Gynecologic Health Care Schuiling chp. 4-7

Gynecologic Health Care Schuiling chp. 4-7 Adolescence - -10-21 -Early = 11-14 -Mid 15-17 -Late 18-21 -Consists of puberty and changes in the brain. -Adult height and weight will be attained. -For females in consists of breast development and menarche** (important milestone) -Identity vs autonomy Adolescence - Mobidity - Pregnancy, STD, running away, and suicide Early Adulthood - age 18-35 This is the reproductive years Early adulthood important aspects - Contraception, substance abuse, intimate partner violence, stress, and psychiatric illness Early adulthood - two main crisis - Intimacy vs isolation, generativity vs stagnation Early adulthood - health disparities - Cardiac is the #1 killer, stress, smoking, lack of exercise, and poor nutrition. Midlife adulthood - 35-50 years - 50-65 years Perimenopausal to menopause Midlife Adulthood - is time for - transitions. Less estrogen = hot flashes, decreased genitalia, breast changes, decreased skin elasticity Older women - WOMEN WHO HAVE COMPLETED MENOPAUSE Often are caregivers to spouses. Fixed incomes, poor diet and exercise What tests are covered by the affordable care act - Well women exams: counseling, screening, immunizations Contraceptives Breastfeeding support: pumps and supplies Maternity and newborn care Primary care - Preventing disease in susceptible population Examples: health education, counseling, lifestyle modification, immunizations Secondary care - Early detection of disease states and treatment to reduce severity Examples: routine laboratory screenings and mammograms Vaccines for all adults - Flu TDAP MMR Varicella PCV 13 PPSV23 Hep A, B Men ACWY MenB HIB Tdap - every 10 years, with every Pg, with wounds MMR - 1-2 Varicella - 2 doses PCV13 - 1 dose PPSV23 - 1-2 doses Hep A & B - 2-3 doses MenACWY - 1-2 doses MenB - 2-3 doss HIB - 1-3 doses ages 19-23 specific vaccine difference - HPV 2-3 doses Ages 27-49 specific vaccine differences - HPV from 27-45 recommended Ages 50-64 vaccine differences - NO live flu or HPV Add zoster vaccine 2 doses Ages 65 vaccine differences - No LIVE flu, MMR Add zoster vaccine 2 doses PCV and PPSV only 1 dose Skene's glands - Located adjacent and distal to the urethra -releases mucus Bartholin's glands - Glands of the female genitalia that secrete a lubricating fluid during sexual excitement. Average age of menarche - 12-15 years Average age of menopause - 45-55 from powerpoint 51 found online Usual menstrual cycle length - 21-35 days with flow being 3-5 days Hypothalamus produces - GnRH to the pituitary the Anterior pituitary produces _____ in response to the GnRH - FSH and LH to the ovary it produces other hormones too Ovary produces ______ in response to the LH and FSH - estrogen and progesterone Ovarian cycle: 3 phases - follicular phase, ovulation, luteal phase Ovarian Cycle: Follicular Phase - days 1-14, period of follicular growth - Increase in FSH and estrogen Ovarian cycle: Ovulation - Estrogen feedback increases LH -LH surge 34-36 hrs prior to ovulation - ovulation occurs 10-12 hours after peak of the surge Ovarian Cycle: Luteal phase - Corpus luteum functions for 8 days. Secretes progesterone and some estrogen Uterine/endometrial cycle three phases - Proliferative, secretory, and menstruation Uterine/endometrial cycle: Proliferative - from day 4 and lasts 10 days and ending with ovulation. -influenced by estrogen Uterine/endometrial cycle: secretory - Begins at ovulation if there is no ovulation this does not occur -Endometrial thickening secondary to increase in progesterone