OB final

T/F Irregular pill taking is one of the major causes of "break through bleeding"

TRUE

Progesterone decreases ____ ____and _____ caused by estrogens, thereby preparing the uterus for implantaion after the ovum is fertilized.

uterine motility; contractility

Estrogens serve mainly a proliferative function, causing enlargement of the _______, ______ and breast glandular tissue, and increases vascularity and vasodialation near the end of pregnancy.

uterus; breasts

Under the influence of progesterone the vaginal epithelium proliferates and the cervix secretes thick, ____ _____.

viscous mucous

Average age of menarche is about _______ for girls in the U.S. but it may occur anywhere between ages _______.

12.5 years; 8-16

The fertile cycle is _______ days before the end of the shortest recorded cycle through ____ days from the end of the longest recorded cycle.

18; 11

Symptoms of chlamydia include a thin or ____ discharge, cervical _______, friable cervix (bleeds easy), ______ and _____ of ______, and lower _______ pain. However up to _____ are asymptomatic.

mucopurulent; ectropia; burning; frequency; urination; abdominal; 50%

Glucose level of fetal blood is ordinarily ____-______ lower than glucose level in the maternal blood, because glucose id being metabolized rapidly. This causes rapid transport of additional glucose form the maternal blood into the fetal blood.

20-30%

Most COC's are taken for ______ or ___ days.

21;28

Progesterone levels above ______ are typically associated with normally developing intrauterine pregnancies.

25 ng/ml

The amount of flow is approximately ______ mL per period. Flow is normally ______ at first and ____ towards the end of the period.

25-60; heavier; lighter

A 20-year-old nulligravid client expresses a desire to learn more about the symptothermal method of family planning. Which of the following would the nurse include in the teaching plan? Choices 1. . This method has a 50% failure rate during the first year of use. 2. . Couples must abstain from coitus for 5 days after the menses. 3. . Cervical mucus is carefully monitored for changes. 4. . The male partner uses condoms for significant effectiveness.

3

(chlamydia)For pregnant women, patients with persisting symptoms, or those with medication non-adherence concerns repeat testing is recommended _____ weeks after completion of the prescribed medication as a test of a cure.

3

menses normally lasts _____ days and may last up to ___ days.

3-5; 7

Placental estrogens increase markedly toward the end of pregnancy to as much as ____ ties the daily production in the middle of a normal monthly menstrual cycle.

30

progesterone levels that are below _____ typically indicate a nonviable fetus

5 ng/ml

Maximum fertility for the woman occurs approximately ____ days before ovulation and _____ rapidly the day after. Therefore the couple must abstain from _______, or use a barrier method, during the _____ days.

5; decreases; intercourse; fertile

(calendar method) the menstrual cycle is recorded for ___ months to get the shortest and longest cycles.

6

With seaonale and seasonique there are _____ active pills and then a ____ pill portion with reduced estrogen to promote less bleeding. Women taking these have ___ periods a year instead of 12. These pills also reduce side effects like _____, _____, ___ ____, ____ and ____.

84;7;4; bloating, headache, breast tenderness, cramping and swelling

Chlamydia is a major cause of _____ _____ (___) in men. In _____ it can cause infections similar to those that occur with gonorrhea. However, asymptomatic infection is common in both ____ and ____.

nongonococcal urethritis NGU; women; men; women

A newly married Catholic couple comes to the nurse in the family planning clinic. They are not yet ready to start a family but wish to abide by their religious beliefs. The nurse decides to teach the couple about natural family planning (NFP). Which statement, if made by the couple, would indicate the need for further teaching? A. "If we have intercourse during the fertile days this is known as natural family planning." B. "If we use natural family planning, it will also be useful in helping us to plan a pregnancy." C. "Natural family planning does not involve the use of artificial substances or devices." D. "Natural family planning is free, safe, and acceptable according to our religion."

A.

What are some of the pros to Natural Family planning method(NFP)?

Free, safe and acceptable to many whose religious beliefs prohibit other methods, it provides an increased awareness of the menstrual cycle, involves no artificial substances or devices, encourages a couple to communicate about sexual activity and family planning, useful in helping a couple plan a pregnancy.

Extravillous trophoblast cells which invade the uterine decidas, have human leukocyte antigen _____, which is not readily recognized by sensitized __ ____ and natural ____ _____>

G; T lymphocytes; natural killer cells

_______ is of the upmost importance while taking a sexual history and should always be made clear to the patient.

Confidentiality

Treatment of secondary dysmenorrhea: if cause is a polyp, removal of the polyp with a ______.

