health
Final Exam Study Guide
Conception, fertilization, infertility, Sexually Transmitted Infections, Endometritis
Conception
• After ovulation, the ovum must be fertilized within 12-24 hours for fertilization to occur.
• The sperm’s ability to fertilize the ovum lasts an average of 48-72 hours.
Fertilization & Implantation
1. What is the route that the sperm must travel to reach the
egg?
Vagina > cervix > through uterus > fallopian tube
2. Where does fertilization usually take place?
In fallopian tube
3. How long does it take for implantation?
1 week
4. Where does this usually occur?
uterus
5. Where else could implantation occur?
Fallopian tube; tubal pregnancy
6. What are methods to prevent this from occurring?
Birth control
Infertility
Female AGE: Age greater than 35 years can affect fertility.
DURATION OF INFERTILITY: More than 1 year of coitus without contraceptives. For females older than
35 years or who have a known risk factor, the recommendation is for 6 months.
Male SEMEN ANALYSIS: In 40% of couples who are infertile, inability to conceive is due to male
infertility. This test is the first in an infertility workup because it is less expensive and less invasive than
female infertility testing. It can need to be repeated.
MEDICAL THERAPY
● Ovarian stimulation-medications are prescribed to stimulate the ovary to produce follicles:
◯ Clomiphene citrate
◯ Letrozole
● Other medications used to support ovulation: metformin
● Appropriate antimicrobial medications for preexisting infections
,Common STIs
• Chlamydia: Bacterial
• Gonorrhea: Bacterial
• Syphilis: Bacterial
• Trichomoniasis: Protozoan parasite
• Human Papilloma Virus (HPV): Viral
• Candidiasis: Yeast Infection
What is the most reported bacterial STI in the US?
Chlamydia
Sexually Transmitted Infections: STI
• Bacterial Infections
Chlamydia
• Treat with broad spectrum antibiotic: Azithromycin or Amoxicillin
Gonorrhea
• Treat with broad spectrum antibiotic: Ceftriaxone or Azithromycin
STIs
• Chlamydia and Gonorrhea can be difficult to diagnose because they are often asymptomatic. If
left untreated, can lead to pelvic inflammatory disease (PID), which can lead to infertility.
• In pregnancy it can increase the risk of PROM, Chorioamnionitis, and newborn sepsis.
• The CDC recommends screening all sexually active women younger then 25 years and/or at high
risk be screened at their first prenatal visit and in the third trimester.
Syphilis
Syphilis is caused by the bacterium Treponema pallidum
It has 3 stages: • Primary: painless Genital Chancre (3-90 days) • Secondary: Body Rash (4-10 weeks) •
Tertiary: Internal Organs (3-15 years) •
• Serology Tests: VDRL or Rapid Plasma Reagin (RPR)
• Treatment: Penicillin G IM in a single dose.
Trichomoniasis
,• Trichomoniasis is an STI caused by a protozoan parasite.
• It can lead to PID which can cause infertility.
• Pregnant woman who contract Trichomoniasis are more likely to have preterm delivery and low
birth weight.
• Symptoms: yellow-green, frothy vaginal discharge with foul odor
• Treatment: A single oral dose of Metronidazole.
• What symptom makes Trichomoniasis identifiable?
Odor
Human Papilloma Virus HPV
• It is the most common viral STI and can cause genital warts (cauliflower appearance) and cancers
• It is spread through oral, vaginal and anal sex. Genital warts may require a cesarean delivery.
• A pap spear can detect abnormal changes to the cervix, along with an HPV test that should be
done every 3 years until age 30.
• CDC recommends all 11-12 year olds get 2 HPV vaccines, 3 vaccines if over 14 years.
Candidiasis
Itching and burning
Vaginal pH becomes acidic during pregnancy to protect baby
• Candidiasis (yeast) is a fungal infection
Candidiasis (yeast) is a fungal infection.
• Symptoms: vulvar and vaginal pruritus (itching)
• Assessment: thick, creamy, white cottage cheese-like vaginal discharge.
• Treatment: single dose of oral fluconazole or topical therapies during pregnancy
What are ways to decrease getting a yeast infection?
Avoid tight fitting clothing
Avoid douching
Limit damp clothing
Wear cotton underwear
Increase intake of active cultures “yogurt”
, Endometritis – expected findings
● Pelvic pain
● Chills
● Fatigue
● Loss of appetite
Endometritis – physical assessment findings
◯ Uterine tenderness and enlargement
◯ Dark, profuse lochia
◯ Lochia that is either malodorous or purulent
◯ Temperature greater than 38° C (100.4° F)
◯ Tachycardia
Endometritis- Nursing Care
● Collect vaginal and blood cultures.
● Administer IV antibiotics.
● Administer analgesics.
CLIENT EDUCATION
● Perform effective hand hygiene techniques.
● Maintain interaction with the infant to facilitate bonding
Effectiveness of contraception including The Birth Control Pill, diaphragm, IUD
Spermicides -more effective with condom
• Minimally effective alone
• Use with barrier method increases effectiveness
• Used alone, not effective against Sexually Transmitted Infections (STIs)
Barrier Methods
• Male condom
• Female condom
• Diaphragm
• Cervical Cap
• Vaginal Sponge
The Male Condom
What are advantages and disadvantages of the condom?
