OB Exam 1: BC and Menstruation

What are the phases in life a woman generally seeks healthcare?

1. adolescence/puberty

2. abortion

3. fertility

4. reproductive years

• family planning

• pregnancy

3. perimenopause

4. menopause and aging

Whats perimenopause?

• signs? (4)

• time b4 menopause around 40 y/o; estrogen goes haywire

1. hot flashes

2. irregular periods

3. mood changes

4. vaginal dryness

What are 3 important prenatal assessments to conduct in the beginning?

1. Pre pregnancy BMI and weight

2. Dietary intake/ eating habits

3. Lab values (iron, hgb, glucose)

What hormones are in Combined Oral Contraceptives (COCs)?

• what are the types?

Both Estrogen and Progesterone

• pills

  • 3 weeks on, 1 week off

• patch

• ring

How does COCs work? (3)

1. suppress ovulation

2. thicken cervical mucus (makes it harder for sperm to pass through)

3. thins uterine lining

Contraindications for COCs: (5)

1. hx of blood clots

2. smoking >35 y/o

3. migraines w/ aura

4. breast cancer

5. uncontrolled HTN

What are some Progesterone only methods “POP”? (4)

• when do u take it??

• and when would u replace them?

1. “mini-pill” ****needs to be taken @ same time daily!!

2. Implant: change q3 yrs

3. IUD: varies 3/5/10 years

4. Shot (Depo-Provera): q3 months

What are Natural Family Planning Methods? (5)

1. abstinence during fertile window

2. coitus interruptus (pull out)

3. Calendar method

4. basal temperature

5. 2 day method

• vaginal secretions present 2 days in a row, no sex!

5. Cervical mucus method

• Thin, stretchy, egg-white-like mucus, no sex!

Whats a diaphragm?

• When should it be placed and removed?

• dome-shaped silicone cup covering the cervix

  • put spermicide on cervical side, insert up to 6 hrs b4 sex, and leave in 6 hrs after!!!

Whats the problem with leaving the diaphragm in over 6 hrs?

• signs? (7)

Toxic Shock Syndrome (TSS)

1. fever

2. rash

3. fainting

4. low BP

5. HA

6. muscle aches

7. diaphoresis

What are the 4 phases of menstrual cycle?

1. Menstrual phase:

• shed uterine lining

• 1st day of bleeding till the last day

2. Follicular phase:

• Estrogen rises → egg matures

• beings with 1st day of menstruation and lasts till day 14 (longest phase)

3. Ovulation:

• egg released from ovary

• day 14

4. Luteal phase:

• progesterone rises+preps uterus for pregnancy

• from day 14-28 (1st day of period)

What are “ACHES” warning signs for COCs?

1. Abd pain

• liver/gallbladder problem or CLOTS!!

2. Chest pain:

• or SOB → CLOT!! in lungs or heart

3. HA (sudden or persistent)

• d/t cardiovascular accident OR HTN

4. Eye problems

• vascular accident OR HTN

5. Severe leg pain

• thromboembolic process/ DVT

How much folic acid should normal women take vs pregnant daily?

• normal: 400 mcg

• preggo: 600 mcg

Whats a normal persons BMI range and normal weight gain?

• 18.5-24.9

• gain 25-35 lbs

How much weight should be gained during the 1st trimester vs 2nd and 3rd?

1st: 2lb-4lbs TOTAL

2nd and 3rd: 1 lb/week

What nutritional considerations should nurse address during pregnancy? (6)

1. take iron supplements

2. calcium 1000 mg daily

3. folic acid daily 600 mcg

4. limit caffeine < 300 mg/day

5. no alc duh/ unpasteurized foods

6. PICA: craves non food items (ice, dirt, chalk, sand)

Xtra calories when breastfeeding and during 3rd trimester:

• breastfeed: +400-500 cals

• 3rd trimester: +452 cals/day

Differences bw barrier vs hormonal methods of contraception in terms of STIs?

• Barrier: condoms; protect against STIs and preggo

• Hormonal: prevents pregnancy BUT NOT STIs