NUR-209 Mod 1
Conversational Space
18 inches to 4 feet away
Birth Rate
The number of births per 1,000 population
During what years should an annual clinical breast examination begin?
19 - 39
Cultural Compotence
Respecting cultural differences or diversity.
Gonad
A body organ that produces the cells necessary for reproduction - the ovary in females, the testes in males.
What types of changes may occur during menopause?
Physical, emotional and menstrual changes.
What does the AAP recommend to help prevent SIDS?
Place infants on their back to sleep, use room sharing but not bed sharing, avoid exposure to overheating or cigarette smoke and if possible avoid use of pacifiers. These techniques have led to a decrease of 50%
Disadvantages of IUDs
Possible excessive bleeding, cramps and backaches, slight risk of tubal pregnancy, slight risk of pelvic infection on insertion, displacement of the device, and rarely perforation of the cervix and uterus.
What is the most effective form of emergency contraception?
Postcoital Intrauterine Device Insertion
Cultural Values
Preferred ways of acting based on cultural tradtons.
What are some preconception wellness strategies?
Pregnancy intention, access to care, preconception multivitamin with folic acid, tobacco and teratogenic medication avoidance, absense of uncontrolled depressions, healthy weight, absence of STIs, optimal glycemic control in women with pregestational diabetes.
What are the leading causes of neonatal death
Prematurity associated with low birth weight or congential malformations, maternal complications of pregnancy and SIDS.
What is the most important intervention related to family child maltreatment or intimate partner violence?
Prevention, the Nurse can be obsevant for families who seem to be at risk for maltreatment or violence and role model optimal ways to handle family stress.
Benefits of hormonal contraceptives
Prevents pregnancy, decreased cramps/bleeding, regular cycle, decreased anemia and acne, protection from uterine/ovarian cancer/benign breast disease, decreased ectopic pregnancy and incidence of pelvic infection.
Abusive Head Trauma
Previously known as shaken baby syndrome, it is the repetitive, violent shaking of a small infant by the arms or shoulders, causing a whiplash injury to the neck, edema to the brain stem, possible subdural hemorrhage and distinct hemorrhages to the retinas.
Your patient is opting for an induced abortion but are RH negative, what will they require?
Rho (D) immunge globulin (RhoGAM) to prevent isoimmunization.
Perinatal Death Rate
The number of deaths during the time period when a fetus reaces about 500 grams to week 20 of prgenancy, ending about 4-6 weeks after birth. It is the sum of fetal and neonatal rates.
Infant Mortality Rate
The number of deaths per 1,000 live births occurring at birth or in the first 12 months of life.
Neonatal Death Rate
The number of deaths per 1,000 live births occurring at birth or in the first 28 days of life.
Childhood Mortality Rate
The number of deaths per 1,000 population in childen aged 1 to 14 years.
Fertility Rate
The number of pregnancies per 1,000 women of childbearing age
What is important not to assume until clarified when obtaining the patients sexual history?
The nurse must not assume the patients sexual preference, and the nurse must also not assume the patient is married or unmarried.
Internal Os
The opening in the cervix to the uterine cavity.
Cervix
The opening to the uterus that projects into the vagina.
Why is the size of the hymen opening and unreliable indicator of sexual experience?
The opening varies widely among women.
Why are the ovaries not covered in a layer of peritoneum
The ova can readily escape from them and enter the uterus by way of the falloian tubes.
What happens if an ectopic pregnancy causes a fallopian tube to rupture?
The ovum is discharged into the abdominal cavity and the woman experiences agonizing pain, dizziness, faintness and nausea/vomiting due to the peritoneal reaction.
What is a late stage symptom of a ruptured ectopic pregnancy?
The pain becomes generalized in the abdomen and radiates to the shoulder and neck because of accumulating intrapertioneal blood that irritates the diaphragm.
What happens at week 10 during fetal development if testosterone isn't present?
The paramesonephric duct becomes domninant and develops into femal reproductive organs.
How can a breastfeeding mother who has taken Emergency Contraceptive Pills avoid exposing infants to synthetic hormones in her milk?
The patient can manually express milk and bottle-feed for 24 hours after treatment.
Uterus
The pear-shaped muscular organ in a woman's abdomen that houses the developing baby.
Perimenopause
The period around menopause, lasting between 3 and years before the last menstrual period.
Perimenopause - Define and when does it usually occur
The period preceding menopause, can begin as early as 35 years of age
Pain Tolerance
The point at which an individual withdraws from a stimulus
Pain Threshold
The point at which the individual reports a stimulus is painful
What are the three types of spontaneous abortion?
Threatened, inevitable, incomplete, or complete.
Emergency Contraceptive Pills
Three types are available in the US, a properly timed adequate dose of medication after intercourse without effective contraception or when a method has failed can prevent pregnancy by inhibiting or delaying ovulation.
How is menstrual flow discharged?
Through the cervix and into the vagina.
How long is the Uterus? How wide is the uterus at the upper part?
7.5 or 3 inches long, and 5 cm or 2 inches wides at its upper part.
Premenstrual Syndrome
A cluster of physical, emotional and behavioral symptoms that are usually related to the luteal phase of the menstrual cycle.
Permissive Reporters
An individual who reports suspected child abuse and neglect, but is not legally obligated by statute to do so
Your patient is opting for an induced abortion but are anemic, what will they require?
An iron supplement
What may cause menopause to occur earlier in life?
If the ovaries are surgically removed, or are destroyed by radiation or chemotherapy because of an unknown etiology.
What disorder may place a female at risk for premature ovarian failure?
If they are a carrier of Fragile X
True or False: A patient who has taken a Emergency Contraceptive Pill may experience her next menstrual period either a few days earlier or later
True
True or False: Almost all women are able to use an IUD
True
True or False: Condoms made from animal tissue do not protect against the HIV infection
True
True or False: Females who are competitive athletes often experience amenorrhea
True
True or False: For women a urinary retention catheter doesn't usually interfere with coitus
True
True or False: If a woman decides to go to the shelter, let her make the call.
True
True or False: Irregular menstural periods are expected during the first 2 years of menarche.
True
True or False: Just because maltreatment information is in a private interview doesn't mean it can't be reported.
True
True or False: LGB Children are more likely to be abused?
True
True or False: Medical and surgical abortions used in the first trimester are highly effective with low complication rates
True
True or False: Most men with spinal cord injuries can achieve erection with manual stimulation of the penis or psychological stimulation
True
At what week of intrauterine life do external genital develop?
12
What are some inquiries about possible sexual dysfunction using the The P.L.I.S.S.I.T. approach?
"Are you having any problems related to your current sexual performance?"
When does puberty occur in males?
12 to 14 years.
What is the average age at which menarche occurs?
12.4 years, though it may occur as early as 9 and as late as 17.
How much iron is lost during menses? Who would beneift from iron supplements due to this?
11 mg, this is enough loss that many adolescent women could benet from a daily iron supplement to prevent iron depletion during their menstruating years.
What is the diameter of the Cervix?
2 - 5 cm depending on childbearing history.
When does ovulation usually occur?
2 weeks prior to the next menstrual period.
What is the length of the Cervix in a non-pregnant female?
2.5 - 3 cm
When should an annual pelvic exam begin for females?
21
Common complications of implants
22% of Etonogestrel implant users experience amenorrhea, and 34% experienced infrequent spotting, 7% reported frequent bleeding.
Approximately ________ % of women a have experience one of the four types of I.P.V.
27%
How long is a typical menstrual cycle?
28 days, though there are many normal variations from 21 - 42 days
What happens to a fetus if a woman is prescribed a form of testosterone or because a metabolic abnormality she produces a high level of testosterone?
A chromosomal female could be born with male appearing genitalia.
What happens if testosterone secretion is halted in utero?
A chromosomal male could be born with female-appearing genitalia.
Wrongful Life
A claim that neglient prenatal testing on the part of a healthcare provider resulted in the birth of a disabled child
What is the current expected lifespan after menopause for the average woman?
30 to 35 years.
Cystocele
A bladder hernia that protrudes into the vagina.
At what week of intrauterine life does the tissue that will become ovaries and testes form?
5
When can women switch to a mammogram every 2 years?
55 and older, though they can choose to continue annual screening.
How long should a diaphragm remain in after intercourse?
6 hours after, no longer than 12 hours.
What percentage of abortions result from chromosomal anomalies?
60%
Normal sperm count
60-100 million sperm per mL
Where do most out of hospital births occur?
68% occur in the home, and 30.9% occur in a freestanding birth center
How long is the vagina and where does is extend?
7.4 - 10 cm or 3-4 inches in length, it extends upward and backward from the vulva to the cervix.
Resolution phase of sexual response cycle
A 30 minute period after orgasm to which the internal genital organs return to an unaroused state. Men experience a refractory period during which further orgasm is impossible, women do not experience this.
What are some types of uterine deviations?
A bicornutae uterus, a septum-divided uterus, a doube uterus.
NuvaRing
A combination hormonal contraceptive, as effective as oral contraceptives and results in lower hormone blood levels than oral contraceptives. It is flexible and doesn't require sizing or fitting, and is effective when place anywhere in the vagina.
Infertility
A couple's inability to achieve pregnancy after 1 year of unprotected intercourse.
Levator Ani
A deep muscle layer that provides support for the pelvic organs, forms most of the pelvic diaphragm.
Magnet Status
A designation for organizations that have characteristics that make them attractive to nurses as workplaces. These hosspital typically demonstrate a high level of nursing job satisfaction low staff nurse turnover rate and have policies in place that include nurses in data collection and decision making about patient care.
Megan's Law
A federal law that requires law enforcement authorities to report to neighbors when a sexual abuser moves into a neighborhood.
Rape Trauma Syndrome
A form of PTSD demonstrated by many rape victims that has emotional and physical symptoms that can last for weeks. Has two phases - disorganization phase and reorganization phase.
The Cochrane Databse
A good source for discovering evidence-based practices as the organization consistently reviews, evaluates and reports the strength of health related research.
Your client reports that their tampon is difficult to remove and sometimes shreds when it is taken out, what should you advise them to do?
A less absorbent tampon should be used.
Cultural Humulity
A lifelong process of self-reflection and self-critique that begns, not with an assessment of a patient's beliefs, but rather with an assessment of your own.
Epididymis
A long, coiled duct on the outside of the testis in which sperm mature.
The Fern Test
A microscopic slide test to determine the presence of amniotic fluid leakage. Just before obulation when estrogen levels are high cervical mucus forms a fern-like pattern, when progesterone is the dominant hormone after ovulation this pattern is no longer discernible.
