H&I IV - Lifespan: Midterm Study Materials

most common STI

chlamydia

what are the bacterial (curable) STIs

-gonorrhea

-chlamydia

-syph

-BV

-candidiasis

-trich

-PID

what are the vaginal infections that are not considered STIs

-bacterial vaginosis

-trichominiasis

-candida

-group beta strep

what % of pts with STIs have no symptoms

75%

s/s of chlamydia

-dysuria/pareunia

-abnormal discharge

-spotting

-nausea

-fever

-PID

-ectopic pregnancy

risks for pregnant women with chlamydia

-premature delivery

risks for neonates whos mothers have chlamydia

-conjunctivitis (can cause blindness_

-pneumonia

tx for neonatal conjunctivitis

routine erythromycin ointment at birth may help, but oral abx also needed for full tx

s/s neonatal pneumonia

congestion, tachypnea, and a worsening cough that appears within 2-12 weeks after birth

gonorrhea s/s

-pruritis

-eye drainage

-rectal itching

-dysuira/pareunia

-heavy meses

-intramenstrual bleeding

-erythema

-abnormal vaginal discharge (yellow, green, bloody)

stage of syphilis

-primary

-secondary

-latent

primary s/s of syphilis

lesion or chancre on genitals

-5-90 days after infection

secondary s/s of syphilis

palms/soles of hands/feet

-6 weeks/month

latent s/s of syphilis

-2 years after

-serum positive

early latent stage of syphilis

infectious/lesions may occur

late latent stage of syphilis

only infectious to fetus

what is the tertiary stage of syphilis

develops in 1/3 of untreated

-neurologic, MSK, MODS

length of stage 1 of syphilis

3-90 days (after initial infection)

length of stage 2 of syphilis

4-10 weeks (after initial infection)

length of stage 3 of syphilis

3-15 years (after initial infection)

HSV s/s

-blisters/lesions on lips/genitals

-tingling/burning

-flu-like symptoms (fever, chills, dysuria, lymphadenopathy*)

-vesicle/pustules/crusted ulcers (painful, itching, discharge)

recurrent infection of HSV s/s

-local symptoms only

-only 5-7 days

what is recurrent infection of HSV triggered by

stress, trauma, infection, menses

tx for HSV

-wash w/ water

-pat dry

-clean hygiene/hands

-no contact w/ lesions

-B vitamins

-life style modification

-reduce stress

-vala/acyclovir

HPV s/s

-genital warts

-itching

-vag discharge

-cervical changes on PAP

hep B s/s

-fever

-HA

-fatigue

-N/V

-loss of appetite

-malaise

-joint/abd pain

late s/s of hep B

-dark urine

-clay-colored stools

-jaundice

PID s/s

-abdominal/back pain

-irregular bleeding

-fever, nausea, chills (late)

what can PID cause

infertility/ectopic pregnancy

trichomoniasis s/s

-yellow, green, grey frothy discharge/odorous

-redness

-itching

-redness

BV s/s

-thin, white, fishy discharge-malodorous

GBS treatment

tx w/ penicillin G during labor

-can stop taking as soon as baby is delivered

pt education for STI prevention

prevent recurrences (safe sex, condom use, routine testing, and tx)

-need to abstain till 1 full week after tx

how do we know that bacterial STI is cured

TOC- test of cure

herpes spread prevention

-abstain w/ open sores

-wash hands w/ perineal care

-wear condoms

what is depoprovera/DMPA

medroxyprogesterone

-progestin only injectable

advantages of depoprovera

-progestin only- considered safe, simple, and convenient

-effective/long lasting (12 weeks)

-no daily pill

-periods become fewer and lighter; after 1 year 50% stop having periods completely

-private method of BC (promoted to teens)

disadvantages of depoprovera

-IM injection

-must be repeated Q12 weeks

-no STI protection

-irregular bleeding/spotting (common in first 6-12 months)

-rare= longer, heavier periods

-decreased bone mineral density (increase calcium/vit D, weight bearing exercise, reversed once stopped)

-weight gain, lipid changes

-delayed fertility return

-may cause a decrease in milk supply

how long does depoprovera/DMPA last

12 weeks

-IM injection

what do we need to do if pt on depoprovera comes in at 13 weeks

test for pregnancy

periods in deprovera/DMPA

-fewer/lighter

-50% no periods after a year

-may have spotting, longer, or heavier periods

fertility with deprovera/DMPA

delayed return

what does deprovera/DMPA lower

bone mineral density (need to take vitamin D)

mneumonic for birth control warnings signs

ACHES

ACHES

-abd pain (liver)

-chest pain/SOB (MI/PE)

-HA (CVA)

-eye problems (CVA)

-severe leg pain or swelling (DVT)

*need to call provider right away

what does estrogen increase the risk of

clotting

what are the types of IUDs

-mirena

-paraguard

-skyla

-nexaplanon

-levonorgestrel IUD (LNG IUD)

advantages of IUD

-inexpensive, long lasting pregnancy protection

-inserted by HCP

-can be used during breast feeding

disadvantages of IUD

-spotting between periods is common

-increased menstrual cramps/backaches possible

-infection/perforation (rare)

