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.

All of these could be possible reasons for bleeding in early pregnancy, including physiologic or implantation bleeding. Bleeding may indicate threatened miscarriage or other serious condition, or it may simply be due to the implantation of the embryo into the endometrium.

Preeclampsia is a potentially life-threatening disorder that generally includes gestational hypertension, proteinuria, edema, red-blood cell dysfunction, and signs of liver or kidney dysfunction. It is more common in weeks 32-40 and develops in 2-8% of pregnancies worldwide.

There are several risk factors for preeclampsia. These include history of hypertension, diabetes, older maternal age, first-time pregnancies (primigravida), and pregnancies with twins or multiples.

Preeclampsia develops into eclampsia at the onset of seizures. Seizures are tonic-clonic and may appear during pregnancy, during labor, or postpartum. It is relatively rare, affecting only approximately 1.2-1.8% of pregnancies.

The most common time for miscarriage to occur is during the first trimester, between 8 and 12 weeks. This may even occur before an individual is aware that they are pregnant. Chromosomal abnormalities are identified in approximately 50% of first trimester miscarriages, while later miscarriages may be more likely in individuals with uterine malformations or cervical incompetence.

Endometriosis will increases risk of both infertility and of miscarriage. This may be due to a paracrine effect as hormones are released locally by ectopic endometrial tissue, causing disruptions in hormone levels required for implantation and for sustaining an implanted embryo before the formation of the placenta.

In a study surveying 120 women with endometriosis, the prevalence of celiac disease, an autoimmune condition triggered by ingestion of gluten, was nearly four times higher than the general population. No association has been made between the presence of endometriosis and lactose intolerance or incidence of anaphylaxis.

In placenta previa, the placenta develops in such a way that all or part of it is positioned in the lower one-third of the uterus, placing it between the fetus and the cervix. This can cause the placenta to tear and bleed. The most common sign is painless vaginal bleeding in the third trimester (generally after week 32).

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.