nurs 3800 exam 1
How can nurses help women and their partners with prevention?
Nurses should help educate and counsel women about STIs. how they affect the body and their partners, the nurse can offer some vaccines if the woman has not had them already. Also the nurse can educate the woman about using condoms to stop the spread of STIs.
What is polycystic ovarian syndrome (PCOS)?
Occurs when an endocrine imbalance results in high levels of estrogen, testosterone, and luteinizing hormone and decreased secretion of follicle-stimulating hormone. This syndrome is associated with a variety of problems in the hypothalamic-pituitary-ovarian axis and with androgen-producing tumors. The care depends on the symptoms that are the greatest concern to the woman. The nurse should educate the patient on lifestyle modifications that might help relieve symptoms, such as losing weight. the management of presenting symptoms such as infertility, irregular menses, and hirsutism are the focus.
What is dysmenorrhea?
Pain during or before menstruation and is super common in women of all ages. Young women ages 17-24 are most likely o report painful menses, and 75% of women report some level of discomfort associated with menses, and approximately 15% report severe dysmenorrhea.
What is the difference between a pelvic exam and a Pap test?
Pap test is used to screen for disease, where as a pelvic exam is used for inspection, palpation, examination of the exterior and interior of the female genitalia. The nurse should look for signs of poor health, sexual maturity, poor hygiene, etc
Who is at risk (characteristics of a woman in an abusive relationship)?
People at risk are [women] who are dating, living with, or married to an abusive partner (usually men). Race, religion, social background, age, and educational level do not differentiate women at risk, but poor or uneducated women tend to be seen as the group at risk because they are seen in the emergency department more and do not have financial, educational, or social support/resources.
What is preconception counseling?
Preconception care guides couples on how too avoid unwanted pregnancies, identity and manage risk factors in their lives and their environment, and identify healthy behaviors that promote the well being of the woman and her potential fetus. It is used when women may not know that they were pregnant until the middle or end of their first trimester, and may have exposed the baby to teratogens (such as alcohol) during its most vulnerable phase. This type of care also is important for women who may have experienced troubles with a previous pregnancy (such as a miscarriage or a premie birth). In many cases, the problem can be identified early and treated before the next pregnancy.
What is the Marquette model?
A natural family planning method that was developed through the MU college of nursing institute for NFP. The MM uses cervical monitoring along with the ClearBlue Fertility Monitor, a handheld device that uses test strips to measure urinary metabolites of estrogen and LH. This monitor will provide the woman with "low", "high", and "peak" fertility readings
What is secondary dysmenorrhea?
menstrual pain that develops later in life than primary dysmenorrhea (typically after 25 years of age). It is associated with adenomyosis, endometriosis, pelvic inflammatory disease, endometrial polyps, or sub mucous or interstitial myxomas (fibroids). Symptoms may include heavy menstrual flow with dysmenorrhea.
What is the cervical mucus method?
method in which the woman recognize and interpret the cyclic changes in the amount and consistency of cervical mucus that characterize her own unique pattern of changes at the time of ovulation. Cervical mucus transforms prior and during ovulation to facilitate and promote the viability and motility of the sperm. Without adequate cervical mucus, coitus does not result in conception. So, the nurse should teach the woman how to check the quantity and character of mucus on the villa or introits with her fingers or tissue paper each day for several months and evaluate the mucus for cloudiness, tackiness, and slipperiness. She should do this for one full cycle so that she knows exactly how her cervical mucus responds to ovulation during menstrual cycles. To ensure an accurate assessment of changes, the cervical mucus should be free from semen, contraceptive gels or foams, and blood or discharge from vaginal infections for at least one full cycle. Intercourse is considered safe without restriction beginning the fourth day after the last day of wet, clear, slippery mucus which would indicate that ovulation occurred 2-3 days previously
What is chlamydia?
most commonly reported STI in American women, almost 1.6 million cases were reported. The nurse should enquire about symptoms when screening for Chlamydia. There should be yearly screening for all sexual active women under 25 years of age or women over 25 who are at high risk. All women with two or more of the risk factors for chlamydia should be screened. All pregnant women should be screened for chlamydia at the first prenatal visit. Screening late int eh third trimester (36 weeks) may be repeated if the woman was positive previously or she's younger than 25 years old. Lab diagnosis of chlamydia is by culture, DNA probe, or enzyme immunoassay. Azithromysin or doxycycline is used for treatment of chlamydia, and when a woman is pregnant azithromycin and amoxicillin is used. Pregnant women should be retested in 3-4 weeks to determine if treatment was effective. Because chlamydia is often asymptomatic, the women should be cautioned to take all medication prescribed. All exposed sexual partners should be treated.
what bacterial vaginosis?
most moon cause of vaginal symptoms today, and is most common in women of childbearing age or ages 14-49. Women with new or sexual partners, those who douche or do not use common, and those who lack vaginal lactobacilli are at higher risk for infection. To screen, the nurse should get a focused history that may help distinguish BV from other vaginal infections if the woman is symptomatic. Reports of fishy odor and increased thin vaginal discharge, a microscopic examination of vaginal secretions should be performed, vaginal secretions should be tested for pH and amine odor. Treatment of bacterial vaginosis with oral metronidazole is most effective, and sexual partners should be treated as well. Metronidazole should not be used if the woman is breast feeding, so the nurse should counsel her on alternative treatment or if it is prescribed the nurse should
What is hepatitis (specifically) B?
most threatening to the fetus and the neonate and is caused by a large DNA virus. Screening for active or chronic disease/disease immunities based on testing for the antigens and antibodies that this disease is associated with. HBsAg has been found in the blood, sweat, tears, vaginal secretion, and semen. It can be transmitted perinatally and most often occurs in infants whose mothers have had acute hepatitis infection late in the third trimester or during the intrapartum/postpartum period from exposure. HBV is a disease of the liver and is often a silent infection. In an adult the course can be sudden and severe and the outcome fatal. All women at high risk for contracting HBV should be screened regularly at routine appointments. Screening only individuals at high risk Amy not identify up to 50% of positive women, so screening for presence of HBsAg is recommended for all pregnant women at the first prenatal visit regardless of whether they have been tested previously. The woman could be identified as a carrier, and if it is found in the blood further tests should be ordered. There is no specific treatment for hepatitis B, and recovery is usually spontaneous in 3-16 weeks. Pregnancies that are complicated by acute viral hepatitis are managed on an outpatient basis. Women should be advised to increase rest periods, eat a high protein and low fat diet, and eat their fluid intake. The should also avoid alcohol and medications metabolized in the liver. All unvaccinated women at high or moderate risk of hepatitis B vaccine. Cient education includes explaining the meaning and intricacies of hepatitis B infection.
What is the birth rate?
number of live births in 1 year per 1000 population
What is maternal mortality rate?
number of maternal deaths from births and complications of pregnancy, childbirth, and puerperium (the first 42 days after end of the pregnancy) per 100,000 live births
What is transdermal Contraceptive?
