B234 Exam 3

what would a woman notice when checking her basal temperature prior to ovulation

temperature will drop

what kind of condoms do NOT protect against HIV and other STIs

natural ones (lambskin)

what kind of condoms protect against HIV and other STIs

male condoms

what type of lubricants should be used with condos and what type should not

use water-soluble ones and NOT oil-based

what birth controls are considered hormonal

implants, IUDs, pills, rings, skin patches, and injections

what birth controls are chemical

spermicides that inactivate the sperm (sponge)

how does the contraceptive sponge work

fits over the cervix, supposed to fit just over the opening of the cervix to kill the spermicide

which methods of birth control are considered permanent

tubule ligation and vasectomy

which methods of birth control are considered long-actin reversible contraceptives (LARC)

nexplanon (arm) and IUS

which women should avoid using the diaphragm as a method of birth control

history of toxic shock syndrome, latex allergy, or frequent UTIs

what would you teach a woman about diaphragm use in terms of when it can be inserted, how long it needs to stay in place, and what needs to be used with it

use it right before or up to 6 hours before intercourse, stays in place for up to 6 hours after intercourse, and use with a spermicide

how does phexxi's contraceptive gel work

keeps the vaginal pH within normal pre-sex range, can be used alone or in addition to barrier method, and up to 60 minutes before having intercourse

what would you teach a woman about how to use the vaginal contraceptive ring (how often it changes, how long it stays in)

change every 3 weeks, and stays in for 3 then take out for 1

what would you teach a woman about how to use the transdermal contraceptive patch (how often it is changes, how long it stays on, where it goes)

change every week, stays on for 1 week then removed then added another, goes on rotating sites of the body

what hormones are contained in combined oral contraceptives (COCs)

estrogen and progestin

what hormone is contained in depo-provera injections

progestin

what are the contradictions for COCs

smokers > 35, history of CV or CAD, HTN, breast cancer, pregnancy, estrogen dependent or liver tumors, lactation less than 6 weeks, headaches, history of diabetes mellitus, thromboembolic disorders

what are ACHES

abdominal pain, chest pain, headache/hypertension, eye problems, severe leg pain/swelling/heat/redness

how often is depo-provera adminsitered

every 3 months

what hormone is in nexplanon and how is the method of bc administered

progestin, every 3 years

what are the 2 main types of IUDs

mirena, skyla, liletta, kyleena

paraguard

which IUD may be used as an emergency contraceptive

paraguard, mirena, liletta

how does a physicians office determine when a post-vasectomy man is no longer able to father children

must have 2 consecutive sperm counts of 0

what contraceptives are the most effective (tier 1) - less than 1 pregnancy per 100 women

implant, vasectomy, tubul occlusion, IUD

what contraceptives are in tier 2 - 4-7 pregnancies per 100 women

injectable, pill, patch, ring

what contraceptives are the least effective (tier 3) - more than 13 pregnancies per 100

male condom, fertility awareness based methods, diaphragm, sponge, withdrawal, female condom, spermicides

how is our state vs allen county doing in meeting Healthy People 2030 infant mortality goal of 5 infant deaths per 1000

indiana: 6.75, allen county 7.3

what can be done to reduce infant mortality rates

Improve overall health for women

Promote early and quality prenatal care

Decrease elective deliveries before 39 weeks gestation

Decrease smoking & substance abuse

Increase breastfeeding

Support birth spacing

Promote safe sleep for infants

what are the recommendations for preconception care and counseling

being up to date on vaccines, folic acid to prevent NTDs, chronic disease management, screening and treatment for STIs and depression, lifestyle modifications

which trimester contains the most critical time of embryonic development in terms of brith defects

1st trimester

what does GTPAL stand for

gravida, term (38-42 weeks), preterm (20-37 weeks), abortion (elective and spontaneous), living children

what does GTT stand for

glucose tolerance test

what does gravida mean

pregnancy

what does nulligravida mean

a woman who has never been pregnant

what does EDD stand for

estimated date of delivery

what does EDC stand for

estimated date of confinement

what does multigravida stand for

woman who has had 2 or more pregnancies

what does HCG stand for

human chorionic gonadotropin

what does CRL stand for

crown rump length

what does NTD stand for

neural tube defects

what does FHR stand for

fetal heart rate

what does NAS stand for

neonatal abstinence syndrome (groups of conditions caused when a baby withdraws from certain drugs they are exposed to in the womb before birth)