The P.L.I.S.S.I.T. model
A model of sexual assessment and intervention that stands for Permission, Limited information, Specific Suggestions, and Intensive Therapy
Physical Neglect
A more subtle form of maltreatment, child may appear unwashed, thin, and malnourished or be dressed inappropriately such as without mittens, a coat, or shoes in cold weather. This is applicable to families where parents can afford these things but do not provide them.
Hymen
A mucous membrane that encircles the introitus.
Prejudice
A negative attitude toward members of a group is an intellectual act.
What type of diet should a woman follow for PMS?
A nutritious diet consisting of whole grains, fruits, vegetables, as well as increased water intake.
Bulbourethral glands
A pair of exocrine glands near the male urethra. They secrete fluid into the urethra. Also called Cowper glands
What are som signs parents are at risk for maltreatment of their child?
A parent who is overly concerned about the physical appearance or sex of the child may have difficulty accepting a child who does not meet these expectations. Also, a parent who is conerned about not letting their children get the upper hand, or thast they had better be good conveys worry about they will act when a child misbehaves.
What tests are performed on a patient prior to abortion?
A pelvic exam to determine uterine size, a pelvic ultrasound, lab studies to confirm the pregnancy, hematocrit to rule out anemia and RH determination, STI screening to prevent introducing pathogens upward through the cervix during the procedure.
Transgender
A person is an individual whose gender identity does not match the sex assigned at birth.
What does F.G.M. violate?
A person's rights to health, security, physical integrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death.
What must the nurse assess the woman for prior to her receiving a diaphragm?
A possible latex allergy.
Mandated Reporters
A professional who is mandated by law to report child maltreatment.
Supernumerary Breast Tissue
A relatively common congenital condition in which abnormal accessory breast tissue is found in addition to normal breast tissue.
Premenstrual dysphoric disorder
A severe form of PMS with significant severity of symptoms.
What are some signs of sexual maltreatment in a child?
A sexual vocabulary beyond their years, girls will have tears or inflammation of the vagina or perneium, both sexes may have rectal tears or symptoms of an STI.
Intrauterine Device (IUD)
A small device, usually T-shaped, that is inserted into the uterine cavity to prevent pregnancy
Race
A social construct, refers to a category of people who share a socially recognized physical characteristic, often skin color of facial features, it can also refer to a group of people who share the same ancestry.
Saplingotomy
A surgical procedure which involves opening and evacuating the fallopian tube and controlling bleeding to salvage the tube during ectopic pregnancy.
Failure To Thrive
A synrdome in which an infant falls below the 5th percentile for weight and height on a standard growth chart or is falling in precentiles on a growth chart.
Helfer & Kempe Triad of Circumstances
A theory regarding why child maltreatment occurs: A parent has the potential to maltreat a child, a child is viewed as different in some way by the parents, an event or circumstance brings about the maltreatment.
Mons pubis
A thick pad of adipose tissue that cover the symphysis pubis and cushions it during intercourse.
Ortho Evra
A thin, beige, matchbook-size skin patch that releases an estrogen and a progestin continuously. It is chanted every 3 weeks and no patch is used during the 4th week resulting in withdrawal bleeding. As effective as oral contraceptives.
Vagina
A tubular-shaped canal lined with glandular mucous membrane.
Threatend abortion
A type of spontaneous abortion in which the cervix doesn't dilate, with bed rest and conservative treatment the abortion may be prevented, though if it cannot the abortion is imminent.
Single Rod Implants
A type of subdermal contraceptive implant that is effective for 3 years, it is usually placed inside the upper arm using a small incision.
bBcornuate uterus
A uterus with paired uterine horns extending to the uterine tubes
Culture
A view of the world and set of traditions a specific social group uses and trasmits to the next generation.
Induced Abortion
A voluntary induced termination of pregnancy performed by skilled health care providers. During the first trimester decision is made by the woman and her physician, during the second trimester the state may regulate practice in the interest of a woman's health.
Multiparous
A woman who has completed two or more pregnancies to the stage of fetal viability.
Nulliparous
A woman who has note completed a pregnancy to the stage of fetal viability.
Clomiphene Citra
AKA Clomid or Serophene, is a an estrogen antagonist that increases gonadotropin release resulting in follicular rupture or ovulation. Used when the hypothalamus is not stimulating the pituitary gland to release FSH and lutenizing hormone.
Gamate Intrafallopian Transfer
AKA GIFT, this variation of IVF is the treatment of choice for patients with ovarian failure, and is considered in unexplained fertility, or if there is religion based discomfort with IVF. The most common indications are irreparable tubal damage, endometriosis, unexplained infertility, inadequate sperm, exposure to DES.
Follitropin Alfa/Follitropin Beta/Urofollitropin
AKA Gonal-F, Follistim and Bravelle, these are used to treat ovulation disorders or to stimulate a follicle and egg productions for intrauterine insemination or IVF.
Intracytoplasmic Sperm Injection
AKA ICSI, an ovum is retreived and a single sperm is injected through the zona pelucida, through the egg membrane, into the cytoplasm of the oocyte. The fertilized egg is then transferred back to the donor.
Urofollitropin
AKA Metrodin and Bravell,e contains FSH with a small amount of LH, used in some disorders to stimulate follicle growth, followed by Clomiphene to stimulate ovulation.
Bromocriptine
AKA Parlodel may be used in treatment for infertility due to elevated prolactin levels.
Flunitrazepam
AKA Rohypnol, a drug easily dissolved in drink used by sexual assaulters to commit date rape.
Tubal Embryo Transfer
AKA TET involves the placement of fertilized eggs or embryos into the fallopian tube, some women chose TET after IVF failure.
Habitual Abortion
AKA recurrent abortion, defined as successive, repeated, spontaneous abortions of unknown cause.
Coitus Interruptus
AKA withdrawal, removing the penis from the vagina before ejaculation. It is considered an unreliable method of contraception.
What is in a safety plan for a victim of abuse?
AN organized plan for departure with packed bags and important papers hidden in a safe spot.
What happens in the follicular phase of ovulation?
An ovum enlarges into a cystic structure called a graafian follicle until it reaches the surface of the ovary, where transport occurs.
What is abnormal uterine bleeding usually secondary to?
Annovulation
Postcoital Intrauterine Device Insertion
Another form emergency contraception, involves insertion of a copper-bearing IUD within 5 days of coitus, prevents fertilization by causing a chemical change in sperm and egg before they can meet.
What methods can you use to enhance teaching about family planning?
Illustrations from books journals, video clips, or models of internal and external reproductive organs, websites set up by health professionals.
What type of clients does the nurse need to be especially observant for signs of maltreatment and hy?
In a family because these increasing during pregnancy and possibly during the care of an ill child.
Diversity
In a population this means there is a mixture or variety of sociodemographic groups, experiences, and beliefs in the population.
Batholin Glands
Located on each side of Introitus, these glands secret mucus through tiny ducts that lie within the labia minora, and are external to the hymen.
What is the most effective reversible method of preventing pregnancy?
Long Acting Reversible Contraceptive AKA LARC, over time they are 20 times more ffective than birth control pills, the patch or the ring.
What is the outer layer of myometrium composed of? What is it's chief function?
Longitudinal fibers, chiefly in the fundus, which provides the power to expel the fetus.
What is the function of the infundibulum AKA the the most distal portion of the fallopian tubes? What are they covered in?
Their wavelike motion helps to pull the egg into the tube. They are covered in fimbriae.
True or False: Most toddlers have some ecchymotic spots on their legs from bumping into tables or chairs during normal toddler activites, as do preschoolers on their knes from play.
True
True or False: The anterior and posterior walls of the vagina normally touch each other
True
True or False: The birth rate in the US is declining
True
True or False: The risks of hormonal contraceptives are rare in healthy women
True
Why do some women experience their first orgasm during pregnancy?
There is no vasocongestion of the lower pelvis becuase of the blood supply needed by a rapidly growing fetus, this may last after pregnancy because the new groth of vessels lasts for some time.
What effect does psychological maltreatment have on childre?
These children are likely to have difficulty becoming emotionally confident adults.
Taboos
Actions not acceptable to a culture.
How can a woman help keep her menstrual symptoms minimal?
Adequate rest, nutrition and exercise.
Why do vaginal tears during childbirth tend to bleed profusely?
They are arterial bleeds from the rich blood supply of the vaginal artery, a brnach of the internal iliac artery.
At what age does the uterus begin to grow in size?
Age 8
What do neighborhoods who have more off-premises alcohol outlets and liqour stores tend to predispose parents to and why?
An increased amount of maltreatment as parents who drink at home are more likely to maltreat when they perceive the child as being bad.
What conditions may causes the ovaries to be present on palpation?
Abnormalities such as an enlarging ovarian cyst causes tenderness and enlargement.
How thick is the uterus?
About 1.25 cm or 0.5 inches thick.
How long are the fallopian tubes?
About 10 cm in length.
What is the only complete means of preventing pregnancy?
Abstinence
The condition of the vagina is basic or acidic? Why?
Acidic, it is a condition that is detrimental to the growth of pathologic bacteria.
Signs/symptoms of a ruptured fallopian tube from an ectopic pregnancy
Air hunger and symptoms of shock may occr and signs of hemorrhage such as a rapid & thready pulse, decreased blood pressure, subnormal temperature, restlessness, pallor and sweating are evident.
Family and Medical Leave Act
Allows employees of government agencies and companies with more than fifty employees to take up to three months of unpaid leave during or after a pregnancy.
Ovaries
Almond-shaped bodies that produce the eggs and hormones, they lie behind the broad ligaments and behind the fallopian tubes.
Spontaneous Abortion
Also known as a miscarriage, occurs in one out of every 5-10 conceptions. Most occur because an abnormality in the fetus makes survival impossible, other causes may systemic disease, hormonal imbalance, or anatomic abnormalities.
What should you do when caring for a patient who speaks a different dialect or language than your own?
Always ask them to repeat your instruction to be certain it was interpreted correctly, and repeat what the patient said so he or she can confirm you understood correctly.
How do you remain objective when dealing with suspected child abusers?
Always assume the parents have done the best they could under the circumstances in which they found themselves.
Depo-Provera
An IM injection every 3 months that inhibits ovulation and provides a reliable, privates, and conveient contraceptive method. Also available in subcutaneous formulations.
What disadvantage are the ovaries at because the are suspended in position rather than firmly fixed in the abdomen?
An abnormal tumor or cyst growing on them can enlarge to a size easily wice that of the organ before pressure on the surrounding organs or the ovarian blood supply leads to symptoms of compressions. This is the reason ovarian cancer is one of the leading causes of death from cancer in women.