"the patch" which delivers continuous levels of norelgestromin (progestin) and ethynyl estradiol. The patch can be applied to intact skin of the upper outer arm, upper torso, lower abdomen, or buttocks. Application is on the same day once a week for three weeks, followed by a week without the patch. Withdrawal bleeding occurs during the "no patch week". The advantages of the patch are the simpleness of use. The disadvantages are that the side effects are similar to COCs, the typical failure rate is about 9% in women weighing less than 198 lbs
What 3 key phases need to be identified for natural family planning (NFP) to be effective?
(1) infertile phase: before ovulation (2) fertile phase: approx 5-7 days around the middle of the cycle, including several days before and during ovulation and the day afterward (3) infertile phase: after ovulation
What is the ABCDES of caring for abused women?
-A is reassuring the woman that she is not Alone -B is Belief of the woman -C is for Confidentiality -D is for Descriptive Documentation -E is for Education especially that violence can recur and escalate -S is for Safety of the woman and the nurse should make sure to point out danger
What is human immunodeficiency virus (HIV)?
25% of people living with HIV infections are women. HIV can lead to a severe depression of the cellular immune system called acquired immunodeficiency syndrome (AIDS). Although behaviors that place women at risk have been well documented, women should be assessed for the possibility of HIV exposure. Once HIV enters the body, the patient can become positive within 6-12 weeks. Symptoms include fever headache, night sweats, malaise, generalized, lymphadenopathy, myalgia, nausea, diarrhea, weight loss, sore throat, and rash. Screening, teaching, and counseling regarding HIV risk factors, indications for being tested and testing major roles for nurses caring for women today. Reactive screening tests must be confirmed by an additional test, such as the western blot or an immunofluorescence assay. If a positive antibody test is confirmed by a supplemental test, it means that a woman is infected with HIV and is capable of infecting others. The nurse should also make sure to counsel a mown who has a positive test, and make sure to be understanding. During the initial contact with an HIV-infected woman, the nurse should assess the woman's knowledge about HIV, and she may need a mental health consult. Extra resources also may be needed, such as legal or financial assistance or suicide prevention. For HIV-positive women, pregnancy can be associated with adverse health risk, so the nurse housed discuss contraception with the woman. There is no cure for HIV infection, but opportunistic infections can be managed vigorously. The nurse should counsel and offer testing to a woman at her first prenatal care. Perinatal transmission of HIV has decreased significantly since 2004 because of the administration of antiretroviral prophylaxis to pregnant women in the pre and perinatal periods. Treatment of HIV-infected women with triple-drug antiretroviral therapy (ART) or highly active antiretroviral therapy (HAART) during pregnancy has been reported to decrease mother-child transmission to 1% and 2%. Antiretroviral therapy is administered orally and continued throughout pregnancy. The major side effect is bone marrow suppression. Many tests on blood cell count should be performed and the woman should be up to to date on vaccines. Women who are infected with HIV but are without symptoms may have an unremarkable postpartum course. Immunosuppressed women with symptoms may be increased risk for postpartum UTIs, vaginitis, postpartum endometritis and poor wound healing.
What is the purpose of papanicoloau "pap" test? What is the screening schedule?
A Pap smear is a test in which a broom device is inserted into the woman's vaginal canal and rotated 90-180 degrees, followed by a gentle smear of the entire transformation zone by using a spatula. This test is used to screen for cervical cancer or signs of cervical cancer (HPV)
What are cervical caps?
A bc device made of silicone rubber. The cap should be inserted into the vagina and fit around the base of the cervix and should remain in place no less than 6 hours and no longer than 48 hours. The seal provides a barrier to sperm, and spermicide inside the cap adds a chemical barrier. the extended period of wear may be an added conveinience for women. IT is inserted much like a diaphragm. The angle of the uterus, the vaginal muscle tone, and the shape of the cervix may interfere with the cap's ease of fitting and use. Correct fitting requires time, effort, and skill from both the woman and the clinician. The advantages are its timing of keeping it in and multiple use. Disadvantages are the time and effort that goes into getting the right fit and the gyno appts it requires.
What is bulimia nervosa?
A binge eating disorder in which the woman binges a lot of food (mostly junk food) then it alternates with methods to prevent weight gain (i.e. self-induced vomiting, laxatives, strict diets, fasting, rigorous exercise) Complications can include dehydration and electrolyte imbalance, GI abnormalities, and cardiac dysrhythmias.
What does the acronym ACHES stand for related to birth control pills?
Abnormal (stomach) pains Chest pain Headaches Eye problems Severe calf or thigh pain
What are the barriers for women to seek healthcare: impact of social determinants of health (SoDH)?
Access to care depends greatly on the persons ability to pay, the type of the system, the woman's insurance, etc. Health disparities in the US depend on race, socioeconomic class, and many other factors of life. Poor finances are associated with lack of access to care, delay in seeking care, limited care, and little information about care. impoverished women are at most times underinsured or uninsured. Our health care system is based on risk factor paradigm that focuses on patient behavior modification, which is not an effective approach because individuals not being in control of the factors that make them sick. The nurse should address the social determinants that could impact a woman and her family's health. this approach could make families and even communities healthier.
What is trichomoniasis?
Almost always caused by an STI and is a common cause of vaginal infection and discharge. Caused by T. vaginalis, an anaerobic one -celled protozoan with characteristic flagellae. Commonly women have a characteristic yellowish to greenish discharge that is frothy, mucopurulent, copious, and malodorous. Inflammation of the vulva, vagina, or both may be present, and the woman may complain of irritation and pruritus. Often the cervix and vaginal walls will demonstrate the characteristic "strawberry spots" or tiny petechiae, and the cervix will bleed on contact. In severe infections, the vaginal walls, cervix, and occasionally also the vulva may be acutely inflamed. To screen, the nurse should get a careful sexual history. Any history of the similar symptoms should be noted.
What is anorexia nervosa?
Anorexia nervosa is an eating disorder women have a distorted view of their bodies or weight and think they are way too heavy. In turn the women affected may practice strict dieting and rigorous exercise, which can lead to the point of starvation. This can result in endocrine and metabolic abnormalities.
What is uterine prolapse?
Type of displacement in where the cervix and the body of the uterus protrude through the vagina and the vagina is inverted. Can be caused by congenital or acquired weakness of the pelvic support structures. The nursing care includes teaching exercises to treat the conditions, such as the Kegel exercise or the knee-chest position. The nurse can also teach the woman how to use a pessary.
How to do breast self exam?
Self breast exams are not clinically proven to discover cancer or issues, but a woman should know what her breasts feel like usually. For a breast self examination, a woman should lie down with a pillow under her right shoulder and put her right arm above her head. She should use the finger pads of her fingers on her left hand to feel for lumps or thickening. The woman should sue firm pressure to feel the skin above the chest and ribs and lighter pressure for the breast tissue. Then the woman should move the breast up and down in a vertical line. Then she should repeat on the other side
What is gonorrhea?
