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Med Surg II Nrsg 110 > Ch. 46 & 47 Female Reproductive Disorders > Flashcards

Ch. 46 & 47 Female Reproductive Disorders Flashcards

1
Q

What is done in a pelvic examination?

A

Inspecting the cervix; Obtaining pap smears and other samples; Inspecting the vagina; Bimanual palpation; Cervical palpation; Uterine palpation; Adnexal palpation; Vaginal and rectal palpation

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2
Q

What are some of the diagnostic exams and tests done to detect female reproductive disorders?

A

Pelvic exam; pap smear; Colposcopy and cervical biopsy; Cyrotherapy and laser therapy; Cone biopsy and loop electrosurgical excision (LEEP); Endometrial biopsy; Dilation and Curettage (D&C); Laparoscopy (pelvic peritoneoscopy) and hysteroscopy

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3
Q

List some menstrual disorders.

A

Premenstrual syndrome, dysmenorrhea, amenorrhea, and abnormal uterine bleeding

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4
Q

What does PMS stand for?

A

Premenstrual syndrome

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5
Q

Define dysmenorrhea.

A

Painful cramping during menstruation.

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6
Q

Define amenorrhea.

A

Absence of menstruation.

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7
Q

What is classified as abnormal uterine bleeding?

A

Menorrhagia, metrorrhagia, and postmenopausal bleeding

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8
Q

Define menorrhagia.

A

Heavy bleeding

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9
Q

Define metrorrhagia.

A

Irregular bleeding

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10
Q

What are some medications for PMS?

A

Diuretics (spironolactone)(for bloating), hormones, SSRIs (prozac, paxil, zoloft)(mood changes), NSAIDs (for pain)

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11
Q

What does TSS stand for?

A

Toxic Shock Syndrome

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12
Q

What causes TSS?

A

Caused by a toxin produced by certain types of staphylococcus bacteria. Streptococcus pyogenes (group A strep) or Staphylococcus aureus (staph)

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13
Q

Who can get TSS?

A

Women using tampons, children, postmenopausal women and men

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14
Q

What are the risk factors for TSS?

A

Current S. aureus infection, foreign bodies or packing (such as those used to stop nosebleeds), menstruation, surgery, tampon use (particularly if you leave in for a long time), use of barrier contraceptives such as a diaphragm or vaginal sponge

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15
Q

What are the s/s of TSS?

A

HA (most common), confusion, high fever (possibly with chills), low BP, petechiae, organ failure (usually kidneys and liver), redness of eyes/mouth/throat (common), seizures, and widespread rash that looks like a sunburn (skin peeling occurs 1-2 weeks after the rash, particularly on the palms of the hands or bottom of the feet

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16
Q

How can you prevent TSS?

A

Change tampon q4hr, substitute pads, wash hands, care with barrier contraceptives, report symptoms promptly

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17
Q

Define menopause.

A

Permanent physiologic cessation of mensus associated with declining ovarian function; no mensus for 1 year

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18
Q

What is the medical management of menopause?

A

HRT; risks (increase risk of MI, stroke, blood clots, and breast CA) and benefits (decreases hot flashes and risk for fracture due to osteoporosis)

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19
Q

What are some alternative therapies used for hot flashes?

A

Vitamin B6 & E, Paxil, Effexor

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20
Q

What nutritional adjustments need to be made for a woman in menopause?

A

Decrease fat and calories & increase calcium, whole grains, fiber, fruit, and vegetables; Calcium and vitamin D supplementation may be helpful

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21
Q

Define infertility.

A

A couple’s inability to achieve a pregnancy after 1 year of unprotected intercourse.

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22
Q

What are some factors that play a role in infertility?

A

Ovarian and ovulation (PCOS, not ovulating at all or irregularly), tubal (scar tissue), uterine (lining not thick enough, endometriosis), semen (decreased sperm count), other male factors (varioceles and varicose veins around testicles increases temperature and decreases semen quality)

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23
Q

Describe the management of infertility.

A

Pharmacologic therapy, artificial insemination and in vitro fertilization

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24
Q

What are some complications of pharmacologic therapy?

A

Potential for multiple pregnancies and ovarian hyperstimulation syndrome (OHSS)

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25
Q

What is ovarian hyperstimulation syndrome (OHSS)?

