not obvious except during pregnancy and lactation, when they enlarge and secrete a substance that keep the nipple soft
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What are nursing considerations for women taking depo provera (DMPA)?
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Given IM within 5 days of period, spotting/ breakthrough bleeding common, amenorrhea common @ 1 yr, wt gain of 4 lb per year, headaches, nervousness, decreased libido, breast discomfort, depression
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Your pt. is contemplating the use of Oral contraceptives, however she has a history of thrombophlebitis, is she a candidate?
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No, women who have had thrombophlebitis or strokes should not use OCs becasue the hormones used may cause these conditions to recur
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Your pt. has a history of toxic shock syndrome, what contraceptives should she be advised to not use?
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The diaphragm and cervical cap, because TSS is a possible complication of these methods
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What contraceptive offers the best protection against STDs?
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The male condom
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For which contraceptives would the nurse need a written consent?
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Surgical sterilization, OCs, hormone injections, IUDs
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Your pt. is a health adolescent girl, she is at the health department for oral contraceptives and condoms, you have informed her of the pelvic exam, however, she is very fearful and does not want to do the exam, what should you do?
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Pelvic examinations are not needed for a helathy adolescent girl to begin using contraceptives (condoms or hormonal contraceptives OCs)
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When should Papanicolaou PaP test begin?
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They should begin within 3 years of the first vaginal intercourse or by age 21
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How is female sterilization achieved?
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Cutting or mechanically occluding the fallopian tubes
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What should you teach a woman after she as just been sterilized?
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She should rest for 24 hours, and not lift heavy objects for a week, she should call her Dr. if she has fever, fainting, severe pain, or bleeding or discharge from the incision.
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Your pt. wants to have the nonsurgical method of female sterilization, what should you ask your patient before giving her information about the procedure?
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Are you allergic to nickle?
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What is the procedure like?
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A tiny coil (Essure) is inserted through the cervix and into each fallopian tube, it becomes permanetly block within 3 mo, during which she should use other forms of contraceptive. A hysterosalpingogram is done at the end of the three months to ensure the tubes are completely blocked
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How would you explain a vasectomy to your male pt.?
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It is a male sterilization procedure, and involves making a small incision or puncture in the scrotum to lift out the vas deferens, which carries sperm from the testes to the penis
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What should you inform the pt. to do after he has his vasectomy?
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He should rest for 48 hours, apply ice to the area, use scrotal support for 2 days, avoid strenous activity for one wk, Call Dr. if fever, severe pain, bleeding or discharge, or swelling mroe than twice the normal size or a painful nodule
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When can intercourse be resumed?
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In 2-3 days , however he will not be sterile, until about 3 mo.
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What is Implanon and how long does it work?
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Capsule inserted into the upper inner arm SQ, and releases progestin continuously to provide 3 years of contraception, fertility returns as soon as the rod is removed
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How does Depo Provera work?
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It is an injectable progestin that prevents ovulation for 12 weeks
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How long can someone use Depo Provera?
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It cannot be used for longer than 2 years
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Women who take Depo, should add what in their diet?
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Calcium and vitamin D, and increase their wt bearing exercise
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How long does it take for fertility to return after stoping depo?
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10 to 18 months
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Your pt. gave birth 6 weeks ago and is breast feeding, can she take depo?
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Yes
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What is the difference between monophastic and miniphills?
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Monophasic pills have estrogen and progestin, Minipills only have progestin, and have no hormone free days
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What should you teach a pt. newly started on minipills?
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She should use contraception during the first cycle
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Whom should not use estrogen containing contraceptives?
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Women over the age of 35 who smoke more than 15 cigaretts a day and women age 40 who amoke at all
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If a woman misses a period and thinks she may be pregnant because she missed one or more doses, what should she do?
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Stop taking the pills and get a sensitive pregnancy test immediately
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Your pt. had her baby today, and is inquiring about when she can start taking Oral Contraceptives, what do you tell her?