Secondary Amenorrhea
An absence of mesnes for three cycles or 6 months after a normal menarche.
In Vitro Fertilization
An assisted reproductive technology, refers to a set of procedures that if successful result in pregnancy, these procedures involve ovarian stimulation, egg retrieval, fertilization and embryo transfer. Ovaries are stimulated to produce multiple eggs or ova usually with medications.
Diaphragm (Mechanical Barrier)
An effective contraceptive device that consists of a round, flexible spring 50 to 90 mm wide covered with a domelike latex rubber cup. Spermicidal jelly or cream is used to coat the concave side of the device before it is inserted deep into the vagina covering the cervix completely.
Clitoris
An erectile organ located beneath the pubic arch, consists of a shaft and glands. It secretes smegma, a pheromone and is sensitive to touch and temperature.
What is the only contraindication to Emergency Contraceptive Pills?
An established pregnancy
Culdoscopy
An examination of the pelvic cavity using an endoscope or culdoscope
Serious Health Condition
An illness, injury, impairment, or physical or mental condition involving such circumstances as inapteitn care or incapacity requiring 3 workdays absence.
What do neighborhoods who have more bars tend to predispose parents to and why?
An increased amount of child neglect, as parents who drink in bars leave children at home alone.
True or False: There is no significant evidence of untoward effects from the use of tampons.
True
True or false: In most males one testis is slightly larger than the other and is suspended slightly lower than the other
True
True or False: Bleeding between menstrual periods by women taking oral contraceptive agents is usually not serious
True,
True or False: Lactating women can use the implants as a means of contraception
True, as are almost all women.
Patient Protection and Affordable Care Act protections for breastfeeding
Mandates work settings with more than 50 employees to provide reasonable break time for a woman to express breast milk for her nursing child for 1 year after the child's birth each time such an employee has need to express breast milk.
What places lesbians at risk for STIs and infection?
Many participate in heterosexual activity and believe they are at lower risk for STis, and if sex toys are used and not cleaned pelvic infections can occur
What is the purpose of estrogens?
They are responsible for developing and maintaining the female reproductive organs and the secondary sex characteristics associated with the adult female. They also play an important role in breast development and in monthly cyclic changes in the uterus.
What is the second part of the The P.L.I.S.S.I.T. approach
BY inquiring about resent sexual activity and sexual orientation such as "Are you having sex? With a man, woman or both?"
What are the advantages of Fertility Awareness Based Methods
They aren't hazardous to health, they are inexpensive, they are approved by some religions that don't approve of other contraceptive methods.
What can happen in the Bartholin Glands that causes pain? How does this pain primarily present?
They can become blocked by cyst formation or infected by abscess formation. Pain interferes with sitting and walking.
What are children who are sexually maltreated at risk for?
They can develop STis or have long-term effects of depression, guilt, and difficulty enjoying sexual relations.
What may happen to the muscles of the pelvic floor during childbirth?
They may become damaged.
Why do adolescents experience abnormal uterine bleeding?
They often do not ovulate regularly as the pituiary-ovarian axis matures.
Why do many women who are victim of I.P.V. complain or generally not feeling well?
They often have high levels of depressions due to the stress or fear and anticipation of impending abuse.
What statements by parents are warning signs for maltreatment during a health maintenance visit for an infant?
Be alert for parents who say things like the baby is nothing but trouble, cries all the time, or is bad. If you ask them how being a new parent is a usual answer should be I'm exhausted but enjoying it, instead of it takes too much time or it's not much fun.
What is a warning signs of maltreatment during the postpartum period?
Be aware of parents who do not touch their infant within 24 hours and those who make disparaging reamrks about the child's appearance, as this lack of contact could signal risk, however keep in mind not all parents immediately bond or react warmly.
Why is the middle layer of the myometrium referred to as living ligature?
Because it is composed of fibers interlaced with blood vessels in a figure-eight pattern, it contracts after childbirth to help control blood loss.
Why do perimenopausal women experience abnormal uterine bleeding?
Because of irregular ovulation secondary to decreasing ovarian hormone production.
Why should Depo-Provera be limited to 2 years of use?
Because of loss of bone mineral density.
What else are children who suffer maltreatment also at risk for?
Because the family home is often a disrpupted one, children often have undiagnosed medical problems, such as anemia, otitis media, or lead poisoning.
What happens to the reproductive organs during menopause and why?
Because the ovaries are no longer active they become smaller.
Why do some studies show lesbians abuse drugs and alcohol more than other women?
Because their social venues may contribute to alcohol and drug use.
What are the disadvantages of Fertility Awareness Based Methods
They require discipline by the couple who must monitor the cycle and abstain from sex during the fertile phase.
What other functions do the fallopian tubes have?
They secrete nutrients for growth and development of the ovum after fertilization while it passes down the tube to the uterus.
What happens to the cells of the graafian follicle after the ovum is dischagred?
They undergo a rapid change, becoming yellow and producing progesterone - a hormone that prepares the uterus for receiving the fertilized ovum.
Surgical Terminations for Induced Abortion
D & C or vacuum aspiration of uterine contents.
What is a characteristic of many adults who maltreat children?
They were maltreated themselves as children, which is why it is important to stop the cycle.
The vagina is _________ walled and can be __________ during birth
Thin walled, and can be distended during birth.
What are the physiologic effects on menopause?
Decreased ovluation, vasomotor instablity/hormonal fluctuations, decreased bone formation and vaginal lubrication, thinning of urinary/genital tracts, increased vaginal P.H., thnning of pubic hair and shrinking labia.
True or False: Minor positions variations of the uterus do not tend to cause reproductive problems.
True, though extreme abnormal flexion or version positoons may interfer with fertility because the sharp bend can block the deposition or migration of the sperm.
Vas Deferens
Tube that carries sperm from the epididymis to the urethra
Fibroids
Tumors that may distort uterine size.
After how many consecutive abortions is the patient referred for genetic counseling and testing?
Two
Labia Minora
Two narrow folds of hairless skin, beginning at the clitoris and extending to the fourchette, this area is high vascular and rich in nerve supply and glands that lubricate the vulva. They join at the top to form the prepuce.
Testes
Two ovoid glands 2 to 3 wide that rest in the scrotum, encased by a protective white fibrous capsule, produces sperm.
What are the signs and symptoms of menopause?
Decreased/lost conception ability, increased infertility, irregular menses with eventual cessation, hot flashes/flushing, night sweats, sleep disturbances, mood swings, fatigue, bone loss, dysparenuia resulting in lack of libido, increased risk for UTI and increased inflammation/discharge
What does F.G.M. represent?
Deep-rooted inequality between the sex, and constitutes an extreme form of discrimination against women.
Seminal vesicles
Two small glands that secrete a fluid rich in sugar that nourishes and helps sperm move
What is an early sign of ectopic pregnancy?
Delay in menstruation from 1 to 2 weeks followed by slight bleeding or a report of a slightly abnormal period suggests the possibility of an ectopic pregnancy.
Wrongful Conception
Denotes that contraceptive measure failed allowing an unwanted child to be conceived and born.
What conditions are survivors of incest and childhood sexual abuse more prone to?
Depression, PTSD, morbid obesity, marital instability, GI Problems, and headache.
Patricia Benner's Nursing Theory
Describes the way nurses move from novice to expert as they become more experienced and prepared to give interprofessional care.
Female Condom
Developed to give control of barrier protection to women and to provide them with protective from STIs, HIV and pregnancy. Consists of a cylinder of polyurethane enclosed at one end by a closed ring that covers the cervix and the other end by an open ring that covers the perineum.
Gynecomastia
Development of breast tissue in males
True or False: Most childhood injuries are unintentional
True, as most are the result of injuries caused by the child's inability to distinguish safe situations from dangerous ones or by parents overestimating their child's ability to do things like lighting a fire or using a saw.
What are some indicators of psychological maltreatment in children?
Developmental delays, bed-wetting without medical cause, frequent psychosomatic complaints, severe depression, anxiety, aggression, self-destructiv behaviors, child is overly compliant, child models emotional abuse playing with other children.
True or False: More boys attempt suicide between the ages of 10-19 than girls
False, more girls attempt suicide, but boys are more succesful.
True or False: Nurses are Permissive Reporters
False, nurses are mandated reporters.
True or False: Orgasm can cause a spontaneous miscarriage
False, though levels of oxytocin do rise during orgasm, this rise is not enough that it will lead to premature labor.
True or False: Even with proper insertion the partner will still feel the diaphragm during intercourse
False, when properly fitted and inserted it is not felt by the user or her partner.
What are some common symptoms when menstruation begins?
Fatigue, some discomfort in the lower back, legs and pelvis, as well as temperament or mood changes.
What other causes aside from age may cause abnormal uterine bleeding?
Fibroids, obesity and hypothalamic dysfunction.
What is the Cervix composed of?
Fibrous connection tissue
How do normal testes feel?
Firm and smooth and are egg shaped.
True or False: Out of hospital births are predicted to increase in the future
True, as women who choose these settings feel they have a greater control in their birth experience and their family can be more involved in the birth.
What are the priorities when planning treatment for a suspected victim of maltreatment?
First, ensure the safety of the maltreated family member and minimize the effects of trauma, second report the discover to the authorities as nurses are mandates reports by law if it is a child.
True or False: Any fracture in a nonmobile infant is always suspicious
True, especially long bone fractures.
Labia Majoria
Two thick folds of connective tissue covered with ubic hair, they cover the ova-shaped area known as the vestibule where the labia minora orginates.
How should HT be used for menopause?
With the lowest dose possible for the shortest time possible due toe the risk of complications the longer HT is used.
What did Masters discover about masturbation
Women may find masturbation to rogasm the most satisfying sexual expression and use it more commonly than men.
True or False: Most children who are sexually abused will not have a physical finding on examination
True, less than 5% of children do and oh god why do I have to study this, this is horrible, I want to vomit and I am completely losing my faith in humanity.
What are the UN/WHO global health goals?
To end poverty/hunger, achieve universal primary education, promote gender equality and empower women, reduce child mortality, improve maternal health, combat HIV/Aids, malaria and other diseases. ensure environmental sustainability, develop global partnership for development.
What are the two main overarching national health goals?
To increase quality and years of healthy life, to eliminate health disparities.
How can women best manage the symptoms of PMS?
To keep a record of their symptoms so they can anticipate and cope with them.
True or False: No ovarian hormones are produced during menopause
True, no more ova mature.
What is the purpose of obtaining a sexual history?
