Term
| Bacterial Vaginosis “BV” aka vaginitis gardenella |
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Definition
The whiff test
Very common in pregnant pts.
Interruption of normal vaginal
bacterial flora
Treat as it can lead to preterm labor, PROM or chorioamnionitis |
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Term
| Bacterial Vaginosis “BV” (Symptoms) |
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Definition
Although more than 50% have no symptoms, when symptoms do occur they include:
excessive, thin gray or white vaginal discharge that sticks to the vaginal walls
fishy or musty, unpleasant vaginal odor, most noticeable after sexual intercourse
vaginal itching and irritation |
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Term
| Factors That Increase Transmission of HIV |
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Definition
Previous child with HIV
Chorioamnioitis
Preterm birth
Decreased maternal CD4
Firstborn twin
SVD
Chorioamnioitis
Intrapartum blood exp. Failure to treat mom and fetus/newborn during perinatal period with "zidovudine “AZT” aka “ZDV" |
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Term
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Definition
Screen all women
Test HIV + women for other STD’s, CMV and Toxoplasmosis and offer PPD
Check varicella and rubella titers
PAP
All positive pts. receive AZT throughout pregnancy regardless of CD4 counts (watch for BM depression)
CD4 counts < 200 get PCP prophylaxis
Immunize against Hep B, Hib, PCV, flu |
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Term
| HIV Nursing Considerations |
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Definition
Consider social, cultural & spiritual needs of the mother and confidentiality
A disproportionate number of women are minorities
Identify family strengths and capitalize on them
Teaching includes “safe sex” throughout pregnancy
While pregnancy is discouraged in HIV positive women, provide a hopeful milieu if the patient is pregnant |
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Term
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Definition
Support for immune system by discussing importance of rest, diet, activity & stress reduction
Treatment and teaching for substance abuse
Deliver within "4 hours" of ruptured membranes
C/S if viral load high
Avoid internal fetal monitoring
Avoid vacuum and forceps delivery
Watch for postpartum bleeding and infection
Avoid breastfeeding |
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Term
| Effects of Syphilis on Pregnant Women |
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Definition
25% will have stillbirth or neonatal death
40-70% will have syphilis-infected babies
if untreated |
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Term
| Syphilis is divided into four stages: |
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Definition
1. Primary
2. Secondary
3. Latent
4. Tertiary (late)
An untreated infected person may infect others during the first 2 stages (1-2 years).
Even though untreated syphilis is not contagious in the late stage serious complications can occur:
blindness
mental disorders or neurological problems
serious heart abnormalities
death |
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Term
| Babies with congenial syphilis can have these symptoms at birth or symptoms may take weeks |
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Definition
Anemia
Fever
Rashes
skin sores
Moist sores of _________ are infectious
Liver and spleen and various deformities
The rise in infant syphilis morbidity is a public health concern |
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Term
| Ways infectious diseases can be contracted. |
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Definition
Infections of Pregnancy
T - Toxoplasmosis
O – other like hepatitis
R - Rubella
C – CMV
H - Herpes Simplex
Symptoms of some may appear in mother as flu-like, while effects on developing fetus are more serious. Most of these are not STD’s |
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Term
| Sexually Transmitted Infections that can lead to preterm birth. |
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Definition
Syphilis
HIV
Chlamydia: Fastest spreading STD in US women
~1 in 20 girls between 14-19 yrs. has had it
Trichomoniasis
Bacteria Vaginosis “BV” (Technically not an STD) |
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Term
| Human Papilloma Virus “HPV” |
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Definition
Most common STD caused by a virus
Many types of genital warts
Leading cause of cervical and penis cancer
Picture shows 7 month old born to mother with HPV who was successfully treated with "Imiquimod" cream |
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Term
| Human Papilloma Virus (HPV)(Treatment) |
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Definition
cryotherapy or topical agents (Imiquimod aka Aldara).
Cryo-therapy if pregnant
No treatment is completely effective
Women need regular PAP exams even after lesions have disappeared
Associated with oral and rectal cancer
Non judgmental
Vaccine available for some strains |
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Term
| Gardasil or Cervarix for Prevention of Human Papilloma Virus (HPV) |
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Definition
Available to women and girls aged 9-26 yrs.
3 shot series
Approved for use in boys and men.
Protects against HPV types 16 – 18 which cause ~70% of cervical cancers.