Caused by the aerobic gram-negative diplococcus through genital to genital contact or oral to genital contact. Gonorrhea in women is usually asymptomatic, so all sexually active women under the age of 25 should be screened yearly. All pregnant women should be screened at first prenatal visit. Specific diagnosis or infection can be performed by eating endocervical , vaginal, or urinary specimens. culture and on culture tests are available to test for gonorrhea. To manage and treat gonorrhea, the nurse should offer antibiotic there. The treatment of choice or uncomplicated urethral, endocervical, and rectal infections in pregnant and non pregnant women is dual therapy with ceftriazone and azithromycin.
How to do a clinical breast exam?
Clinical breast exams include mammograms, which can produce false positives so there will sometimes be extra testing after that. Every 1-2 years between ages 40 and 49 or earlier if at high risk. Anually after age 40-50, biennially after ages 50-74, after age 75 discuss with your health care provider.
Which contraceptive methods are the least effective?
Coitus interruptus, spermicide (if used alone), withdrawal methods
What is cultural competency, and can it be achieved? How can one strive for cultural competency/cultural understanding?
Cultural competence involves acknowledging, respecting, and appreciating ethnic, cultural, and linguistic diversity. One can strive for cultural competence by providing cultural and linguistically appropriate services, respecting health beliefs, practices, and needs of the client. Culturally competent professionals meet the needs of the client and are respectful of ways and traditions that may be different from their own
What is a female condom?
a vaginal sheath made of synthetic rubber which protects from HIV an CMV 100% and other STIs 95%. The closed end of the pouch is inserted into the vagina and anchored around the cervix while the open end covers the labia. The nurse should tell the woman that she could use lubricant to decrease the distracting noise that is produced with penile thrusting. Female condoms are for one time use, and are one size fits all. Advantages to the female condom is its ability to protect from STIs. Disadvantages are that it can tear, and that first year rates of failure are 21%
Why is it important for nurses and other providers to provide evidence-based care?
Evidence-based care is important for nurses and other health care workers to provide because medical errors are the third leading cause of death in tehunited states, and the medical world needed to put out a concerted effort to analyze causes of errors and develops strategies to prevent them. Evidence based practice is providing care based on evidence gained through research and clinical trials. Health care workers must use the best information and research to base their health interventions on. An example of EBP is the Cochrane pregnancy and childbirth database which oversees the systematic reviews of trials, and these trials and information provide reliable evidence about the effects of care.
What is menorrhagia?
Excessive menstrual bleeding, either in duration or amount. It can be caused by hormonal disturbances, systemic diseases, benign and malignant neoplasm, infection and contraceptions (IUDs). H&H are objective indicators of actual blood loss and should always be assessed. A single episode of heavy bleeding may be an early sign of pregnancy loss. It could also be caused by infection, disease, chemo, anticoagulants, neuroleptics, and steroid hormone therapy. Uterine leiomyomas can also called heavy bleeding. Treatment can be pharmacologic and surgical. The woman should get frequent examinations, and the nurse should warn women with bleeding between menses to avoid aspirin (can increase bleeding). Pharmacologic treatment is directed toward temporarily reducing symptoms, shrinking the myoma, and reducing the blood supply.
What are some healthy people 2020's objectives for maternal, infant, and child health?
Healthy people 2020's objectives for maternal, infant, and child health are attaining high-quality, longer lives free of preventable disease, disability, injury, or premature death; achieving health equity, eliminating health disparities, and improving the health of all groups; creating social and physical environments that promote good health for all; promoting quality of life, healthy development, and healthy behaviors across all life stages. Their main goal is to improve the health and well-being of women, infants, children, and families. HP 2020 believes that improving maternal, infant, and child health can determine the well-being of the next generation and predicts future public health challenges for families, communities, and health care systems. Their many objectives of maternal, infant, and child health is to reduce the rate of fetal and infant deaths, reduce the rate of child/adolescent/young adult deaths. Also, they want to reduce the rate of maternal mortality, reduce maternal illness, reduce cesarean births among low-risk women. HP2020 has the objectives to reduce preterm births, increase the proportion of pregnant women receiving early and adequate prenatal care, increase abstinence from drugs and alcohol in pregnant women. HP 2020 also has objectives for postpartum women, such as reducing relapse of additions after abstaining for the baby, increase postpartum women attending a meeting with health care workers, and decease the postpartum depressive symptoms. There are many more objectives, but I believe those ones are very important.
What is rectocele?
Herniation of the anterior rectal wall through the relaxed or ruptured vaignal fascia and rectovaginal septum. It almost appears as a large bulge. For treatment, women with mild symptoms may get relief from high fiber diets and fluid intake as well as still softeners and mild laxatives. Large rectoceles can be removed surgically.
What is genital herpes (HSV-2)?
Herpes is a painful genital ulcers and is caused by two antigen subtypes of herpes simplex virus (HSV-1 and HSV-2). Many with herpes are asymptomatic and undiagnosed, they can transmit the infection however. To screen and diagnose, the client history is really important. A person with herpes would have a history of viral symptoms like malaise, headache, fever, or myalgia, other symptoms such as vulvar pain, dysuria, itching, burning at the site. The nurse should ask about primary infection, prodromal symptoms, vaginal discharge, and dysparenuria. Women should be asked whether their partners have had genital lesions. Genital herpes is a chronic and recurring disease for which here is no cure, so management is directed toward specific treatment during primary and recurrent infection. antiviral medications partially control the s/s of HSV. Cleaning the lesions twice a day with saline helps prevent secondary infections, so the nurse should counsel and educate the patient. Information regarding the disease (etiology, s/s, transmission, and treatment) should be provided and explained to the woman. Neonatal HSV infection prevention is critical, so pregnant women must be screened and examined about the symptoms of HSV on the onset of labor, if visible lesions are not present at the onset of labor, vaginal birth is acceptable.
What are alternative therapies?
Homeopathy, acupuncture, and herbs have been used with varying degrees of success for menopausal problems such as heavy bleeding, hot flashes, irritability, and headaches. Menopausal symptoms are healed by the body's efforts with homeopathy. Some remedies homeopathy include sepia (relieves dry mouth, eyes, and vagina), nut vomica (relieves backaches, constipation, and frequent awakenings), pulsatilla (relieves severe menstrual symptoms and hot flashes). Acupuncture may also provide relief from hot flashes and other symptom. Herbal therapy can be used to treat menopausal discomforts. Herbs can also be used to combat mood swings and depression. Some plant foods contain phytoestrogens and are capable of interacting with estrogen receptors in the body. Vitamin E is a popular alternative to HT.
What is human trafficking?
