Chapter 23 Gynecologic Emergencies

What is (are) the primary female reproductive organ(s) called?
Ovaries

The sperm typically fertilizes the egg in the _________.
fallopian tube

Menstrual flow will typically last approximately _________.
1 week

If fertilization has not occurred in approximately 14 days postovulation:
menstruation will begin.

Chlamydia, bacterial vaginosis, and gonorrhea are all examples of _________.
sexually transmitted diseases

Signs and symptoms of bacterial vaginosis typically include _________.
“fishy,” foul-smelling discharge

______________ may be a cause of vaginal bleeding in a patient who states that she is NOT pregnant.
Ectopic pregnancy

A patient with vaginal bleeding _________.
may not have obvious signs of shock even if she has experienced significant blood loss

The EMT should perform a “rapid scan” to determine if the patient is __________ during the __________.
stable or unstable; primary assessment

Which of the following signs/symptoms is considered particularly significant in gynecological emergencies?
Syncope

When prioritizing care for the victim of a sexual assault, the EMT should focus on _________ first.
life-threatening injuries

At the scene of a sexual assault, the EMT should attempt to preserve evidence by _________.
discouraging the patient from removing clothes, using the bathroom, or showering

What is typically the most important intervention that an EMT can provide to the victim of sexual assault?
Comfort and reassurance

When a female has reached menarche:
she is capable of becoming pregnant.

Which of the following statements regarding pelvic inflammatory disease (PID) is correct?
PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy.

As a woman approaches menopause:
her menstrual periods may become irregular and vary in severity.

During your assessment of a young female with nontraumatic vaginal bleeding, you note that her level of consciousness is decreased, her respirations are rapid and shallow, her skin is cool and moist, and her pulse is rapid and weak. You should:
assist her ventilations with a BVM.

You are dispatched to a residence for a 40-year-old female who complains of lower abdominal pain, fever and chills, and a foul-smelling vaginal discharge. Which of the following additional assessment findings would increase your index of suspicion for pelvic inflammatory disease?
A shuffling gait when walking

EMTs receive a call for a possible sexual assault. The patient is a young female who is conscious and alert and has no apparent injuries. She states, “I cannot remember anything, but I know I was raped.” The EMTs should suspect that:
the patient was given a drug prior to the incident.

General treatment for a woman with vaginal bleeding and shock following sexual assault includes all of the following, EXCEPT:
carefully removing any foreign bodies from the vagina.

A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should:
administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay.

A patient with pelvic inflammatory disease will typically complain of _________.
abdominal pain associated with menstruation

Causes of vaginal bleeding include which of the following?
A. Ectopic pregnancy
B. Vaginal trauma
C. Spontaneous abortion
D. All of these answers are correct ****.

During gynecologic emergencies, in addition to the standard SAMPLE questions, the EMT should attempt to determine which of the following?
A. The amount of time since of the patent’s last menstrual cycle
B. The possibility that the patient may be pregnant
C. If the patient is sexually active
D. All of these answers are correct.****

In anticipation of receiving a fertilized ovum, the lining of the uterine wall:
becomes engorged with blood.

In cases of sexual assault, it is important to ensure that you do which of the following?
A. Immediately write down your observations of the scene before assessing the patient.
B. Call for a female EMT or ALS care provider.
C. Discuss with law enforcement any suspicions that you may have about the perpetrator.
D. All of these answers are correct.***

In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer:
may be relatively painless.

It is common for young females who experience their first menstrual period to:
experience abdominal cramping, which may be misinterpreted.

Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should:
provide emotional support and visually assess her for obvious trauma.

Patient complaints of pain during intercourse, lower abdominal discomfort, and nausea may be indicative of which of the following?
Pelvic inflammatory disease

Some women experience ___________ during ovulation.
slight cramping

The __________ and _________ are folds of tissue that surround the urethral and vaginal openings.
labia majora; labia minora

The _____________ connect(s) each ovary with the uterus.
fallopian tubes

The EMT should ensure that vaginal bleeding is _________.
taken seriously and the patient is transported for gynecologic evaluation

The physical examination of a sexual assault victim should be:
limited to a brief survey for life-threatening injuries.

When caring for a female patient who has been sexually assaulted, you should:
place any bloodstained clothing or other articles in separate paper bags.

