4 steps to conception
1) menstruation
2) ovulation
3) fertilization
4) implantation
typical 28-day menstrual cycle
- 3-7 days: period - lining of uterus sheds
- 7 days: new egg matures, lining begins thicking
- 3 days: ovulation - egg released
- 13 days: egg travels to uterus, liining thickens
menstruation
period + new egg matures, uterine lining thickens
ovulation
egg enters a fallopian tube & starts moving towards uterus
fertilization
- After vaginal intercourse or alternative insemination
- During vaginal intercourse; hundreds of sperm through the uterus and into the fallopian tubes
- Joining of egg and sperm is called fertilization
overall conception process
woman releases egg; sperm meets up with egg in the fertilization process; the fertilized egg implants and pregnancy begins
implantation
- fertilized egg moves down fallopian tube & divides into more cells, formin ga ball
- ball reaches the uterus 3-4 days after fertilization, floats in it for another 2-3 days
- pregnancy begins if the ball attaches to the lining of the utereus - called im
embryo
develops from cells on inside of the ball
placenta
develops form the cells on the outside of the ball
hormonal contraception - role of 2 hormones in this
estrogen & progestin - prevent ovulation, thickens cervical mucus, alter the uterine lining
2 hormonal contraceptive methods
1) use estrogen & progestin
2) use only progestin
combo pill - types
pill, patch, ring
combo pill
- most commonly prescribed type of pill
- ratios differ
progestin options
shot, implant, mini-pill, IUDs with hormones
progestin only method - when is it used?
- aka the "minipill,"
- prescribed when women using the combo pill want to decrease the side effects associated with estrogen or when life changes (beginning to nurse a child, for example) hinder using synthetic estrogen.
what can the minipill cause early on?
more irregular menstruation than the combo pill, decreasing the # of periods in the 1st year
if you're taking the pill, you should use a backup method as well when...
- 1st 7 days of use
- you miss >1 pill
- you're taking certain meds
contraceptive pills don't do what?
Cause birth defects
Cause infertility
Build up in a woman's body
correct way to use the patch
- 1 patch/wk for 3 weeks
- No patch is worn the 4th week
- Alternate patch site to avoid skin irritation
if you use the patch you should use a back up method if...
- it's During the first 7 days of use
- the patch is used incorrectly
- you're taking certain medications
correct use of nuvaring
- Insert into the upper portion of the vagina
- Wear for 3 consecutive weeks
- The fourth week, no ring is worn
if you're using the nuvaring you should use a backup method when?
- During the first 7 days of use
- Anytime that the ring is used incorrectly
- When taking certain medications
when is the highest risk for unintended pregnancy?
at end of hormonal-free week
benefit of extended cycle contraception
hormone use is extended, less risk time for unitnended preganacy
the shot - correc tuse
- get injections once every 12 weeks
- Initial injection given during 1st few days of menstrual cycle for immediate protection against pregnancy
if you use the shot you should use a backup method if what?
if late for scheduled injections
special consideration for the shot?
it's non-reversible for 3 months
implant - correct use?
- inserted by a trained health care provider
- Once inserted, there is no maintenance
- remove 3 years after insertion
implant - special considerations
- Implants can be felt (sometimes seen)
- Fertility can return within 24 hours after removal
hormonal IUD - correct use
- Must be inserted by health care provider
- Once inserted, there is no maintenance
- Mirena to be removed 5 years after insertion
- Skyla to be removed 3 years after insertion.
hormonal IUD - special considerations
Fertility can return within 24 hours after removal
hormonal IUD does what?
release a small amount of progestin - prevents teh egg from leaving the ovary in some women, also thickens the cervical mucus
do hormonal contraceptives protect against STIs?
no
is the cervix a muscle?
no
barrier methods
- prevent egg & sperm from joining
- no sperm comes into contact with the egg to begin with (sterilization; abstinence)
- sperm prevented or delayed from reaching egg (prevent from entering uterus with condoms or slowed down/blocked from entering uterus-c
non-hormonal contraceptive methods that require a device
Male Condoms
Female Condoms (receptive condoms)
Diaphragm & Cervical Cap
Spermicides
Intrauterine Device
non-hormonal contraceptive mthods - no device required
Abstinence
Coitus Interruptus (Withdrawal)
Lactational Amenorrhea (LAM)
Fertility Awareness Methods
correct use for male condoms
- Check the expiration date and store at room temperature
- Make sure that the condom is properly lubricated
- Pinch a � inch tip at the end
- After intercourse, remove the condom before the erection is lost. Hold the condom at the base when withdrawing t
if the male condom breaks, do what?
