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OB GYN
Women's Health Issues: Obstetrics and Gynecology (OB/GYN)
| Question | Answer |
|---|---|
| Obstetrics (OB) involves | studying pregnancy, labor, delivery, and the period following labor called postpartum. This field is often combined with gynecology (GYN), the female reproductive system's care. An OB/GYN practices both specialties |
| The gynecological side of OB-GYN involves | regular screening exams by the provider and many opportunities to educate patients about disease prevention and management. |
| pseudocyesis | false pregnancy |
| amniochorial | pertaining to the amnion and chorion |
| amniorrhexis | rupture of the amnion |
| amniotomy | incision into the amnion to induce labour |
| ntrapartum | within (during) labour and delivery |
| amniorrhea | discharge (escape) of amniotic fluid |
| neonate | new born (infant from birth to four weeks of age) |
| postpartum | after childbirth referring to the mother |
| para | A woman who has given birth to an offspring after 20 weeks, live or stillborn |
| teratogenic | producing malformations |
| omphalocele | herniation of the umbilicus |
| primigravida | first pregnancy |
| lactogenic | producing milk |
| lactorrhea | discharge of milk |
| primipara | first birth |
| polyhydramnios | much amnion water |
| multipara | many births |
| natal | pertaining to birth |
| teratology | The study of malformations |
| transesophageal fistula | abnormal passageway between the trachea and esophagus |
| puerperal | pertaining to immediately after childbirth |
| fetal | pertaining to the fetus |
| gravida | pregnant (woman) Note, that this is referring to a woman who is or has been pregnant regardless of outcome |
| microcephalus | small head |
| embryogenic | producing an embryo |
| neonatology | study of the newborn |
| amnionitis | *rebel does not follow the rules inflammation of the amnion |
| pelvic sonography | Process of recording sound pertaining to the pelvis |
| neonatologist | physician who studies and treats disorders of the new born |
| teratogen | agent producing malformations (in a developing embryo)such as chemicals, viruses and environmental factors |
| oligohydramnios | scanty amnion water |
| episiotomy | incision into the vulva |
| amniocentesis | surgical puncture into the amnion to remove fluid |
| embryoid | resembling an embryo |
| chorioamnionitis | inflammation of the chorion and amnion |
| dystocia | labor that is difficult |
| omphalitis | inflammation of the umbilicus |
| nullipara | no pregnancies a woman who has never been pregnant |
| postnatal | pertaining to after birth (reference to the newborn) |
| postpartum | after childbirth referring to the mother |
| hysterorrhexis | rupture of the uterus |
| intrapartum | within (during) labour and delivery |
| multigravida | many pregnancies A woman who has been pregnant two or more times regardless of outcome |
| lactic | pertaining to milk |
| antepartum | before childbirth referencing the mother |
| puerpera | childbirth |
| choriocarcinoma | cancerous tumour of the chorion |
| pyloric stenosis | narrowing of the pylorus or pyloric sphincter |
| prenatal | pertaining to before birth |
| amniorrhea | amni/o/rrhea discharge (escape) of amniotic fluid |
| Menstruation | is a woman’s normal cycle of preparation for conception |
| conception | the union of egg and sperm that initiates pregnancy |
| he normal age range of menarche—the beginning of menstruation—is | 10 to 15 years of age |
| he endometrium, which lines the uterus, is | shed in vaginal bleeding. |
| Menstrual cycles are prompted by | hormonal (estrogen and progesterone) levels. |
| Amenorrhea | Absence of menstrual flow |
| Dysmenorrhea: | Difficult or painful menstruation |
| Menorrhagia: | Excessive menstrual flow, number of days of flow, or both |
| Metrorrhagia: | Periods of bleeding between the regular monthly flow |
| Menorrhagia | Synonymous with dysmenorrhea; pelvic pain during menstruation; may indicate endometriosis. |
| Menopause, defined earlier as a cessation of menses, occurs | around the age of 52 but can occur anytime after 40 |
| Women can be thrown into “premature” or “induced menopause” due to | complete hysterectomy or certain treatments that can damage the ovaries, like radiation or chemotherapy. In some cases, premature menopause can result from genetics, autoimmune disorders, or other medical conditions |
| The ovaries are responsible for | storing and releasing eggs and producing estrogen and progesterone. |
| Natural menopause usually occurs in four phases:❖ Phase 1: Premonopause: | starts when an adolescent girl enters her reproductive years and ends with the first signs of menopause, which usually begin to appear between the ages of 48-52. |
| Natural menopause usually occurs in four phases:❖ Phase 2: Perimenopause | begins when estrogen production by the ovaries gradually decreases. This stage normally lasts from one to two years, when estrogen production is greatly decreased. Many women will experience the symptoms of menopause during this phase. |
| Natural menopause usually occurs in four phases:❖ Phase 3: Menopause | is the complete cessation of menstrual flow. The ovaries have stopped producing almost all estrogen and have stopped releasing eggs. A diagnosis of menopause is determined after a female has not had a period of 12 months |
| Natural menopause usually occurs in four phases:Phase 4: Postmenopause | is the phase that includes all years after menopause. Usually, menopausal symptoms will stop, but other health risks related to estrogen loss will increase with natural aging. |