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If she is not going to breastfeed, she may start taking the pills in 3-4 weeks
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She says that she is planning on breastfeeding, what is your response?
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She will have to take progestin only pills because they do not affect milk production, which can start 6 weeks after birth
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What medicines effect the effectiveness of OCs?
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Rifampin, St. John's Wort, Phenobarbital, phynytoin, topiramate, carbamazepine, oxcarbazepin, felbamate, primidone, and antibiotics
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What two antibiotics do not reduce the effectiveness of OCs?
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Amoxicillin and tetracycline
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Pt. A presents who has been taking OC's c/o severe abdominal pain, what could it be?
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Benign liver tumor, gallbladder disease
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Pt. B who has been taking OC's presents to the ER with c/o chest pain, dyspnea, and hemoptysis, what do you suspect?
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Pulmonary emboli or MI
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Pt. C who has been taking OC's presents to the ER with c/o severe heacache, weakness and numbness of extremities and hypertension, what do you suspect?
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Storke, migraine with neurologic problems
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Pt. D who has been taking OC's presents to the ER with c/o eye problems, visual changes, blurred and double vision, and speech disturbances, what do you suspect?
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Stroke
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Your pt. who has been taking OC's speaks of her wish to become pregnant, she wants to know how long it will take to get pregnant after she stops taking the pills?
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2-3 months
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What should you encourage her to take to prevent neural tube defects?
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Folic Acid
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Your pt. has just started Ortho Evra, should she use another contraceptive in combination with the patch?
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She should use a nonhormonal contraceptive during the first week of use, unless the patch is started on the first day of the menstrual period
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Where is the patch applied?
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Clean, dry skin, on the abdomen, upper torso (NOT the breast, buttock or upper outer arm)
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What should you tell the patient to avoid doing to the patch?
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She should avoid using oils or lotions in the area, or put the patch where straps or waistbands may rub the patch
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When should the pt. taking Ortho Evra change the patch?
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A new patch is applied to a different site weekly on the same day of the week for 3 weeks and worn continuously for 7 days, then she goes for one week without the patch
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A pt. is interested in the NuvaRing, what information should you tell her about its use?
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It is inserted into the vagina for three weeks, it releases estrogen and progestin, and is removed at the end of the ethird week and bleeding occurs, prescription is required
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When is the ring placed in the vagina?
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During the first 5 days of the menstrual cycle
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Whom should not use NuvaRing?
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Women who shouldn't use OC's shouldn't use the Nuva Ring
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Your pt. who is using the nuvaring, complains that her partner can feel it during intercourse, what should you tell her to do?
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She can remove the ring for up to 3 hours, however if longer time elapses, a backup method is necessary for 7 days
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How long after unprotected intercourse can a pt. wait before she takes plan B?
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Greatest effectiveness occurs within 72 hours, but it can be as long as 120 hours
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What is copper T 380A (ParaGard) IUD?
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Can be used as EC (within 5 days of intercourse), provides 10 years of contraceptive
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What is mifepristone used for?
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It can be used as an EC but is will also disrupt an existing pregnancy
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What is the most effective contraceptive (excluding abstinence)?
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Minerna
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How long after birth can an IUD be inserted?
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6 wks
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After removal of an IUD, how long does it take for fertility to return?
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Immediately
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When does Mirena have to be replaced?
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In 5 years
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What causes many women to remove ParaGard sooner than 10 years?
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Menorrhagia (increased bleeding during menstruation)
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Whom should not use IUDs?
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Nulliparous women, those with recent or recurrent pelvic infections, a history of ectopic pregnancy, bleeding disorders, or abnormalities of the uterus, women with high risk for STDs
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How can the woman check for placement of the IUD?
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She can feel for the strings once a weeks during the first 4 weeks of use , then monthly after periods
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What are signs of expulsion?
