CH 20: Reproductive System Health Flashcards
effects of Aging on the Reproductive System in women
Hormonal changes _ vulva atrophy
Flattening of labia & loss of SQ fat and hair
Drier vaginal environment and thin vaginal epithelium _ uncomfortable intercourse
Atrophy of cervix, uterus, fallopian tubes, and ovaries atrophy
Uterus and ovaries decrease in size
Replacement of mammary glands by fat tissue _ Breasts sag and are less firm
Nipple retraction from shrinkage and fibrotic changes
Effects of Aging on the Reproductive System on men
Seminal vesicles have thinner epithelium _ Reduction in sperm count
Atrophy of testes _ decrease mass of testes
Slightly decreased testosterone
More time to achieve an erection and lost easily
Enlargement of the prostate gland
Reproductive System Health Promotion
Annual gynecologic exam for women
Women > 65 with 3 normal PAPs don’t need a PAP test unless
they have HIV, immunocompromised, exposed to
diethylstilbestrol (DES) before birth, or cervical cancer
Men with prostatic hypertrophy get exams Q6months
PSA testing routinely for history of prostate CA
Self-breast and self-testicular exams monthly
Complete physical exam
Women: age related vulva disorders can lead to:
irritation and infection
indicates serious disease
what is vulvitits
inflammation of the labia majora and labia minora — the outer folds of the vulva and the parts of a woman’s genitals that are outside her body, rather than inside
causes of vulvitis
Poor hygiene and incontinence
s/s of vulvitis
pruritis
blisters
redness
swelling
tx of vulvitis
treat cause
good nutritional status
sitz baths
local application of saline compresses and
steroids
keep incontinent client clean and dry
vulvular cancer commonly diagnosed when
in the 70s
biopsy any mass of lesion
tx of vulvular cancer
radical vulvectomy
radiation (less
common)
counseling on sexual activity and body
image
reasons behind vaginitis
Increased fragility of vagina causes it to be more
irritated increased risk of vaginitis
s/s of vaginitis
soreness
pruritis
burning
reddened vagina
foul-smelling discharge that is brown/clear/white
tx of vaginitis
local estrogens (with teaching on med
admin)
things the pt can do at home to avoid vaginitis
- Avoid douches, perfumed soaps and spray to area
- If using a douche, measure solution temp. first; altered
sensory perception can cause injury - Wear cotton underwear
- Keep genital area clean and dry
- Use lubricants during sex
- Good hygiene
prevalence of cancer of the vagina
half of cases in women >60
risk factors of cancer of the vagina
HPV
smoking
previous radiation therapy to vagina
hx of cervical cancer
DES
treatment for cancer of the vagina
radiation
therapy
chemo
signs of cervical cancer in aged women
Vaginal bleeding
leukorrhea
generally no pain
ACS suggested screening >65
had regular screen in the last 10 years can stop cervical screening if nothing found in last 20 years
tx of cervical cancer
radium or surgery
risk factors of endometrial cancer
late onset of periods
infertile
PCOS
obesity
family history
estrogen without progesterone use
tx of endometrial cancer
surgery
radiation
prompt identification
prevalence of ovarian cancer
increase after 60
most deadly when it occurs
early nonspecific symptoms of ovarian cancer
GI discomfort
difficulty eating
bloating
constipation
abd pain
late symptoms of ovarian cancer
vaginal discharge
bleeding
ascites
masses
tx of ovarian cancer
surgery
chemo
hormone therapy
radiation
Common problem from stretching and tearing of muscles at childbirth
and age-related changes
perineal herniation
s/s of perineal herniation
lower back pain
pelvic heaviness
pulling sensation
incontinence x2
retention
constipation
difficulty with intercourse
tx for perineal herniation
surgery
painful intercourse
Dyspareunia
cause of dyspareunia
hormonal changes
take measures to improve sexual satisfaction
second leading cause of cancer death in women
brest cancer
prevalence and screening for breast cancer
- Get regular breast exams
- Incidence increases with age
- Older women are less likely to receive
mammograms and breast exams - Women with average risk should have
annual breast exams at 50 - Mammograms annually for women 45-54
and every other year or annually for women
>55
erectile dysfunction in older adults
- Affects half of men >70
- NOT a normal outcome of aging
- Several causes
- Be aware of contraindications with drugs for treatment
- Ask specific questions to clarify symptoms
tx of erectile dysfunction
oral erectile agents
drugs injected into the penis
penile implants
vacuum pumps
penile artery reconstruction
Benign Prostatic Hyperplasia s/s
hesitancy
frequency
decreased force of urinary stream
nocturia
dribbling
overflow incontinence
bleeding
urinary retention increased risk of UTI
tx of benign prostatic hyperplasia
prostatic massage
urinary antiseptics
TURP ( Transurethral Resection Of The Prostate)
- Most common prostatectomy approach is transurethral
- Care for client after TURP
S/S of prostate cancer
hesitancy, frequency, decreased force of urinary stream,
nocturia, dribbling, overflow incontinence, bleeding, urinary
retention increased risk of UTI
with mets back pain,
anemia, weakness, weight loss
how to detect prostate cancer
DRE
PSA
biopsy
tx for prostate cancer
active surveillance
radical prostatectomy
radiation
signs of tumors of the penis
rare
resembles a growth/wort leads to misdiagnosis
biopsy
tx of tumors of the penis
radiation
local incision
partial/total
penile amputation
signs of tumors of testes
testicular enlargement
pain
breast enlargement
tx of tumors of testes
chemo
radiation
orchiectomy
Testicular self-exams
tumors of scrotom
usually benign
come from hydrocele
spermatocele
hernia;
treat the underlying cause