Also protects against strains 6 and 11. |
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Term
| Pelvic Inflammatory Disease “PID” |
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Definition
| May result from untreated Chlamydia trachomatis or Neisseria gonorrhea or both |
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Term
| Primary "Prevention" of _________ on Women's Health. |
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Definition
Pain
Anxiety
Depression
Ineffective coping |
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Term
| Primary "Promotion" of __________ on Women’s Health |
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Definition
Wellness
Centeredness
Joy
Assertivenes |
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Term
|
Definition
Primary: Teaching “safe sex”
Secondary: Screening a high risk client
Tertiary: Treating infection and it’s
complications
Medical Management stresses eradication of infection in order to prevent complications |
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Term
| Uterine Fibroids aka myomas |
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Definition
| Benign tumors of smooth muscle |
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Term
| Fibroids(Treatment Medical) |
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Definition
OCs reduce heavy bleeding
IUD’s reduce bleeding, minimize pain • NSAIDs such as ibuprofen or naprosyn for cramps or pain
Short-term hormonal therapy injections to help shrink the fibroids -GnRH agonists
Iron supplements to prevent or treat anemia due to heavy periods |
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Term
| Fibroids (Treatment Surgical) |
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Definition
Uterine Artery Embolization
If childbearing is important, myomectomy
Severe cases may require hysterectomy or endometrial ablation |
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Term
|
Definition
Painful menstruation
Onset 1 to 2 days before menses and generally lasts several days after menses begins
Primary form occurs within 3 years of menarche
R/T uterine cramping and associated with ovulation and changes in progestin levels.
May ease after pregnancy
Secondary dysmenorrhea r/t pathology, treat underlying problem |
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Term
| Primary Dysmenorrhea (Treatment) |
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Definition
NSAIDS
Oral Contraceptives (inhibits ovulation)
Supplemental vitamins E and B6 may help, but best forms are naturally occurring.
Low fat, lower Na, well balanced diet
Heating pad
TENS |
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Term
|
Definition
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Term
|
Definition
| "Absence of menses" by age 16 years or "within 4 years of breast development" |
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Term
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Definition
"Cessation of menses for @ least 3-6 months."
This is a classic symptom of what psychiatric disorder primarily seen in younger women?
Anorexia |
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Term
| Hypogonadotropic Amenorrhea |
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Definition
Hypothalamic suppression from stress, weight loss, eating disorders, strenuous exercise and mental illness may lead to amenorrhea.
Rare cases linked to pituitary disease or genetics |
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Term
| Hypogonadotropic Amenorrhea (Treatment) |
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Definition
| address the underlying issues |
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Term
| Exercise Associated Amenorrhea |
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Definition
| At risk: > 20% under weight Excessive/rapid weight loss Engaging in rigorous exercise |
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Term
| Exercise Associated (Treatment) |
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Definition
Focus on decreasing activity and improving nutrition:
Intake of 1500mg Ca+/D plus weight gain as needed to support physiological processes |
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Term
| Premenstrual Syndrome (PMS) |
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Definition
Cyclic and predictable not well understood
In luteal phase of the cycle(after ovulation) and ends soon after menstruation begins
85% of women experience some mood and somatic complaints
9% report physical, mood and behavioral symptoms as disabling |
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Term
| Premenstrual Syndrome(PMS) (symptoms) |
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Definition
irritability,
depression,
HA
GI disturbances
urinary retention,
breast tenderness
acne flair-ups. |
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Term
| Premenstrual Dysphoric Disorder (PMDD) |
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Definition
Rarer form of PMS (~5% of women affected) that entails meeting very specific criteria for diagnosis. Multifactorial etiology.
• Management of PMS & PMDD includes diet with additional calcium, magnesium, vitamin B6 and E, exercise, medications (possibly SSRI’s) and counseling. OC’s may help* |
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Term
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Definition
| (drospirenone)YAZ first. It is associated with increased risk for clots so use with caution!!! |
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Term
| Premenstrual Dysphoric Disorder (PMDD)(Treatment) |
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Definition
Management includes diet with additional calcium, magnesium, vitamin B6 and E,
exercise,
medications (possibly SSRI’s)
and counseling.
OC’s may help* |
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Term
| Uterine Fibroids aka myomas (Symptoms) |
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Definition
heavy bleeding - menorrhagia.
Urinary urgency,
frequency or retention Bowel complaints, pain Occasionally infertility or recurrent pregnancy loss |
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Term
| Bacterial Vaginosis (BV) Treatment |
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Definition
| Rx with metronidazole or clindamycin |
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