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Cramping or unexpected bleeding, if the strings are longer or shorter than they were
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How long does it take for suppositories to become effective?
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15 minutes
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How long are they effective?
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for about 1 hour
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What should your pt. know about polyurethane condoms?
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They are thinner than latex buy may require lubrication to avoid breakage
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What should your pt. know about natural membrane condoms?
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They do not prevent the passage of viruses and do not protect against STDs caused by viruses
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Your pt. is asking about the sponge, what can you tell her?
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It provides contraception for 24 hours, It should remain in place for at least 6 hours after intercourse, and should not be left in place for more than 30 hours
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How does she prepare the sponge for insertion?
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She should wash her hands and wet the songe with water, squeezing it until it beomces sudsy
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What is the female condom made of?
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Polyurethane
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What is the diaphragm made of?
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Latex
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What are some disadvantages of a diaphragm?
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It must be fitted by a health care provider, the woman has to be checked yearly, and after a wt. gain or wt. loss of 10 lb, and must be replaced every 2 years
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What are some advantages of the FemCap?
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It is smaller than the diaphragm, and does not cause pressure on the bladder, can remain in place for 48 hours
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When should FemCap not be used?
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It should not be used during menses or in women with a history of TSS
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Using the standard days method (string of beads color coded ) what days are considered the fertile days?
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Days 8-19
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How is the calendar method used?
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Subtract 18 days from the shortest cycle and 11 days from the longest cycle to determine fertile period example 28-32 day cycle= fertile between days 10 and 21
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How does a woman calculate her basal body temperature?
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A woman charts her oral temp each morning before getting out o bed or increasing her activity
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What happens to the temperature just before ovulation?
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A slight temperature drop
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What occurs to the temp during ovulation?
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It rises 0.2-0.4 and remains higher throughout the rest of the cycle because of progesterone
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When is the woman no longer fertile?
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Affter the temperture rise
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What is ovulation or Billings method?
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It is a method in which cervical mucus is assessed (wiping mucus from vaginal orifice with tissue each day)
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How do couples prevent pregnancy using the Billings method?
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Couples avoid intercourse from the time clear stretchy mucus is first present to 4 days after the end of the slippery mucus, (Intercourse is allowed every other day because semen interfers with assessment)
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What is usuallly the first test to check for infertility in the male?
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Semen analysis, semen specimens are obtained over a period of several weeks to obtain the best evaluation
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What is usually the first test to check for infertility in the female?
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Usually determine if she is ovulating each month. An ovulation predictor kit is most often used.
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What do the white beads represent?
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ovulation
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What do the brown or tan beads represent?
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pregnancy is unlikely to occur
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What do the red beads represent?
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Menstrual flow
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What is the cervical mucus like before and after ovulation?
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It is scant, thick, sticky, and opaque, stretches less than 6 cm
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What is cervical mucus like just before and for 2-3 days after ovulation?
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raw egg white, thin , slippery, and stretches 6 cm or more and means that the woman has ovulated and could become pregnant
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What could cause a false reading of cervical mucus?
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If she takes antihistamines, vaginal mucus may be thicker, and it may be thinner if she has a vaginal infection, or uses foams or jellies or if she has had intercourse
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When should the couple have intercourse?
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Every 2 days during the period of ovulatory mucus (days 12 to 16)
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You have a male pt. who is conducting a semen analysis, when should he begin to collect the semen specimen?
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He should collect the specimen by masturbation after a 2-3 day abstinence
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After collecting the semen specimen, how long does he have to transport it to the Lab?
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He should transport it near the body to keep it warm and it should arrive within 1 hour
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When should the Postcoital test be done?
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6 to 12 hours after intercourse
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How does Clomid work?
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It matures the ovarian follicle, and causes release of the ovum
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How does Gonal F and Detrotide, and Antagon work?
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They Stimulate ovarian follicle growth, and reudce endometriosis, and reduce ovarian hyperstimulation
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How does Zoladex, Lupron, and Synarel work?
