Obstetrics and Gynecological Conditions - NCLEX-PN

The criteria for diagnosis of PID are as follows: fever, cervical motion tenderness, abdominal pain, leukocytosis, elevated ESR, and purulent cervical discharge.

The primary risk in rubella infection during pregnancy is to the fetus. The rubella virus is able to cross the placenta, and acts as a teratogen by inducing apoptosis in fetal cells. This is termed congenital rubella syndrome. Birth defects can include deafness, ocular damage, cataracts, congenital heart defects, hepatomegaly, and developmental disability or delays.

Rh sensitization can be prevented by treatment of an Rh negative mother with Rho(D) immunoglobulin at 28 weeks, then again within 72 hours of delivery. This is a solution of IgG antibody to Rh-D, which is able to destroy any fetal red blood cells that enter the mother's bloodstream before her own immune system is able to form develop a sensitization.

Yoga once per week (light exercise) is the least likely of the above to cause a change in regular menstruation. Cross country or long distance running (vigorous exercise) is more likely to cause changes to a woman's cycle. Poor lifestyle choices such as eating habits and health issues such as kidney disease can also cause irregular menstruation. Likewise, pharmaceuticals can have the same effect.

There are many different ways to treat painful periods (dysmenorrhea). Ibuprofen and naproxen are anti-inflammatory agents that do not require a prescription and can be very effective. They have relatively few side effects. Lifestyle modification (such as exercise) is another good alternative. The use of oral contraceptives are also frequently used to give women lighter and milder periods. Percocet is not generally used because it is an opioid analgesic and not recommended for long term use because they carry potential for addiction.

Metrorrhagia is bleeding between periods. Menorrhagia refers to excessively heavy periods. Oligomenorrhea refers to light, scattered periods (typically spaced by greater than 35 days). Polymenorrhea is used to describe short cycles of equal to or less than 21 days. Menometrorrhagia is used to describe periods that are heavier, sporadic, and more frequent than normal periods.

Diethylstilbestrol (DES), a medication used from 1940 to 1971 to reduce the risk of miscarriage, resulted in the later development of clear-cell adenocarcinoma in many of the unborn children of these pregnancies.

According to the family planning method of contraception, the period in which conception can occur and one should refrain from intercourse is up to 7 days before and 7 days after ovulation. Some references show that sperm can live for up to five to seven days inside the female reproductive system. An unfertilized egg can live from between 12-24 hours. This greatly increases the window in which conception can occur.

Oral contraceptives may increase the risk of breast cancer, increase the risk of depression, and increase the risk of developing a blood clot (higher in women who smoke cigarettes). They can reduce the risk of uterine cancer and are frequently used in women with primary dysmenorrhea. Primary dysmenorrhea refers to painful menstrual cycles without an underlying cause.

Amenorrhea is the complete absence of a period. There are many different causes for amenorrhea. One of the most frequent causes of amenorrhea for women in the fifth decade of life, is menopause. Menopause is the most likely cause of amenorrhea in this particular patient because she has not been experiencing periods for 12 months and is 51-years-old. While pregnancy is possible, the nurse would suspect menopause first. Pelvic inflammatory disease (PID) is a pelvic infection usually resulting in severe pain. Endometriosis is a condition in which uterine tissue inappropriately grows in areas such as the rectum or ovary, also typically causing severe pain. Polycystic ovarian syndrome is a condition causing hormone imbalance. It can cause amenorrhea. This question requires the use of strategy to answer. There are several choices that could be responsible for amenorrhea, but which one is the most correct?

Magnesium sulfate is used to prevent seizures in women with severe preeclampsia. Calcium gluconate is the antidote if magnesium toxicity is assessed. It should be readily available when a woman is receiving magnesium sulfate. Pitocin is used to stimulate the uterus, often to induce labor. Nubain is an opioid that can be given to women during labor to treat pain. Zolpidem (Ambien) is a sleep aid.

In pregnancy, the ribs start to flare (expand slightly) as the pressure from the growing fetus moves the diaphragm upwards. Many women experience this during the third trimester as the baby is at it's largest. The flaring of the ribs is assisted by maternal hormones that enable more flexibility throughout the body.

Induction of labor may occur for various indications: diabetes, postmaturity, hypertensive disorders or pregnancy, fetal jeopardy, or logistical factors including distance from qualified hospital or a rate of rapid birth. Induction of labor may only occur if the mother does not have cephalopelvic disproportion (CPD), the fetus has a vertex presentation with an engaged head, and the mother has a "ripened" cervic or is prepared to be "ripened". Fetal macrosomia is a concerning condition and may require intervention, but is typically not resolved by inducing labor. With fetal macrosomia, a cesarean section may be considered instead of vaginal delivery, due to the potential risks of delivering a large infant vaginally.

Increasing fluid and oxygen administration may increase the overall oxygenation of the fetus and result in greater variability in heart rate. It is advisable to change the position of the patient, however, a supine position is not compatible with pregnancy. Contacting the provider is an acceptable intervention given concern for fetal well-being.

The most common cause of mucopurulent cervicitis is chlamydia trachomatis, followed by neisseria gonorrhea. Human papillomavirus, while it is associated with increased risk of development of cervical cancer, does not cause mucopurulent cervicitis, nor does herpes simplex.

Placental aromatase deficiency is a condition that prevents testosterone from being aromatized into estrogen during pregnancy. This results in a temporary masculinization of the mother that does not continue past delivery. Neither chloasma nor growth hormone deficiency result in masculinization, and masculinizing symptoms of polycystic ovarian syndrome often improve during pregnancy, rather than getting worse.

Lichen sclerosus is a condition that presents as vulvar pruritus and pain with porcelain-white vaginovulvular atrophy. It is most common in post-menopausal women, though it does occur on occasion in younger women and girls. While all of the other conditions listed can cause puritis and pain, none of them are associated with frank atrophy.

The Amsel criteria for bacterial vaginosis are as follows: clue cells seen on microscopic examination, a positive "whiff" test on addition of potassium hydroxide to the vaginal discharge, a vaginal pH > 4.5, and thin gray or white vaginal discharge.

The most common tumor of the female reproductive tract by far is uterine leiomyoma, also known as a uterine fibroid. Uterine fibroids are benign smooth muscle tumors that grow into the myometrium. They can often cause pain in the lower back or pain during penetration, dysmenorrhea, and menorrhagia.