Human trafficking is the forced labor (globally) trafficking for work and sexual exploitation or held in slavery-like situations. Women and girls represent 55% of the people in captivity. Asia-Pacific people represent 56% and Africa represents 18% of the people in human trafficked captivity Human trafficking involves the exploitation of someone for the purpose of compelled labor or a commercial sex act through force, fraud, or coercion. Health care professionals are "first responders" and have the opportunity to intervene with these trafficked humans. Captives may go to health care professionals to seek help from their violence-related injuries, disease, pregnancy, birth control, abortion, substance abuse, or psychological problems. The nurse should know the "red flags" of a person being abused (i.e. signs of being kicked, punched, beaten, being forced to have sex). Many of these signs may have overlap with those who have experienced IPV, but a nurse may tell the difference through the presence of communicable diseases in human trafficking victims.
What is IPV?
IPV is intimate partner violence, which refers to the behavior by an intimate partner (or an ex partner) that causes physical, sexual, or psychological harm, including physical aggression, sexual coercion, psychological abuse, and controlling behavior. It is the most common form of violence against women, and has been socially ignored or tolerated for a very long time.
What is metrorrhagia?
Intermenstrual bleeding, spotting, menses, or hemorrhage. It would occur at a time other than the normal menses. To treat metrorrhagia, you need to look at the cause. Treatment may include reassurance and education, observation of three menstrual cycles for a suspended functional ovarian cyst, adjustment of an OCP, removal of foreign bodies, and treatment for vaginal infection.
To ensure adequate education is being provided to ensure informed decision making, what factors must a provider consider when discussing appropriate birth control?
Interprofessional approach may assist a woman in choosing and correctly using an appropriate contraceptive method. Family, friends, media, partner(s), religious affiliation, and health care professionals influence a woman's perception of contraceptive choices, and form her unique view. The nurse should support the woman's decision based on her unique views and ensure she has the most accurate information. Assessing the woman's reproductive history, doing a physical exam, and (sometimes) getting lab tests should be parts of the evaluation of the couple desiring contraception. Informed consent is a vital part in education of the client about contraception or sterilization. The nurse should teach the patient about all kinds of contraception she is using and how it should be used
What is the psychological impact of a STI diagnosis?
It can affect someones mental state because it can cause embarrassment. The nurse should make sure that the patient feels understood and not judged. HIV patient should be offered suicide prevention help, as well as other patients diagnosed with an STI
How would you describe the current state of maternity, women's, and infant's health in the US?
Maternal mortality is actually increasing within the US, despite the advances in our country's health care (and a decrease in maternal mortality globally). Chronic conditions (i.e. CVD, diabetes, obesity) obviously add to this increase as well. Racial disparities also increase maternal mortality rate. Black women are facing. greater rate of labor-related deaths than white women, and this is due to the lack of access to pre-pregnancy, pregnancy, and reproductive health services
What is maternity and women's health nursing?
Maternity and women's health nursing is a focus on the physical, psychological, and social needs of women throughout their life and is done through the focus on general well-being, childbearing functions, and diseases. Maternity and women's health nurses study and care for conditions unique to women, and factors related to women's health problems (i.e. sociocultural and occupational factors that relate to women's health problems- poverty, rape, incest, domestic violence, human trafficking).
What is osteoporosis?
Metabolic disease characterized by decreased bone mass and increased incidence of bone fractures. Estrogen is required for the conversion of vitamin D to calcitonin, which is essential in the absorption of calcium by the intestine. Reduced calcium absorption from the gut, in addition to the thinning of the bones, places postmenopausal women at risk for problems associated with osteoporosis. Ostepporosis is one of the key disease that predominately affect women, and half of all women aged 50 and older will break a bone d/t osteoporosis in their lifetimes and 2 million bone breaks are caused by osteoporosis every year. medications to relieve osteoporosis include salmon calcitonin, bisphosphates, risedronate sodium, ibandronate, estrogen agonist/antagonists (roloxifene), PTH, or HT
How long can sperm be effective in fertilizing the ovum?
Motile sperm have been recovered from the uterus and the oviducts as long as 60 hours after coitus, but their ability to fertilize the ovum lasts no longer than 24-48 hours
What is infant mortality rate?
Number of deaths of infants younger than 1 year of age and per 1000 live births
What is neonatal mortality rate?
Number of deaths of infants younger than 28 days of age per 1000 live births
What is fertility rate?
Number of live births per 1000 women between the ages of 15 and 44 years (inclusive), calculated on a yearly basis
What is perinatal mortality rate?
Number of stillbirths and the number of neonatal deaths per 1000 live births
What are the various types of sexual violence?
Sexual violence is a broad term that includes a wide range of sexual victimization, including sexual harassment, sexual assault, and rape. Sexual harassment is defined as unwelcome sexual remarks, contact, or behavior (i.e. exhibitionism) that makes the work or other environments uncomfortable/difficult. Sexual assault can include rape, attempted rape, sexual coercion, sexual contact with a child, fondling, or unwanted touching above or under clothes. Finally, rape is a legal erm that changes definitions from state to state, but can be defined as "the penetration, no matter how slight, or the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without consent of the person."
How long can the ovum be fertilized after ovulation?
The human ovum can be fertilized no later than 12-24 hours after ovulation
What are 91-day oral contraceptives?
Some women prefer to take these and have fewer menstrual periods, they take 3-month cycles of active pills and then 1 week of inactive pills. Menstrual periods occur during the 13th week of the cycle. There is no protection from STIs and risks are similar to COCs
What is amenorrhea?
The absence of menstrual flow, which can be a sign of many disorders. The nurse should evaluate if the woman has had the absence of both menarche or secondary sexual characteristics by 13 years of age, the absence of menses by 15 years of age (regardless of normal growth and development (primary amenorrhea)), the absence of menstruation (secondary amenorrhea). Not a disease, but can be a sign of one. Also could be a sign of pregnancy, endocrine dysfunction, polycystic ovarian syndrome, hypothyroidism, or hyperthyroidism. Hypogonadortopic amenorrhea is a problem of the central hypothalamic-pituitary failure and led to amenorrhea. Some causes are potentially reversible (i.e. street, weight loss, weight gain). Otherwise, for endocrine problems can be managed with medication and vitamins.
What happens in the endometrial cycle of menstruation?
The endometrial cycle has four phases- (1) the menstrual phase, (2) the proliferative phase, (3) the secretory phase, (4) the ischemic phase. In the menstrual phase, the compact and spongy layers (the functional parts of the endometrium) are initiated by the periodic vasoconstriction in the upper layers of the endometrium. The basal layer is retained, and regeneration begins near the end of the cycle from cells derived from remaining glandular remnants or stromal cells in this later. Next, the proliferative phase is a period of rapid growth lasting from ~5 days into the cycle until ovulation. The endometrial surface is completely restored in ~4 days, or slightly before bleeding ends. From then, the endometrium thickens with a leveling off of growth at ovulation. This phase depends on estrogen stimulation derived from ovarian follicles. The secretory phase extends from the day of ovulation until about 3 days before the next menstrual period. After ovulation, progesterone levels increase greatly. Now, an edematous, vascular, functional endometrium is now apparent. At the end of the secretory phase, the secretory endometrium reaches the thickness of heavy/soft velvet. This endometrium become luxuriant with blood and glandular secretions, creating a suitable protective and nutritive bed for fertilized ovum. If fertilization and implantation do not occur, the corpus luteum (which secretes estrogen and progesterone) regresses. This decrease in progesterone and estrogen levels sends the arteries into spasm. In the ischemic phase, the blood supply to the endometrium is blocked and necrosis develops. The functional layer separates from the basal layer, and menstrual bleeding beings, marking day one of the next cycle.