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They stimulate ovulation in the female and stimulate testosterone production in the male
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How does progesterone work?
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It prepares uterine lining and promotes implantation
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How does Pregnyl and Ovidrel work?
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They stimulate progesterone production by the corpus luteum.
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Clomid is designed for what kind of pt.?
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A female who is infertile and whose estrogen levels are normal
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What should you warn your pt. who is on clomid?
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She can have multiple gestation
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What is IUI?
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A variation of therapeutic insemination that allows sperm to be placed directly into the uterus, thus bypassing the cervical mucus and reducing some immunologic incompatibilities, it removes many of the antibodies that interfere with sperm motility and ability to penetrate the ovum
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If a man has retrograde ejaculation, what can he do?
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He should take sodium bicarbonate 2 hours before obtaining the semen to render the urine alkaline
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Why might egg donation be less successful?
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If it is used for women who have a birth defect like turner's syndrome, or for women who have had radiation therapy to the pelvis
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What should you teach the woman who has undnergone in vitro fertiliazation about menstrual periods?
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Because of supplemental progesterone, the woman will not have a menstrual period even if she is not pregnant
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What is a requirement for GIFT?
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the woman must have at least one open fallopian tube
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Who can have IVF?
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Women who have blocked or absent fallopian tubes
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What is the requirement for ZIFT aka TET?
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The woman must have at least one patent fallopian tube
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What is different about ZIFT from GIFT and IVF?
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The womans ova are fertilized outside her body , but they are placed in the fallopian tubes and enter the uterus naturally for implantation
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What is the primary advantage of GIFT and ZIFT over IVF?
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People or religious groups may find these procedure more natural
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What are characteristics of fibrocystic breast changes?
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multiple, smooth, well delineated nodules, which are bilaterally consistent, painful, tender, improve during pregnancy
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A FNA of a fribrotic cyst does what?
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Relieves pain, follow up needed if the cyst disappears and the aspirated is clear
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What can women do to decrease discomfort r/t fibrotic cysts?
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Avoid caffeine, coffee, tea, chocolate, and some soft drinks
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What are fibroadenomas
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Benign tumors of the breast, common during teen and early twenties,
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What are characteristics of fibroadenomas?
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They are firm, freely mobile nodules that may or may not be tender, they do not change during the menstrual cycle, and are usually located in teh upper, outer quadrandt of the breast and more than one is often present
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What are characteristics of ductal ectasia?
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occurs usually as a woman approaches menopause, dilation of the collecting ducts, become distended and filled with cellular debris, the mass feels firm and irregulaar, enlarged axillary nodes, nipple retraction and discharge, signs are similar to breast cancer
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What is the treatment of ductal ectasia?
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Excisional biopsy, removes the mass, the condition is benign mammary duct ectasia, no further treatment necessary
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What is intraductal papilloma?
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develops just before or during menopause, occurs when papilomas develop in the epithelium of the ducts of the breast
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What are characteristics of intraducatl papilloma?
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lesions under the aerola, trauma and erosion within the ducts, serous or bloody discharge from the nipple
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What is breast conservation treatment?
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Lumpectomy
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What is a simple mastectomy/
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The removal of the entire breast
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What is modified radical mastectomy?
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The removal of breast tissue, axillary nodes, and some chest muscles
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What can women do to decrease discomfort r/t fibrotic cysts?
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Avoid caffeine, coffee, tea, chocolate, and some soft drinks
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What are fibroadenomas
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Benign tumors of the breast, common during teen and early twenties,
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What are characteristics of fibroadenomas?
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They are firm, freely mobile nodules that may or may not be tender, they do not change during the menstrual cycle, and are usually located in teh upper, outer quadrandt of the breast and more than one is often present
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What are characteristics of ductal ectasia?
