Final Exam Nursing Study Guide

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 rout ...

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”