[Exam 3] Chapter 56: Assessment and Management of Female Physiologic Processes (Page 1666-1668, 1681-1684) Flashcards
What does the Affordable Care Act do?
Requires private insurers to cover preventive health care
What are some prevent health care that were covered by the affordable care act?
Evidence-Based Screening, Annual well-woman visits, 3d mammorgrams and all contraceptions.
Function of the female reproductive system?
Ovulation and the menstrual cycle
Significant hormones and hormonal changes in women?
Estrogen, PRogesterone, Androgens
Follicle-Stiulating Hormone (FSH) and Luteinizing Hormone (LH)
Health History of Women: You get a history of what?
Menstural history and history of pregnancies and exposure to medications.
STDs, surgieres, and sexual histories
Health History of Women: Is there pain with what?
Menses or intercourse
Health History of Women: Monitor for
Vaginal discharge, odor, or itching,
Physical Assessment: Annual Breast and Pelvic Examiniations recommended for who?
All women 21 years of age or older and those who are sexually active, regardless of age
Physical Assessment: Alleviate feelings of anxiety with explanations and education of what?
Explain sexual issues are valid health issues
REassure its safe to talk about sexual issues
Explain that changes or problems in sexual functioning should be discussed
Physical Assessment: What may a patient be asked to do in a total assessment?
Empty her bladder and to provide a urine specimen if urine tests are a part of it
What is Perimenopause?
Period extended from the first signs of menopause (decreased estrogen) and ends one year after cessation of menses
What are some signs of perimenopause?
hot flashes, vaginal dryness, insomnia, difficulty with memory or irregular menses
REproductive function is perimenopause?
Gradually ceases
Perimenopause duration?
Lasts about one year after last menstrual period
Can you get pregnant is perimenopuse?
Yes, you are still able to get pregnant until last period occurs
Perimenopause: Changes in sexual function include
DEcreased estrogen levels
Changes in nerve transmission and response in peripheral vascular system
Changing in timing and degree of vasocongestion during sexual response
Perimenopause: Women will often complain of
Vaginal dryness, due to change in timing during sexual response
What is Natural Menopause?
Permanent cessation of menses, result of aging
At what age does Natural MEnopause occur?
Between 48-55 years of age
How does Chemical Menopause occur?
Cancer chemotherapy-Cytotoxic drugs arrest ovarian function
What is Surgical Menopause?
Ovaries removed in premenopausal women, reducing estrogen and progestin production
If a woman has a hysterectomy (removal of uterus) but not an oophorectomy (Removal of ovaries), what will she be in?
Will not be in menopause
Menopause increased health risks
Heart Disease, because Estrogen protects our organs.
Osteoporsis because they lose calcium from bones
Breast Cancer
Macular Degeneration
Menopause: What will change nutrition wise?
Decrease fat and calories will increasing calcium, whole grains, fiber, fruit, and vegetables
Menopause: Ensure calcium intake what what type of exercise?
Weight bearing
Menopause: What may worsen hot flashes?
Fatigue and stress
Menopause: After this, what screenings do we want women to do?
Mammograms and Pap Tests
Postmenopausal Bleeding: Bleeding after 1 year must be…
investigated, and malignant condition must be considered
Postmenopausal Bleeding: What is a transvaginal ultrasound used for?
Measure the thickness of the endometrial lining, which should be thin because of low estrogen levels
Hormone Replacement Therapy: Benefits of this?
Beneficial in women at risk of osteoporosis, slowing down the process
Hormone Replacement Therapy: This may relieve what?
Vaginal dryness, hot flashes, and night sweats
Hormone Replacement Therapy: Used to believe that it used to fight what?
Prevent heart disease, but is the opposite. It can make it worse
Hormone Replacement Therapy: WHo should not use this?
Those with history of vascular thrombosis
Active liver disease
Uterine Cancer
Undiagnosed vaginal bleeding
Breast Cancer
Cardiovascular
Hormone Replacement Therapy: What is prescribed for women who have not had a hysterectomy?
