Benign d/o of female reproductive tracts

Question 1

types of pelvic organ prolapse

Answer 1

-cystocele
-rectocele
-enterocele
-uterine prolapse

Question 2

therapeutic mgmt of pelvic organ prolapse

Answer 2

-kegel exercise, multiple times daily
-hormone replacement therapy
-dietary and lifestyle modifications, prevent constipation
-pessaries
-colpexin sphere, used with kegel exercises
-surgery, anterior or posterior coporrhaphy, vaginal hysterectomy

Question 3

type of urinary incontinence

Answer 3

-urge
-stress
-mixed

Question 4

nursing assessment for urinary incontinence

Answer 4

-history, physical exam
-lab tests (urinalysis and urine culture), and urodynamic testing

Question 5

mgmt of urinary incontinence

Answer 5

-discuss tx options
-educate on good bladder habits
-support and encourage
-stress incontinence: weight loss, smoking cessation, avoid constipation, periurethral injection, meds, estrogen RT
-urge incontinence: bladder training, kegel exercises, pessary ring, anticholinergics, surgery if other methods fail

Question 6

polyps

Answer 6

benign abnormal tissue growth; frequently result from infection

Question 7

most common polyps on cervix and in uterus

Answer 7

-cervical polyps, appear after cycle
-endocervical polyps, seen in multiparous women age 40-60
-endometrial polyps, rare in women <20, peaks around 50, gradually declines after menopause

Question 8

polyps therapeutic mgmt

Answer 8

-removal via forceps, during hysterectomy or D&C
-laser vaporization

Question 9

uterine fibroids

Answer 9

-leiomyomas, benign growth
-rapid growth during childbearing years due to estrogen dependency; shrinks during menopause
-peak incidence around age 45

Question 10

mgmt of uterine fibroids

Answer 10

-medical: GnRH agonists, progestin agonists, uterine artery embolization
-surgical: myomectomy, laser surgery, hysterectomy (abdominal, vaginal, laparoscopic), hormones, uterine atony embolization, magnetic resonance-focused ultrasound

Question 11

bartholin gland cyst

Answer 11

-blockage of one of the ducts of bartholin gland, possible infection and abscess development
-recurs often despite drainage

Question 12

mgmt of bartholin gland cyst

Answer 12

-conservative methods, hot press, NSAIDs
-surgery

Question 13

assessment of bartholin gland cyst

Answer 13

-health hx
-s/s, asymptomatic if cyst is small, s/s of infection
-physical exam
-protrusion of tender labial mass

Question 14

mgmt of bartholin gland cyst

Answer 14

-encourage sitz bath, helps reduce size
-culture drainage or I&D to get drainage, open it and place catheter inside to drainage
-marsupialization: small cut, making permanent opening for continuous drainage, for extreme cases

Question 15

types of ovarian cysts

Answer 15

-follicular: benign functional cyst, normal, should resolve at start of cycle
-corpus luteum: forms on corpus luteum tissue after release of egg
-theca-lutein: benign neoplasm r/t molar pregnancies and twin pregnancy
-PCOS: multiple cysts on ovary for a long time

Question 16

therapeutic mgmt of ovarian cysts

Answer 16

-benign vs. solid ovarian malignancy
-transvaginal ultrasound
-laparoscopy
-oral contraceptives for benign
-analgesics

Question 17

PCOS drug and non drug therapy, lifestyle changes

Answer 17

-limit simple sugars and carbs
-metformin helps regulate cycle, helps ovulate, and lowers insulin!!
-OCP: restores menstrual regulation, doesn’t help ovulate
-syndrome x: effects menstrual function, increased testosterone, thin hair on head, obesity, elevated insulin levels