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Maternal Newborn
Reproductive Issues
| Question | Answer |
|---|---|
| Why does the vagina have an acidic environment | prevent the spread of bacteria leading to infections (not a good environment for sperm so the vaginal vestibule has Bartholin's glands that secrete alkaline mucus for lubrication and in males there are Cowper's gland which secrete an alkaline mucus) |
| What position is the uterus usually in | Usually antroverted, fundus tipped foward towards pubic bone. Can be anteflexed where fundus flexes right on top of the cervix. Retroverted is when fundus is in poosterior position toward sacrum which chould be related to back pain during menses |
| Which female organ lubricates, bacteriostatic, alkaline environment for sperm also help sperm tranverse the vagina and into the uterus | cervix |
| ____ support and stabilize the uterus, could be strained during late pregnancy | ligaments |
| Name the three parts of the fallopian tubes | isthmas (very narrow area off the fundus of uterus), Ampulla (wider section of tube usual site for fertilization), Fimbriae (large opening of tube accepting egg from ovary) |
| ____ is the primary source of estrogen and progesterone | ovaries |
| What bones make up the bony pelvis | Innominate including ilium ischium and pubis, sacrum and coccyx |
| What is the most narrow spot where fetus must pass | ischial spines |
| What is the difference between the true and false pelvis | seperated by the pelvic brim, the true pelvis is below the ischial spines and the false pelvis is the upper flaring part of the innominate bone or the flaring part that supports the uterus |
| What are the four types of pelves and which one is best for childbirth | Gynecoid (female - best for childbirth), android (male), platypoid and anthropoid |
| What are the three female hormones responsible for reproduction | Estrogen, Progesterone and Prostaglandins |
| ____ control is when the hypothalmus and anterior pituitary are involved to secrete FSH that stimulates follicle in ovary to develop and LH helps corpus luteum in production of progesterone and ovaries = cycle of stimulus | Neurohumoral control |
| The ovarian cycle is divided in two phases, what are they | Follicular phase (FSH & LH before ovulation) and Luteal phase (LH maintaining the corpus luteum which surrounds the follicle before it is released after ovulation) |
| The menstrual cycle is divided into 4 cycles, what are they | Menstrual (avg 5- dys) proliferative (estrogen grows endometrium), secretory (following ovulation progesterone gets endometrium ready to support) and Ischemic (no fertilization = uterine wall sloughed off) |
| What is the most predictable part of the menstrual cycle | from ovulation to menstration (14 days). Menstruation to ovulation is not very predictable could be 7-17 days |
| Which menstrual phase coordinates with the follicular phase of the ovarian cycle | Proliferation phase |
| Which hormone becomes predominate after a follicule ruptures | progesterone - an inadaquate amount ends up in miscarrage progesterone relaxes the uterus. (b4 rupture it is estrogen) |
| how long does is an eggs life, sperm viability | egg - 24 hrs. sperm - 48-72 hrs but most effective first 24 hrs |
| Which fertility awareness method can be used only with predictable periods | calendar method - record S&S on calendar and then look back and see predictable pattern |
| Which fertility awareness method involves taking temperature every morning before get out of bed | Billings method - When estrogen is produced the temp is stable then a decrease in temp occures during ovulation, then progesterone takes over and temp increases about 1/2 degree |
| What two fertility awareness methods can be used with an irregular cycle | Billings method (temp) and checking cervical secretions |
| What changes occure in cervical secretions during ovulation | Thin, watery and stretchy, normally thick and cloudy without stretch |
| ____ aka coitus interruptus or withdrawal metod | situational - not very effective because can have sperm in preejaculate, If repeted over short period of time, preejaculate increases sperm count |
| condoms, diaphragms, female condoms, cervical cap, spermicide, today sponge are all ____ contraceptives | barrier |
| Nuva ring, patch, implannt, Norplnt, IUD are all examples of ____ contraceptives | hormonal |
| operative sterilization works by inserting ____ into each fallopian tube, scar tissue developes causing inside of tube to be inaccessible for sperm, not reversible | microcoil |
| How does Plan B work (emergency contraception) | progestin to prevent follicle eruption. Only works if taken within 72 hrs of sexual intercourse 2 pills taken 12 hrs apart |
| How long do the following hormonal contraceptives work: Nuva ring, Patch, Implant, Mirena IUD and copper IUD | Nuva ring (3 wks in vagina), Patch (1 wk at a time 3 weeks at a time then 1 week off), Implant (5 yrs surgically implanted), Mirena IUD (5 yrs inserted into uterus), copper IUD (10 years inserted into uterus) |
| When does bacterial vaginosis occure and what causes the fishy odor | eco system is disrupted. fishy odor due to release of amines from anerobic bacteria - dangerous in pregnancy can lead to preterm labor |
| What is bacterial vaginosis and Trichomoniasis tx with | metroniazole (Flagyl) Do not drink alcohol |
| ____ aka yeast infection occures when there is a change in eco system of vagina, may be due to antibiotic tx, high blood glucose - what does it look like | Vulvovaginal candidiasis - thick white cheesy looking - itch and irritation |
| Which two conditions that cause vaginal discharge are not sexually transmitted | Bacterial vaginosis and vulvovaginal candidiasis |