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occurs usually as a woman approaches menopause, dilation of the collecting ducts, become distended and filled with cellular debris, the mass feels firm and irregulaar, enlarged axillary nodes, nipple retraction and discharge, signs are similar to breast cancer
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What is the treatment of ductal ectasia?
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Excisional biopsy, removes the mass, the condition is benign mammary duct ectasia, no further treatment necessary
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What is intraductal papilloma?
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develops just before or during menopause, occurs when papilomas develop in the epithelium of the ducts of the breast
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What are characteristics of intraducatl papilloma?
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lesions under the aerola, trauma and erosion within the ducts, serous or bloody discharge from the nipple
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What is breast conservation treatment?
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Lumpectomy
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What is a simple mastectomy/
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The removal of the entire breast
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What is modified radical mastectomy?
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The removal of breast tissue, axillary nodes, and some chest muscles
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What can women do to decrease discomfort r/t fibrotic cysts?
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Avoid caffeine, coffee, tea, chocolate, and some soft drinks
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What are fibroadenomas
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Benign tumors of the breast, common during teen and early twenties,
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What are characteristics of fibroadenomas?
|
They are firm, freely mobile nodules that may or may not be tender, they do not change during the menstrual cycle, and are usually located in teh upper, outer quadrandt of the breast and more than one is often present
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|
|
What are characteristics of ductal ectasia?
|
occurs usually as a woman approaches menopause, dilation of the collecting ducts, become distended and filled with cellular debris, the mass feels firm and irregulaar, enlarged axillary nodes, nipple retraction and discharge, signs are similar to breast cancer
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What is the treatment of ductal ectasia?
|
Excisional biopsy, removes the mass, the condition is benign mammary duct ectasia, no further treatment necessary
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What is intraductal papilloma?
|
develops just before or during menopause, occurs when papilomas develop in the epithelium of the ducts of the breast
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What are characteristics of intraducatl papilloma?
|
lesions under the aerola, trauma and erosion within the ducts, serous or bloody discharge from the nipple
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What is breast conservation treatment?
|
Lumpectomy
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What is a simple mastectomy/
|
The removal of the entire breast
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What is modified radical mastectomy?
|
The removal of breast tissue, axillary nodes, and some chest muscles
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What is a sentinel lymph node biopsy?
|
removes a few key lymph nodes to evaluate cancer spread rather than removing most of the nodes in the area (axillary dissection)
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|
What are side effects of radiation?
|
sunburn
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|
|
What are side effects of chemotherapy?
|
Sore, bleeding gums , infection, hair loss, menstrual irregularities , anemia, fatigue
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|
|
What are side effects associated with Tamoxifen (Nolvadex)?
|
Hot flashes, vaginal dryness, increased vaginal discharge, nausea, anorexia, elevated calcium, cholestrol, and triglycerides
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What is applied to the mastectomy woiund after surgery to prevent bleeding and maintain a fine surgical scar line?
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A pressure binder
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What does the mastectomy dressing look like?
|
Like clear nail polish
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What will the incision look like?
|
It may appear red and raised for the first few weeks
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What exercises should the woman do after having a mastectomy?
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Armlifts and pulley exercises
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What can be used to treat and prevent lymphedema?
|
Compression armsleeves, TED hose
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|
What is amenorrhea?
|
Absence of menses
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|
|
What is cyclic pelvic pain?
|
occurs repetitively and predictably in a specific phase of the menstrual cycle
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|
What causes cyclic pelvic pain?
|
Mittelschmerz, primary dysmenorrhea, and endometriosis
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What is acute pelvic pain?
|
Sudden in onset and is not experienced with each menstrual cycle
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What is Mittlelschmerz?
|
middle pain, pelvic pain that occurs midway between menstrual periods at the time of ovulation
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What is the characteristic of mittelschmerz pain?
|
fairly sharp and is felt on the right or left side of the pelvis, lasts from a few hours to 2 days , slight vaginal bleeding may accompany the discomfort
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What is primary dysmenorrhea?