D & C

What are the 3 ways the COC's can be started?

Day 1 start: start taking the pill on the first day of the menstrual cycle. Sunday start: taking the pill on the first sunday after the first day of the menstrual cycle and ends packet on a saturday Quickstart: starts taking the pill the day she gets it at a practitioners office if she is certain that she is not pregnant.

T/F The placenta produces enough progesterone and estrogen to maintain pregnancy after the 6th week.

False, its after the 11th week

What are the two types of oral contraceptives?

Progestin only pills and the combined oral contraceptives

_______ _______moves substances from an area of higher concentration to an area of lower concentration.

Simple diffusion

When taking a sexual history the interview should be done in a ______ and _______ place.

Quiet; private

What is the recommended treatment for chlamydia?

a single dose of azithromycin 1g orally or doxycycline 100 mg by mouth twice a day for 7 days. Sexual partners should also be treated and the couple should abstain from intercourse for 7 days after taking the single-dose treatment or for the entire 7 days of the doxycycline therapy. Doxycyline is contraindicated during pregnancy

Of the lab tests currently available to diagnose chlamydia, ____ ____ ____ ____ (NAAT) is the most sensitive. Routine screening is recommended in all sexually active women less than _____ years of age.

nucleic acid amplification testing; 25

______ ____ can work against a concentraion gradiant, allowing molecules to move from areas of lower concentration to areas of higher concentration.

active transport

Annual screening for chlamydia are recommended for these groups of people:

all sexually active adolescent females and women ages 20-25 even if they are asymptomatic. women over the age of 25 who are at risk for chlamydia (hx of STIs, multiple sexual partners, new sexual partner, inconsistent use of barrier contraceptives). ACOG also recommends screening of high-risk pregnant women at their first prenantal visit or during the third trimester of pregnancy, or both.

Major problems of the mini pill are ______ or _________ ____ ______.

amenorrhea; irregular bleeding patterns

____ ______, _____, ______, _____, _____-____ _____, and _____ are transferred across the placenta using active transport.

amino acids, calcium, iron, iodine, water-soluble vitamins; glucose

Natural family planning is a "natural" noninvasive method of contraception often used by people whose religious beliefs prevent them form using ____ _____.

artificial methods

what are some of the Fertility awareness-based methods?

basal body temperature method, ovulation method, calendar rhythm method, symptothermal method, coitus interruptus, billings method (cervical mucous method)

(sexual history) The nurse needs to identify the patients level of understanding about his or her own_____ and _____ ____ ____ and the patients knowledge and awareness of his or her own ______ and ____ ____>

body; how it works; sexuality; sexual health

Mini pills are primarily used by ____ _____ because this kind of pill does not interefere with ____ _____ production.

nursing mothers; breast milk

The measured amino acid content of fetal blood is greater than that of maternal blood, and _____ and _____ ____ occur in greater concentration in fetal blood than in maternal blood.

calcium; inorganic phosphate

Calendar method of contraception is also know as the ____ _____ _____ ______.

calendar rhythm method cycle.

In women, ______ can infect the fallopian tubes, cervix, urethra, and bartholians glands. Severe sequelae can result from untreated chlamydial infection, including ____ ____ _____, infertility, and ectopic pregnancy.

chlamydia; pelvic inflammatory disease

Progesterone is secreted by the ____ ____ and is found in greatest amounts during the ___ ____ of the menstrual cycle.

corpus luteum; luteal phase

Women who are taking contraception need to contact provider is she becomes ____, jaundiced, has a breast lump or experiences any of the warning signs; sever chest pain/ ______, severe ________, dizziness, changes vision, ___ ____, severe leg pain.

depressed; SOB; headaches; speech problems

It may be helpful when taking a sexual history to use _____ ______ _____ as much as possible unless it is culturally unacceptable.

direct eye contact

When taking a sexual history go from _______ topics to more _______ ones and clarify any ______.

easier; difficult; terminology

Conditions that frequently cause secondary dysmenorrhea are....

endometriosis, residual pelvic inflammatory disease, cervical stenosis, uterine fibroids, ovarian cysts, benign or malignant tumors of pelvis or abdomen, presence of intrauterine device, prolonged or excessive uterine bleeding

