Maternity Final Exam Study Guide
Chapter 3: Anatomy
The mucus-secreting glands of the cervix are capable of storing live sperm for 48 to 72
hours (2 to 3 days), enabling pregnancy to occur after intercourse has occurred 1 or 2 days before ovulation.
The Bartholin glands are located in the vestibule and secrete a mucus which moistens the vaginal mucosa during sexual intercourse.
Ovulation is controlled by FSH and LH.
Ovulation should occur on Day 14 of a normal 28 –day cycle.
The endometrium is the inner layer of the uterus; it builds with hormones during the month in potential preparation for pregnancy.
The myometrium is the muscular layer.
The perimetrium is a protective layer, and the fundus is the upper area of the uterus.
As a woman’s reproductive capabilities end, her menstrual cycles will become irregular and finally cease is called menopause.
During ovulation, the cervix produces thin, clear, stretchy, slippery mucus that is designed to capture the man’s sperm, nourish it, and help the sperm travel up through the cervix to meet the ovum for fertilization.
The testes serve two functions: production of sperm and synthesis of testosterone, the primary male sex hormone.
During the menstrual phase of the cycle, the endometrium, or lining of the uterus, is shed because of low estrogen and progesterone levels.
The vagina is a canal that connects the external genitals to the cervix.
Before birth, the external cervical os is a small, regular, oval opening. After birth, the opening is converted into a transverse slit that resembles lips.
The average menstrual flow is 4 to 6 days in length
Chapter 4: Common Reproductive Issues
The contraceptive patch should be applied only to the buttocks, back, abdomen, or torso (never the breasts)
The effect of progesterone, released with ovulation, is to increase body temperature .
The nurse should screen the client for deep vein thrombosis (DVT), migraine headaches, neurological symptoms, coronary artery disease or cerebral vascular disease, severe diabetes, hypertension, liver disease, breast or endometrial cancer, and unexplained vaginal bleeding when combined oral contraceptives are used.
The nurse should tell the client to inspect the cervical cap before insertion for cracks, holes, or
tears and to wait approximately 30 minutes after insertion before engaging in sexual intercourse
to be sure that a seal has formed between the rim and the cervix. In addition, the cap should not be used during menses because of the potential for toxic shock syndrome; an alternative method such as condoms should be used during this time.
oThe client should be told not to apply spermicide to the rim because it may interfere with the seal.
oIt should be left in place for a minimum of 6 hours after sexual intercourse .
Levonorgestrel (postcoital contraception pill) can be taken anytime within 72 hours (3 days) of unprotected sexual activity.
With endometriosis, endometrial tissue migrates into the fallopian tubes and peritoneum or other sites outside of the uterus. Ovulation occurs, but the egg may be trapped by the
misplaced tissue.
oEndometriosis presents with painful menstrual periods, chronic pain in lower back and pelvis
Chapter 5: STIs
Symptoms of bacterial vaginosis include a characteristic “stale fish” odor and thin, white homogeneous vaginal discharge.
Dysfunctional uterine bleeding is a sign of chlamydia, not bacterial vaginosis.
oChlamydia is the most common and fastest-spreading bacterial STI in the United States. Erythema in the vulvovaginal area is a symptom of vulvovaginal candidiasis
Penicillin G is used to treat syphilis.
Miconazole and fluconazole are used to treat candidiasis.
Gonorrhea is a single intramuscular dose of a broad-spectrum cephalosporin such as ceftriaxone
Genital warts or condylomata are caused by the human papilloma virus (HPV).
Genital herpes simplex is transmitted by contact of mucous membranes or breaks in the skin with visible or nonvisible lesions and can include kissing, sexual contact (including oral sex), and vaginal birth.
oThe presence of genital warts (condyloma) increases the risk of developing cervical cancer.
An infected mother can transmit HIV infection to her newborn before or during birth and through breastfeeding.
The discharge associated with infection caused by Trichomonas organisms is homogenous, greenish gray, watery , and frothy or purulent.
oOral metronidazole or tinidazole is used to treat trichomoniasis.
It is the priority that the client understands the need to finish the antibiotic therapy required to treat PID in order to eradicate the offending bacterial infection.
To prevent gonococcal ophthalmia neonatorum in the baby, the nurse should
instill a prophylactic agent in the eyes of the newborn. Chapter 6: Breast Disorders
Warm compresses are soothing and help reduce inflammation associated with mastitis. Other treatment includes fluids, and supportive bra.
o Breastfeeding is encouraged with mastitis to ensure continued emptying of the breast. A personal history of ovarian cancer is considered a risk factor for breast cancer.
oEarly menarche (before 12 years of age) or late onset of menopause (after age 55 years) is associated with an increased risk for breast cancer.
Clinical breast examinations are recommended every year starting at age 40.
A fibroadenoma is a benign mass in the breast. It is the most common breast mass among women. The cause of fibroadenomas is not known but can be attributed to the reproductive hormonal estrogen cycles.
oFirm and rubbery nodule that is well circumscribed and moves freely
Mammograms
oPowder, deodorant, and jewelry can distort the images on film and should not be worn.
oThe procedure should be scheduled just after the menses, when the breasts
are the least tender.
oPain relievers such as acetaminophen and ibuprofen may ease discomfort during the procedure and thereafter.
oMammograms are 5- to 10-minute procedures.
Typical side effects of chemotherapy include nausea and vomiting, diarrhea or constipation, hair loss, weight loss, stomatitis, fatigue, and immunosuppression.
Lymphedema occurs in some women after breast cancer surgery.
oElevate the arm to stop swelling after surgery
Malignant breast disease is generally characterized by immobile, fixed lumps that may
cause skin dimpling and nipple retraction. They are generally painless and not tender.
oThe primary sign of breast cancer is a painless mass in the breast.
oOther signs of breast cancer include:
oa bloody discharge from the nipple,
oa dimpling of the skin over the lesion,
oretraction of the nipple,
opeau d’orange (orange peel) appearance of the skin,
oa difference in size between the breasts.
Women with peripheral nonlactating breast abscesses present with greenish nipple discharge, nipple retraction, and noncyclical pain.
Duct ectasia has secretions appears thicker and creamy, yellowish and ointment-like; toothpaste like.
Chapter 7 Benign of Reproductive Tract
