Ch 53 Flashcards
Group of physical and emotional symptoms that occur in some women 7 to 10 days before menstruation
Premenstrual syndrome(PMS)
Or it’s more severe form premenstrual dysphoric disorder (PMDD)
Diagnosis of PMS is based on data from an ___ in which the client keeps daily recordings of her symptoms for at least ___ months. The classic finding is that the client is symptom free during the period between the onset of menstruation and ovulation
Menstrual diary
2 months
To supplement medical treatment, the nurse encourages the client to make healthful lifestyle changes, such as the following: SATA (3)
Reducing or eliminating caffeine
Eliminating alcohol & smoking
Exercising aerobically 30 minutes most days of the week
Painful menstruation
Dysmenorrhea
Dysmenorrhea is treated with ___ and by treating the underlying cause if one is identified
Mild nonnarcotic analgesics
Knee to chest position to relieve discomfort
In dysmenorrhea
The absence of menstrual flow
Amenorrhea
Is infrequent menses
Oligomenorrhea
Treatment of amenorrhea and oligomenorrhea
Focuses on the correction of the underlying cause
A condition characterized by a cluster of signs and symptoms that include amenorrhea and oligomenorrhea
PCOS
What age does polycystic ovarian syndrome affect
Women between 20 and 40
Women with PCOS tend to have problems including: SATA (5)
Interference with menstruation and ovulation
Weight gain
Excessive growth of body hair,acne, thinning hair or baldness
Abnormal lipid levels
Hypertension
PCOS is associated with multiple endocrine abnormalities such as overproduction and inefficient use of ___ and high __ levels
Insulin
Testosterone
Excessive bleeding at the time of normal menstruation. It may be quantified as a menstrual flow that lasts more than 7 days
Menorrhagia
Symptomatic relief is accomplished in Menorrhagia with __,___, and ___
NSAIDs
Progestins
Contraceptives with combinations of estrogen and progestin
Detachments of the lining of the uterus
Endometrial ablation
Vaginal bleeding at the time other than menstrual period (unexpected and irregular)
Metrorrhagia
Post menopausal period begins __ after __
1 year after menstruation ceases
This period refers to the time during which ovarian activity gradually ceases
The climacteric or perimenopausal period
The cessation of the menstrual cycle (“change of life”)
Menopause
Menopause normally occurs as a natural physiologic process between __ &__ yrs of age
45 & 55
__ menopause that occurs when the ovaries are removed can occur at any age
Surgical
Menopause occurs when ___ function diminishes
Ovarian
In menopause __ and __ are reduced, ovulation gradually ceases, menstruation becomes irregular until it stops, and natural reproductive capacity ends
Estrogen & progesterone
__ and menopause share many of the same symptoms, indicating the need for further evaluation to determine if a mood disorder is present
Depression
During the perimenopausal period (the transitional period surrounding menopause) the women may experience vasomotor disturbances such as:
These common symptoms often are the ones for which women seek treatment
Hot flashes accompanied by sweating, sleep disturbances, irritability or depression, vaginal dryness, diminished libido, dyspareunia (pain during sex)
Medical management for menopause
HRT; made for each pt on an individual basis
HRT or ERT is prescribed in the lowest appropriate does for the shortest time necessary.
It is believed that estrogen in small doses can help prevent __ and relieve menopausal symptoms such as __ ___ and __. The risks of endometrial or breast cancer & seriousness of future MI and stroke may outweigh the potential benefit of preventing hip fractures and kyphosis that are secondary to osteoporosis
Osteoporosis
Hot flashes, night sweats, vaginal dryness
Menopause = may need antidepressants
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FDA approved prescription substances made from soy and yams, are indistinguishable and similarly effective as those from naturally occurring estrogen and progesterone
Bioidentical hormones
Nursing management with menopause: the nurse give the following suggestions:
Discuss with prescriber the benefits, risks and alternatives for HRT or ERT
Contact the provider if breakthrough bleeding or other symptoms occur while taking hormonal replacements
A condition in which the vagina is inflamed
Vaginitis
Most common cause of vaginitis (chemical or mechanical)
Feminine hygiene products, allergic reactions, age related tissue changes (atrophic vaginitis with menopause) INFECTIONS
Assessment finding with vaginitis
Abnormal vaginal discharge
Although the vagina is self protected by mucus secreting cells and an acidic environment (pH of __ to __) the tissue still may become disrupted
3.4-4.5
__ women, those with __, and those who take __ have an excess of glycogen in vaginal mucus, which supports the growth of microorganisms
Pregnant
Unregulated diabetes
Hormonal contraceptives containing estrogen
Curdy white discharge (cottage cheese)
Thick consistency
Strong odor
Candida albicans
Candida albicans
Color of discharge:
Consistency:
Odor:
Curdy white (cottage cheese)
Thick
Strong
Yellow white discharge
Foamy consistency
Foul odor
Trichomonas vaginalis
Trichimonas vaginalis
Color of discharge:
Consistency:
Odor:
Yellow white
Foamy
Foul
Grayish white discharge
Watery consistency
Fishy odor
Gardenerella vaginalis
Gardnerella vaginalis
Color of discharge:
Consistency:
Odor:
Grayish white
Watery
Fishy
Nursing management for vaginitis
Nurse may insert first vaginal med while teaching pt how to repeat (at bedtime)
Avoid routine douching
Lactobacillus acidophilus in capsule form or yogurt with active cultures of lactobacilli to replenish normal vaginal microorganisms
Sitz baths to relieve itching, burning or swelling of vulva and perineum,
Skin protectants containing zinc oxide to promote healing
Inflammation of the cervix
Cervicitis
In cervicitis the infection can travel upward through uterine and tubal structures leading to ___
Pelvic inflammatory disease (PID)
In cervicitis inflammation and subsequent formation of scar tissue increase the potential for __ or ___
Ectopic pregnancy
Difficulty conceiving
Chronic cervicitis decreases the amount and quality of__ and alters __, both of which are underlying causes of infertility
Cervical mucus
pH
An infection of the pelvic organs other than the uterus, including the ovaries (oophoritis), fallopian tubes (salpingitis), pelvic vascular system, and pelvic supporting sutures
Pelvic inflammatory disease (PID)
Most common pathogens related to PID
Gonicocci
Chlamydia trachomatis
In PID the infection can travel up to the uterus to the fallopian tubes (salpingitis) and ovaries (oophoritis) and can result in a __ or __ as pus from the infected tube leaks into the abdomen
Pelvic abscess
Peritonitis
A ruptured pelvic abscess requires __
Emergency surgery
A type of septic shock, it is life threatening systemic reaction to the toxin produced by several kinds of bacteria
Toxic shock syndrome (TSS)
PID = contact precautions
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