To obtain information that provides a picture of a woman's sexuality and sexual practices and to promote sexual health. It may lead to discussion about STI's, unintended pregnancies, and ways of reducing high risk sexual behaviors.
Once an official report of child maltreatment has been made, how long can a hospital hold a child for protection?
For 72 hours to give an appointed casworker time to investigate whether maltreatment has occurred, after the 72 hours a court proceeding will determine whetehr the child should be returned to the parents care or kept in a safer location.
Androgens
Hormones produced by the ovaries and adrenal glands in small amounts that affect many aspects of female health including follicle development, libido, oiliness of hair and skin, and hair growth.
Why does the open pathway of the fallopian tubes leave a path for infection?
Because tubes are open at their distal ends, a direct pathway exists from the external genital organs, through the vagina to the uterus and tubes, to the peritoneum. This open pathway is what makes conception possible, but also leaves a path for infection to spread from the perineum through the uterus and tubes to the pelic cavity.
Your client who has a history of habitual abortion reports bleeding, what should she do to attempt to save the pregnancy?
Bed rest, administration of progesterone to support the endometrium , sexual abstinence, a light diet, and no straining on defecation are attempted to save the pregnancy. If infection is suspected antibiotic agents may be prescribed.
When should a positive parent-child interaction have begun by>?
By the time they arrive for their inital health maintenance visit.
When is additional spermicide necessary when using a diaphragm?
If more than 6 hours have passed before intercourse occurs and before each act of repeated intercourse.
Public Space
Any distance beyond business space such as shouting across a parking lot.
Sexual Maltreatment
Any sexual contact between a child and adult.
What factors can the nurse educate a client to consider when picking a healthcare setting for their family
Are personnel interested in you as well as your child, do they ask about family concerns and individual ones, can the setting be reached easily, will staff provide continuity of care, does physical setup provide sense of privacy yet a sense that providers share pertinent information so you don't have to repeat your history each visit, is the cost of care and referrals to specialists explained clearly, are preventive care and education stressed, is education done at your learning level, do providers respect your opinion and ask for your input, will it be accessible if a family member becomes disabled?
How should you refer to menstrual cycle?
As a period, rather than "being sick."
What method is an IUD as effective as? More effective than?
As effective as sterilization, and more effective than barrier methods.
How long should mammographies continue for?
As long as the woman is in good helath, and is expected to live 10 more years or longer.
When should Emergency Contraceptive Pills be taken?
As soon as possible, and within 5 days of unprotected intercourse.
Briefly describe the process of IVF
As the appropriate time the ova recovered by transvaginal ultrasound retrieval, sperm and eggs are co-incubated for up to 36 hours, and the embryos are transferred about 48 hours after retrieval.
Why are vaginal douches or sprays not regularly recommended?
As they interefere with the natural acidic medium of the vagina, opening it up to infection.
What ethnic backgrounds are predisposed to hereditary breast and ovarian cancer mutations?
Ashkenazi Jewish Populations
When obtaining a sexual history what label may some women find inappropriate, and how can this be avoided?
Asking a patient to label herself as single, married, widowed, or divorced. Asking about a partner or about current meaningful relationships may be a less offensive way to initiate a sexual history.
What are some strategies to provide sensitive care following abuse, maltreatment and neglect?
Assure them they're not along and that you believe no one should be hurt and the abuse is that of the batterers and against the law, and that all info will be kept confidential though it will be on the medical record, document a statement and photograph any visible injuries in written formal consent has been obtained.
Secondary Infertility
At least one conception has occured but currently the couple cannot ahieve a pregnancy.
At what age do the ova begin to mature causing the menstrual cycle to begin?
At puberty, usually between 11 - 13 years of age.
Why is pain the vulvar area diminished druing child birth?
At the time of birth normal stretching of the perineum causes a temporary loss of sesnation to the area, limiting the amount of local pain felt during childbirth.
When should girls be educated about their menstrual cycle?
Before it occurs.
Cultural Awareness
Being aware cultural differences exist.
Between what ages should a woman receive an annual mammography?
Between 45 to 54 years.
Business Space
Beyond 4 feet
The vaginal wall is so thin at the fornices that an examiner can plapate the ____________ through the anterior fornix, the ___________ through the lateral fornices, and the _________ through the posterior fornix
Bladder, ovaries, rectum.
Why is postemnopausal bleeding a cause for concern?
Bleeding 1 year after menses cease at menopause ma indicate a malignant condition must be considered until proven otherwise.
Metorrhagia
Bleeding between regular menstrual periods.
Risks of hormonal contraceptives
Breakthrough bleeding, breast tenderness, nausea, weight gain, mood changes, small increased risk of blood clots stroke or heart attack but these are related to smoking, possible incidence of benign liver tumor and gallbladder disorders, no protection from STIs
With the use of extended regimens of oral hormonal contraception what can women expect an increased incidence of?
Breakthrough bleeding, the blood may be dark brown rather than red.
What do some women report 1 to 2 days before menstruation begins?
Breast tenderness and a feeling of fullness.
What does the 3 B's stand for?
Burns on Babies are nearly always Bad.
How can the nurse assess for risk of STIs when interviewing a client about their sexual history?
By asking about the number of sexual partners in the past year or in the patient's lifetime.
How can the nurse begin The P.L.I.S.S.I.T.
By explaining the purpose of explaining a sexual history, such as "I ask all my patients about their sexual health, may I ask you some questions about this?"
What advantage does obtaining a sexual history offer the nurse?
By incorporating sexual history into the general health history, the nurse can move from areas of lesser sensitivity to areas of greater sensitivity after establishing initial rapport,
How should your female client describe the amount of bleeding to their primary provider?
By pad/tampon count and saturation.
How do oral contraceptives prevent pregnancy?
By preventing the release of FSH from the anterior pituitary gland, in the absence of FSH a follicle doesn't ripen and ovulation doesn't occur.
How can you instruct your client to perform the Spinnbarkeit Test?
By stretching a cervical mucus sample between their thumb and finger
How can women who take Emergency Contraceptive Pills minimize the common side effect of nausea?
By taking the medication with meals and with an antiemetic agent.
Where are androgenic hormones produced in females?
By the adrenal cortext and the ovaries.
When does the Endomterium slough?
If pregnancy does not occur - resulting in menstruation, if pregnancy occurs it sloughs after delivery.
What are women who identify as LGBT at a high risk for?
Cancer, heart disease, depression, and alcohol abuse.
Transcultural Nursing
Care guided by cultural aspects and respects individual differences.
What can the nurse ask their agency to do to help assist with cultural practices
Change a policy to accomodate family's cultural preferences such as the length of visiting hours, type of food served, oy type of hospital clothing provided.
What are some practices of physical neglect?
Child is inappropriately dressed, malnourished, parents fail to seek early medical care for an infection, parents don't require the child to attend school or delibriately keep child out of school without setting up home school program, allowing child to go unsupervised after school.
What are some signs of sexual maltreatment in children
Child reports it, child demonstrates awareness of sex & vocabulary, participates in expression with dolls, girl younger than 15 of age is pregnant, signs of tears on exam, child younger than 15 has an STI, anxiety, sleep disturbance, nail biting, stuttering, change in school performance/phobia/truancy, child is afraid to be alone with certai nadult, vague abdominal pain or acts out.
What are some common traits of emotionally maltreated children?
Childen whose parents do not interact with them are apt to be more withdrawn and to have a flatter affect than others.
What age children are usually subject to deliberate poisoning?
Children younger than 2.5 years of age
What is the inner layer of myometrium composed of? What is it's chief function?
Circular fibers that are concentrated around the internal cervical os to help keep the cervix closed during pregnancy.
In females with delayed puberty or primary amenorrhea what should you assess for?
Clinical features of Turner syndrome such as short stature, webbing of the neck, widely spaced nipples.
What cultural practices can be mistaken for child abuse?
Coin rolling, at ype of massageto draw illness out of the body used by some Asian cultures in which a coin is heated and then vigrously rubbed over the body, leaves red welts on the back similar to those that would appear on a child who has been struck repeatedly.
What are the two types of hormonal contraception
Combination progestin and estrogen, or progestin only
Female Genital Mutilation or Cutting
Comprises all procedures that involve partial or total removal of the external female genitalia or other injury to the female genital organs for non medical reasons, it is recognized as a human rights violation.
Dorothea Orem's Nursing Theory
Concentrates on examining patients ability to perform self care.
Psychological Maltreatment
Constant belittling or threatening, rejecting, isolating, or exploiting a child, or is the absence of positive parenting.
What type of therapy may be effective in relieving primary dysmenorrhea?
Continuous low-heat therapy - this works well in conjunction with medication therapy.
What may be necessary to diagnose Facitious Disorder
Covert video surveillance.
What symptoms characterize Dysmenorrhea?
Crampy pain that begins before or shortly after onset of menstrual flow and continues for 48 to 72 hours.
Ritual Maltreatment
Cult-based or religiously, spiritually, or satanically motivated and typically involves physical, sexual or psychological maltreatment with bazarre or ceremonial activities. With this type of maltreatment, multiple perptrators may maltreat multiple victims over an extended period.
What are the steps, from least to most, of the cultural competence continuum
Cultural destructiveness, cultural blindness, cultural awareness, cultural sensitivity, cultural competence, cultural humility.
Mores
Cultural norms.
Menstrual Cycle
Cycle during which an egg develops and is released from an ovary and the uterus is prepared to receive a fertilized egg.
What conditions are older women at risk for? Why are these often dismissed?
Diabetes, dyslipidemia, hypertension and thyroid disease, they are often dismissed as they are viewed as typical signs of aging.
Dyspareunia
Difficult or painful intercourse, may be superficial, deep, primary or secondary.
Always assess for injuries in children that ____________
Do not match a child's developmental level or abilities or injuries that do not match the explanation of how the injury occurred.
Intimate Partner Violence
Domestic violence or battering between two people in a close relationship
Nonhormonal IUDs
Don't release any hormones, is effective for up to 10 years.
Why are girls beginning puberty at the ages of 8 to 11?
Due to a combination of better nutrition and increased obesity.
Why is breast cancer apt to metastize quickly?
Due to the rich blood supply of the blood tissue.
What is the leading cause pregnancy death in the firs trimester?
Ectopic Pregnancy
Contraindications to medication induced abortion
Ectopic pregnancy, adrenal failure, allergy to the medication, bleeding disorder, irritable bowel syndrome or uncontrolled seizure disorders.
What should the nurse inform the menopausal patient receiving HT?
Educated about the signs and sy,ptoms of DVT and PE, women need to be informed about the importance of regular follow up care including a yearly physical exam and mammogram.