|
menstrual pain without identified pathology
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What is the characteristics of dysmenorrhea?
|
usually 1-3 years after menstruation begins, when ovulatory menstrulal cyces are wll established, common in young women, commonly called cramps, spasmodic or colicky,felt in the lower abdomen but often radiates to the lower back or down the legs, nausea, vomiting, loose stools, or dizziness may also occur, usually lasts 48 to 72 hours
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What are the S&S of endometriosis?
|
pain, infertility, deep, unilateral or bilateral, sharp or dull constant pain, dyspareunia (painful intercourse), rectal pain, diarrhea, constipation, rectal pressure
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How is endometriosis treated?
|
Oral contraceptives, Danocrine, Lupron, Synarel, Laparoscopy, hysterectomy, bilateral salpingo oophorectomy, post op HRT
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What are some SE of danazol?
|
masculinizing effects, deepening of the voice, facial and body hair, wt. gain (3-6 mo)
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What is one of the most importatn Nursing actions with a pt. who has dysmenorrhea?
|
Acknowledge the pain:" I understand this is really uncomfortable and you are concerned that you have this much pain every month."
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What is PMS?
|
cyclic and recur in the luteal phase, symptom free during the follicular phase, diagnosis based on the womans prospective symptom recording
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Women who have PMS can do what to decrease breast pain?
|
Reduce caffeine and take vit E (400 IU/day) during the luteal phase and evening pimrose
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When is surgical abortion needed over drug induced?
|
If the woman has been pregnant for over 7 weeks
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What is the method of choice if the woman is 12 weeks gestation?
|
Vacuum aspiration with curettage
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What should you inform the woman about the procedure?
|
Cramping may last 20-30 min
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|
What may be given to induce contractions?
|
prostaglandin E12
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Unexpected postmenopausal bleeding should be investigated because?
|
It could suggest endometrial cancer
|
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|
What is the characteristics of premenopausal period?
|
ovulation is sporadic and menstrual periods are irregular
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What can women do to counteract the effects of genital atrophy?
|
Kegal eercises
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What does Black cohosh do?
|
reduces sweating (should not be used with hormone therapy
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What do soy products do?
|
used to reduce hot flashes, should not be used in women who take tamoxifen
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What does Dong Quai do?
|
May reduce hot flashes, has a vasodilation and antispasmodic effect
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What does Vit E do?
|
inhibits platelet aggregation
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What does chasteberry do?
|
It may reduce PMS symptoms of mood alteration anger and headache
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|
Anterior vaginal wall prolapse involves the bladder and urethra and is known as?
|
cystocele
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Prolapse of the posterior wall produces what?
|
Enterocele or rectocele
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|
|
What causes the cystocele to develope?
|
When weakened upper anterior wall of the vagina is no longer able to support the wt. of urine in the bladder
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What happens when cystocele developes?
|
Incomplete bladder emptying, cystitis b/c of the stagnant urine
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|
____________ may occur when the urethra bulges into the lower anterior vaginal wall, producing stress urinary incontinence
|
Urethral displacement, Urethrocele
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|
|
What is stress incontinence?
|
the loss of urine that occurs with a sudden increase in intraabdominal pressure, sneezing, coughing, laughing, lifting, or sudden jarring motions
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What is enterocele almost always associated with?
|
Herniation of the pouch of Douglas (a fold of peritoneum that dips down between the rectum and the uterus)
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____________ is prolapse of the upper posterior vaginal wall between the vagina and rectum
|
Enterocele
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____________ occurs when the posterior wall of the vagina becomes weakened and thin
|
Rectocele
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|
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What are some symptoms of a rectocele?
|
difficulty emptying the rectum, the woman may have to facilitate bowel elimination by applyig digital pressure along the posterior vaginal wall to keep the retocele from protruding during a bowel movement
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_______________ prolapse occurs when the cardinal ligaments that support the uterus and vagina are unduly stretched during pregnancy and do not return to normal after childbirth.
