STD's and Final Exam Material

Human Papilloma Virus symptoms...

** can be prevented by a new vaccine (Gardisil) - Soft grayish cauliflower- like lesions(genital warts) - May cause itching - be friable(bleed), painful

Gonorrhea: Bacteria symptoms...

- 80% asymptomatic (~all pg screened) - purulent, greenish, yellow discharge - Swelling/inflammation of vulva/cervix

Is there a pH difference between Candidiasis, Bacterial Vaginosis and Trichomoniasis? If so what is it for all three?

- Bacterial vaginosis and trichomoniasis the pH is higher than orignal - Candidiasis the pH stays the same

Spontaneous Abortions... Imminent (inevitable):

- Bleeding and cramping increase. - The internal cervical os dilates. - Membranes may rupture.

Chlamydia Bacteria symptoms...

- Commonly asymptomatic - Thin, mucopurulent discharge - Burning and frequency - Lower abdominal pain - Test: NAAT

Contraception: Cervical Cap

- Dr. needs to prescribe and fit - will refit 10-15lbs up or down - no more than 4 hours - use spermicide with it

Herpes Simplex Virus Recurrent lifelong disease symptoms...

- Painful blisters/vesicles - Flu like symptoms - unpredictable recurrence

Spontaneous Abortions... Incomplete:

- part of the products of conception are retained, most often the placenta. - The internal os is dilated

Late causes (greater than 12 weeks- 20 weeks) of miscarriages?

- structural problems (bicornate uterus/ split in half and not enough space) - maternal age - recreational drug use

Spontaneous Abortions... Threatened:

- unexplained bleeding, cramping, or backache indicate that the fetus may be in jeopardy. - Bleeding may persist for days. - The cervix is closed. Maybe followed by partial or complete expulsion of pregnancy, or it may resolve without threatening the fetus.

3 positive signs of pregnancy...

1. FHR is audible 2. palpable fetal movement 3. visualization of fetus via ultrasound

Chronic Villus Sampling

10-12 weeks earliest genetic testing done; can cause fetal limb reduction, spontaneous abortion, Rh sensitization

Amniocentesis

15-20 weeks chromosomal abnormalities during 2nd trimester; can be used again in 3rd trimester for fetal lung maturity Lecithin : Sphingomyelin ration - 2:1 is accepted as mature lungs

With Plan B you must take it __ days after unprotected sex, and within ___ hours is best

5 days 72 hours

What is the most common STD (overall)?

HPV; people can carry HPV and not know

When hemorrhaging HR (increases/decreases), BP (increases/decreases), RR (increases/decreases)

HR increases BP decreases or stays the same RR increases

Hegar's Vs. Goodell's Vs. Chadwick's Sign

Hegar's:softening of lower uterus Goodell's: softened cerix (good and soft) Chadwick's: purple/ bluing of the vaginal canal and cervix

The nurse is educating a group of adolescent women regarding STIs. The nurse knows that learning was achieved when a group member states that the most common sign/symptom of STIs is which of the following? Menstrual cramping Heavy menstrual periods Flu-like symptoms Lack of signs or symptoms

Lack of signs or symptoms

Can you breastfeed while on birth control pills?

NO (has estrogen in pill)

Can you breastfeed on Nuva Ring?

NO- combination of progesterone and estrogen

VEAL CHOP GO

Variable decels Cord compression Early decels Head compression, document Accelerations OK late decels Placental insufficiency variable decels? place in trendelenburg or knee to chest to get pressure off cord, give O2, stop pitocin, call Dr. late decels? place left side lying position, give O2, stop pitocin, call Dr.

