EXAM ONE REVIEW
modules 1 & 2
HIPAA- Health Insurance Portability and Accountability Act of 1996. Ensures that
information is kept confidential and only viewed by those with an active role in the
care of the patient.
Family Communication- Family is the primary unit of socialization; it plays a
pivotal role in health care decisions. The focus is turning to family-centered care.
Family is whatever the patient says it is.
· Genogram: 3 generations of your family. It includes age, sex, & medical
diagnosis.
· Ecomap: Social relationships of women and family.
Interprofessional Communication- SBAR, Delegating, Patient-Centered Care,
Informatics, QSEN, Evidence-Based Practice
Teaching and Learning Process:
Teaching: imparting knowledge or giving instruction
Learning: acquiring knowledge of skills through instruction or experience
Health Literacy: ability to obtain, process, and understand basic information and
services needed to make appropriate health decisions and follow instructions of
treatment.
Role of Health Literacy and Nursing-
· Read and identify credible health information
· Understand numbers in context of the patient's health record
· Make appointments
· Fill out forms
· Gather health records and ask appropriate questions
· Use technology to access information and services
· Navigate complex insurance programs
CONTRACEPTION-
o Intentional prevention of pregnancy.
o Birth control is the device or practice to decrease the risk of conceiving.
o Family planning is the conscious decision on when to conceive or avoid
pregnancy.
o No contraception is 100% affective. Person may still be at risk for
pregnancy.
- Responsible Sexual Behavior is SAFE SEX. Safe sex includes condoms, abstinence,
oral contraceptives, diaphragm, vaginal ring, Norplant, Depo Provera
- Approximately 15% of couples in the US have some degree of infertility. BUT more
than 50% of pregnancies in the US each year are unintended (not a part of family
planning).
Oral Contraception-
· 99% effective when used APPROPRIATELY (appropriate use discussed more in
pt. teaching).
, · What are some contraindications?- antibiotics, smokers (increase risk of
blood clots), cancer or family history of cancer, person with memory problems
· Patient Teaching? - NO smoking, taking it at the same time, missed dose -
take as soon as your rememeber, but it lowers the effectiveness, side effects:
change in mood or appetite, missed period, break through bleeding
IUDS:
Assess for PAINS:
P: period late
A: abdominal bleeding
I: infection
N: not feeling good
S: string is missing (longer/shorter)
Male Condoms: Consistent/correct use of latex condoms ("made in the USA
recommended") are effective in preventing sexual transmission of HIV infection and
can REDUCE RISK OF OTHER STDs. Prevention of infections transmitted by fluids
from mucosal surfaces (GC, CT, trichomonas, HIV) than those transmitted by skin-
to-skin contact (HSV, HPV, syphilis).
*Avoid condoms with NONOXYNOL 9 (spermicide)
Spermicides: N-9 vaginal spermicides are not effective in preventing CT, GC, or
HIV infections.
· Frequent use of spermicides/N-9 have been associated with genital lesions.
· Spermicides alone are not recommended for STD/HIV.
· N-9 should not be used as a microbicide or lubricant during anal intercourse.
Coitus interruptus - “pulling out”
Sponge: wash hands thoroughly; moisten the sponge with water, don't soak; place
sponge in vagina, against cervix; The string should be toward the outside of the
body.
Can be left in place for up to, but not more than 24 hours (can cause Toxic
Shock Syndrome), and can be used for numerous intercourses. Leave in place
at least 6 hrs after sex.
REMOVAL-- Pull on the string attached to the sponge to remove it.
Diaphragm- has a 16% failure rate.
Other options for Birth Control: Hormonal patches; injections; implants=
etongesteral implant; vaginal ring; cervical caps; spermicidal; emergency
contraceptive pill; oral contraceptives (99-100% effective…) Who should not take
these?; Sterilization (Vasectomy, Tubal Ligation).
With any intra-vaginal device: call HCP if… Fever (for unknown reason), abdominal
pain… Think toxic shock syndrome…
, Toxic Shock Syndrome treatment: Multidisciplinary approach, antibiotics,
corticosteroids possible, blood administration may be necessary, rare but acute
illness caused by Staph Aureus, Associated with tampons or vaginal barriers
(sponge, vaginal ring, cervix caps).
Sterilization (if federal funds are used) client MUST be 21 years of age
regardless of number of children.
· 30 day waiting period once consent is signed.
· Informed consent must be in person's native language or have an interpreter
to translate.
Pap Smear: Effective in detecting precancerous and cancerous cells from the
cervix. Also used to detect viral, fungal, and parasitic disorders.
Recommendations: 1st pap at age 21 (or within 6 months of becoming sexually
active); ages 21-29- every 3 years (including HPV screen); 30- ever 5 years if
HPV is included- every 3 years if PAP done alone; after 65 depending on
medical history; If after hysterectomy including removal of cervix, no longer
needed if no history of abnormal paps
Reproduction/Normal Reproductive Health-
· Total process by which organisms produce offspring.
· Sequence of reproductive process: Gametogenesis (formation of sperm and
ova), ovulation, fertilization, cleavage, implantation
· Stages of development: ovum, embryo (weeks 4-8, greatest risk for
teratogenicity), fetus (weeks 9 to birth)
· Menstruation
Abnormalities of Menstrual Cycle:
Primary dysmenorrhea- occurs with no organic disease, common under 20
years of age
Secondary dysmenorrhea- associated with pelvic disease
(endometriosis/uterine fibroids)
Amenorrhea- absence of menstrual periods
Oligomenorrhea- light irregular menses
Menorrhagia- excessive uterine bleeding, occurs at regular intervals
Metrorrhagia- uterine bleeding, normal amount, occurs at irregular intervals
Perimenopause: prior to the onset of menopause. 3-11 months of amenorrhea or
increased irregularity. It is natural, it can occur over 3-5 years. Surgical removal of
ovaries cause immediate onset.
Clinical/psychological manifestations-
Menopause: amenorrhea for (1) full calendar year. Average age is 51.5 years old.
· Signs/symptoms: hot flashes/night sweats; mood swings/forgetfulness;
insomnia; vaginal dryness; heart disease; osteoporosis.
Structural disorders:
Fistula- abnormal tube-like passage: due to incomplete closure, injury,
inflammation