Conditions Affecting Female Sexuality Flashcards
Uterine prolapse anteversion
Forward tilt
Uterine prolapse retroversion
Uterus tilted toward rectum
Causes of Uterine prolapse
If baby is too large, forceps are used, chronic cough
Rectocele/cystocele
Herniation of rectum or bladder
Signs of severe rectocele/cystocele
Difficulty emptying bladder, difficulty pooping
Treatments for uterine displacement
Legal exercise, pessary, surgery, meds
Pessary
Device inserted in vagina that helps decrease urine leakage. Pt can insert and remove themselves
Meds for incontinence and uterine displacement
Detrol, ditropan, tofranil, urecholine
Colporrhaphy
Surgical repair to the vaginal wall to treat rectocele/cystocele
Sacrocolpopexy
Surgery for suspension of the uterus
postoperative nursing care after uterine displacement surgery
Voiding or catheter care before leaving hospital, cleanse with sterile saline solution &dry with sterile material, ice pack to perineum, head and knees slightly elevated, avoid constipation, Tylenol for pain
Myomas size
Develop slowly during reproductive years, growth is accelerated during pregnancy, atrophy after menopause
Myomas s/s
Low back pain, fertility problems (if not treated), menorrhagia
Myomas treatment
Small fibroids=no treatment, if they have pain they can have surgery to remove them, hysterectomy
If cervical cancer is detected what other tests can they preform
Colposcopy (scope used to examine cervix), cervical biopsy
S/s of cervical cancer
Irregular bleeding, pain in pelvic, flank or legs, malodorous vaginal discharge, dyspareunia (vag pain during sex), rectal pressure (always feel like they need to poop)
Cervical cancer risk factors
Intercourse before age 20, multiple sex partners, non circumcised males, no barrier contraceptives, no regular paps , smoking, exposure to HIV
LEEP (loop electrosurgical excision procedure)
An electric current is used to cut away cells in the cervix. It’s quick and they go home that day
Cold knife cone biopsy
Freeze off cells in cervix
Post cervical biopsy instructions
Rest for 24 hrs, avoid heavy lifting or strenuous exercise, no tampons and sex for 3-4 weeks or until vag discharge stops, if vag packing then don’t remove until instructed, teach s/s of infection
When should pt call doctor after a cervical biopsy?
If excessive bleeding occurs, if s/s of infection occur
Total hysterectomy
Removal of uterus, cervix & ovaries
Radical hysterectomy
Removal of uterus, ovaries, Fallopian tubes, proximal vagina, bilateral lymph nodes
Endometrial cancer is most likely occurs in which kind of women?
Obese, postmenopausal, diabetic, late menopause, nulliparous
2 big s/s of endometrial cancer
Abnormal vaginal bleeding, pelvic pain
Endometrial cancer treatment
Total or radical hysterectomy, radiation therapy (if advanced)
Most deadly gynecological malignancy
Ovarian cancer
Risk factors for ovarian cancer
Any age but mostly over 40, nullipara, fertility drugs, obese, BRACA1 &2 gene
What does it mean when there is a palpable mass in abdomin with ovarian cancer?
Cancer invaded surroundings tissues s/s don’t usually appear until then
Late s/s of ovarian cancer ( in stage 3 or 4)
Increased abdominal girth(mistaken for being fat), indigestion, change in bowel function, urinary frequency, back pain, menstrual cramps
Screening tests of ovarian cancer
CA-125 antigen test (blood test) , ultrasound, CT, pelvic exam
Ovarian cancer complications
Ascites, intestinal obstruction, dvt, lymphedema (leg)
Ovarian cancer treatment
Hysterectomy
Big postop hysterectomy complication nurse needs to watch for?
Bleeding/hemorrhage
Endometriosis
Tissue growth outside of uterus
Endometriosis is most common during what age group?
30-40
Endometriosis s/s
Pelvic/back pain, bowel symptoms, dysuria, GI complaints, infertility, dyspareunia (pain in vag)
Laparotomy
Surgery used to cut some of the tissue in endometriosis
Endometriosis treatment
Laparoscopy or BC to suppress estrogen
Causes of fistulas
Injury from childhood, pessary not being removed for a long time
Fistulas can occur where?
Vagina, bladder, rectum
Fistula treatment
Heal on its own or surgery with a temporary colostomy
External radiation therapy
Beam delivered deep in pelvis
External radiation therapy can cause what problems
Decreased WBC and platelets, decreased sexual desire, fatigue, diarrhea, abdominal cramping, cystitis
Since radiation can cause severe diarrhea, what kind of diet should they be on?
Low residual
External radiation therapy teaching
Plenty of rest, good nutrition, protect skin from sun, don’t scrub skin, don’t remove ink marks placed by radiologist, 1 cup of liquid after each bowel movement, avoid sugar free gum/candy because of sorbitol
Intracavitary implant teaching
Private rm for 24-72 hrs, 10-30 min visits, no childbearing visitors, must be 6 feet from pt, BEDREST, no prego nurses
What do you want to asses for with a pt who has a intracavitary implant?
Burning sensations, excessive perspiration, chills, fever, NV, fistulas, diarrhea
Elective termination of pregnancy what is it and how old is baby when it happens
Ends pregnancy before fetus reaches age of viability (20-24 weeks)
When does Mifepristone(mifeprex) need to be given and what’s the dose
Needs to be given within 49 days of last mentryal period; single oral dose of 600 mg
What happens after medical termination of pregnancy
Painless heavy bleeding
Teaching after medical termination of pregnancy and when to call dr
Tylenol or ibprofen for pain, take temp daily for a week, avoid sex, call dr of heavy bleeding, pass clots, abdominal tenderness, or depression occurs
When is the follow up visit afteredical termination of pregnancy
2 weeks
Menstrual extraction, endometrial aspiration is done when?
5-7 weeks gestation, no anesthesia
D&C can be preformed when?
Less than 13 weeks gestation
D&C
Mechanical dilation of cervix, scrape with curette
D&E can be preformed when and what is it
12-16 weeks gestation. Cervix is dilated and its vacuumed out
D&E potential probs
Uterine perforation, cervical trauma, not able to have kids again
Late abortion accurate during how many weeks and how is it done
After 16 weeks; prostaglandin, saline induction, hysterotomy,