What are the key external structures of the female reproductive system?
The external structures of the female reproductive system include the mons pubis, which is a fatty pad that lies over the anterior surface of the symphysis pubis and is covered with coarse/curly hair on a woman post puberty. The labia major are two folds of fatty tissue covered with skin that extend downwards and back from the mons pubis and are also covered with hair after puberty; the labia major protect the inner vulvar structures. Next, the labia minor are the folds of tissue that would be visible when the labia major are separated, the have no follicles but there are sebaceous follicles and sweat glands are present. The labia minor fuse together to form the prepuce, which is a hood like covering over the clitoris. They also fuse to form the frenulum which is the fold of tissue under the clitoris. Next, the labia minor join to form a thin, flat tissue called the fourchette underneath the vaginal opening at the midline. The clitoris is prepuce and is a small structure composed of erectile tissue with numerous sensory nerve endings. The vaginal vestibule is an almond-shaped area which is enclosed by the labia minor that contains openings to the urethra, skene glands, vagina, and bartholin glands. The vaginal opening is in the lower portion of the vestibules and varies in shape and size. The hymen surrounds the vaginal opening. Finally, the perineum is an area between the fourchette and the anus and is a skin covered muscular area that covers pelvic structures. It is a wedge shaped mass that anchors muscles, fascia, and ligaments of the pelvis.
How is family defined? describe various types of families
The family has traditionally been viewed as the primary unit of socialization, or the basic structural unit within a community. The family plays a pivotal role in health care, and the family is the primary target of health care delivery for maternal and newborn nurses. The nuclear family is the "traditional" American family with the husband, wife, and kids (both biologic or adopted). multigenerational families consist of three or more generations in one house (grandparents, parents, children) and is becoming super common in America. Non-biologic parent families are families in which the children live in foster or kin-ship care, such as living with a grandparent. Married-blended families are formed as a result of divorce or remarriage, and consist of unrelated family members (such as stepparents or stepsiblings). Cohabiting-parent families are those in which children live with two unmarried biologic or adoptive parent who may not be living with other adults, these can reseal from the death, divorce, separation, or desertion of the parent's significant other. Alternative families are families that have a person in the LGBTQ community
What is menarche?
The first menstruation of a young woman
What are the key internal structures of the female reproductive system?
The internal structures of the female reproductive system include the vagina, uterus, uterine tubes, and the ovaries. The vagina is a tubular structure that extends from the villa to the ovaries. The lining of the vagina is arranged in the folds called rugae, which allow the vagina to expand during childbirth. The uterus is a muscular organ with a pear-like haps that is positioned in the midline in the pelvic cavity between the bladder and the rectum (above the vagina). The uterus has two parts, the corpus (upper triangular portion) and the cervix (the lower cylindric portion). The funds is the dome-shaped top of the uterus and is where the uterine (or fallopian) tubes enter the uterus. The uterus functions as a place for reception, implantation, retention, and nourishment of the fertilized ovum and later the fetus during pregnancy. The cervix connects the uterus and vagina.
What are the key health issues for women across the lifespan (i.e. adolescents, middle adulthood, etc)?
The key goal for all women in health care is to maintain optimal health done through identification of unrecognized problems and potential risks and the education/health promotion needed to reduce those problems and potential risks. For adolescents, the key health issues are stress, pregnancy, STIs, drug risks, eating disorders, depression, and anxiety. BEcause adolescence is a time where a person develops their identity, sexual orientation, and emancipation from the family, and also a time where they are establishing career goals, teenager often have to deal with a great amount of stress. Health care policy for teenagers is that they should get a Pap smear starting at the age of 21. Another health issue for adolescents and teenagers women is teen pregnancy. Most young women begin having sex in their mid to late teens, but recent studies show that teenage pregnancy is actually decreasing. The nurse should provide information and education about sex and family life because education is shown to reduce the amount of teen pregnancy and STIs. Teenaged pregnancy can also lead to additional stress on a teenager, and can change their emotional level (teens tend to be impulsive and have self-centered behaviors). In young and middle adulthood (~20-40 y/o), the main concern is screening for cancers and other illnesses. Pelvic and breast screening happens yearly (mammograms and Pap smears) and pregnancy care if the woman becomes pregnant. Because this time in a woman's life can be stressful (juggling family life, career, etc), one of the heath goals is to maintain a healthy lifestyle. This means regular exercise, healthy eating and drinking habits, no smoking, sufficient rest, and stress reduction. Common ailments in this age group are vaginitis, UTIs, menstrual variations, obesity, sexual and relationship issues, and finally pregnancy (less of an ailment). Also, parenting at the age of 35 or above can put stress on illnesses a mother may have pre-pregnancy (i.e. diabetes), this can be dangerous to the pregnancy and must be monitored more closely. Finally in late adulthood, women experienced change and reorder in their personal priorities. Many goals have been achieved, and there are new interests being created. There is a higher divorce rate at this age, and teenagers leaving the house so the mother might experience "empty nest syndrome" which can result in depression. Chronic disease can come with this age, and finally menopause comes in this age. Screening continues to be important because breast and ovarian cancer become a little more prevalent.
What is the nurse role in identifying, reporting, supporting, and preventing IPV (e.g. legal responsibility)?
The nurse has an important role in assisting the survivors of abuse- as well as the perpetrators. The nurse should explore her attitudes toward woman in abusive relationships so that the nurse can be her most helpful. The nurse should assess for abuse in all women entering the health care system because this setting could be then only contact that a socially isolated woman could have with someone outside the relationship. Failure to do this may risk the safety of the woman and her children. The nurse should interview the woman suspected of being a victim of abuse in private, never in front of the partner because it could increase the danger that the woman is in and decrease the likelihood for disclosure. The nurse should know that women who are in a current safe relationship can still carry the emotional problems of a previous violent relationship. A therapeutic relationship and interview skills may help abused women disclose their abuse, so language is very important when talking with these women. The nurse should do her best to understand that this is hard for the woman of abuse to tell others about it, the nurse should not be judgmental. To prevent this violence, screening is a common approach to prevent abuse. The US preventative services task force recommend the screening of al women of childbearing age. Nurses can make difference in stopping the abuse of women, so educating the women about their rights and legal services is super important. Prevention can also include promoting assertiveness, self-defense courses, support/self-hip groups that encourage self-regard, confidence, and empowerment. Classes to learn English can be helpful to immigrant women, and helping children to learn problem-solving skills and conflict management management skills may eliminate the need for violence to solve stress
What is endometriosis?