Advantages of IUDs
Effectiveness over a long period of time, few if any systemic effects, and reduction of patient error.
Elevated levels of what in the blood inhibit F.S.H. secretion and promote L.H. secretion?
Elevated estrogen levels
Elevated levels of what inhibit L.H. secretion?
Elevated progesterone levels
Common cause of Menorrhagia in young women
Endocrine disturbances
What does Depo-Provera reduce the risk of?
Endometrial cancer, PID, endometriosis, uterine fibroids.
What effect does testosterone have on girls?
Enlargement of the labia major and clitoris, and the formation of axillary and pubic hair.
What do the ovaries produce?
Estorgens and progesterone.
What is the most potent estrogen produced by the ovarian follicle?
Estradiol
What prepares the breast for producing and secreting milk?
Estrogen and progesterone
What happens if the ovum is fertilized?
Estrogen and progesterone levels remain high, and the complex hormonal changes of pregnancy follow.
When should a patient who has taken a Emergency Contraceptive Pill return for a pregnancy test?
If she has not had her menstrual period in 3 weeks and should be offered another visit to provide a regular method of contraception if she doesn't have one currently.
How often should a woman obtain a paper smear?
Every 3 years from 21-29
How often should a woman obtain a paper smear from ages 30 to 64?
Every 3 years, or cytology and HPV testing every 5 years.
What type of evidence helps guide healthcare actions from tradition to a solid, safer and scientific basis?
Evidence obtained from randomized controlled trials.
What should a woman do each time she uses a diaphragm?
Examine it carefully by holding it up to bright light to ensure that it has no pinpoint holes, cracks or tears. Once this is done apply spermicidal jelly or cream. When removed it should be cleansed thoroughly with mild soap/water, rinsed, dried and stored in its original container.
What should you inform your client about using alternative therapies for hot flashes? What are some examples?
Examles in clude natural estrogens and progestin, black cohosh, ginseng, donquai, soy product. Inform your patient that scant data exists about thweir safety and effectiveness.
Menotropins
Examples include Repronex and Pergonal, these are combination of LH and FSH, used to stimulated the ovaries to produce eggs. Used in women with deficincies in LH and FSH.
What is thought to cause Dysmenorrhea?
Excessive production of prostalgandins causing painful contraction of the uterus.
Stereotyping
Expecting a persdon to act in a charateristic way without regard to their individual traits.
What happens if the ovum isn't fertilized?
F.S.H. and L.H. output diminished, estrogen and progesterone secretion falls, the ovum disintegrates and the endometrium which has become thick and congested becomes hemorrhagic producing menstrual flow
What should the patient be informed of if they repeatedly use emergency contraception?
Failure rate with this is higher than regularly used method.
Why should you ask about the start and completion of puberty?
Failure to complete puberty can lead to infertility.
True or False: Most women with spinal cord injuries can still experience orgasm
Fals, but they are able to conceive and have children.
True or False: Bleeding between menstrual periods by women receiving hormone therapy is usually not serious
False
True or False: Nurses investigate the concern of maltreatment
False, Nurses do an initial screening to assess the need for referall and reporting, the agnecy's patient protective services department will do the actual investigation.
True or False: A healthcare provider can be sued for making unintentionally false maltreatment reports.
False, as long as it is in good faith.
True or False: Condoms provide full protection from STIs
False, because HPV may be transmitted from skin-to-skin contact, and other diseases may be transmitted if any abraded skin is exposed to body fluids.
True or False: Perpetrators of I.P.V. can't change
False, however change can only occur with extensive counseling and motivation.
True or False: Violence is often a one time occurrence in a relationship
False, it is rarely a one time occurence, and usually escalates and continues in severity.
True or False: The number of children born to women older than 40 years of age is steadily decreasing
False, it is steadily increasing.
Facitious Disorder
Formally known as Munchausen Syndrome, refers to a parent who repeatedly brings a child to a healthcare facility and reports symptoms of illness when in fact the child is well. Parents may pick difficult to diagnose conditions like abdominal pain or seizure, or intentionally harm the child.
When age ranges does Maternal and child health nursing cover?
From preconception to menopause
What can cause secondary amenorrhea?
Functional hypothalamic amenorrhea, pituitary disease, primary ovarian failure, pregnancy, breast-feeding, menopause, too little body fat, eating disorder, thyroid disease, or polycystic ovary syndrome.
What type of questions should a nurse use for a patients who identify as LGBT?
Gender neutral
What are some common causes of Primary Amenorrhea?
Genetic and anatomical disorder, turner syndrome, anorexia, polycystic ovarian syndrome.
Aside from estrogen and progresterone what other hormone affects the rate of F.S.H. and L.H. release
Gonadotropin-releasing Hormone (GnRH) from the Hypothalamus
In what order do pubertal changes occur in girls?
Growth spurt, increase in the transverse diameter of the pelvis, breast development, growth of pubic hair, onset of menstruation, growth of axillary hair, vaginal secretions.
What are teenagers who identify as LGBT at risk for?
HIV, STIs, smoking, depression and suicide.
What are some signs of maltreatment in a child?
Head trauma, missing patches of hair, cigarette burns, burn on dorsal surface of hand, hidden or excessive bruising, scalded feet and legs, nail biting & other stress mannerisms, multiple fractures in different stages of healing.
What opportunity does menopause offer?
Health promotion and disease prevention education and counseling.
What are the 4 QSEN comptencies to care for families during child-bearing and childrearing years?
Health promotion, health maintenance, health restoration, health rehabilitation.
What topics should nurses educate older women about?
Heart disease prevention, pharmacology, diet, signs of dementia or cognitive decline, fall prevention, osteoporosis prevention, gynecologic and breast cancers, and sexuality.
What therapies are effective for treating period cramps?
Heating pads or N-Saids.
Menomterorrhagia
Heavy vaginal bleeding between and during periods.
Progesterone Vaginal Suppositories
Help improve the uterine lining after ovluation.
What is included in long-term planning for maltreatment victims?
Helping a maltreated family member find safe refused and re-establishing self-esteem through a self-help or advocacy program. Teaching empowerment is also important for older children and women in families where there is maltreatment or violence.
Retocele
Herniation of the rectum wall into the vagina.
What are some support people that parents can get for assistance?
Home visits, family cousneling and therapy and referall to organiations for parents who maltreat children, such as Parents Anonymous.
What are the two types of IUDs?
Hormonal and nonhormonal
Complete Abortion
If the fetus and all related tissue are spontaneously evacuated, no further treatment is required.
In what type of countries does the fertility rate tend to be high?
In countries where the average woman has access to good nutrition and feels safe to begin a family.
In what type of countries does the fertility rate tend to be low?
In countries where there are fewer nutritional resources as poor nutrition makes conceiving diffiuclt, as well as in countries where the propotion of young adult men is low because of war or disease.
Prostate Glands
In human males single gland that lies below the bladder and surrounds the top of the urethra secretes a thin akaline fluid that helps sperm move and survive
Why is it important to explain the use of Speculum to a patient?
In some developing countries these are not be used, and it may resemble a form of F.G.M.
Where is the fourchette located?
In the midline below the vaginal opening where the labia majora and minora merge.
When does spontaneous abortion most commonly occur?
In the second or third month of gestation.
Hostile Work Environment Sexual Harassment
In which an employee feels uncomfortable and exploited such as being addressed as "honey" or "baby" and being asked to wear revealing clothing, or working where the walls are decorated with sexist posters.
Quid Pro Quo Sexual Harassment
In which an employer asks for something in return for sexual favors such as hiring or promotion preference.
What is the order that secondary sex characteristics usually occur in boys?
Increase in weight, growth of testes growth of face, axillary and pubic hair, voice changes, penile growth, increase in height, spermatogenesis.
Clinical manifestations of menopause
Increased body fat, intra-abdominal deposition of body fat, levels of total and LDL cholesterol increase, hot flashes occur due to alterations in thermal regulation. Other signs include irregular menses, breast tenderness, and mood changes long before menopause occurs.
Common causes of Menorrhagia in older women
Inflammatory disturbances, tumors of the uterus, hormonal imbalance.
Causes of Dyspareunia
Injury during childbirth, lack of vaginal lubrication, history of incest, sexual abuse, or assault, endometriosis, pelvic or vaginal nfection, vaginal dryness due to breast-feeding or menopause, GI disorders, fibroids, STIs, vulvodynia.
Your client is pregnant and states that her extreme breast sensitivity has made her enjoy getting her breasts licked more, but is worried this may release oxytocin and cause labor
Instruct your client that this isn't contraindicated unless she has a history of premature labor.
Where is the ovum discharged into?
Into the peritoneal cavity, usually finding it's way into the fallopian tube where it is carried to the uterus.
What is the treatment of choice for severe male interfility?
Intracytoplasmic Sperm Injection
What are the progestin-only methods of hormonal contraception
Intrauterine system, implant, injectable and the mini pill.
Methods of hormonal contraception
Intrauterine, implantable, injectable, oral, transdermal or intravaginal.
When a woman lies on her back for a pelvic examination, the course of the vagina is what?
Inward and downward.
What must women be prepared for with continued use of Depo-Provera?
Irregular bleeding episodes and spotting decrease, or amenorrhea.
Side effects of Depo-Provera
Irregular menstrual bleeding, bloating, headache, hair loss, decreased sex drive, bone loss, weight loss or weight gain, bone loss though this is usually reversed when injections are stopped.
Abnormal Uterine Bleeding
Irregular, painless bleeding of endometrial origin that may be excessive, prolonged, or without pattern
What is the role of progesterone during pregnancy?
It becomes a function of the placenta and is essential for maintaining a normal pregnancy.
In what ages does abnormal uterine bleeding usually occur?
It can occur at any age, however it is common at opposite ends of the lifespan. Common in adolescents and women approaching menopause
Why is evaluating fetal death rates important?
It evaluates the overall health of a nation because it reflects the overall quality of maternal health and whether common services such as prenatal care are available.
How does the appearance of the external ox change after childbirth?
It is round before the first birth, and often slitlike in shaped after childbirth.
How would the pelvic diaphragm be described when viewed from above?
It looks like joined cupped hands.
What should women be advised about regarding pain during intercourse?
It should never been painful, and that pain should be investigated by a care provider.
Your client notes they have an absence of smell, what could this indicate?
Kallman Syndrone, which if untreated can lead to infertility.
Fertility Awareness Based Methods
Knowing and recognizing when the fertile time occurs in the menstrual cycle, if the couple is using it as birth control they need to avoid having intercourse during the fertile period. When used as a contraceptive during the first year of typical use up to 18 women out of 100 will become pregnant.
