Women’s health encompasses breast care, GYN exams, and assessments. Be comfortable with
the parameters of education for Self breast exams, normal
... [Show More] menstrual cycle - what is the most
common complaint with the menstrual cycle, and complications; STI’s and risks.
The most common compliant women have with menstrual cycle is abnormal bleeding,
painful menses (dysmenorrhea), treatment is heating pad and NSAIDs. Other OBGYN
complaints are fibroids, ovarian cysts, endometriosis. Self breasts exams monthly 7-10
days after the cycle. Two hormones with women’s health are Estrogen(growth hormone
makes everything bigger), Progesterone(slows things down, makes lining thicker, the
pregnancy will not survive without enough of this hormone)
2. If a patient finds a breast lump how will you advise her?
Its never normal to feel a lump, make sure you follow up and have other testing,
discharge is not normal unless it’s a milk discharge after pregnancy
3. What is your role in the GYN exam
Our role in the GYN exam assisting the physician and the patient, explain to her what is
happening so she is not nervous, pap smears are never down in the ER
4. Contraception - Forms of birth control – good subject for your postpartum patients as well –
know them, know the risks and some of the educational points to share with them regarding
each type. Remember birth control choice should be based on a patient’s lifestyle – if she can
not swallow pills do not offer oral contraception – right? Etc…
Types of birth control- diaphragm, IUD, the pill, condoms, depo shot, patches, sponge,
cervical cap, nuva ring, rod in arm, abstinence, withdrawal, sterilization
5. Emergency contraception – know education.
Plan B used as soon as possible up to 72 hours, doesn’t cause abortion, if your pregnant
it won’t hurt the baby, high dose birth control, bad side effects-N/V, headache.
6. Preconceptual care is provided for a means to identify risks and provide nutrition – not to
establish who should become pregnant
Identify risk factors, is it safe for them to become pregnant. Healthy nutrition and
lifestyle. Weight and folic acid. Immunizations. Are they smoking or drinking?
7. Pregnancy – understand the structure and function of the external and internal genitalia. Know
the purpose of each in the process of pregnancy.
Uterus has two functions that are to house the baby and expel it. Vagina is a collapsible
tube that stretches to deliver baby. Cervix is usually closed but will thin and open to
10cm to allow baby to come out. Ovaries are egg storage, you start with all the eggs you
have, you don’t make new ones. If the Bladder is inflamed, or UTI can cause preterm
labor. Bowel, if you have diarrhea, if you use enema or laxative, can start preterm labor.
Illegal drugs can also can use preterm labor. Three things uterus needs are food, fluids
and rest if it doesn’t have these things if can cause muscle irritation and preterm labor.
8. Please identify pregnancy history – G, F, P, A, L – know how to complete this given each women’s
obstetrical history.
Gravida- Number of pregnancies
Full term pregnancies- Live or dead 37-40 weeks
Pre term pregnancies-Live or dead 20-37 weeks
Abortion/Miscarriages- Prior to 20 weeks
Living- children that are living
Twins are one pregnancy
9. What is fetal well- being and how do we measure it. Can you date a pregnancy using Naegele’s
Rule? Can you measure fundal height? Know the normal parameters of fetal growth. When are
fetal heart tones audible with a Doppler? What are the parameters and what does it mean if the
fetus falls outside those parameters
Naegele’s Rule is first day of last missed period subtract 3 months add 7 days and add
one year
Fetal well-being is fetal movement, fetal heart tones and fundal height. All moms can
feel the baby movement first between 16-20 weeks, primigravida feel it first at 18-20
weeks, it is a butterfly feeling low in the abdomen. Multigravida is 16-18 weeks.
When can we hear fetal heart tones with a Doppler? By 12 weeks because the uterus is
coming outside of the pelvis at this time.
Fundal height starts at 14 weeks, it grows with the weeks gestation, we don’t use cm till
after 20 weeks, if a mommy is 16 weeks where would we see fundal height? Halfway
between the symphysis pubis and the umbilicus, 20 weeks is the umbilicus and 12-14
weeks is the symphysis pubis. We start at the symphysis pubis and measure cm to the
top of the uterus. Give or take 2 cm. So if its 28 weeks it could be 26 or 30. If the
measure is wrong by more than 2cm the date could be wrong or twins or something else
is growing in the uterus. If it is less than 2 cm the date could be wrong, the baby isn’t
growing.
10. Fetal development from the conception through the embryonic (critical) period, to the placental
development and beyond. – It is all about the placenta. What risk factors will impede placental
perfusion to the baby. [Show Less]