- Immediately stop intercourse and insert an over-the-counter spermicide
- Consider taking emergency contraception
female condoms - correct use
- Check the expiration date and store at room temperature
- Pinch the ring on the inside of the pouch together and guide the condom into the vagina, placing it as far back into the vagina as it will go.
- The outer ring serves as the opening.
exceptions to condoms protecting against STIs and HIV
lambskin condoms don't. condoms provide SOME protection against STIs transmitted by skin-to-skin contact
diaphragm
shallow, dome shaped cup with a flexible rim. It fits securely in the vagina to cover the cervix
cervical cap
thimble shaped and smaller than the diaphragm. It fits snugly onto the cervix
correct use of diaphragm & cervical cap
- Each method MUST BE used with spermicide cream or jelly.
- A woman must be "fitted" for a diaphragm or cervical cap by a health care provider.
- Can be inserted up to 2 hours before intercourse.
- CANNOT be removed for 6-8 hours following intercourse.
correct use of spermicides
- Varies, depending on the brand/type
- Spermicides are typically inserted inside of the vagina, on a diaphragm, or on the inside/outside of a condom
common side effect of spermicides
irritation of the vaginal lining or urethra
non-hormonal IUD
- no hormones
- lasts 10 years
no device required methods
abstinence, withdrawal, lactacitonal amenorrhea, fertilitiy awarenss methods
tubal ligation
Requires hospital recuperation time. More risky than vasectomy. Interrupts fallopian tubes, preventing passage of eggs from ovaries into uterus.
vasectomy
Interrupts vas deferens, preventing passage of sperm into seminal fluid and reproductive tract.
Fertility Awareness methods
- include a set of techniques that can be used for pregnancy prevention that involve tracking a woman's ovulation and menstrual cycle, and using condoms or abstaining from vaginal sex on the days when she is likely to become pregnant.
- must be done corre
emergency contraception
- Not an abortion pill
- Take within 72 hours (ASAP!)
- BMI and drug interactions impact efficacy
- "The Morning After Pill" aka "Plan B": OTC, Efficacy declines within 72 hours
- ella: Prescription by pharmacist/clinician, effective for up to five days a
post-conception options
prenatal care & abortion (medical, surgical)
medical abortion
- Can be used up to 9 weeks after first day of woman's last period
- Must schedule an appointment with a provider to have the pill administered
- NOT Plan B!
surgical abortion
- Can be performed up to 20 weeks into pregnancy in NC
- After 20 weeks, must be a significant medical threat to health or life of the woman. The woman can also travel to Georgia, Maryland, or Washington, DC to obtain a later term procedure
drug use
appropriate use of LEGAL drug for medically intended reasons and taken in prescribed amount
alcohol misuse
inappropriate use; not intended or used in an improper way
alcohol abuse
the use (most often excessive) of any drug legal or illegal
binge drinking
pattern of drinking alcohol that results in BAC concentration of 0.08 or above
ethyl alcohol (ethanol)
the psychoactive ingredient (primarily acts on central nervous system) in alcohol
alcohol fermentation
an aerobic pathway where simple sugars are converted to ethanol and carbon dioxide
proof value
measurement of alcoholic strength corresponding to twice the alcohol percentage (13%=26 proof)
what kind of drug is alcohol
depressant drug
absorption
alcohol passes from stomach/small intestine into the bloodstream
metabolism
breakdown of food/beverages in the body to transform them into energy
what level of BAC is intoxication
BAC > .08 = intoxication
aspirated vomitus
loss of gag reflex
BAC
measured in grams of alcohol per deciliter of blood
when alcohol transitions into acetaldehyde
alcohol dehydrogenase
when acetaldehyde transitions into smaller molecules and energy
acetaldehyde dehyrogenase
Binge drinking amount for men
5 or more drinks within 2 hours
binge drinking amount for women
4 or more drinks within 2 hours
motivations for drinking
coping-avoid problems
conformity-gain acceptance
enhancement-positive mood
social-parties
how many calories are in alcohol
7 calories/gram
what is the main site of metabolism
the liver
The more body water a person has...