whats the time frame for term pregnancy

38-42 weeks

what is the time frame for preterm pregnancy

20-37 weeks

what is the time frame for post-term pregnancy

beyond 42 weeks

what is the time frame for the first trimester

14-26 weeks

what is the time frame for the 2nd semester

14-26 weeks

what is the time frame for the 3rd trimester

27-40 weeks

what is the time frame for viability

23-24 weeks

how do you calculate naegele's rule

determine LMP, subtract 3 months, add 7 days

what hormone is tested for in pregnancy tests

HCG (human chorionic gonadotropin)

what are presumptive signs of pregnancy (subjective)

nausea/vomiting, change in breast size, increased urinary frequency, missed menstrual period

what are the probable signs of pregnancy (objective)

enlargement of uterus, softening of the uterine isthmuc, bluish/cyanotic color of the cervix or upper vagina, softening of the cervix, positive HCG test, changes in skin pigmentation

what are the positive signs of pregnancy (can't be taken for anything else)

auscultation of fetal heart, fetal movements detected by a examiner, visualization of the embryo or fetus

what is the typical prenatal schedule visit

- Initial visit (history, pap, pelvic, bloodwork, CCMS for C & S) and education

- Q4 weeks up to 32 weeks gestation-BP, weight, urine dip

- Q2 weeks from 32 to 36 weeks gestation

- Weekly from 36 to 40 weeks gestation

- 40 to 42 weeks: twice weekly, NST prn

what are the specific recommendations for a pregnant woman's diet

64-96 oz of water, 70g of protein, increased fiber, increased vitamins/minerals (ironmg, folic acid 400mcg), prenatal visit

what is the recommended weight gain for a woman with a normal BMI

25-35 lbs

why have rates for spina bifida gone down

increased intake of folic acid

what is quickening and when is it felt

Fetal movement (16-20 weeks)

what is the TORCH screen

toxoplasmosis, other (hep B, HIV, varicella), rubella, cytomegalovirus, herpes simplex

how does the treatment of an HIV+ pregnant mom help the baby in terms of HIV transmission

monitoring infection to limit transmisson

what moms are in the high-risk group for HIV

IV drug user, bisexual partners, multiple sexual contacts, hx STIs, exchange sex for money or drugs

when is the GTT done and what information does it provide

between 24 and 28 weeks of pregnancy, tests for gestational diabetes in low-risk women

Which babies are at risk for Rh incompatibility and why?

when the mother is negative and the father and fetus are positive

who should recieve RhoGam and when is it given

all pregnant women with Rh-poisitve blood type, at 28 weeks and within 72 hours of post-birth

what are the effects of alcohol on a fetus

fetal alcohol syndrome

what are the effects of nicotine on a fetus

prematurity, low birth weight, congenital abnormalities

secondhand smoke (asthma, SIDS, respiratory infections, ear infections)

behavioral counseling for smoking cessation

what is Pica

eating non food items

what is vena cava syndrome

group of symptoms that happen when something blocks or compresses your superior vena cava

when are FHRs normally heard

10-12 weeks

what is a nonstress test and the desired results

prenatal test to check on baby's health (baby's heart rate is monitored to see how it responds to movements), reactive NST (contains 2 or more FHR acceleration within 20 minutes)

for contraction stress tests (CSTs) what results are desired

no late decelerations (negative results)

what are testing and treatment guidelines for group B streptococcus infection

between 35-37 weeks on all pregnant women

why is it important to test for GBS infection

baby may develop bacterial infection of transmission during descent in the birth control (can lead to sepsis)

when considering cervical dilation, how many cm do the following compare

penny 2cm, oreo 4cm, soda can 6cm, donut 8cm, bagel 10cm

what is normal baseline FHR

110-160 bpm

what is VEAL CHOP

variable decelerations - cord compression

early decelerations - head compression

accelerations - okay

late decelerations - placental insufficiency

what are braxton hick's contractions

They are preterm or false labor contractions.

what is effacement

Shortening and thinning of the cervix

what is dilation

opening and enlargement of cervix; expressed in centimeters (1 to 10 cm

what does frequency mean in relation to contractions

how frequent the contractions are, beginning of one contraction to the next

what does duration mean in relation to contractions

how long the contractions are lasting, from beginning of one contraction to the end of the same contraction

what does interval mean in relation to contractions

relaxation time, period between the end of one contraction and the beginning of the next contraction

what does intensity mean in relation to contractions

mild, moderate, strong