The presence and growth of endometrial tissue outside of the uterus. The tissue may be implanted on the ovaries, anterior and posterior cut-de-sac, broad/uterosacral/round ligaments, rectovaginal septum, sigmoid colon, appendix, pelvic peritoneum, cervix, and inguinal area. Endometrial lesions can be found in the vagina and surgical scars and on the vulva, perineum, and bladder. Endometriosis happens in about 5-15% of reproductive age children, 30-40% in infertile women, and 33% in women with chronic pelvic pain. It can be found in adolescents with disabling pelvic pain or abnormal vaginal bleeding. To manage endometriosis, it depends on the severity of the symptoms. Women without pain who do not want to become pregnant do not need treatment, but women with mild pain who do want to become pregnant may use NSAIDS. Some may use medications such as leuprolide, nadarelin, or goserelin to reduce endometrial lesions. Danazol may be used to suppress FSH and LH secretion. Women who have early symptomatic disease and and can postpone pregnancy may be treated with continuous OCPs that have a low estrogen-to-progesterone ratio and will help to shrink endometrial tissue. The OCPs are taken continuously for 6-12 months without any withdrawal time for the OCP. Surgical intervention is often needed for severe, actor, or incapacitating symptoms. Also endometriosis recurs in approx 40% of women.
What is cystocele?
The protrusion of the bladder downward into the vagina that develops when supporting structures in the vesicovaginal septum are injured. Treatments include vaginal pessary or surgical repair, which involves surgical shortening of pelvic muscles to provide better support for the badder. The nurse can also teach Kegel exercises to the woman and educate her on other treatments.
What happens in the hypothalamic-pituitary cycle of menstruation?
Toward the end of the cycle blood levels of both estrogen and progesterone decrease which stimulate the hypothalamus to secrete gonadotropin-releasing hormone (GnRH). GnRH stimulates the anterior pituitary secretion of follicle-stimulating hormone (FSH), which then stimulates the development of ovarian graafian follicles and the production of estrogen. As the estrogen levels decrease, hypothalamic GnRH makes the anterior pituitary release luteinizing hormone (LH). The increase of LH and small peak in estrogen expel the ovum form the Graafian follicle. LH peaks about halfway through the 28-day cycle. If fertilization and implantation of the ovum does not occur, the corpus lute regresses. Progesterone and estrogen levels decrease again, menstruation occurs, and the hypothalamus is stimulated to secrete GnRH.
Who are considered vulnerable populations? What makes them vulnerable? What factors should nurses consider when caring for vulnerable populations?
Vulnerable populations are people in the African American, Hispanic American, Native American, Pacific Islander, and Asian American communities because of the burden of preventable disease, death, and disabilities compared with non-minorities. These communities are vulnerable in terms of sociocultural, economic, and environmental risk factors that contribute to disparities in heath. Health disparities are conditions that affect a certain racial, ethnic, or minority group. Nurses should consider these factors when caring for vulnerable populations: nurses can focus perinatal care focused on women and their newborns, direct nursing care toward treatment and prevention of other health conditions (i.e. communicable disease or STIs) nurses should be culturally sensitive, compassionate, and critically aware of family dynamics
What happens with IPV among populations (i.e. pregnancy, LGBTQ, etc.)?
Women who are pregnant are at a greater risk for IPV, and the majority of women who experience IPV during pregnancy have been hit before- but for some abuse begins at pregnancy have been hit before- but for some abuse begins at pregnancy. It was estimated that ~300,000 pregnant women in the US are affected by IPV annually.There are even different patterns around IPV and pregnancy: (1) commencement of violence with pregnancy, (2) violence before and during pregnancy, (3) termination of violence with pregnancy, (4) no violence before or during pregnancy. Teens who are pregnant are also at risk for being abused by their partners, and may leave these young women feeling trapped. Women with disabilities are significantly more likely to report experiencing rape, sexual violence, physical violence, stalking, and psychologic aggression that those without disabilities. People who identify as LGBTQ+ community. It may even be heightened because the people in this community have added pressures, such as their partner exposing their sexual or gender identity to their loved ones, friends, or peers.
What is candidiasis?
Yeast infection; second most common type of vaginal infection in the US. Actually common in healthy women, those seen in women with HIV infection are most severe. To screen, the nurse housed bet a complete record of the woman's symptoms, onset, and course to assess for risk factors. Physical examination should include a thorough inspection of the vulva and vagina, and a speculum examination is always done. Vaginal pH is normal with a yeast infection- if the pH is greater than 4.5, trichomoniasis or BV should be suspected. Candidiasis can be treated with anti fungals, such as monistic or gene-lotrimin (over the counter ). Also exogenous lactobaillis (yogurt) and garlic have been suggested for the prevention and treatment of a yeast infection (research inconvlusive). Women who have extensive irritation, swelling, and discomfort of the labia and vulva many find sitz baths helpful in decreasing inflammation and increasing comfort. Women should be instructed to continue the meds even during menstruation and avoid using tampons during menses because the tampon will readily absorb the medication, women should avoid intercourse during treatment.
What is primary dysmenorrhea?
a condition associated with the ovulatory cycle, and appears about 6-24 months after menarche when ovulation is established. This can include painless anovulatory bleeding and is common in the first few months after menarche because both estrogen and progesterone are necessary for primary dysmenorrhea to occur. Management of this problem depends on the severity of the problem, sometimes the application of heat to the lower abdomen, aerobic exercise, relaxation training, biofeedback, and transcutaneous electrical nerve stimulation (TENS). Women can also use dieting and medications to ease dysmenorrhea.
What are diaphragms?
a dome shaped latex or silicone device with a flexible rim that covers the cervix. There are four different types of diaphragms (1) coil spring, (2) arcing spring, (3) flat spring, (4) wide seal rim. Its available in many sizes and can be worn without the woman being aware. If used correctly and in partner with spermicide, the failure rate is only about 4-8%. Women at high risk for HIV should avoid using spermicides with diaphragms. A woman should go to the gyro to get fit for a diaphragm, ad the device should be inspected before every use and should be replaced every two years. The diaphragm should be inserted into the vagina before intercourse. Advantages to a diaphragm are its effectiveness with spermicide, and that it is fit to the woman. The disadvantages of diaphragms include the reluctance of some women to insert and remove it, it can decrease response to sexual stimulation, spermicide can be messy, and can have side effects such as irritation of tissues related to contact with spermicides, and can lead to shock.
What is the vaginal rings?
a flexible ring worn in the vagina to deliver continuous levels of etonogestrel and ethyl estradiol. One vaginal ring remains in the vagina for 3 weeks, followed by a week without the ring. Ring is inserted by the woman and does not have to be fitted. Some wearers may experience vaginitis, leukorrhea, and vaginal discomfort. Withdrawal bleeding occurs during the "no-ring" week. Advantages are that if there is discomfort during coitus, the woman can remove the ring but only for about 3 hours for it to still be effective. the disadvantages are that the side of effects are similar to COCs and the vaginitis, leukorrhea, and the vaginal discomfort.