| Symptoms of Menopause | Headaches Joint and muscle pain Vaginal dryness Bladder control problems Fatigue Mood swings Insomnia Hot flashes |
| Hormone replacement therapy (HRT) used to be common among | peri-menopausal and postmenopausal women. |
| omen were placed on hormones to help | alleviate hot flashes and sleep problems and help protect them from colon cancer, osteoporosis, and heart disease. |
| The latest studies now conclude that HRT may be linked | to breast cancer, blood clots, dementia (in a small number of women), and cardiovascular disease. |
| HRT only be used:To treat or prevent osteoporosis | in those at high risk of developing the disorder. The risks of taking HRT must be weighed against the possible side effects. |
| HRT only be used: Short-term use to relieve peri-menopausal symptoms. | Again, women must decide if the benefits of using HRT outweigh the risks. |
| The gynecological (GYN) exam | consists of a breast exam, abdominal and pelvic exam, and a Pap test |
| The Pap test, | is performed to detect early signs of cervical cancer |
| The GYN exam may include | a wet mount, hanging drop, or KOH wet prep if the patient is complaining of vaginal symptoms. |
| steps that take place during a GYN exam: | Complete and thorough breast exam ❖ External pelvic and vaginal exam ❖ Collection of tissue for Pap smear and possible cultures when indicated ❖ Bimanual pelvic/abdominal exam ❖ Rectal–vaginal exam |
| Pertinent information to be included in a complete GYN history includes: | Age at onset of the menstrual cycle ❖ Gravida (how many pregnancies?), para (how many live births?), and abortions (specify how many and whether they were spontaneous or elective) ❖ Date of last menstrual period (LMP) |
| Pertinent information to be included in a complete GYN history includes: | Regularity and duration of cycles ❖ Date of last Pap ❖ Any history of abnormal Pap or biopsies ❖ Contraception method used |
| Pertinent information to be included in a complete GYN history includes: | HRT information ❖ Date of the last mammogram for women over 40 or who are at high risk ❖ Types and dates of GYN surgeries ❖ Sexual activity and history (up to provider) |
| Pertinent information to be included in a complete GYN history includes: | Signs or symptoms of GYN disorders including vaginal discharge or painful intercourse |
| Cervical Cancer Screen | Two tests are used for cervical cancer screening, the Papanicolaou (Pap) test and the test for human papillomavirus (HPV). Both can be performed before the pelvic examination. |
| The Pap test | is used to identify the cervix's precancerous and cancerous cells. |
| The HPV test | is used to identify HPV infections leading to cervical cancer. |
| The Pelvic Exam | The provider will conduct exam hat consists of several components. First, a visual inspection of the external genitalia is conducted. Next, the cervix and vagina are visually examined. |
| A vaginal speculum | is inserted to observe the vagina and cervix and obtain a Pap test sample. A speculum is used to view internal structures during a gynecologic exam. |
| pelvic exam, the licensed practitioner checks the | external genitalia, cervix, vaginal wall, internal reproductive organs, and rectum. Exam methods include palpation and inspection. |
| MA role | pt remove all clothing and put on the gown with the front opening. assist the pt into position, with her feet in the stirrups of the examining table and her buttocks at the end of the table. Drape her so that only the area between the thighs is exposed. |
| Pap and HPV Screening Pre-procedure After obtaining a complete GYN history, the medical assistant will prep the patient by instructing | Have the patient empty the bladder. ❖Place the client in the lithotomy position and drape appropriately. ❖Explain to the patient how the procedure will be carried out. ❖Have all necessary equipment available |
| Pap and HPV Screening Intra-procedure | Remain with the client and provide support. ❖Have ready the necessary equipment for the provider during the procedure. ❖Transfer specimens to slides and apply fixative to slides. |
| Once the specimen is collected, the medical assistant will prepare the slides to be sent to the laboratory for evaluation. The slides must be properly labeled and accompanied by a cytology lab requisition | Slides must be labeled with the proper patient identification, and the source of the specimen labeled as (V) for vaginal, (C) for cervical, or (E) for endocervical. |
| Post-procedure | Medical Assistant Actions: Provide perineal pads and tissues Patient Education: Minimal bleeding can occur from the cervix. Follow up with the provider if the results are abnormal. |
| Sexually transmitted diseases (STDs), also referred to as sexually transmitted infections (STIs) | there are various diseases that are considered STDs; they affect all age groups, including seniors. |
| Colposcopy is the exam of the | vagina and cervix with an instrument called a colposcope. |
| inserts the colposcope into the vagina and uses the | attached magnifying lens to identify abnormal cells, such as cancerous or precancerous cells. The abnormal cells may not be cancerous but may be caused by infection or medication. |
| endocervical curettage if a lesion is visible. | A cone biopsy is an extensive surgical biopsy. The provider excises a cone-shaped sample of tissue to remove potentially harmful cells. |