-the more the alcohol is diluted
-the lower the person's BAC
The more body fat a person has
-less alcohol is absorbed by the body tissue
-more alcohol there is to circulate in the bloodstream and reach the brain
-the higher the BAC
What foods slow down alcohol absorption
protein and fat; they are digested more slowly
What kinds of mixers speed up the absorption process
carbonated beverages
women reach higher BAC's than men because
-women have more adipose tissue
-women produce less of the alcohol-metabolizing enzyme ADH (alcohol dehydrogenase)
acute intoxication
another term for alcohol poisoning; occurs when alcohol is consumed too quickly and the liver can't break it down
asphyxiation
person chokes on their own vomit while unconscious
fetal alcohol syndrome
pattern of birth defects that appear in children of mothers who drink higher levels while pregnant
alcohol dependence
alcholism; addiction
nicotine
an alkaloid derived from the tobacco plant that is responsible for smoking's psychoactive and addictive effects
tar
sticky, thick brown residue that forms when tobacco is burned and its chemical particles condense, a byproduct (main carcinogenic agent)
cigarettes release...
more than 60 carcinogenic chemicals
environmental tobacco smoke
-the smoke nonsmokers are exposed to when someone has been smoking nearby
-some chemicals are in higher concentrations than in the smoke inhaled by the smoker
sidestream smoke
smoke emanating from the burning end of a cigarette; worse than mainstream smoke
mainstream smoke
exhaled smoke
environmental tobacco smoke is a ________ carcinogen
class A
cigars
-contain as much nicotine as several cigarettes
-double risk of heart attack/stroke
because most cigar and pipe smokers DO NOT inhale
-they have lower risk of cardiovascular and respiratory problems
-but increased risk of cancers of the oral cavity, esophagus, and larynx
clove cigarettes
contain 40% ground cloves and 60% tobacco; higher levels of tar, nicotine, and carbon monoxide than regular cigarettes
bidis
-small hand-rolled, flavored cigarettes
-wrapped in tendu leaf that requires to inhale more often and deeper
leukoplakia
pre-cancerous condition characterized by leathery white patches inside the mouth produced by contact with irritants in tobacco juice
why do healthy cells divide
when needed to replace cells that have died or have been sloughed off
stem cells
a special protective mechanism that exists for certain cells
what cells act as repair system for the body
stem cells and progenitor cells
initiating event
occurs as a result of an error in duplication or in response to a carcinogen
oncogene
mutated gene that encourages the uncontrolled cell division that results in cancer
malignant tumor
a tumor that is capable of spreading to other tissues; classified according to the type of cells
benign tumor
slow growing tumor because of the mass of cells that are contained in a membrane
cancer cell growth
a group of diseases characterized by uncontrollable growth and spread of abnormal cells
metastasis
the spreading of cancer cells occurs because they don't stick together as strongly as normal cells
carcinomas
cancers arise from the epithelial cells; account for most cases of breast, lung, skin and prostate cancers
sacromas
cancers arise from connective tissue such as bone, muscle, cartilage and blood vessels; frequently spread to affect the lungs
lymphomas
cancers that develop in lymphatic tissue
leukemias
cancers develop in the blood-forming cells, which reside mainly in the bone marrow
how are tumors graded
the basis of the degree to which the tumor cells resemble healthy cells of the same type under the microscope
grade 1 cancer cells
cells slightly abnormal and well differentiated
grade 2 cancer cells
cells more abnormal and moderately differentiated
grade 3 cancer cells
cells very abnormal and poorly differentiated
grade 4 cancer cells
cells immature and undifferentiated
staging
-describes the extent or spread of the disease at the time of diagnosis
-essential in determining the choice of therapy and in assessing prognosis
what determines a cancer's stage
tumor size, location, whether it has spread to other areas of the body
in situ
cancer cells only present in the layer in which they originated
invasive