What is the two-day method?
a symptom-based method based on the monitoring and recording of cervical secretions, and does not involve analyzing the characteristics of the secretions, but each day the woman would ask herself (1) did I note secretions today/ (2) did I note secretions yesterday? and if her answer to those questions is yes then she should avoid coitus or use a backup method of birth control. If her answer to those questions is no, her probability of getting pregnant is very low. after two days without secretions, the woman may resume unprotected intercourse
What is a male condom?
a thin, stretchy sheath that covers the penis and should be applied before genital, oral, or anal contact and is removed when the penis is withdrawn from he partner's orifice after ejaculation. The male condom protects from both pregnancy and STI transmission
What is zika virus?
a virus spreads from the bites of the aedes mosquito, and from sexual contact through semen. Women who become pregnant and are infected by the Zika virus have an increased risk of giving birth to an infant with microcephaly. Zika is also associated with risk for Guillian-barre syndrome which is a neurologic condition that can lead to muscle weakness and possible paralysis. This mosquito is found predominantly in Africa, Southeast Asia, Caribbean, Central America, South America, and the Pacific Islands, also some are found in southeastern US. Pregnant women or women trying to get pregnant should avoid traveling to areas that are known to harbor the Aedes mosquito. Women should use condoms or abstain from sex with male partners who have traveled to. areas identified with transmission of the zika virus. Testing depends on whether pregnant women have symptoms or have been exposed. Asymptomatic pregnant women with ongoing possible zika exposure should be offered zika virus nucleic acid amplification test (NAAT) testing three tries during pregnancy.
What is cyclic peimenstrual pain and discomfort (CPPD)?
a women's symptoms of discomfort during a menstrual cycle. s/s can include mood swings and pelvic pain or discomfort
What is an abortus?
an embryo or fetus that is removed or expelled form the uterus at 20 weeks of gestation or less, weighs 500g or less, or measures 25 cm or less
What is stillbirth?
an infant who, at birth, demonstrates no signs of life, such as breathing, heartbeat, or voluntary muscle movements
What is pelvic inflammatory disease (PID)?
an infectious process that most commonly involves the uterine tubes, uterus, and more rarely the ovaries and peritoneal surfaces. Multiple organisms may cause PID such as N. gonnorhoee and C.trachomatis. Most PID results from the ascending spread of microorganisms from the vagina and the endocervix to the upper genital tract. This spread most frequently happens at the end of or just after menses. PID is difficult to diagnose, so the CDC recommends treatment for it in all sexually active women should be screened for the following symptoms: lowering abdominal tenderness, bilateral adnexal tenderness, and cervical motion tenderness, oral temp of 38.3 or above, abnormal cervical or vaginal discharge, elevated erythrocyte sedimentation rate, elevated C-reactice protein, and laboratory documentation of cervical infection with N.gonorrhoeae and c.trachtomatis. The most important nursing intervention is prevention, but the treatment generally used is a broad-spectrum antibiotic oral medication or may involve a combination of oral and parenteral agents. Analgesics for pain and all other nursing measures applicable to a woman confined to bed.
What is Abnormal uterine bleeding (AUB)?
any form of uterine bleeding that is irregular in amount, duration, or timing and is not regulated to regular menstrual bleeding and affects nearly one-third of women of reproductive age. Can be anovulatory or ovulatory, but is usually caused by anovulation. It is most common during a woman's reproductive years when the menstrual cycle is just becoming established at menarche or when it draws close to menopause. AUB occurs with conditions that give rise to chronic an ovulation such as obesity hyper- and hypothyroidism. The most effective treatment for AUB is oral or IV estrogen. This means the woman can take OCPs
What is the calendar rhythm and standard days method?
based on the number of days in each cycle, counting from the first day of menses. The nurse should teach the woman or couple how to count the woman's cycle and know which days she is fertile. For example, if the shortest cycle is 24 days, and the longest is 30, application of the formula to calculate the period is as follows: shortest cycle: 24-18=sixth day longest cycle:30-11= nineteenth day; the couple would abstain from sexual intercourse during the fertile period (days 6-19). If the woman is very regular her counting would then go as follows: shortest cycle 28-18=tenth day longest cycle= 28-11= seventeenth day the couple would abstain from sex on days 10-17
what is syphilis?
caused by treponema palladium, a motile spirochete, and is transmitted through small abrasions during sexual intercourse. It can lead to serious systemic diseases an Deven death when left untreated. All women who are diagnosed with another STI or HIV should be screened for syphilis and all pregnant women should be screened for syphilis at their first prenatal appointment., in the third trimester, and at the time of giving birth (if they are high risk). Diagnosis depends on the microscopic examination of the lesion tissue. Management for syphilis is penicillin G because it is the only proven therapy that has been wifely used to treat neurosyphilis, congenital syphilis, and syphilis during pregnancy.
What is family planning?
conscious decision on when to conceive or to avoid pregnancy throughout the reproductive years
What is the mini pill?
contains only progesterone hormones, effectiveness is increased if taken correctly. Because the dose is so low, the minipill must be taken at the same time every day, users often complain of irregular vaginal bleeding.
What are the advantages of natural family planning?
low to no cost, heightened awareness and understanding of personal fertility, increased self-reliance, absence of chemicals, instant availability, increased involvement and intimacy with partners, and the ability of the couple to follow religious/cultural traditions
What is hormone therapy?
menopausal hormonal therapy (mht) (estrogen therapy) is hormonal therapy in which a woman takes estrogen and progestins. They are widely prescribed for discomforts associated with perimenopausal years including hot flashes and vaginal/uritary tract atrophy. All women considering HT must understand that research and studies are ongoing and the health care world is still learning. The nurse should provide information and counseling to assist women in making decisions regarding HT use. Women may feel side effects such as headaches n/v, bloating, ankle and foot swelling, weight gain, breast soreness, brown spots on the skin, eye irritation with contras, and depression. Treatment includes medicine, and the education to teach the women on HT.
What is oligomenorrhea?
decreased menstruation (either in amount, duration, or both), infrequent menstrual periods characterized by intervals of 40-45 days or longer and hypomenorrhea to scanty bleeding at normal levels. Treatment is aimed at reversing the underlying cause if possible through the use of progestins. Women with menstruation characterized by prolonged intervals between cycles needs education and counseling.
