OB/GYN Test 1 Nursing Study Notes

OB/GYN Test 1 Nursing Study Notes

• Standard Days Method: Count from first day of period for 14 days. Days 14-24 are fertile. No sex during fertile days.

• Basal Body Temperature Method: Measure temperature every morning before getting out of bed. Ovulation is indicated by a dip, then a spike in temperature.

• Cervical Mucous Ovulation-Detection Method: Monitor cervical mucus condition. Abstain during "egg white" days.

• Male and Female Condoms: Only contraceptive method protecting against STIs. Never use both at the same time. Inconsistent use is a problem.

• Cervical Sponge: Barrier method of contraception, rarely used. Single use, more expensive than other methods.

• Cervical Cap: Barrier method of contraception, fitted, requires spermicide. Use for at least 6 hours after intercourse, but no longer than 48 hours. Risk of toxic shock syndrome. Use other birth control during period.

• Diaphragm: Barrier method of contraception, fitted annually. Re-evaluated after weight changes, birth, or surgery. Can be placed up to 6 hours before intercourse. Use 2 tsp of spermicide in diaphragm. Leave in for 6 hours after intercourse.

Combined Oral Contraceptives

• Suppress ovulation by adding estrogen and progesterone.
• Increases cervical mucus thickness.
• Inhibits ovulation.
• Thins lining of uterus.

Oral Progestins

• Do not contain estrogen, ovulation remains.
• Thickens cervical mucus.
• Thins uterine lining.
• Taken at the same time daily.
• Safe for breastfeeding.

Missed Oral Contraceptive Pills

• One missed pill: Take it as soon as possible and continue at regular time. No backup needed.

• Two missed pills (week 1 or 2): Take two pills a day for two days. Finish the pack normally. Use a backup method for 7 days.

• Two missed pills (week 3): Sunday starter pack: Take one pill every day until Sunday. Start a new pack on Sunday. Use a backup method for 7 days. Day 1 starter pack: Throw away the rest of the pack. Start new pack on the same day. Use a backup method for 7 days.

• Three or more missed pills: Use a Sunday starter pack or a day 1 starter pack. Use a backup method for 7 days.

Other Contraceptive Methods

• The Patch: Transdermal contraceptive system applied to lower abdomen, upper outer arm, buttocks, or upper torso, except breasts. For those 198lbs or less. Applied weekly.

• Depo-Provera: Injectable progestin. Given first 5 days of menstrual cycle, then every 11-13 weeks. It can inhibit pregnancy for 12-18 months after stopping. Good for teenagers.

• Vaginal Ring: Inserts for 3 weeks, releasing hormones to stop ovulation. Take out for 1 week.

• Implantable Progestin Device (Nexplanon): Placed under the skin of the arm. Effective for 3 years. Great for teenagers.

• Intrauterine Device (IUD): Constant contraception from intrauterine device, hormonal or non-hormonal. Impairs sperm motility, irritates uterine lining, thickens cervical mucus.

• Signs of IUD complications: Period irregularities, pregnancy, abnormal spotting or bleeding. Abdominal pain, pain during sex. Infection exposure, abnormal vaginal discharge. Feeling unwell, fever, or chills. String missing; shorter or longer (PAINS)

• Plan B: Emergency contraception. Use within 72 hours of unprotected sex.

• Vasectomy: Ligation and severance of the vas deferens. Safe and simple procedure. Does not provide immediate contraception and does not protect against STIs

Diseases and Conditions

• Chlamydia: Most common STI. Often asymptomatic. Can cause PID, newborn blindness.

• Gonorrhea: Second most common bacterial STI. Often co-infected with chlamydia. Curable. May be asymptomatic or have strawberry cervix, cervicitis, or greenish yellow discharge.

• Trichomonas Vaginalis: Parasitic STI. Symptoms: itching in genital area, smelly thin vaginal discharge, burning with urination, pain with sex. Curable.

• Human Papillomavirus (HPV): Most common viral STI. A cause of cervical cancer. Low risk types cause genital warts. High risk causes cancer. No cure. Preventable.

• Herpes Simplex Virus (HSV): Cold sores (HSV1) or Genital Herpes (HSV2). No cure, suppressive therapy available.

• Hepatitis B: STI transmitted through blood, saliva, semen, vaginal secretions. Result in liver damage. Preventable through immunizations.

• Dysmenorrhea: Extremely painful menstruation.

• Menorrhagia: Heavy menstrual bleeding.

• Dyspareunia: Painful intercourse.

Other Procedures and Tests

• Salpingectomy: Tying or removal of fallopian tubes. Risk of ectopic pregnancy is reduced.

• Chorionic Villus Sampling: Performed at 10-13 weeks. Diagnoses chromosomal problems. Collects a sample of chorionic villi from the placenta.

• Nuchal Translucency Screening: Measures the fetal neck fold. Screens for chromosomal abnormalities. Performed at 11-14 weeks.

• Alpha-fetoprotein Analysis (AFP): Measurement of AFP in maternal blood (16-18 weeks). Screens for neural tube defects and trisomy.

• Marker Screening Tests: Used to identify fetal risk for trisomy 13, 18, and 21, and neural tube defects. Performed at 16-18 weeks. Triple or quad screening.

• Doppler Flow Studies: Measures blood flow in the fetus. Used in mothers with chronic hypertension or preeclampsia. Noninvasive.

• Amniocentesis: Collection of amniotic fluid. Screens for chromosomal abnormalities. Performed at 15-20 weeks and 35 weeks.

• Non-Stress Test: Indirect measure of uteroplacental function and fetal well-being. Assess fetal heart rate for 20 minutes.

• Biophysical Profile: Ultrasound and non-stress test to assess fetal well-being. Reduces stillbirth, hypoxia detection.

• Pregnancy Tests: Urinalysis, CBC, Blood typing and Rh factor, Rubella titer, Hep B surface antigen, HIV test, RPR/VDRL (syphilis).

• Continue Routine Labs Each Visit: Blood pressure, urinalysis, fundal height, fetal movement, fetal heart rate

Other Important Info

• False labor: Contractions irregular or regular but stop with walking/position changes, short & mild, upper back and upper abdomen. Cervix softens but no dilation. Fetus not engaged.
• 5 Ps Affecting Labor and Birth: Passageway, passenger, powers, position, psychological response
• Ideal Pelvis Shape for Vaginal Delivery: Gynecoid
• Dilation of Cervix: Progressive opening of cervix. Measured 0-10 cm.
• Effacement: Thinning of the cervix (0-100%)
• Engagement: Presenting part passing through the pelvic brim.
• Station: Relationship of presenting part to ischial spines.
• Cephalic Presentation: Head first
• Vertex Presentation: Head first, chin tucked
• Breech Presentation: Buttocks or feet first.
• Two Primary Fetal Lies: Cephalic and breech.
• Fetal Position: Relation of landmark on presenting part to mother's pelvis. Abbreviated by letters.