Disadvantages
Final Exam Study Guide
Conception, fertilization, infertility, Sexually Transmitted Infections, Endometritis
Conception
• After ovulation, the ovum must be fertilized within 12-24 hours for fertilization to occur.
• The sperm’s ability to fertilize the ovum lasts an average of 48-72 hours.
Fertilization & Implantation
1. What is the route that the sperm must travel to reach the
egg?
Vagina > cervix > through uterus > fallopian tube
2. Where does fertilization usually take place?
In fallopian tube
3. How long does it take for implantation?
1 week
4. Where does this usually occur?
uterus
5. Where else could implantation occur?
Fallopian tube; tubal pregnancy
6. What are methods to prevent this from occurring?
Birth control
Infertility
Female AGE: Age greater than 35 years can affect fertility.
DURATION OF INFERTILITY: More than 1 year of coitus without contraceptives. For females older than
35 years or who have a known risk factor, the recommendation is for 6 months.
Male SEMEN ANALYSIS: In 40% of couples who are infertile, inability to conceive is due to male
infertility. This test is the first in an infertility workup because it is less expensive and less invasive than
female infertility testing. It can need to be repeated.
MEDICAL THERAPY
● Ovarian stimulation-medications are prescribed to stimulate the ovary to produce follicles:
◯ Clomiphene citrate
◯ Letrozole
● Other medications used to support ovulation: metformin
● Appropriate antimicrobial medications for preexisting infections
,Common STIs
• Chlamydia: Bacterial
• Gonorrhea: Bacterial
• Syphilis: Bacterial
• Trichomoniasis: Protozoan parasite
• Human Papilloma Virus (HPV): Viral
• Candidiasis: Yeast Infection
What is the most reported bacterial STI in the US?
Chlamydia
Sexually Transmitted Infections: STI
• Bacterial Infections
Chlamydia
• Treat with broad spectrum antibiotic: Azithromycin or Amoxicillin
Gonorrhea
• Treat with broad spectrum antibiotic: Ceftriaxone or Azithromycin
STIs
• Chlamydia and Gonorrhea can be difficult to diagnose because they are often asymptomatic. If
left untreated, can lead to pelvic inflammatory disease (PID), which can lead to infertility.
• In pregnancy it can increase the risk of PROM, Chorioamnionitis, and newborn sepsis.
• The CDC recommends screening all sexually active women younger then 25 years and/or at high
risk be screened at their first prenatal visit and in the third trimester.
Syphilis
Syphilis is caused by the bacterium Treponema pallidum
It has 3 stages: • Primary: painless Genital Chancre (3-90 days) • Secondary: Body Rash (4-10 weeks) •
Tertiary: Internal Organs (3-15 years) •
• Serology Tests: VDRL or Rapid Plasma Reagin (RPR)
• Treatment: Penicillin G IM in a single dose.
Trichomoniasis
,• Trichomoniasis is an STI caused by a protozoan parasite.
• It can lead to PID which can cause infertility.
• Pregnant woman who contract Trichomoniasis are more likely to have preterm delivery and low
birth weight.
• Symptoms: yellow-green, frothy vaginal discharge with foul odor
• Treatment: A single oral dose of Metronidazole.
• What symptom makes Trichomoniasis identifiable?
Odor
Human Papilloma Virus HPV
• It is the most common viral STI and can cause genital warts (cauliflower appearance) and cancers
• It is spread through oral, vaginal and anal sex. Genital warts may require a cesarean delivery.
• A pap spear can detect abnormal changes to the cervix, along with an HPV test that should be
done every 3 years until age 30.
• CDC recommends all 11-12 year olds get 2 HPV vaccines, 3 vaccines if over 14 years.
Candidiasis
Itching and burning
Vaginal pH becomes acidic during pregnancy to protect baby
• Candidiasis (yeast) is a fungal infection
Candidiasis (yeast) is a fungal infection.
• Symptoms: vulvar and vaginal pruritus (itching)
• Assessment: thick, creamy, white cottage cheese-like vaginal discharge.
• Treatment: single dose of oral fluconazole or topical therapies during pregnancy
What are ways to decrease getting a yeast infection?
Avoid tight fitting clothing
Avoid douching
Limit damp clothing
Wear cotton underwear
Increase intake of active cultures “yogurt”
, Endometritis – expected findings
● Pelvic pain
● Chills
● Fatigue
● Loss of appetite
Endometritis – physical assessment findings
◯ Uterine tenderness and enlargement
◯ Dark, profuse lochia
◯ Lochia that is either malodorous or purulent
◯ Temperature greater than 38° C (100.4° F)
◯ Tachycardia
Endometritis- Nursing Care
● Collect vaginal and blood cultures.
● Administer IV antibiotics.
● Administer analgesics.
CLIENT EDUCATION
● Perform effective hand hygiene techniques.
● Maintain interaction with the infant to facilitate bonding
Effectiveness of contraception including The Birth Control Pill, diaphragm, IUD
Spermicides -more effective with condom
• Minimally effective alone
• Use with barrier method increases effectiveness
• Used alone, not effective against Sexually Transmitted Infections (STIs)
Barrier Methods
• Male condom
• Female condom
• Diaphragm
• Cervical Cap
• Vaginal Sponge
The Male Condom
What are advantages and disadvantages of the condom?
Disadvantages