IN men, chlamydial infection can result in _____ and ______. IN addition, chlamydia infection is associated with an increased risk for acquiring and transmitting _____ _____.

epididymitis; infertility; HIV infection

The placenta breaks down certain substances such as ____ and _______ and stores ____ and ____.

epinephrine; histamine; glycogen; iron

The mini pill can also be used by women with the contratindication of ____ (history of thrombophlebitis, hypertension, other side effects)

estrogen

Combined oral contraceptives (COC) are a combination of synthetic ____ and a _______. They are popular because they are safe, effective, and rapidly ______.

estrogen; progestin; reversible

IN the US newborn exposure to chlamydia in the birth canal of the mother is the most common cause of _____ ______. Chlamydial conjunctivitis responds to _____ _____ _______. The newborn may also develop chlamydial ________. Instill ophthalmic erythromycin to all infants prophylactically.

opthalmia neonatorum; erythromycin opthalmic ointment; pneumonia

IN conjunction with a FAB method or NFP, women may choose to augment identification of their fertile days by use of an ____ _____ ____ _____ prediction kit. THey may also use a temperature computer or a _____ computer to help predict fertile days.

over-the-counter ovulation; hormone

The calendar method of contraception is based on the womans _____ _____ assumed to be ____ days give or take 2 days.

ovulation cycle; 14

______ ______involves a carrier system to move molecules from an area of greater concentration to an area of lower concentration.

facilitated transport

(calendar method) to be most effective it is recommended to abstain from intercourse during the ____ phase. This is the _____ _____ of the fertility awareness-based methods.

fertile; least reliable

If the couple using a FAB method also uses a barrier method during fertile days, it is known as ____ ______-_____ ______. If the couple abstains completely from intercourse during fertile days. it is known as ____ _____ ______ (NFP).

fertility awareness-combined methods; natural family planning

Menstruation cycle length is from the first day of one menses to the _____ day of the next menses.

first

Molecules that travel through facilitated transport include _____,_______and some ______.

glucose; galactose; oxygen

The placenta continuously produces _____, ______ and _____ for fetal use and hormone production.

glycogen; cholesterol; fatty acids

The placental produces hormones that are vital to survival of the fetus such as ____, ____ ____ _____, and two steroid hormones, estrogen and progesterone.

hCG; human placental lactogen

progesteron is often called the ____ ____ _____ becasue its effects on the uterus allow pregnancy to be maintained.

hormone of pregnancy

_____ and ______ pressures allow the bulk flow of water and some solutes to cross the placenta.

hydrostatic; osmotic

Treatment of secondary dysmenorrhea: ______ may be the treatment of choice if there are anatomic disorders and childbearing is not desired.

hysterectomy

The placental hormones progesterone and hCG suppress cellular ____ during prganancy.

immunity

One theory posits that chorionic villi syncytiotrophoblastic tissue is ________ _____. The chorionic villi may lack major histocompatibiloty antigens and thus do not evoke ____ ______. It does however protect against _____ ______.

immunologically inert; rejection responses; antibody formation

To be used effectively, all FAB methods require extensive _____ _____ and are best suited for women with regular ____ _____.

initial counceling; menstrual cycles.

Initially length may be _____ and may be unpredictable for the first _____. Once established the cycle is about _____ to _____ days but may vary from ____ to _____ days. Cycle length often varies by _______ days from one cycle to the next and greater than these variations may occur.

irregular; year; 28 to 30; 21 to 35; 1-2

the mini pill is slighty ____ effective than combined oral contraceptives and must be consistently taken at the same time every day,

less

In the breast progesterone stimulates development of _____ and _______ and supports secretory function of the breast during lactation.

lobules; alveoli

(Chlamydia) the organism is an intracellular bacterium with different immunotypes. Immunotypes of chlamydia are responsible for _______ ______ amd ________, which is the worlds leading cause of preventable blindness.

lymphogranuloma venereum; trachoma

CONS to FAB methods are...

may interfere with sexual spontaneity, require the couple to maintain records for several cycles before beginning use, may be difficult or impossible for certain groups of women to use, may not be as reliable in preventing pregnancy as other methods.