if cancer has penetrated past the original layer
basal
cells on the lower part of the outer layer of the skin; appear as a sore that bleeds and scabs but never completely heals; face is most common location
squamous
flat cells that form on the surface of the skin; more common with dark-skin; found on the legs and feet
most dangerous form of skin cancer
malignant melanoma
main risk factor for skin cancer
most all cases can be traced to excessive exposure to ultraviolet radiation
ABCDE Malignant Melanoma test
A= assymetry
B=border irregularity
C=color variation
D=diameter
E=evolving
when are most intense hours of UVA and UVB rays
between 10am and 4pm
what SPF sunscreen
at least 30 SPF that blocks 97% of the sun's rays (no sunscreen can block 100% of sun's rays)
water resistant sunscreen
make sure it says "water resistant for up to 40 or 80 minutes;" sunscreen can no longer claim to be sweatproof or waterproof
professional skin exams
every 3 years for individuals 20-40; annually for those over 40
lung cancer
kills more people than any form of cancer; tobacco smoke is the primary cause
palliative care
care provided to give temporary relief of symptoms but do not cure the cancer
risk factors of breast cancer
-strong genetic factor
-"disease of civilization"
-lack of regular exercise
first line of treatment for breast cancer
surgery; lumpectomy (removal of a section of the breast), mastectomy (removal of the entire breast)
where does testicular cancer begin
the germ cells-produce immature sperm
cervical cancer
in part a sexually transmitted disease; 80% stems from infection by HPV; associated with multiple sex partners
ovarian cancer
90-95% of women have no risk factors; strongest risk factor is family history
leukemia
overproduction of one type of white blood cell, prevents normal growth of other blood cells and increases risk of infection, anemia, and bleeding
Hodgkin lymphoma
orderly spread from lymph node to another; presence of Reed-Sternberg cells (RS cells); first cancers to be treated using radiation and chemotherapy
environmental health
collective interactions of humans with the environment and the short-term health consequences of those interactions
sustainibility
ability to meet society's current needs without compromising future generations' abilities to meet their own needs
ecological footprint
collective impact of an entity on its resources, ecosystems, and other key environmental features
globalization
interaction and integration of regional phenomena globally
how much water do people require
at least 20-50 liters per day
safe drinking water act of 1974
-water systems must meet federal drinking water safety standards
-does not regulate private wells serving 25 people or less
greatest typical household water use comes from:
the toilet
municipal solid waste
known as nonhazardous trash or garbage
superfund
federal program tha funds and carries out emergency and long-term identification, analysis, removal, and cleanup of toxic sites
what level are solid-waste programs managed
on the local level accrording to individual community needs
what product takes up the most municipal solid waste
paper
the greenhouse effect
warming of the lower atmosphere due to buildup of carbon dioxide that are trapped and reflected back to earth; may contribute to global warming
ozone layer
protects us from ultraviolet B (UVB) radiation (the primary cause of skin cancer)
ozone hole
thin spot in ozone layer each southern spring
major cause of ozone layer depletion
chloroflurocarbons (CFCs)
montreal protocol
the guidelines for CFCs use to protect the ozone layer
asbestos
mineral used in insulating materials and fire protection in the 1960s; if fibers become loose they can penetrate into the lung tissues
lead
metal found in paint, batteries, drinking water, pipes, etc.; most detrimental to children living in older buildings
pesticides
used to prevent spread of insect-borne diseases and to maximize food production by killing insects that crops; DDT banned from US in 1972
mercury
a metal that is toxic to humans; slows fetal/child development and causes irreversible health defects; fish may carry high levels of this
radon
odorless, colorless gas; natural by-product of the decay of uranium and radium in soil; penetrates the home through cracks, pipes, etc.