A

Characterized by enlarged multicystic ovaries and is complicated by a shift of fluid from the intravascular space into the abdominal cavity

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26
Q

What are s/s of ovarian hyperstimulation syndrome (OHSS)?

A

Bloating and cramping; Fluid shifting that can result in ascites, pleural effusion, and edema

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27
Q

What is the most common sexually transmitted disease among active young people?

A

Human papillomavirus (HPV)

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28
Q

What is HPV linked to?

A

Cervical CA and cervical dysplasia (need annual PAP smears)

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29
Q

What is commonly treated along with HPV?

A

Genital warts

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30
Q

Does Herpes type 2 infection (herpes genitalis) ever go away completely?

A

No. It is a recurrent lifelong viral infection with flare ups and remissions

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31
Q

What are the s/s of herpes genitalis?

A

Causes painful itching and burning herpetic lesions

32
Q

Which antiviral agents suppress the symptoms of HSV-2?

A

acyclovir (Zovirax), valacyclovir (Valtrex), and famiciclorir (Famvir)

33
Q

What are recurrences of HSV-2 associated with?

A

Stress, sunburn, dental work, inadequate rest and inadequate nutrition

34
Q

Is there a risk to an infant born vaginally to a mother who has HSV-2?

A

Yes, therefore cesarean section delivery may be performed

35
Q

What are the 2 main interventions for a pt that has HSV-2?

A

Measures to prevent reinfection and spread of infection and measures to reduce anxiety

36
Q

What is pelvic inflammatory disease (PID)?

A

An inflammatory condition of the pelvic cavity that may begin with cervicitis and may involve the uterus (endometriosis), fallopian tubes (salpingitis), ovaries (oophoritis), pelvic peritoneum, or pelvic vascular system

37
Q

What are some causes of cervicitis?

A

Infection (most common), devices inserted into the pelvic area (cervical cap, device to support the uterus, and diaphragm), an allergy to spermicides used for birth control or to latex in condoms, and exposure to a chemical

38
Q

How common is cervicitis?

A

Very common, affecting more than half of all women at some point during their adult lives

39
Q

What are some risk factors for cervicitis?

A

High-risk sexual behavior, hx of sexually transmitted disease (STD), many sexual partners, sex (intercourse) at an early age, and sexual partner (s) who have engaged in high-risk sexual behavior or have had an STD

40
Q

Which STDs can cause cervicitis?

A

Chlamydia, Gonorrhea, Herpes virus (genital herpes), HPV (genital warts), trichomoniasis and bacteria (such as staph and strep) and too much growth of normal bacteria in the vagina (bacterial vaginosis)

41
Q

What is the most common cause of cervicitis?

A

STDs

42
Q

What is salpingitis?

A

Inflammation of the fallopian tubes

43
Q

What is endometritis?

A

An inflammation or irritation of the lining of the uterus (the endometrium)

44
Q

What are the causes of endometritis?

A

Infections such as chlamydia, gonorrhea, tuberculosis, or mixtures of normal vaginal bacteria. More likely to occur after miscarriage or childbirth, especially after a long labor or c-section

45
Q

What are the risk factors for developing endometritis?

A

Increased risk in a medical procedure that involves entering the uterus through the cervix. This includes a D&C, hysteroscopy, and placement of an IUD

46
Q

What are some other pelvic infections that can occur at the same time as endometritis?

A

Acute salpingitis, acute cervicitis, and many STDs

47
Q

What are the s/s of endometritis?

A

Abdominal distention or swelling, abnormal vaginal bleeding or discharge (may be purulent), discomfort with bowel movement (constipation may occur), fever (100-104), general discomfort/uneasiness/ill feeling (malaise), and lower abdominal or pelvic pain (uterine pain)

48
Q

What s/s will be present in a physical and pelvic exam for endometritis?

A

The lower abdomen may be tender, BS may be decreased, tenderness in the uterus and cervix, and cervical discharge

49
Q

In diagnosing endometritis, what cultures from the cervix might be performed?

A

Chlamydia, gonorrhea, and other organisms

50
Q

What are some diagnostic tests performed for endometritis?

A

Cultures (STDs), endometrial biopsy, ESR (sedimentation rate), laparoscopy, WBC, and wet prep (microscopic exam of any discharge)

51
Q

Why is douching not good?

A

It affects the pH levels of the vagina and then it’s not protected from infection

52
Q

What are the risk factors for PID?