What type of clients can use Depo-Provera
Lactating women, women with hypertension, liver disease, migraine headaches, heart disease, and hemoglobinopathies.
"Every Woman Every Time" Campaign
Launched to encourage health care providers to address reproductive health choices every time a woman has contact with a healthcare system.
When is sperm count low enough to cause infertility?
Less than 20 million sperm per mL
What are some physical characteristics of failue to thrive?
Lethargy, poor muscle tone, loss of subcutaneous fat, skin breakdown, lack of resistant to examiners manipulation, rocking on all fours excessively, greate reluctance to reach for toys or initiate human contact, staring hungrily at people as they are deprive for contact, little cuddling or conforming to being held, delays in sitting/standing/crawling/walking, delayed or absent speech.
Prepuce
Located at the top of the labia minora, this is a hoodlike structure that partially covers the clitoris.
Urinary Meatus
Located below the clitoris, this is the external opening of the female urethra, and has a lit apperance.
Introitus
Located below the meatus, this is the vaginal opening,.
Skene Gland
Located in the urethral meatus, it is a gland that produces mucus for lubrication.
What treatment may women obtain aside from HT for hot flashes?
Low dose effexor, psychoeducational approach, diet and lifestyle changes, vitimain B6 and vitamin E may also be effective
What are the advantages of circumcision?
Lower rates of UTIs, HIV, STis and penile cancer.
Gonadotropin-Releasing Hormone Agonists
Lupron and Synarel, suppress FSH and prevent premature egg release, and shrink fibroids.
Spermicides
Made from nonoxynol-9 or octoxynol and are available over the counter as foams, gels, films and suppositories.
Level 2 of Intimate Partner Violence
Maltreatment is becoming more frequtn, beatings are sustained and cause fractures such as a broken jaw or rib fracture.
Level 3 of Intimate Partner Violence
Maltreatment is even more frequent, perhaps daily. A weapon such as a gun, baseball bat, or broom handle may be used. Permanent disability or death from injuries such as intracrnail hemorrhage or concussion may occur.
Level 1 of Intimate Partner Violence
Maltreatment is ocassional, consiting of slapping, punching, kicking, verbal. Contusions occur.
Menopausal Period - Define and when does it usually occur
Marks the end of reproductive capacity, usually occurring between 45 and 55 years of age
What factors can cause fetal deaths before birth?
Maternal factors such as premature cervical dilation and maternal hypertension, and fetal factors such as chromsomal abnormalities or poor placental attachement.
CHronic gonadotropin
May be used in polycystic ovarian syndrome to induce regular ovulation.
Reorganization Phase of Rape Trauma Syndrome
May last months or years, characerized by recurring nightmares, sexual dysfunction, continuing inability to relate to the opposite sex or to face new situations. Many change their residence at great sacrifice to finances and lifestyle.
Cultural Assimilation
Means people blend into the general population or adopt the values of the dominant culture.
Hormone Therapy
Medications that containes estrogen or estrogen and profestin together to replace the ones the body is no longer making, this practice is controversial but is prescribed to treat moderate to severe menopause related vasomotor symptoms in women without contraindications.
Why may children assume a role reversal when suffering maltreatment?
To prevent maltreatment, children may assume a role reversal with the parent or become the comforting, solacing person, as they recognize very early when the parent becomes upset they will be hurt.
What topics should the nurse obtain aside from general topics during the health history specific to a womans health?
Menstrual history, pregnancies, exposure to meds, dysmenorrhea/dyspareunia, symptoms of vaginitis, problems with urine/bowels, sexual history, STis/treatment, current or previous sexual/physical abuse, reproductive surgery, illness that may affect health/reproduction, family history of genetic disorder.
What pharmacological therapy is used to manage ectopic pregnancies?
Methotrexate, which stops the pregnancy from progressing by interfering with DNA synthesis and the multiplication of cells, interrupting the early, small, unruptured ectopic pregnancies.
What is the most significant form menstrual dysfunction and why?
Metorrhagia, because it may signal cancer, benign tumors of the uterus, or other gynecologic problems.
When should the fern test be performed?
Midcycle to detect whether a high estrogen surge is present.
Medications for Induced Abortion
Mifepristone AKA Mifeperex, used only in early pregnancy up to 49 days from the last menstrual period.
What can cause secondary amenorrhea in adolescents?
Minor emotional upset related to being away from home, attending college, tension due to schoolwork or interpersonal problems.
What age of clients are the most likely targets of F.G.M.?
Minors
What are the structures of the Female External Genitalia?
Mons pubis, perpuce, clitoris, labia majora, urinary meatus, labia minoria, vaginal introitus, hymean, perineum, anus.
Disadvantages of the female condom
More costly than male condoms, inability to use the female condom with some positions such as standing
What do women who are survivors of incest and childhood sexual abuse report more of than non-victims?
More mental and physical health problems.
Cervical Cap
Much smaller (22 to 35 mm) than the diaphragm and only covers the cervix. It can be left in place for 2 days after coitus and doesn't require additional spermicide for repeated sex, though it may cause cervical irritation, this is why prior to fitting a cap many primary providers obtain a pap smear and repeat it after 3 months.
What does the cervix produce in response to cyclic hormones and what is the function?
Mucus, it is an important factor in fetrility awareness.
What are the three universal taboos
Murder, incest, cannibalism
What are Androgenic hormones responsible for?
Muscular development, physical growth, and the increase in sebaceous gland secretions that cause typical acne in both boys and girls during adolescence.
In what races is infant mortality rate high in the US?
Native Alaskans, Native Americans, and Black Infants.
What are the side effects of Emergency Contraceptive Pills
Nausea, breast soreness, and irregular bleeding.
How long should a tampon be used?
No more than 4 to 6 hours
What are some known causes of maternal mortality?
Noncardiovascular & cardiovascular disease, infection & sepsis, hemorrgage, cardiomyopathy, pulmonary embolism, hypertensive disorders of pregnancy, stroke, amniotic fuid embolism, anesthesia complications.
Advantages of Spermicides
Nonhormonal, user controlled, don't cause systemic effects, and are immediately effective
What type of Failure To Thrive is considered a form of child neglect?
Nonorganic - the parent may not be offering enough food because of the lack of attahment, or they unaware of the unger cues the infant is offering, or the parent doesn't have enough concern for the child to offer food regularly.
When collecting data related to reproductive health what can the nurse educate the client in?
Normal physiologic processes such as menstruation and menopause, and assess possible abnormalities.
Culture-Specific Values
Norms and patterns of behavior unique to one particular culture.
Maternal Mortality Rate
Number of maternal deaths per 100,000 live births that occur as a direct result of the reproductive process.
What should you do if your clients cultural beliefs about menstruation are different from accepted medical practice?
Nurses are in a position to provide women with facts in an accepting and culturally sensitive manner, the objective is to be mindful of these unexpressed, deep-rooted beliefs and to provide the facts with care.
What nutritional disturbances can cause secondary amenorrhea?
Obesity, eating disorders such as anorexia and bulimia.
Masters and Johnson Study
Observed and measured physiological responses during all phases of sexual intercourse, defined by four discrete stages.
Luteal Phase of uterine cycle
Occurs after ovulation, under the combined stimulus of estrogen and progesterone, the endometrium reaches the peak, it is thick and high vascular.
Proliferative Phase of uterine cycle
Occurs at the beginning of the cycle just after menstruation, F.S.H. output increases, and estrogen secretion is stimulated causing the endometrium to thicken and become more vascular.
Secretory Phase of uterine cycle
Occurs near the middle portion of the cycle, day 14 in a 28 day cycle, L.H. output increase and ovulation occurs.
Ectopic Pregnacy
Occurs when a fertilized ovum becomes implaneted on any tissue other than the uterine lining, most commonly along the fallopian tube.
Orgasm phase of sexual response cycle
Occurs when stimulations proceeds through the plateau stages to a point which a vigorous contraction of muscles in the pelvis area expels or dissipates blood and fluid from the are congestion.
Excitement phase of sexual response cycle
Occurs with physical and psychological stimulation that causes parasympathetic nerve stimulation and arterial dilation and venous construction in the genital area. The vagina widens in diameter and increases in length, in men the penis becomes erect and the scrotum thickens & testes elevate.
What is menstrual flow made up of?
Old blood, mucus, and endometrial tissue.
What are the two categories are Failure To Thrive
One where severe loss of weight can be explained because of organic causes such as a cardiac disease, and a second that occurs because of a nonorganic causes disturbance in the parent-child relationship, resulting in maternal role insufficiency.
Incomplete Abortion
Only some tissue is passed, an emptying or evacuation procedure or administration of oral misoprostol is usually required to remove the remaining tissue.
What are the combination methods of hormonal contraception
Oral, transdermal, intravaginal ring.
What should the nurse anticipate being administered in the event of an incomplete abortion?
Oxytocin to cause uterine contractions
Dysmenorrhea
Painful mensuration with no identifiable pelvic pathology, occurring at the time of menarche or shortly thereafter.
What organizations can you refer maltreamtnet victims to?
Parent Anonymous, the Child Abuse Prevention Network, the National Coalition Against Domestic Violence, Women Organized Against Rape.
What factors affect the size of the uterus?
Parity (number of pregnancies, size of inants, uterine abnormalities
True or False: The vagina is highly vascular and is very sensitive.
Partly true only - the vagina is highly vascular but has little sensation.
Six QSEN Competencies necessary for quality care
Patient centered care, teamwork & collaboration, quality improvement, informatics, and evidence based practice.
What criteria must the patient meet to receive Methotrexate for an ectopic pregnancy?
Patient must be stable, have no renal/hepatic disease, no evidence of thrmobocytopenia or leukopenia, and have a very small, unruptured ectopic pregnancy on ultrasound.
Symptoms of secondary dysmenorrhea
Patients frequently have pain that occurs several days before menses, with ovulation, and occasionally with intercourse, may be accompanied by nausea, diarrhea, dizziness and backache.
How are healthcare settings changing? Give examples.
Patients homes, community center, or school-based or retai settings emergent care clinics are examples of places in which comprehensive heatlh may be administered.
Secondary dysmenorrhea
Pelvic pathology involved such as endometriosis, tumors, polyps or pelvic inflammatory disease.
What are three layers of the uterine wall?
Perimetrium, myometrium, endometrium
What are some common traits of physically maltreated children?
Phsyically maltreated children are found to be more angry, noncompliant, and hyperactive than others., they may demonstrate poor self-control and low self-esteem.
In women what is chronic pelvic pain often associated with?