-pregnancy

-unintentional expulsion

-no protection against STIs

-lack of correct info by professionals and pts

what is mirena

-levonogestrel/progestin

-5 years

-tx heavy menstrual flow/period cramps

what is paraguard

-copper

-may cause heavy bleeding (anemia)

-10 years

-does not change hormone levels

what is skyla

-levonogestrel/progestin

-nulliparas

-3 years

what is nexaplanon

-etonogestrel

-3 years

-arm

-can cause spotting and decrease periods

-good for women not suited for estrogen

-implants in arm

benefits of IUDs

-quick return to fertility

-can use while BF

-long lasting

negative side effects of IUDs

-increased menstruation

-back aching

-spotting

-may expel/perforate/cause infection

advantage of lactational amenhorrhea method (LAM)

-used worldwide to prevent pregnancy

-no change in maternal hormones

-prolactin surge of BF inhibits ovulation

-safe/inexpensive

-promotes exclusive BF

-fertility rates are low if 3 criteria are met

what are 3 criteria needed to make LAM effective

-must exclusively BF

-no maternal menses

-infant under 6 months of age

disadvantages of LAM

-must exclusively BF

-only effective during exclusive BF with no ovulation (3 criteria)

-decreased effectiveness when supplementing with formula, solids, feeding less than 3-4 hours, menses return

what is the fertility awareness method based on

identifying beginning and end of fertility period

what are the fertility awareness methods

-body basal temp (temp changes throughout cycle)

-marquette model/calendar method

-ovulation method (bilings and creighton- cervical mucus)

how does the fertility awareness method work

by keeping sperm out of vagina near days of ovulation when women are most fertile

advantages of fertility awareness method

effective, safe, inexpensive, easy when done correctly

failure rate of FAM

25% failure rate in 1st year of typical use; 5% with perfect use

disadvantages of FAM

-requires pt education

-careful monitoring

-control/records

-no STI protection

calendar method

ovulation occurs 14 days before onset of next menstrual cycle and avoids intercourse during that period, days 8-19 is fertile period

basal body temp

temp drops during ovulation

cervical mucus method

Check color and consistency to determine fertile times.

Avoid sexual activity when mucus is present and for several days afterward.

what is GTPAL

Gravida, Term, Preterm, Abortions, Living

what is gravida in GTPAL

number of pregnancies:

-nulligravida

-primigravida (first pregnancy)

-multigravida

what is term in GTPAL

T=term=number of pregnancies to term (37 weeks)

what is pre-term in GTPAL

before 37 weeks

what is abortions in GTPAL

abortions (therapeutic/spontaneous) <20 weeks

what is living in GTPAL

total living children

what is naegels rule

LNMP + 7 days - 3 months + 1 year= estimated due date

what is hegars sign

softening of cervical isthmus/uterine softening

chadwicks sign

blue-tint to the cervix

care for negative Rh mother

receives Rhogam; if baby is + then another dose is given after birth

-if baby is negative we dont need to give a second dose

when do blood vessels/cells begin to form in a fetus

3rd week

when does tubular heart begin to beat

end of 3rd week

when does fetal heart develop into 4 chambers

4th and 5th week

-end of embryonic stage heart is developmentally complete

what are the bypasses that the heart creates for the respiratory system

-ductus arteriosus

-ductus venosus

-foramen ovale

what is the ductus arteriosus

connects the pulmonary artery to proximal descending aorta, thus bypasses the lungs and brings oxygenated blood to the aortaw

what is the ductus venosus

shunts blood in the liver coming from the umbilical vein to the inferior VC

what is the foramen ovale

opening from right to left atrium that shunts blood to the left atrium

step 1 of fetal circulation

umbilical vein delivers oxygenated blood to fetus

step 2 of fetal circulation

from liver, ductus venosus shunts blood to inferior vena cava

step 3 of fetal circulation

oxygenated blood mixes with deoxygenated blood from the superior vena cava in the right atrium

step 4 of fetal circulation

high pressure opens foramen ovale which shunts blood from right --> left atrium

step 5 of fetal circulation

some blood goes to pulmonary artery where the ductus arteriosus shunts blood to the descending aorta

step 6 of fetal circulation

some blood goes to lungs, pulmonary veins, then the left ventricle then aorta

step 7 of fetal circulation

blood supplied to body, then returns to placenta through the umbilical arteries (2)

normal fetal HR

110-160

mneumonics for fetal HR monitoring

VEAL CHOP

what is veal

-variable decels

-early decels

-accelerations

-late decels

what is CHOP

- cord compression

- head compression

- oxygenation/okay!

- placental/uterine insufficiency

what are early decelerations

gradual decrease in HR; uterine contraction/head compression

what are late decelerations

gradual decrease in HR, occurs after contraction; indicates decreased perfusion-placental/uterine insufficiency

hx for PROM

-time

-color

-amount

-odor