| ____ is a protozon infection, with malodorus discharge that is green yellow frothy. | Trichomoniasis - sexually transmitted tx with flagyl avoid alcohol and sex until finished Rx |
| ____ may be asymptomatic and picked up at anual exam, can involve pelvic organs (PID) risk of infertility, more common in college aged | Chlamydia - sexually transmitted treated with Azithromycin (Azithromax) single dose both partners |
| ____ purulent, greenish-yellow odorous discharge or asymptomatic,can involve pelvic organs (PID) risk of infertility | Gonorrhea - sexually transmitted. Treated with Ceftriaxone single dose both partners |
| ____ blisterlike vesicles/ulcerated lesions/prutitus | Herpes genitalis - sexually transmitted, treated with acyclovir (Zovirax) TID 7-10 days and then supression therapy at a low dose forever |
| ____ chancer/fever, wt. loss/malise | Syphilis - sexually transmitted, treated with Benzathine Penicillin G IM |
| ____ is a soft, greyish pink, cauliflower-like lesion | Condylomata acuminate (HPV) - sexually transmitted - many tx including podofilox BID X3dys, Podophyllin, Trichloroacetic acid, Cryotherapy, laser, or excision. Vaccine Gardasil for girls 11-12 yo and B4 26 yr only effective for 70% of strains |
| ____ pimples in the perineal area, more common when mons pubis is shaved leaving open areas and infection may develop | MRSA - sexually transmitted |
| T/F a woman may experience pain when the egg releases from the ovary | True - some women feel the eruption |
| Why are oral contraceptives contraindicated with heart disease, HTN, and diabetes | Estrogen thins blood and increases risk of thrombosis. If have DVT can use progestin only or IUD, neither have estrogen |
| T/F there is a relationship between oral contraceptives and gaining weight | False - as women age, gain weight - not due to oral contraceptive use |
| If have vulvovaginal candidiasis (yeast) 4X/yr may be due to | high blood glucose - need to be tested for diabetes |
| Herpes may be initiated by ___ & ___ | stress and menstration |
| non-contraceptive benefits of oral contraceptives | decreases acne, menorrhagia (heavy period), and ovarian, endometrial and colon cancers |
| Although the one week of hormone free period of oral contracpetives are not necessary, why are they used | Worried about failure and getting pregnant have a chance of getting a period will assure not pregnant |
| diaphragm with spermicide is a dome shaped rubber disk that covers the cervix, when is it inserted, for how long and with what | before intercourse, left in at least 6 hrs after intercourse can be left in for 24 hrs with additional spermicide for repeted intercourse |
| What is the difference b/t Lea's shield and cervical cap | Lea's is dome shaped with loop held in place by vaginal wall, cervical cap is small and fits snugly around cervix, both can be left in for 48 hrs with reapplying spermacide for repeted intercourse |
| ____ is a disk shaped polyurethane device containing spermicide inserted before intercourse | Sponge - does not need additional spermicide can be left in place for 24 hrs, must be kept in place for 6 hrs after intercourse |
| Which contraceptives places woman at risk for toxic shock | diaphragm, lea's shield, cervical cap, and sponge |
| How does the oral contraceptive - combined (estrogen and progestrone) pill work | supresses ovulation |
| How does the oral contraceptive progestin only (minipill) work | reduces and thickens cervical mucus to prevent the sperm from reaching the egg |
| Which oral contraceptive is less likely to protect against an ectopic pregnancy | progestin-only (minipill) progestogenic effect of thickening the cervical mucus and thereby reducing sperm viability and penetration. where estrogen circulating in the blood can negatively feed-back to reduce circulating levels of FSH and LH, |
| side effects of combined estrogen/progestrogen oral contraceptive | dizziness, nausea, changes in menstration, mood and weight, blood clots, HA & stroke |
| side effects of progestin only (minipill) | irregular bleeding & breast tenderness |
| What hormone is in the seasonale oral contraceptive | estrogen and progestin (12 weeks active pills followed by one week of inactive pills) |
| How does the patch work | skin patch worn on the lower abdomen, buttocks or upper body that releases the hormones progestin and estrogen into the blood stream |
| The patch is less effective in what population | women weighing more than 198 lbs |
| How often is the patch applied | once a week for three weeks then off a week, then restart |
| What hormone is released with the vaginal contraceptive ring (NuvaRing) | progestin and estrogen from a flexible ring about 2" in diameter, remains for 3 wks then removed for 1 wk |
| How do the post-coital contraceptives (Preven and Plan B) work | Plan B just progestin and Preven contains both estrogen and progestin. The large dose prevents ovulation. Must be taken within 72 hrs of unprotected intercourse - first 24 hrs is mosst effective |
| What hormone is in Depo-Provera and how is it administered | progestin (inhibits ovulation and implantation) One IM injection every 3 months |
| How often is Lunelle injected and what is the hormone involved | once a month - progestin and estrogen |
| How long is the implant Norplant good for | 5 yrs No longer used |
| What is the failure rate of periodic abstinence | 20% |
| which type of contraceptive puts a woman at risk for ectopic (tubal) pregnancy | Trans-abdominal surgical and sterilization implant (Essure System) |
Created by:
cgwayland
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