|
Uterine
|
|
|
When do symptoms of pelvic floor dysfunction become obvious?
|
Usually during menopausal period
|
|
|
What are symptoms of vaginal wall prolapse?
|
Feelings of pelvic fullness, dragging sensation, pelvic pressure, fatigue, low backache, feeling that everything is falling out
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|
|
Symptoms of urinary frequency and urgency and urinary incontinence are seen in what type of prolapse?
|
Cystocele
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|
|
Constipation, flatulence, difficulty defecating are seen in what type of prolapse?
|
Rectocele
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|
|
What makes symptoms of prolapse worse?
|
Prolonged standing
|
|
|
What makes symptoms of prolapse decrease?
|
Lying down
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|
What is the most common surgical treatment cystocele and rectocele ?
|
Colporrhaphy
|
|
|
What is the most common surgery to correct vaginal prolapse?
|
Hysterectomy
|
|
|
How can the nurse determine if a pt. can do a kegel exercise?
|
Ask her to sit with her legs apart while she urinates and to squeeze the muscles to stop the stream of urine
|
|
|
What muscles should be used when doing kegel exercises?
|
Only the pelvic muscles , not the abdomen, thighs or buttocks
|
|
|
How long should the pt. hold the contraction when doing kegel exercises?
|
10 seconds with a min. of 10 secs for relaxation
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|
|
How many kegel exercises should she do a day?
|
24 - 45 repititions a day
|
|
|
What are uterine leiomyomas?
|
aka fibroids, develop from uterine smooth muscle cells and are estrogen dependent, grow rapidly in childbearing years
|
|
|
What are some symptoms of fibroids?
|
may cause no s&S, uterine size increased, excessive menstrual bleeding, infertility, pelvic pressure, bloating, urinary frequency
|
|
|
What signs do males exhibit if they have a yeast infection?
|
erythema and itching of their glans penis (balanitis)
|
|
|
What are the symptoms of yeast infection on the female?
|
vaginal and perineal itching, vulvar and vaginal tissues are inflamed, burning on urination, white cottage cheese discharge
|
|
|
How is Yeast infection treated?
|
Butoconazole, Miconazole, Clotrimazole, Nystaatin, Terconazole, Tioconazole (all are vaginal app)
|
|
|
What med can be given for yeast infection orally?
|
Fluconazole
|
|
|
What are recurrent yeast infections that resist treatment associated with?
|
Diabetes mellitus or HIV
|
|
|
What is trichomoniasis caused by?
|
Caused by T vaginalis, an anaerobic protozoon that thrives in an alkaline env.
|
|
|
What are the symptoms of trichomoniasis?
|
purulent vaginal discharge that is thin or frothy, malodorous and yellow green or brownish gray in color. Ph greater than 4.5 of the discharge, Vulvar itching, edema, redness
|
|
|
What is it treated with?
|
Flagyl, Protostat (if not preg)
|
|
|
What should your pt. be advised to avoid when taking Metronidazole?
|
Alcohol
|
|
|
What are signs and symps. of Bacterial vaginosis?
|
thin grayish white discharge, fishy odor
|
|
|
How is bacterial vaginosis diagnosed?
|
By identifying clue cells
|
|
|
How is bacterial vaginosis treated?
|
Metronidazzole or Clindamycin
|
|
|
What is the most common STD?
|
Chlamydial infection
|
|
|
What causes chlamydial?
|
C. trachomatis
|
|
|
What are the symptoms of chlamydia in women?
|
Its often asymptomatic....yellowish discharge, painful urination, if untreated causes tubal scarring, PID, infertility
|
|
|
How is chlamydia treated?
|
Zithromax, doxycycline, clindamycin, floxin, levaquin, erythromycin
|
|
|
What are the symptoms of Gonorrhea?