It is best to start an interview with less intimate areas such as ______ and _____ history and then move onto sexual history towards the end.

medical; surgical

hCG prevents the normal involution of the corpus luteum at the end of the ___ ______. If the corpus luteum stopd functioning before the ______ week of pregnancy, spontaneous abortion occurs. It also causes the corpus luteum to secrete increased amounts of ____ and ____.

menstrual cycle; 11th; estrogen; progesterone

hPL stimulates certain changes in the mothers _______ processes. These changes ensure that more ______,_____ and _____ are available for the fetus.

metabolic; protein; glucose; minerals

Progestin only pill are also called the ____ _____

mini pill

progesterone provides appropriate nutritive matter for the developing ____ and _____, aids in ovum transport through the _____ _____, and decreases the contractility of the uterus, thus preventing uterine contractions from causing _____ ______.

morula; blastocyst; fallopian tube; spontaneous abortion

Secondary dysmenorrhea is defined as....

painful menstruation

Secondary dysmenorrhea is associated with _____ of reproductive tract and usually appears ____ menstruation is established.

pathology; after

_______ transfers large molecules such as albumin and gamma globulin. Materials are engulfed by amoeba-like cells forming plasma droplets.

pinocytosis

WHat are the absolute contraindications of taking the pill?

pregnancy, history of thrombophlebtis or thrombolytic disease, acute or chronic liver disease, presence of estrogen dependent carcinomas, undiagnosed uterine bleeding, heavy smoking, gallbladder disease, hypertension, diabetes, migraine with visual disturbances, hyperagulable disorders, and hyperlipidemia.

Treatment of secondary dysmenorrhea: If causes is endometriosis, ____ ____ may be used.

presacral neurectomy

temperature rise that accompanies ovulation and persists throughout the luteal phase of the menstrual cycle is due to _____.

progesterone

Fertility awareness-based (FAB) methods are based on an understanding of the changes that occur throughout a womans menstrual cycle and require ____ ____ _____ ____ to identify fertile days.

recording of certain events

Placental functions include fetal _______, _____ and _____.

respiration; nutrition;excretion

Chlamydia is found most frequently in ____ ____ adolescents and ___ _____. Trasmission commonly occurs through ______ ____.

sexually active; young adults; vaginal sex

Many substances of abuse ( cocaine and heroine) cross the placenta via _____ _____>

simple diffusion

The placenta membranes contol the transfer of a wide range of substances by a varitey of transport mechanisms like ______ _____, _____ _______, ______ _______, ______ , and ____ and _____ _______>

simple diffusion, facilitated transport, active transport, pinocytosis, hydrostatic, osmotic pressures.

FAB methods take into account the lifespan of ______ (2-7) days and the _____ (1-3) days in the ______ reproductive tract.

sperm; ovum; female

Low levels of progesterone are associated with _______ _____ and ________ _______.

spontaneous abortions; ectopic pregnancies

the placenta also produces numerous enzymes required for fetoplacental transfer such as _____ (enhances excretion of fetal estrogen precursors) and ________ (which increases the barrier to insulin)

sulfatase; insulinase

Abortion can be performed legally until the point in time when the fetus can ______ ______ of the mother. After that time, abortion is only permissible only when the ______ ____ _____ of the _______ is threatened.

survive independently; life or health; mother

hCG exerts an interstitial cell-stimulating effect on the _____ of male fetus, resulting in the production of ______ and causes male sex organs o grow.

testes; testosterone

Seasonale and seasonique are two COC's marketed for extended use aka ___ ____ ____ packets.

the three month

Women for whom a FAB method might not be an ideal choice of contraception for include...

those with irregular menstrual periods, those who are breastfeeding, those who are in perimenopause

The placenta and embryo are _____ of living tissue within the same species and are considered ______. The placenta and embryo appear exempt from immunologic reaction by the _____.

transplants; homografts; host

3 ways to test for secondary dysmenorrhea are?

transvaginal ultrasound, hysterosalpingography, hysteroscopy

As the maternal blood picks up fetal _____ ____ and ____ ______, it drains back into the maternal circulation through the veins in the ____ ____. Fetal blood is hypoxic by comparison, it therefore attracts oxygen from the mothers blood. Affinity for oxygen also increases as the fetal blood gives up its ______ which decreases its _____.

waste products; carbon dioxide; basal plate; CO2; acidity

Substances that move accross the placenta by simple diffusion are _____, ______, ____ ____, electorlytes ( ____ and ____), _________ _______, and _____. _____ and ____ hormones originating from the adrenal glands and thyroid hormones cross the placenta at a very slow rate.

water; oxygen; carbon dioxide; sodium; chloride; anesthetic gases; drugs; insulin; steroid