Physical violence, emotional neglect, and sexual abuse in childhood.
What are the four types of I.P.V.?
Physical violence, sexual violence, stalking and psychological aggression.
What type of hormonal contraception thickens cervical mucus?
Progestin only methods
What type of Emergency Contraceptive Pills can a woman who is breast feeding use?
Progestin only.
Menorrhagia
Prolonged or excessive menstrual bleeding at the time of regular menstrual flow.
What treatment is needed if a women has undergone unskilled attempts to end a prgenancy?
Prompty medical attention with broad spectrum antibiotics, replacement of fluids and blood components may be required before careful attempts are made to evacuate the uterus.
What type of medications are primarily used to treat primary dysmenorrhea?
Prostaglandin antagonsits such as N-Saids, like ibuprofen, naproxen, mefenamic acid or aspriin, and low dose oral contraceptives.
What areas of the male internal reproductive organs supply semen - list by percentage
Prostate Gland - 60%, Seminal Vessicles - 30%, Epididymis - 5%, Bulbourethral Glands - 5%
What is an indicator an infant admitted for failure to thrive was suffering this condition due to inorganic cuases?
Rapid weight gain when they are place on a diet appropriate for their ideal weight.
Plateau phase of sexual response cycle
Reached just before orgasm, in women the clitoris is dranw forward and retracts under the prepuce, in men vasocongestion leads to distension of the penis. Heart trate increases to 100 - 175 BPM and the breaths to 40 per minute.
What are the alternatives to latex condoms for patients with an allergy?
Reality - a female condom, Avanti -a male condom, both are made of polyurethane.
Advantages of Depo-Provera
Reduction of menorrhagia, dysmenorrhea, and anemia due to heavy menstrual bleeding. May also reduce the risk of pelvic infection, has been associated with improvement in hematologic status in women with sickle cell, and doesn't interfere with efficacy of seizure agents.
Cost Containment
Reeducing the cost of heath care by closely monitoring the costs of personnel, use and brands of suplies, length of hospital stays, inpatient to outpatient ratios as appropriate, number of procedures carried out and number or referrals requested while maintaining quality care.
Primary Infertility
Refers to a couple who has never had a child
Gender Expression
Refers to the behavior a person exhibits which may or may not be the same as the person's gender identity or sex assigned at birth.
Ethnicity
Refers to the cultural group in which a person wad born, although the term is sometimes used in a narrower context to mean only race.
Primary Amenorrhea
Refers to the situation in which a young woman who by 15 years of age has not begun developing secondary sex characteristics, or who by age 16 years or older has developed secondary sex characteristics but has not started menstruation.
Alternative Healthcare Practices
Refers to therapy sych acupuncture, homeopathy, therapeutic, touch, herbalism, and chiropractic care or nontradtional sources of care such as tribal medicine or hispanic herbalists such as yerberos or curanderos.
Culture-Universal Values
Refers to values, norms, and patterns shared across almost all cultures.
What complementary therapies have been proven effective by a few studies for hot flashes?
Reflexology, aromatherapy, yoga, hypontherapy, breating exercises, and meditation.
What is the role of progesterone?
Regulates the changes that occur in the uterus during the menstrual cycle, and is the most important hormone for conditioning in the endometrium in preparation for implantation of a fertilized ovum.
Hormonal IUDs
Release progestin, they come in two varities - 3 years and 5 years.
What should you do if a woman chooses to return to her abuser?
Remain non judgemental and provide information that will make her safer than she was before disclosing her situation. Make sure she has a 24-hour hotline number that provides information and support, and assist her in setting up a safety plan in case she decides to return home.
What type of congential anomalies should you assess for in females with the Mullerian Defect?
Renal and vertebral anomalies.
Scrotum
Rugated, skin-covered, muscular pouch suspended from the perineum, it's functions are to support the testes and help regulate temperature of sperm.
What type of medications may be prescribed for the symptoms of PMS?
S.S.R.I's, Alprazolam though there is a risk of physical dependence, Spironolactone - a diuretic agent used for fluid retention, prostaglandin inhibitors such as ibuprofen and anproxen, calcium supplements as well oral contraceptives.
At what age should you educate girls about menstruation?
School age children and their parents as early as fourth grade, so their first experience with menstruation is not an unexpected negative experience.
Luteinizing hormone (LH)
Secreted by the pituitary gland, responsible for stimulating progesterone production.
Follicle-stimulating hormone (FSH)
Secreted by the pituitary gland, responsible for stimulating the ovaries to secret estrogen.
What questions should be included in the health history of a woman with a disability?
Self care and sensory limitations, accessibility issues, cognitive or developmental changes that affect understanding, limitations secondary to disability, sexual function and concerns, menstrual history/hygiene practice, physical/sexual/psychological abuse, presence of secondary disabilities, health concerns related to aging with a disability.
What do nurses need to be when caring for clients with F.G.M.?
Sensitive, empathetic, knowledgeable, culturally competent, and nonjudgmental.
Why is it controversial to make reporting of spousal abuse mandatory?
Serious opposition is based on the fact that reporting doesn't and cannot currently guarantee a woman's safety and may place her in more danger, as well interfere with her willingness to discuss her personal life and concerns.
What diagnostic studies are used in women experiencing infertility?
Serum progesterone levels and an ovulation index.
What holds the uterus in places?
Several round ligaments that extend anteriorly and laterally to the internal inguinal ring and down the inguinal canal.
SANE Nurse
Sexual Assault Nurse Examiner
Rape
Sexual activity such as intercourse or penetration of a body orifice by a penis or other object under actualy or threatend force.
Satutory Rape
Sexual activity with a person under the age of consent, in most states youner than 18 years of age, occurred regardles of the apparent willingness of the underage person.
What should you inform a victim of suspected abuse of?
Shelter that are available for her and her children, that violence gets worse not better.
Normally, the uterus tips ___________
Slightly forward
What does the clitoris secrete?
Smegma, a pheromone that acts as olfactory ertoic stimulus.
What topics should emphasized in nursing education for couples experiencing infertility?
Smoking cessation, diet, exercise, stress reduction techniques, folic acid supplements, health maintenance disease prevention including STIs.
Myomterium
The middle later of the uterus, made up several smooth muscle layers.
Standard Days Method
The most common fertility awareness based method, users must avoid unprotected sexual intercourse on days 8 to 19 of the menstrual cycle. Works best if the woman has a regular cycle.
What risk factors predispose a patient to ectopic pregnancy?
Smoking, IUD use, history of PID, use of fertility drugs to induce ovulation.
How would the vaginal portion of the cervix be described?
Smooth, firm, and doughnut shaped with a visible central opening referred to as the external os.
What type of documentation should you record when documenting suspected maltreatment?
Specific and factual notes, such as "parent spoke loudly and slurred his words" rather than "parent was intoxicated," or "Mother stated 'this child is nothing but trouble'" not "I think the mother dislikes this child. Photographs of physical maltreatment should also be taken.
Why does aspermia take up to two months to respond to therapy?
Sperm are immobile and incapable of fertiliation as they pass through or are stored in the epididymis, it takes at least 12-20 days for them to travel the length of the tube and a total of 65 to 75 days to reach full maturity.
What conditions must be met for a man to donate for artificial insemination?
Sperm need to be in normal shape, amount, motility and endurance.
What are some red flags on nonaccidental trauma in child maltreatment?
Spiral fractures of bones, and skull fractures.
What is the vaginal surface of the cervix covered with? Why can this be dangerous?
Squamous epithelium. This is a rapid cellular growth iste of cervical cancer and precancerous changes.
Your client reports that their tampon spring has broken or retracted, what should you instruct her to do? What should they do if they cannot or don't want to do this?
Squat in a comfortable position, insert one finger into the vagina, try to locate the tampon ad remove it. If they are uncomfortable doing this or cannot they should consult a gynecologic healthcare provider promptly.
What should you do if you have a suspected pediatric rape victim after you perform basic exam?
Stop immediately after the basic exam and call the Child Advocacy centers if available so they can properly interview and examine the victim, obsering local laws and evidence requirements.
Calista Roy's Nursing Theory
Stresses that an important role of the nurse is to help patients adapt to change caused by illness and other stressors.
What are the risk factors for parents who maltreat children
Substance abuse, mental health issues, young age, low education and income, single parent status, and having multiple dependent children.
What are lesbian teenagers at a higher risk for?
Suicide
What are some manifestations of I.P.V. in clients?
Suicide attempts, drug and alcohol abuse, frequent E.D. visits, vague pelvic pain, somatic complaints, depressions - keep in mind there may be no obvious signs or symptoms.
What is the function of the pelvic diaphragm?
Supports the organs of reproduction and provides elasticity of the pelvic floor by providing support of the organs when increased pressure from coughing and sneezing occurs. W
What are the disadvantages of circumcision?
Surgical complications such as bleeding and pain and reduction of sensation with sexual stimulation.
What causes the antidisestablishment of fortinaicle foxulism in the presence of unfiltered globiscium?
Swiggity swooty I'm coming for that booty.
Spinnbarkeit Test
This test to measure the propety of cervical muscus to stretch a distance before breaking. In the lab this is done by smearing the sample on a slid and stretching it between the slide and cover slip. At the height of estrogen secretion cervical mucus has the ability to tretch into long strands, in contrast to its thick viscous state when progesterone is the dominant hormone.
What type of pregnant patients may Aspirin and Heparin be used in?
To prevent recurrent pregnancy loss in patients with elevated antiphospholipid anitbodies.
What five major categories do Magnet Hospitals meet?
Transformational leadership, structural empowerment, exemplary professional practice, new knowledge/innovation/improvements, and empirical quality results.
What are measures to prevent child maltreatment or intimate partner violence?
Taking high school/college courses on parenting, help children learn problem-solving techniques so they aren't overwhelmed as adults, foster high selfesteem in children & women, help parents with responsible reproductive planning & locate support people and crisis centers, role model caring beahviors, identify children who may be viewed as special, identify parents maltreated ad children, advocate/support laws that implement no hit zone.
How should you begin addressing suspected maltreatment in a pediatric patient?
Talk to the parents first without the child, then interview the child seperately to help uncover any incosistencies in the parents explanations.
What should parents teach children to help prevent sexual maltreatment?
Teach children by a preschool age that their bodies are their own and report anyone who tries to touch them in their private parts.
What three phases does a cycle of violence often follow?
Tension-building in which the offender is angry, argues, blames the victim. Acute VIolence in which physical harm is delivered. The Tranquil phase, also called the honeymoon phase, offender is kind and contrite, lulling the victim into forgiveness.