|
purulent discharge, dysuria, dyspareunia
|
|
|
How is Gonorrhea treated?
|
Suprax, rocephin, cipro,
|
|
|
What is syphilis caused by?
|
Treponema pallidum
|
|
|
What are symptoms of primary syphilis?
|
painless chancre on the genitals, anus, or lips and heals in 6 weeks
|
|
|
What are the symptoms of secondary syphilis?
|
enlarged spleen and liver, headache, anorexia, maculopapular skin rashskin eruptions called condylomata on the vulva (resemble warts)
|
|
|
What happens in the tertiary stage?
|
paralysis, psychosis, involvment of the entire body systems
|
|
|
How is syphilis treated?
|
Penicillin, ceftriaxone, doxycycline
|
|
|
What are the symptoms of HErpes?
|
blisters (vesicles) appear in a cluster on the vulva, perineum , or perianal area, causing pain and tenderness and dyspareunia, flulike symptoms, fever, malaise, enlarged lymph nodes
|
|
|
What drugs are used to treat herpes?
|
Zovirax, famvir, valtrex
|
|
|
What is condylomata acuminata?
|
Genital warts, caused by HPV
|
|
|
What are the symptoms of genital warts?
|
Dry, wart like growths, resemble cauliflower
|
|
|
What can be given to a woman who has HIV so that her fetus is protected?
|
Zidovudine
|
|
|
What are symptoms of PID?
|
pelvic pain, fever, purulen vaginal discharge, nausea, anorexia, irregular vaginal bleeding, tenderness
|
|
|
What foods provide Vitamin A?
|
dark green, yellow or orange veggies, egg yolk, butter and fortified margarine
|
|
|
What foods provide vitamin D?
|
firtified milk, margarine, soy products, butter, egg yolks, sunlight,
|
|
|
What foods provide Vitamin E?
|
Meggie oils, whole grains, nuts, green leafy veggies
|
|
|
What foods provide vitamin K?
|
Dark green leafy veggies
|
|
|
What foods provide vitamine B?
|
Chicken, fish pork, eggs, peanuts, whole grains, cereals
|
|
|
What foods provide folic acid?
|
green leafy veggies, legumes, beans, peanuts, orange juice, asparagus, spinach, fortified cereal and pasta
|
|
|
What foods provide thiamine?
|
lean pork, whole or enriched grain products, legumes, seeds, nuts
|
|
|
What foods provide vit C?
|
citrus fruit, peppers, strawberries, cantaloupe, gree leafy veggies, tomatoes, potatoes,
|
|
|
What foods provide iron?
|
meats, green leafy veg., eggs, grain products, enriched bread and cereal, dried fruits, tofu, legumes, nuts, blackstrap molasses
|
|
|
What foods provide calcium?
|
Dairy products, salmon or sardines, legumes, fortified juice and tofu, broccoli, kale
|
|
|
What foods provide phosphorus?
|
Dairy products , lean meat, fish, poultry , cereals, snacks, carbonated drinks
|
|
|
What food provides Zinc?
|
meat, poultry, seafood, eggs, nuts, wheat germ, yogurt,
|
|
|
What foods provide magnesium?
|
Whole grains, nuts, legumes, dark green veggies
|
|
|
What contins iodine?
|
seafood, iodized salt
|
|
|
What foods are considered hot "yang" for southeast asians?
|
peppers, onions, pork, poultry, fish, broth, eggs, spices, salty food, rice
|
|
|
What foods are considered cold "yin"?
|
most fruits and juices, flour, cold fluids, sour foods, noodles, beef, green veggies
|
|
|
During the third trimester, what is the asian woman said to be?
|
Hot
|
|
|
What should she do to maintain a balance?
|
Eat cold foods
|
|
|
What is the postpartum period considered to be?
|
Cold
|
|
|
What must the mom do?
|
Eat hot foods
|