What is birth control?
device and/or practice used to decrease the risk of conceiving or bearing offspring
What are the disadvantages of natural family planning?
exact time of ovulation cannot be predicted accurately so couples may find it difficult to exercise restraint for several days before and after ovulation, women with irregular menstrual periods have the greatest risk of failure with FAB methods. Also, difficulty with adherence, to strict record-keeping, requirement of male partner support, lower typical effectiveness than other methods, decreased effectiveness in women with irregular cycles (particularly adolescents who have not established regular ovulatory patterns), decreased sponteneity of coitus, no protection from STIs, including HIV infection
Which contraceptive methods are the most effective?
implant and IUDs, pill, ring, patch, or shot (if used perfectly)
What is devo-provera?
injected IM progesterone that is given in the deltoid or gluteus Maximus, there are both considered to be long--acting reversible contraceptives (like IUDs). Should be initiated during the first 5 days of the menstrual cycle and administered every 11-13 weeks. Advantages of DMPA include a contraceptive effectiveness comparable to that of perfect use of COCs. Disadvantages are requirements of injection only four times a year, and the improbability of lactation being impaired. Also include decreased bone mineral density, weight gain, and irregular vaginal spotting
What is contraception?
intentional prevention of pregnancy during sexual intercourse
What is urinary incontinence?
involuntary leakage of urine, and it can affect up to 75% of women across the lifespan, but is more prevalent as women age (i.e. peri-and post- menopausal women). vaginal birth can result in increase incontinence, as well as obesity and smoking. A mild to moderate UT can be significantly decreased or relieved in many women by bladder training and Kegel exercises The nurse should educate the patient on how weight loss, diet changes, and scheduled voiding can help relieve the issue.
What are premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD)?
premenstrual syndrome is a group of symptoms, and is grouped into two syndromes: PMS and premenstrual dysphoric disorder. This is a complex and poorly understood condition that has a lot of physical and psychologic symptoms and begins in the luteal phase of the menstrual cycle. It can affect all age groups, but mostly women in their 20s-30s. To be diagnosed with PMDD, a woman must have five or more affective and physical symptoms present the week before menses, such as symptoms like lability, irritability, depressed mood, feelings of hopelessness, self-deprecating thoughts and/or anxiety. The women also must have decreased interest in usual activities, subjective difficulty concentrating, lethargy, marked change in appetite, hyper-or insomnia, feeling overwhelmed, physical symptoms of breast tenderness, muscle pain, bloating, weight gain. These symptoms need to interfere with work or interpersonal relationships, they should not be caused by another disorder. To manage PMS and PMDD, it really depends on what works for the woman. Any changes that help a woman with PMS exert control over her life have a positive effect. Some find that diet and exercise relive symptoms, so the health care provider may suggest that the woman should incorporate 60 minutes of physical exercise and try to change her diet to include whole grain, legumes, seeds, nuts, vegetables, fruits, and vegetable oils.
What is oral combined (estrogen-progestin combo) hormonal contraceptives?
regular ingestion of combined oral contraceptive pills suppress the action of the hypothalamus and the anterior pituitary, leading to insufficient secretion of FSH and LH, therefore follicles do not matter and ovulation is inhibited. should be taken at the same time every day w water. Advantages to OCPs are that it is more accepted because it is not directly related to a sexual act, improvement in sexual response might occur when possibility of pregnancy is decreased, noncontraceptive health benefits include regulation of cycle, treatment of endometriosis, and reduced incidence. Disadvantages include the amount of estrogen and progesterone agent contained in each tablet have been reduced considerably
What are leiomyomas (uterine fibroids)?
slow-growing benign tumors arising from the muscle tissue of the uterus and are the most common benign tumors of the reproductive system and occur most often after the age of 50. They tend to occur more in African American women, women who have never been pregnant, and women who are overweight. They rarely become malignant. There should be an initial assessment, and based on that, the nurse should educate and counsel the woman about the fear, treatments, and effects on herself. It can be treated pharmacologically, as in NSAIDs for mild cases. GnRH agonists may be prescribed to reduce the size of the leiomyoma. The nurse should teach the woman about the medications and how to take them.
What are contraceptive sponges?
small, round sponges that contain spermicide. The side that is placed next to the cervix is concave for a better fit. The opposite side has a polyester loop for easy removal. To insert, the sponge must be moistened in water before it is inserted, it provides protection for up to 25 hours and for multiple sexual encounters. The sponge should be left in place for at least 6 hours after the last act of intercourse. Advantages of contraceptive sponges are that it is easily insertable and removable. Disadvantages are it can lead to toxic shock syndrome if left in for longer than necessary and spermicide can lead to discomfort in women.
What is spermicide?
spermicide is a barrier method that prevents pregnancy by reducing the sperm's motility by having chemicals attack the sperm flagella and body. To use spermicides the client should insert it into the vagina so that it makes contact with the cervix at least 15 minutes before, and no longer than one hour before sexual intercourse. Spermicide must be reapplied for each additional act of intercourse even if a barrier method is used. Advantages to spermicide are that it can be a good form of contraception. Disadvantages to spermicide are that frequent use can increase the transmission of HIV and can cause lesions, typical failure rate in the first year of spermicidal use alone is 29%, and other barrier methods offer more protection from pregnancy
What is the basal body temperature method?
the basal body temperature is the lowest temperature of a healthy person, taken immediately after walking and before getting out of bed. The BBT varies from about 36.2-36.3 degrees celsius during menses and for approx 5-7 days afterward. About the time of ovulation, a slight drop in temp may occur after ovulation a slight increase in temp may occur. The nurse should teach the woman that the first fertile period is defined as the first day of temperature drop or election through 3 consecutive days of this new temp. Abstinence should behind the first day of menstrual bleeding and last through three consecutive days of sustained temperature rise
What is the symptothermal method?
the method combines BBT and cervical muucus methods with awareness of secondary phase-related s/s of the menstrual cycle. The nurse should teach the s/s to the woman because she will gain fertility awareness as she learns them. Secondary s/s include increased libido, mid-cycle spotting, mttelschmerz, pelvic fullness or tenderness, and vulvar fullness. The woman should palpate her cervix to assess for changes indicating ovulation (i.e. the cerrvical os dilates slightly, the cervix softens and rises in the vagina, and cervical mucus is copious and slippery). The woman notes days on which coitus, changes in routine, illness, and other changes that might affect BBT have occurred
What is the human papillomavirus (HPV)?
virus that has 100 different types and can cause genital warts. Almost 50% of all sexually active women will become infected in their lifetimes, and the highest rate of HPV infection occurs in women aged 20-24 years. HPV types 6 and 11 are responsible for approximately 90% of genital warts. Infections are more frequent in pregnant than non pregnant with an increase incidence from the first to the third trimester. Lesions can become so large during pregnancy that they affect urination, defecation, mobility, and fetal descent. Cesarean birth may be performed when extensive growths are present. To screen and diagnose HPV, the women will have profuse irritating vaginal discharge, itching, dyspareunia or postcoital bleeding, and bumps on her vulva or labia. History of known exposure is important. To screen, there should be physical inspection of the vulva, perineum, anus, vagina, and cervix, only when lesions are suspected. Viral screening and typing for HPV is available but not for standard practice. to diagnose take history, s/s, Pap test, and physical examination. Untreated HPV infection resolves spontaneously in young women because their immune systems may be strong enough to fight the HPV infection. No therapy has been shown to eradicate HPV, and the goal for treatment is removal of the warts and relief of s/s. Pharmacologic treatment may include imiquimo, podophyllin, podofilox, and sinecatechins- but these should not be used in pregnancy. Women should be advised to keep the area dry and clean and to maintain a healthy lifestyle to aid the immune system.
