Common Gynecological Disease Flashcards
Chapter 4
Mentrual Disorder
Amenorrhea
No menses
Mentrual Disorder
Dysmenorrhea
Painful period
Mentrual Disorder
Prementrual Syndrome
Mood swings
Mentrual Disorder
Abnormal Uterine Bleeding (AUB)
excessive, prolonged bleeding
Mentrual Disorder
Premenstrual Dysphoric Disorder (PDD)
Severe PMS that leads to depression
Mentrual Disorder
Endometriosis
Thickening of the uterus
Risk factors: infertillity, scar tissue; eggs and sperm are unable to penetrate (implantation)
Common Symptoms of Menopause
Premenopause
Cramps, anxiety, mood swings, irritatibility, nausea
Common Symptoms of Menopause
Perimenopause
Vaginal dryness, mood swingsm hot flashes, loss of libido, irregular periods
Common Symptoms of Menopause
Menopause
Hot flashes, loss of libido, night sweats, irregular periods
Common Symptoms of Menopause
Postmenopause
Inscreased risk of osteoporosis, Coronary Artery Disease (CAD), UTI
Medical Abortion
Misoprostol and Mifepristone Tablets
- Use misopristone to stop baby from growing.
- Adminsiter misopristol (cytotec) 24-48 hours afterwards for the uterus to dilate, contract, and expulse.
Abortion Procedure
Dilation & Curettage (D&C)
Cervix is dilated, then products are removed by suction.
Uterus is gently scraped by cutterage.
20 minutes procedure.
*Vacuum Aspiration can follow D&C to remove remnants. Complications: bleeding, retained tissue, cervical repair, infection.
Permanent Contraceptive
Vasectomy
Purpose & Pt. Education
Sterilzation for men with local anesthesia.
Vas deferens is cut out.
Post-Op Client Education:
* Patient must send sperm sample for 8-16 weeks until there is no sperm count.
*However procedure is eventually reversible.
Permanent Contraceptive
Tubal Ligation
Sterilization for women.
Fallopian tubes are either…
- cut and cauterized
- tied and cut
- clipped or banded
POST-OP Client Ed.: 3 months of contraception.
Complication: The surgucal cut cauterizes.
*This procedure is not recommended for younger women, because their cells regenerate quickly.
Abortion Procedure
Vacuum Aspiration
Most Comon Method & Potential Complications
Usage of vacuum source to remove and embryo or fetus.
Potential Complications include:
* Fever 100.4 F
* Chills
* Heavy bleeding
* Smelly discharge
* Severe abdominal pain or tenderness
*Includes anesthesia
Emergency Contraception
Progestin Pill - Plan B
- Prevents implantation and does not disrupt implanted preganancy.
How to use:
* Take within 72-120 hourse after unprotected sex.
* Administer 1.5 mg.
Emergency Contraception
Ulipristal Acetate (UPA) - Ella
An oral progesterone receptor agonist–antagonist.
* Take 120 hours post unprotected sex.
* Admnister 30 mg.
*Prescription required.
Potential Complication of Intrauterine Device (IUD)
P.A.I.N.S.
- Period irregularities
- Abdominal pain (dyspareunia)
- Infection (abnormal discharge)
- Not feeling well
- String missing
Hormonal Contraceptive
The Nova Ring
A ring-shaped, flexible contraceptive inserted inside the vagina.
* Must be the inserted by the HCP after first time use.
* 99.7% effective
* S/S: Vaginal discharge.
* S/E: ring odor, expulsion.
*can still get pregnant
Hormonal Contraceptive
Transdermal Patch
Sticker that seeps into the subcutaneous tissue to prevent the egg joining the sperm.
Pt. Ed:
- Rotate patches around different areas for every replacement.
- Most be worn for three weeks.
*prescription is required.
Hormonal Contraceptive
Mini Pill
(ORAL)
- Progesterone only.
- Given in lower dose.
- Can use while breastfeeding.
*DOES NOT PROTECT against STIs
Signs of Potential Complication of Oral Contraceptives
A.C.H.E.S.
- Abdominal pain (gallbladder/liver)
- Chest pain (SOB, blood clot, PE)
- Headaches (sudden or constant CVA/HTN)
- Eye problems (vascular or HTN)
- Severe leg pain (DVT)
Hormonal Contraceptive
Depo-Provera Injection
IM Injection
- Consists of **progestin **that injected to the woman’s arm or butt.