What type of terms should the nurse use when talking to a client with F.G.M.?
Terminology with which the woman familiar, such as cutting instead of mutilation/
An important mark of maltreatment in contrast to an unintentional one is what?
That the injury is out of proportion to the history given by the parent or caregiver, such as an infant with two broken arms that "rolled off the couch" or a toddler with a large hematoma and LOC who "hit their head on the coffee table."
What are some examples of Long Acting Reversible Contraceptive AKA LARC?
The IUD and the single rod implant.
What advantage do EHRs offer?
The ability to allow different healthcare providers to share information, as long as privacy is maintained the system allows for coordination of care never before possible.
Amenorrhea
The absence of menstrual flow, it is a symptom of disorders and dysfunctions.
Learned Helplesness
The abused partner becomes isolated, sinking into hopelesness and depression.
Discrimination
The action of treating people differently based on their physical or cultural traits.
Where are androgenic hormones produced in males?
The adrenal cortex and testes
Threshold Sensation
The amount of stimulus that results in pain
What is the site of fertilization of the egg or ovum?
The ampulla.
What region should always be included when palpating for breast health?
The axilla, as the breast tissue extends into the axilla.
Ethnocentrism
The belief one's won culture is superior to all others.
Wrongful Birth
The birth of a disabled child whose pregnancy the parents would have chosen to end if they had been informed about the disability during pregnancy
What structures are anterior to the vagina?
The bladder and the urethra.
Retroflexion of the uterus
The body of the uterus is bent sharply back just above the cervix.
Anteflexion of the uterus
The body of the uterus is bent sharply foeward at the junction above the cervix
What muscles encircle and support the vagina, urethra and anal sphincter?
The bulbocavernosus, ischiocaernosus, and transverse perinel muscles.
Why do adolescents often mistake supernumerary breast tissue as abnormal?
The nipple on the axillary sites of this tissue often looks like a mole that changes color.
What are the four parts of the Uterus?
The cervix, fundus, corpus and isthmus.
What do kegel exercises strengthen
The circular bocavernosus muscle which acts as a voluntary sphincter.
What is the vestibule of the vagina bounded by?
The clitoris, the fourchette and labia minora.
Evidence Based Practice
The conscientious, explicit and judicious use of current best evidence to make decisions about the care of patients.
What happens after the menstrual flow stops?
The cycle begins again the endometrium proliferates and thickens from estrogenic stimulation, and ovulation recurs.
What happens if a pregnancy occurs with an IUD in place? What is the risk?
The device is removed immediately to avoid infection, spontaneous abortion (miscarriage) may occur on removal
Retroversion of the uterus
The entire uterus tips far back
Anterversion of the uterus
The entire uterus tips far forward
What are the male internal reproductive organs?
The epididymis, vas deferens, seminal vesicles, ejaculatory ducts, prostte gland, bulborethal glands.
What is the passageway for the eggs from the ovary to the uterus?
The fallopian tubes.
Proliferative Phase of the Menstrual Cycle
The first phase, occurs immediately after a menstural flow, the endometrium is thin, and the ovary begins to produce estrogen, The endomterium begins to proliferate rapidly and the thickness increases as much as eightfold from days 5 to 14.
What part of the vagina surrounds the cervix?
The fornix
Menses Phase of the Menstrual Cycle
The fourth and final phase, this is the phase of menstrual flow, usually contains 30 to 80 mL of blood, appears to be more due to the accompanying mucus and endometrial shreds.
Gender Identity
The inner sense a person has of being male or female, which may be the same as or different fom sex assigned at birth.
Endometrium
The innermost layer of the uterus, it is the highly vascular layer that responds to to hormone stimulation to prepare to receive the developing ovum.
What composes the pelvic diaphragm?
The levator ani, iliococcygeus, pubococcygeus, and puborectalis muscles.
Acculturation
The loss of ethnic traditions because of disuse.
What type of tampon should be used and why?
The lowest absorbency to prevent toxic shock syndrome.
Ovulation
The process of releasing a mature ovum into the fallopian tube each month.
What is a signal that a woman is about to undergo menopause?
The process starts gradually and is usually signaled by changes in menstruation - the monthly flow may increase or decrease, become irregular and finally cease. The interval between period is longer, a lapse of several months between periods isnt uncommon,.
What is the primary goal of both maternal and child health nursing?
The promotion and maintenance of optimal family health?
Gender Dysphoria
The realization one's physical sex and gender are mistmatched, which can cause a lot of stress and anxiety.
What structure is posterior to the vagina?
The rectum.
During which stage of the menstrual cycle do women appear to reach the plateau phase and orgasm more quickly, as well as be more interested in sex?
The second half of the cycle
Secretory Phase of the Menstrual Cycle
The second phase, after ovulation, the formation of progesterone in the corpus luteum causes the glands of the uterine endometrium to become corkscrew or twisted in appearance dilated with quantities of glycogen and mucin, taking on the experience of rich, spongy velvet.
The perineum
The skin-covered muscular tissue area between the vagina and rectum or anus.
Intimate Space
The space closely surrounding a person, physical examination is conducted in this very tight space.
Puberty
The stage of life at whcih secondary sex changes begin.
What are the two classic signs of Facitious Disorder
The symptoms aren't easily detected by physical examination, only by history, & the symptoms are present only when the person initiating the symptoms is providing care - the symptoms disappear when care is provided by another person.
Nursding Research
The systemtic investigations of problems that have implications for nursing practice usually carried out by nurses. Results in improved and cost-effective patient care while providing evidence for action and justification for implementing activites.
Ischemic Phase of the Menstrual Cycle
The third phase, if fertilization doesn't occur the corpus luteum in the ovary begins to regress after 8 to 10 days and the production of progesterone decreases, the endometrium of the uterus begins to degenerate, the capillaries rupture with small hemorrhages and the enodmetrium sloughs off.
What happens if an ectopic pregnancy occurs in the fallopian tube?
The tube becomes more and more distended and can rupture if the ectopic pregnancy remains undetected for 4 to 6 weeks or longer after conception.
Where does the uterus lie in relation to the bladder?
The uterus is posterior to the bladder.
What are the internal female reproductive structures?
The vagina, the uterus, the ovaries, and Fallopian AKA uterine tubes.
What is the collective name for the external genitalia?
The vulva
Maltreatment
The willful injury by one person of another, takes many forms such as physical, emotional, neglect, sexual, intimate partner violence and maltreatment or violence of the elderly.
What conditions must be met for a woman to receive artificial insemination?
The woman must have no abnormalities of the genital system, the fallopian tubes must be patent, and ova must be available.
What should clients be encouraged to talk about during sexual history?
Their sexual feelings with their partner, as in an intimate relationship feelings are facts.
Infants born to women of what ages have the highest rate of neonatal and infant deaths?
Under the age of 20, and between the ages of 40 to 54.
How many attempts are artificial insemination may be made in one cycle and why?
Up to 3 attempts my be made as fertilization rarely occurs from a single attempt.
The nurse instructs patients who have chosen male or female sterilization contraception to do what?
Use another contraceptive method for the first 3 months and to use condoms to protect against STIs.
The nurse instructs patients who have chosen the patch method of contraception to do what?
Use condoms to protect against STIs, change the patch once a week
The nurse instructs patients who have chosen the ring method of contraception to do what?
Use condoms to protect against STIs, remove the vaginal ring after 3 weeks.
The nurse instructs patients who have chosen oral methods of contraception to do what?
Use condoms to protect against STIs, take the pill at exactly the same time very day.
The nurse instructs patients who have chosen injectable methods of contraception to do what?
Use condoms to protect against STis, obtain repeat injections on time.
The nurse instructs patients who have chosen the condoms, sponge, withdrawal or spermicides method of contraception to do what?
Use correctly each time you have sex.
The nurse instructs patients who have chosen the diaphragm method of contraception to do what?
Use correctly each time you have sex.
Hormonal Contraception
Use of hormones to suppress ovulation and prevent conception
Sexual Assault
Used to refer to other forces sexual acts such oral-genital or anal-genital acts.
Your client is nulliparous, what size would expect their uterus to be compared to a patient who is multiparous?
Usually they will have a smaller uterus compared to a multiparous patient.
Sex Assigned At Birth
Usually. based on a person's chromosomal sex: male or female
What are some symptoms of ectopic pregnancy?
Vague soreness on the affected side which may proceed to sharp, colickly pain. Most patients experience some pelvic or abdominal pain and some spotting or bleeding. Other symptoms include GI Symptoms, dizziness, or light-headedness.
Sterilization
Vasectomy and tubal ligation.
Disorganization Phase of Rape Trauma Syndrome
Victims feel a combination of humiliation, shame, guilt, embarassment, anger and vengefulness. They feel that their lives have been completely disrupted by the crisis because they were unable to protect themselves from the assault.
Laparoscopy
Visual examination of the abdominal cavity using an endoscope or laprascope.
What alternative therapies are used to help with PMS?
Vitamins B6 and E, calcium, magnesium and oil of primrose capsules.
Vulvodynia
Vulva pain
What happens when the pelvic diaphragm contract?
When this muscle group is contracted, the pelbic floor is lifted upward, supporting continence.
Transition
When transgender people begin to live as the gender they feel they really are. They may have top and bottom surgery or just top surgery.
Your clients fern test is always positive, what does this indicate?
Women who don't ovulate usually show a ferning pattern throughout their menstrual cycle because progesterone levels neve become dominant, alternatively they may never show it because their estrogen levels never rise.
Who are extended regimens of oral hormonal contraception an option for?
Women who have heavy or uncomfortable menstrual bleeding or wish to have fewer periods.
The Ortho Evra patch may not be effective for what type of women
Women who weight more than 90 kg or 198 pounds
How is ovulatory dysfunction treated?
Women with polycstic ovary syndrome may be treated with 4 days of Clomiphene AKA Clomid to induce ovulation, and insulin sensitizing agents are sometimes used - once insulin levels are normalized ovulation often occurs. In women with high prolactin levels ar treated with dopaminergic drugs after a pituitary adenoma is ruled out.
What is the key questions nurses can use to initiate the reproductive life plan conversation with clients aged 18 to 50? What three questions should follow if applicable?
Would you like to become pregnant in the next year? Do you have any children now? Do you want to have more? How many more and when?
What is obtained prior to artificial insemination?
Written consent is obtained to protect all parties involves including the woman, the donor and the resulting child.
Can a healthcare record of a child be subpoenaed in court?
Yes, in the event that maltreatment is confirmed, because it is a crime.
What age of children are are at greater risk for child abuse?
Younger than 4, as well as those who require an increased caregiver burden
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