Which of the following best describes the clinical signs/symptoms of chlamydial infection in woman? a. Most women are asymptomatic b. Most women complain of a discharge c. Most women complain of pelvic pain d. Most women complain of urinary symptoms

a. Most women are asymptomatic--> this can be very dangerous

Plan B will not work if...

already pregnant

Mucus Method...

assess mucus daily, if clear elastic and slippery, no sex for 4 days AFTER it goes back to normal

The risk of perinatal transmission of HIV can be reduced with antiretroviral treatment. Identification in the preconception period is essential. Which of the following statements about HIV screening in pregnancy is most accurate? Pregnant women: a. Are routinely screened for HIV with all prenatal lab testing b. Must be given the option to opt out of routine HIV testing c. Must provide written consent for HIV screening d. Should be offered HIV screening in each trimester

b. Must be given the option to opt out of routine HIV testing

"Mini pills"

birth control that has progesterone only, and this is OK to breast feed

Non-Stress Test

nothing is added to induce stress REACTIVE: moves at least twice for 15 bpm above baseline in 20 minutes NON-REACTIVE: HR didn't increase with movement, not good but baby could be sleeping so the test is repeated; but if still non-reactive then contraction stress test is done

Contraction Stress Test

stress is added (contractions to uterus by Pitocin OR nipple stimulation - done to see if infant can handle vaginal birth Positive CST: BAD, decels were seen in HR Negative CST: good, no decels seen and infant can handle birth

Explain Calendar Method of birth control...

subtract 11 days from longest cycle and 18 days from shortest cycle, and this is the time period you can't have sex - must record 6-8 months of cycles

Glucose Tolerance test...

to determine if gestational diabetes First... 1 hour test, no fasting, if over 140 then... 3 hour test, fasting (4 blood tests total)

How does the Nuva Ring work?

wear for 3 weeks, and remove for week of period

Mucocutaneous lesions and rash are most commonly seen during which stage of syphilis? a. Latent b. Primary c. Secondary stage d. Tertiary

c. Secondary stage

Naegel's Rule...

date of last menstrual period, subtract 3 months and add 7 days

Birth control pills are a combination of _______ and _________

estrogen and progesterone

Why is Rhogam given? When?

fall, trauma, miscarriage (chance of fetal blood mixing) - mother has to be negative blood type - this is done at 28 weeks and if positive within 72 hours after delivery

What is McDonalds Rule?

fnudal height based off weeks of gestation ex.) 12 weeks gestation--> symphysis pubis, 20 weeks--> umbilicus

Risks of IUD?

high risk of ectopic pregnancy

Why is GBS given? When?

if positive, can cause fetal demise - given 4 hours before labor (special window)

Temperature method...

increase of temperature by a 10th degree, can't have sex for 3 days

How to intervene with PP Hemorrhage?

massage fundus, empty bladder, administer meds (oxytocin), frequent vitals

differentiation between miscarriage and fetal demise?

miscarriage before 20 weeks, fetal demise after 20 weeks

Postpartum Hemorrhage: Sings of impending hemorrhage; excessive bleeding is measured by...

more than 2 pads in 30mins-1 hour - light headed, nausea, pale

Side effects of Plan B?

nausea, cramping, bleeding

Depo Shot has what hormone? How long does it last?

progesterone, OK to breastfeed - lasts 3 months

Stages of Syphillis:

- Primary symptoms: chancre sore Secondary: contagious condyloma, they hurt Latent: no s/s Tertiary: tumors

Trichmoniasis Parasite symptoms...

- Strawberry red marks on cervix - Possibly asymptomatic - yellow, green frothy, malodorous discharge - Pain during intercourse

Spontaneous Abortions... Missed:

- The fetus dies in utero but is not expelled. Uterine growth ceases, breast changes regress, and the woman may report brownish vaginal discharge. The cervix is closed. If the fetus is retained beyond 4 233k s fetal autolysis results in the release of thromboplastin and DIC may develop

Bacterial Vaginosis Bacteria symptoms...

- Watery gray discharge - Possible fishy odor - Test: Clue cells seen on wet mount

Spontaneous Abortions... Habitual (Recurrent):

- abortion occurs consecutively in 3 or more pregnancies.