- Effective for 12 weeks.
- Safest option for the mother.
S/E: wt gain, ACHE, and depression
*DOES NOT protect against STIs, must be prescribed.
Hormonal Contraceptive
Long-Acting Reversible Contraceptives (LARCs) IUD
Hormonal vs. Nonhormonal, Nurse Considerations
- “T” Shaped
- Hormonal IUD (minera) - lasts for 3 to 7 years
- Nonhormonal (Copper)* - lasts for 10 years
Nursing Considerations
- teach patient for presence of string (during ADLs)
*IUD feels like menstrual cramps
Hormonal Contraceptive
The Pill
Benefits, Contradindications, Nurse Implications
Benefits:
- decreased menses
- decreased risk for iron deficiency anemia
- regulated menstual cycle
- decreased S/S in PMS
- improves acne
- protects against ovarian/endometrial cycle
- decreases in benign breast disease
Contraindications
- Hx of thromboembolic disorders, cerebrovacular/ heart disease, breast cancer, gallbladder disease, pregancy, liver disease, smoker (>35 y/o), HTN, Diabetes (>20 years)
Nursing Implications
- If one pill is missed, take one ASAP. Then use a back contraceptive (i.e. condoms)
*Birth control can increase blood clots.
Client Education for Hormonal Method
- COC: estrogen and progesterone
- Hormonal pill supresses ovulation
- Thickens cervical mucus
- Alters uterine lining to prevent implantation
- Observe for adverse effects
- Take pill ASAP if pilled missed and use a back up.
- Herbals (i.e St. John’s disease) decreases effectiveness.
- AntiTB, antifungals, anticonvulsants, anti-HIV, and protease inhibitors decrease effectiveness.
When to use procedural and medicinal methods for abortion?
D&C, Vacuum Aspiration, and Medices
Abortion: The interuption of pregnancy before 20 weeks of gestation. Types: Elective; Spontaneous (Miscarriage)
- Before 12 to 13 weeks of gestation use abortion pills (misopristol and mifepristone).
- After the 12th or 13th week, remove remnants from D&C and/or V.A.
Barrier Method
Condoms
For both females and males.
- Female Condoms: Made of polyurethane (95% effective)
- Male Condoms: latex or plastic (98% effective)
Barrier Method
Diaphragm
Replace every 1-2 years and/ or after 10 lbs weight gain or loss; abdominal surgery or pregnancy.
Must be inserted 2 hours and stay 6 hours afterwards, but no longer than 24 hours.
Use spermicide.
*Prevents STIs
Barrier Method
Cervical Caps
- Can be inserted 36 hours prior intercourse.
- Can be changed after one year.
- Must go to HCP for fitting.
*Prevents STIs
Barrier Method
Contraceptive Sponge
- Insert 24 hours prior intercourse
- No fitting is required by HCP
*DOES NOT prevent STIs
Behavorial Contraceptive
Abstinance
Not have intercourse - at all.
Behavorial Awareness
Fertility Awareness
Cervical Mucus, Ovulation, Basal Body Temp, Symptothermal, Standard Days, 2 Day Methods
- Cervical Mucus Ovulation Method: observe vagina for jelly like symptoms
- Basal Body Temp: Assess increase in body temp by 0.5 to 1 degrees up to three days during ovulation
- Symptothermal: combination of cervical and basal methos
- Standard Days: county days to most fertile
- 2 Day Methods: noting to see if fertile by looking at secretions on days 1 and 2
Behavorial Method
Withrawal Method (Coiptus Interuptus)
Pulling out penis prior ejaculation.
Behavorial Method
Lactational Amenorrhea Method
The mother with no menses continuously breast feed until unable to get pregnant.
Infertility
Manifestations & Nurse Interventions
Manifestations
- Overweight, STIs, genetics, thyroids, abortions, amenorrhea, drugs, Polycystic Ovary Syndrome (POCs), smoking
Nursing Interventions
- Infertility leads to stress, and vice versa.
- Explain the role of the genetic counselor, reproductive specialist etc.
- Allow couples to express feelings
- Monitor the use of medications*
- Help consider options
*using medications puts future at risk for multiple birth defects