| Dilation and Curettage (D&C) consist | widening the opening of the cervix (dilation) scraping the uterine lining (curettag)assessing the uterus' size and shape, removing polyps and fibroids from the endometrium, obtaining endometrial specimens for biopsy, abortion, an incomplete miscarriage |
| Hysterectomy is the | surgical removal of the uterus |
| A laparoscope is a | long, tubular instrument. It contains fiber-optic threads that illuminate the organs and a lens that resembles a small telescope |
| Laparoscopy | helps determine the cause of infertility(the inability to conceive), obtain tissue samples, remove abnormal growths, and surgically sterilize a patient |
| Loop Electrosurgical Excision Procedure (LEEP) | a thin wire loop electrode attached to the speculum is inserted in the vagina and used to cut away abnormal cervical tissue that was discovered during a Pap smear. |
| Pregnancy has ______ trimesters, | three |
| A pregnancy is considered full-term at 40 weeks; infants delivered before the end of week ___are considered premature | 37 |
| to know is the baby’s due date. One simple method to estimate the delivery date for a pregnant woman is called | Nägele’s rule |
| Nägele’s rule | Begin with the first day of the patient’s last menstrual period, subtract 3 months, and add 7 days plus 1 year. |
| Nägele’s rule.example | January 11, 2009 + 7 days = January 18, 2009 January 18, 2009 – 3 months = October 18, 2008 October 18, 2008 + 1 year = October 18, 2009 (EDD) |
| Naegele’s Rule: | First day of LMP + 7 days – 3 months + 1 year |
| Obstetrics (OB) | is the medical specialty that provides care and treatment to pregnant women |
| Obstetrical care is provided during | pregnancy (prenatal), labor and delivery, and the postpartum period, also known as the puerperium period |
| Prenatal Care | Expectant mothers need to adhere to the schedule of prenatal visits, as recommended by the provider. Their initial visit is scheduled for the sixth week of pregnancy. |
| The first prenatal exam | usually scheduled after a woman obtains a positive pregnancy test result at home or has missed a second menstrual cycle. Confirmation of the pregnancy and a thorough history and physical will be completed during the first office visit. |
| Parts of the initial prenatal exam include:Complete medical history, | including menstrual and prenatal history: A thorough database can help the provider identify high-risk patients. Any problems related to previous pregnancies and deliveries should also be noted, including miscarriages and abortions. |
| Parts of the initial prenatal exam include: | Physical exam, which includes a breast, abdominal, pelvic, and vaginal exam, along with pelvic measurements ❖ Patient Education ❖ Laboratory tests |
| initial Prenatal Lab Tests | are performed as part of the initial prenatal exam. Conditions may exist that could pose a danger to the mother and the fetus. Cytology, blood, and urine specimens are collected. The table below lists the traditional prenatal lab tests. |
| Return Prenatal Visits | Once the initial visit is completed, and the prenatal database has been established, the patient is seen regularly until the baby is delivered. The schedule for return visits may differ somewhat from one provider to the next. |
| During subsequent OB/GYN visits, the medical assistant will be responsible for | weighing the patient and obtaining a blood pressure reading. A urine sample should be collected and tested for glucose and protein |
| A positive glucose reading may indicate gestational diabetes, while a positive protein reading could indicate | preeclampsia. |
| The medical assistant will then obtain information from the patient about any problems since their last visit. Questions posed to the patient should include: | Any vaginal bleeding? If so, list the amount, any clots or tissue passed, or any cramping. ❖ Any fluid leakage? ❖ Any unusual vaginal discharge? ❖ Any headaches, dizziness, or vision problems? ❖ Any unusual swelling? ❖ Any nausea or vomiting? |
| Prenatal Diagnostic Tests and Procedures | Additional tests or procedures may be performed at specific intervals during the prenatal period to detect possible genetic abnormalities. The table below lists specialized prenatal diagnostic tests. |
| Ultrasound | Since ultrasound uses sound waves, not x-rays, it is safe to administer during pregnancy and will pose no threat to either the mother or fetus. exam allows the provider to obtain a multitude of info about the pregnancy and the fetus and detect problems |
| Amniocentesis | is a prenatal procedure performed to detect certain genetic abnormalities, metabolic disorders, and chromosomal disorders such as It is sometimes performed to evaluate the fetus's lung maturity and can also determine the gender of the fetus. |
| No Known Drug Allergies (NKDA) | An accepted abbreviation used in medical documentation. |
| Gynecologic exam | Include a pelvic and breast examination, which are done to evaluate the reproductive organs and diagnose or treat abnormalities within the organs. |
| Breast examination | Conducted through both a visual check and palpation to determine any signs of abnormalities that may need to be examined further. |
| Axilla | Arm pit |
| Lithotomy position | The position, with knees bent and buttocks at the edge of the table, the patient needs to be in for a pelvic exam. |
| Bimanual examination | An exam in which two fingers are inserted into the vaginal canal to inspect the uterus, fallopian tubes, and ovaries. |
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