Spontaneous Abortions... Complete:

- all the products of conception are expelled. - The uterus is contracted and the cervical os maybe closed.

Early causes (less than 12 weeks) of miscarriages?

- chromosomal abnormalities - maternal endocrine disorders - teratogens - immunologic factors or infection

Contraception: Sponge

- must moisten with water before use - can keep in for 24 hours - covers multiple sexual encounters - disposable

MSAFP

16-18 weeks blood test, screens for neural tube defects

What % of pregnancies end in miscarriage? In less than how many weeks?

8-30% 20 weeks

Pulling out is ____% effective

80%... not a good idea

Which of the STIs have an available vaccine?

Hep B, HPV

Do condoms protect against all STIs?

No

Do you have to have intercourse to get an STI?

No

Is HIV testing required for all pregnant women? What if women does not want to be tested?

Not required. Woman must opt out.

A 14-year-old girl and her mother go to her yearly checkup at the pediatrician's office. The nurse wants to offer a new vaccine against the human papilloma virus. Why is it important for the client to receive this vaccine? The human papilloma virus is spread through casual contact in schools. There is only one type of human papilloma virus that infects the genital tract. The human papilloma virus is found exclusively in genital warts. The human papilloma virus is associated with cervical dysplasia and cancer.

The human papilloma virus is associated with cervical dysplasia and cancer.

If you had a woman who was high risk for HIV infection "opt-out" of testing - what might you educate her on?

Risk of transmission to her baby.

What is the most common reportable STD in the United States?

Chlamydia

A woman has a history of toxic shock syndrome. She should be taught to avoid which of the following forms of birth control? A. Diaphragm. B. Intrauterine device. C. Birth control pills (estrogen-progestin combination). D. Depo-Provera (medroxyprogesterone acetate).

A. Diaphragm.

100% pregnancy and STD free contraceptive?

Abstinence

Syphilis Bacteria symptoms...

All pg tested Stages of disease Primary - Chancre x 4wks weight loss, fever Secondary - contagious condyloma Latent - no s/s Tertiary- tumors

A 19-year-old client with multiple sex partners is being counseled about the hepatitis B vaccination. During the counseling sessions, which of the following should the nurse advise the client to receive? A. The hepatitis B immune globulin before receiving the vaccine. B. A vaccine booster every 10 years. C. The complete series of three intramuscular injections. D. The vaccine as soon as she becomes 21.

C. The complete series of three intramuscular injections.

A woman, 26 weeks' gestation, has just delivered a fetal demise. Which of the following nursing actions is appropriate at this time? A. Remind the mother that she will be able to have another baby in the future. B. Dress the baby in a tee shirt and swaddle the baby in a receiving blanket. C. Ask the woman if she would like the doctor to prescribe a sedative for her. D. Remove the baby from the delivery room as soon as possible.

B. Dress the baby in a tee shirt and swaddle the baby in a receiving blanket.

Chlamydia is a leading cause of ______________

INFERTILITY

Menstrual Cycle GO

LH and FSH stimulates immature follicles to start to mature which then secrete large amounts of estrogen (causes endo lining to start to thicken), Estrogen increases, LH rises and progesterone increases, the LH spike mid-cycle causing ovulation, Progesterone then rises (raises temp) and suppresses LH and FSH; if not fertilized Estrogen and Progesterone drop and cycle starts over

Contraception: Condoms

Male: pull back foreskin for non-circumcised Female: **Twist before removing

Mirena IUD lasts... Copper IUD lasts...

Mirena: 3-5 years Copper: 10 years * good for women with children and one partner

A woman has been diagnosed with primary syphilis. Which of the following physical findings would the nurse expect to see? Cluster of vesicles Pain-free lesion Macular rash Foul-smelling discharge

Pain-free lesion

Are there any specific concerns we need to warn women about while taking Flagyl regarding consuming alcohol?

The woman will get VERY SICK if taking Flagyl and drinking alcohol