Which of the following conditions would MOST likely lead to pelvic inflammatory disease if left untreated?
Chlamydia

Which of the following drugs is commonly referred to as “roofies”?
Rohypnol

Which of the following infections, when left untreated, may lead to infection of the blood and brain?
Gonorrhea

While the ages can vary, women typically experience menstruation from approximately _________ to ____________ years of age.
11; 50

labia majora
Outer fleshy lips covered with pubic hair that protect the vagina.

labia minora
Inner fleshy lips devoid of pubic hair that protect the vagina.

perineum
In a female, the area between the vagina and the anus.

ovaries
The primary female reproductive organs that produce sex hormones and an ovum, or egg, that, if fertilized, will develop into a fetus

fallopian tubes
The tubes that extend from the uterus to the region of the ovary and through which the ovum passes from the ovary to the uterus; the primary location for fertilization of the ovum.

uterus
The muscular organ where the fetus grows, also called the womb; responsible for contractions during labor.

cervix
The lower third, or neck, of the uterus; it is the narrowest portion of the uterus and opens into the vagina.

vagina
The outermost cavity of a woman’s reproductive tract that connects the uterus with the vulva (the external female genitalia); the lower part of the birth canal.

ovulation
The process in which an ovum is released from a follicle.

chlamydia
A sexually transmitted disease caused by the bacterium Chlamydia trachomatis.

bacterial vaginosis
An overgrowth of bacteria in the vagina; characterized by itching, burning, or pain, and possibly a “fishy” smelling discharge.

gonorrhea
A sexually transmitted disease caused by Neisseria gonorrhoeae.

Symptoms of gonorrhea are generally more severe in women than in men.
False

In a gynecologic emergency, you should leave any foreign bodies in place after stabilizing them with bandages.
True

PID is the most common vaginal infection in women age 15 to 44.
False

The most common presenting sign of PID is generalized lower abdominal pain.
True

sexual assault
An attack against a person that is sexual in nature, the most common of which is rape.

rape
Sexual intercourse forcibly inflicted on another person, against that person’s will

What is menarche?
Menarche is the onset of menstruation, which usually occurs between ages 11 and 16 years.

Which of the following organs or structures controls the process of ovulation and menstruation?
The ovaries are the primary female reproductive organs and control the process of ovulation and menstruation.

You are assessing a female patient who tells you she feels blood coming from her vaginal area. She gives you permission to look and you observe moderate bleeding from the vagina. What should you do to manage the bleeding?
You should place a sanitary pad over the vaginal opening.

If PID is not treated, what can occur?
If PID is not treated, it can lead to ectopic pregnancy.

You are assessing a 38-year-old woman who is reporting achy abdominal pain, burning on urination, and a slight fever. As you assist her to the ambulance, you notice that she has a shuffling gait. What condition does this indicate?
PID signs/symptoms include achy abdominal pain, vaginal discharge, fever and chills, and pain or burning on urination. Patients often present with a distinctive gait that appears as a shuffle when they walk.

In the case of a sexual assault, what is your most important treatment option?
A victim of rape or sexual assault has suffered major trauma. You may be the victim’s first contact after the encounter, and how the situation is managed from first contact throughout treatment and transport may have lasting effects for the patient and you. It is very important to always be professional, sensitive, and kind.

In addition to providing medical care to a rape victim, which of the following is the most critical thing you should do?
As the patient’s advocate, you need to provide medical assistance and emotional support and ensure the patient’s privacy.

What should you do when a female patient has vaginal bleeding of unknown cause?
Bleeding can lead to shock, so you should be prepared to treat for hypoperfusion by applying oxygen and keeping the patient supine and warm while you transport her.

What is an EMT’s responsibility regarding evidence in the case of a sexual assault?
An EMT’s responsibility is to preserve evidence without sacrificing patient care.

Why is it important to transport a sexual assault victim to the hospital even if she does not have any obvious injuries?
It is important to transport a sexual assault victim because she may have injuries that were not detected in the field, such as internal bleeding, that have a delayed onset of symptoms.

When a woman presents with abdominal pain or other vague symptoms, the EMT is often unable to determine the nature of the problem until he or she: has gathered patient history information. When caring for a female patient who has …

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ADNEXA appendages or accessory structures of an organ BONY PELVIS The 4 bones of the pelvis that make up the lower part of the trunk of the body; serves to support the upper body and protect the pelvic organs. WE …

Uterus anatomy thicked walled hallow stucture, distensible muscular organ, location of embryo and fetus development Uternus to cervix raito after birth female infant uterus is 2/3 body 2/3 cervix d/t influence of maternal hormones. post partum uterus to cervix becomes …

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