acid precipitation
when atmospheric moisture combines with industrial composition products to from acids such as sulfur dioxide
sulfur dioxide
yellowish-brown gas; by-product of burning fossil fuels; aggravates symptoms of heart and lung disease
nitrogen-dioxide
amber colored gas; by-product of burning fossil fuels; cause increase susceptibility to cold, flu, bronchitis, and pneumonia
photochemical smog
ground-level ozone pollution;" when oxygen-containing compounds of nitrogen and hydrocarbons react in the presence of sunlight; forms brown, hazy mix of particulates and gases
temperature inversion
when a cool layer of air is trapped under a layer of warmer air, preventing air from circulating (seen in areas blocked by hills or mountains)
carbon monoxide
odorless, colorless gas, originates primarily from motor vehicle emissions; interferes with the blood's ability to absorb and carry oxygen
particulate matter
tiny solid particles/liquid droplets that are suspended in the air; irritates the lungs
acid deposition
acid rain;" when rain, sleet, snow, and clouds hold acid particles precipitation that has fallen through acidic air pollutants; can occur thousands of miles away from fossil fuel burning
non-ionizing radiation
microwaves, radio waves; considered less harmful
ionizing radiation
UV rays from the sun, X-rays; increased risk of skin and other cancers
harmful forms of radiation
UV radiation, radon, X-rays, medical radiation
decibels
measure sound intensity
permanent hearing loss
80-85 decibels
credit
any form of deferred payment; it is NEVER free
3 credit bureau sources
experian, equifax, transunion
credit score
based on payment history (i.e. paying bills on time, borrowing money, paying back within designated periods)
range of credit scores
400-900
average US credit score
575
good starting credit score
650
strong credit score
750 or higher
NC ceiling interest rate
33%
where do you establish a credit card
from a financial institution, NOT a place of buisness
primary repayment source
job income
secondary repayment source
2nd job or other sources of income
3rd repayment source
income from relatives, trust funds, etc.
reporting a stolen credit card
if within 2 business days, you have NO liability; if wait longer you're liable for up to $50
credit cards
a license for a loan up to a pre-set amount; each purchase you make is a loan and must be paid off
minimum payments
making minimum payments prolongs and increases your debts
how does debt grow
accruing interest
avoid low intro rates
low intro rates "teasers" jump when the time period expires
the best salary/benefits plan for a new job
want a lower salary with more benefits as opposed to a higher salary with less benefits
graduated payment plan
start you out with lower payments that increase as time goes on
income-related payment plan
your payment amounts are tied directly to your income instead of rising gradually no matter your income
extended repayment
allows you to make smaller payments for a much longer period of time
credit card trap
using a card to "pay for" expenses in excess of your monthly budget
3 C's in recognizing emergencies
Check, call, care
life-threatening conditions
unconsciousness, not breathing, no signs of life, severe bleeding
interviewing the victim
what happened?
do you feel any pain or discomfort?
do you have any allergies?
do you have any medical conditions?
are you taking any medications?
assessing victim's ABC's
a=airway
b=breathing
c=circulation
when checking victim's breathing
look, listen, and feel
good samaritan laws
give legal protection to people who willingly provide emergency care
limitations on good samaritan law
do not exceed the scope of your training
assume each person will do their best in a ______ and _______ manner
reasonable and prudent
implied consent
the victim would agree to the care if he/she could
amount of alcohol in a standard drink
14 grams of pure alcohol
congeners
found in alcoholic drinks, but the body metabolizes them more slowly and are more toxic than ethanol; cause greater hangover effects
alcohol as a depressant
depresses vital functions such as heart rate and respiration
zero tolerance laws
laws that make it illegal for those under 21 to drive after consuming any alcohol
dopamine
neurotransmitter that comes from cigarettes and stimulates feelings of pleasure
emphysema
becomes difficult for the lungs to transfer oxygen to the bloodstream; causing shortness of breath; eventually patients will need to rely on an oxygen tank
chronic obstructive pulmonary disease (COPD)
category of diseases that includes emphysema, chronic bronchitis, and asthma
sudden infant death syndrome
babies who are born to mothers who smoke are 2-3 times more likely to die of this
secondhand smoke has at least twice the amount of nicotine and tar as mainstream smoke
secondhand smoke has at least twice the amount of nicotine and tar as mainstream smoke
secondhand smoke has five times the amount of carbon monoxide as mainstream smoke
secondhand smoke has five times the amount of carbon monoxide as mainstream smoke
a single cigar can contain as much tobacco as an entire pack of cigarettes
a single cigar can contain as much tobacco as an entire pack of cigarettes
recent federal law ban the sell of flavored cigarettes (legal to smoke, but illegal to sell)
recent federal law ban the sell of flavored cigarettes (legal to smoke, but illegal to sell)
primary cause of unintentional injury deaths
motor vehicle accidents
single most effective prevention against motor vehicle crash injury and death
seat belts
aggravated assault
an assault committed with the intent to cause severe injury, often involving a weapon