A

Multiple sex partners, STDs, substance abuse, frequent douching, and IUD use

53
Q

What are the s/s of PID?

A

Abdominal pain, purulent vaginal discharge, pain with intercourse, N/V, and pain on urination

54
Q

What are some interventions done for PID?

A

Antibiotics (used to treat and prevent complications of endometritis), laparoscopic surgery for adhesions and scar tissue, STD testing (may also need to test and treat sexual partners), fluids through IV, rest, and education (on how they developed PID)

55
Q

What is a cystocele?

A

Bladder sags into the vaginal space due to lack of structural support

56
Q

What are the causes of a cystocele?

A

Childbirth (most common) or hysterectomy

57
Q

What are the s/s of a cystocele?

A

Pelvic pressure and stress incontinence

58
Q

What are some alternatives to surgery for a cystocele?

A

Kegel exercises, insertion of a pessary, and HRT

59
Q

What is a pessary?

A

A device that is inserted into the vagina to help support the pelvic organs. They come in different shapes and sizes and must be fitted to the pt by a physician

60
Q

What does HRT do for a cystocele?

A

Hormones may improve the quality of the supporting tissues in the pelvis

61
Q

What is a rectocele?

A

Portion of the rectum sags into the vagina as a result of weakening of the posterior vaginal wall

62
Q

What are the s/s of a rectocele?

A

Pelvic pressure, backache, constipation (pt may actually have to insert fingers into the vagina to push feces up to defecate)

63
Q

What is a uterine prolapse?

A

Abnormal position of the uterus protruding downward into the vagina

64
Q

How is a uterine prolapse diagnosed?

A

Pelvic exam

65
Q

What causes a uterine prolapse?

A

Obstetric trauma and overstretching of the musculofascial supports

66
Q

What are the s/s of a uterine prolapse?

A

Pain (back and pelvic), pressure and heaviness in the vaginal region, and bloody discharge

67
Q

What are some therapeutic interventions used for a prolapsed uterus?

A

Pessary, surgical correction (suspension and hysterectomy) and Kegel exercises

68
Q

What are the causes of uterine fibroid tumors?

A

Unknown. However, fibroid growth seems to depend on the hormone estrogen. As long as a women with fibroids is menstruating, a fibroid will probably continue to grow

69
Q

What are the s/s of uterine fibroid tumors?

A

Irregular bleeding (usually menorrhagia), pain from pressure on other organs, and fatigue due to anemia

70
Q

What does treatment of uterine fibroid tumors depend upon?

A

Age, general health, severity of symptoms, type of fibroids, whether you are pregnant, and if you want children in the future

71
Q

What are some treatments for the symptoms of uterine fibroid tumors?

A

Birth control pills (oral contraceptives) to help control heavy periods; IUDs that release the hormone progestin to help reduce heavy bleeding and pain; Iron supplements to prevent or treat anemia due to heavy periods; NSAIDs such as ibuprofen or naprosyn for cramps or pain; Hormonal therapy (GnRH agonists or Depo Leuprolide injections) may be used to help shrink the fibroids but only on a short term basis

72
Q

What are the treatments for uterine fibroid tumors?

A

Hormone suppression because they are estrogen sensitive; Myomectomy (removal of tumors); Hysterectomy if severe pain or bleeding

73
Q

What is endometriosis?

A

Endometrial cells are carried to other parts of the body via the blood and lymph nodes. Ovarian hormones initiate the cycle of cell sloughing in the uterus as well as those cells that have traveled to other parts of the body. Bleeding will then occur in the abdominal cavity causing pain, swelling, damage to abdominal organs, and development of scar tissue

74
Q

What is the cause of endometriosis?

A

Unknown

75
Q

What are the s/s of endometriosis?

A

Pain, swelling, organ damage, scar tissue, infertility, and long mensus

76
Q

What is retrograde menstruation?

A

The endometrial cells loosened during menstruation may “back up” through the fallopian tubes into the pelvis. Once there, they implant and grow in the pelvic or abdominal cavities

77
Q

What are the treatment options for endometriosis?

A

Hormones (oral, Depo-Provera), stop ovulation (best way because the lining doesn’t thicken), reduce estrogen, analgesics for pain and cramping, surgery (laparotomy which is used to remove endometriosis and hysterectomy)

Med Surg II Nrsg 110 (8 decks)

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