Estrogen and PRogestin
Hormone Replacement Therapy: What does PRogestin do?
Prevents proliferation of the uterine lining and hyperplasia
Premanstrual Syndrome: What is this?
Cluster of complex symptoms that are usually related to the luteal phase of the menstural cyle
Premanstrual Syndrome: What are some signs of this?
Mood swings, breast tenderness, fatigue, irritability, food cravings, depression, headache, fluid retention
Premanstrual Syndrome: When does this occur?
3-14 days prior to menstruation and are relieved by menses
Premanstrual Syndrome: What are some risk factors of this?
Major life stressors
Age > 30
Depression
Premanstrual Syndrome: With someone womens cycles lasting only 21 days.. this means they will go how long without PMS?
Possibly only one week out of theh month
Premanstrual Syndrome: Interventions to help allieve the symptoms include
Increased fluid intake, which helps dilute the hormones and decreasing effect
Increase frequency and intensity of exercises,
Selective Serotonin Reuptake Inhibitors (SSRIs), often given for depression but can help with PMS
What is Amenorrhea?
Absence of menstural flow
Amenorrhea: Primary Amenorrhea refers to the situation in which
a 15 yer old has not begun developing secondary sex characteristics or by 16 or older develop secondary sex characteristics but has not started mensturation
Amenorrhea: What is a Secondary Amenorrhea?
Absence of menses for three cycles or 6 months after a normal menarche
Dysmenorrhea: What is primary Dysmenorrhea
Painful mensturation, with no identifiable pelvic pathology.
Dysmenorrhea: What does Primary Dysmenorrhea signs look like?
Crampy pain that begins before or shortly after onset of menstural flow and continues for 48-72 hours
Dysmenorrhea: This is thoughth to result because of what?
Excessie production of prostaglandings, which causes painful contractions of the uterus
Amenorrhea: Secondary Amenorrhea ma be caused by
functional hypothalamic amenorrhea, pituitary disease, primary ovarin failure , or pregnancy
Dysfunctional Uterine Bleeding: What is this?
Abnormal uterine bleeding
Dysfunctional Uterine Bleeding: What is Menorrhagia?
Prolonged or excessive bleeding at the time of the regular menstrual flow
Dysfunctional Uterine Bleeding, Menorrhagia: What is this a sign of in young women?
Cause is usually related to endocrine disturbances
Dysfunctional Uterine Bleeding, Menorrhagia: What is this a sign of in oldere women?
Inflammatory disturbances, tumors of the uterus, or hormonal imbalance
Dysfunctional Uterine Bleeding, Menorrhagia: Persistent heavy bleeding may result in
Anemia
Dysfunctional Uterine Bleeding, Menorrhagia: Treatment may involve what?
Endometrial ablation or hysterectomy
Dysfunctional Uterine Bleeding, Metrorrhagia: What is this?
Vaginal bleeding between menstural periods, and is the most significant form of menstural dysfunction because it may signal cancer
Dysfunctional Uterine Bleeding, Menometrorrhagia: What is this
Heavy vaginal bleeding between and during periods
Dysfunctional Uterine Bleeding: Amenorrhea causes include
STructural and/or hormonal abnormalities, polycystic ovary disease, imperforate hymen, or ovarian tumors
Dysfunctional Uterine Bleeding: MEnorrhagia causes include
thyroid disorders, endometriosis, PID, ovarian cysts, uterine fibroids, polyps, clotting disorders or anticoagulnt therapy
Dysfunctional Uterine Bleeding: MEtororrhagia causes include
Hormonal imbalance, PID, POlyps, Uterine FIbroids, or cervical / uterine cancer
Dysfunctional Uterine Bleeding: This is seen in what age group and most often caused by what?
ADolescents and most often caused by lack of ovulation
Dysfunctional Uterine Bleeding: Tests that can be performed include…
Pap Smear: Rules out Cervical Carcinoma
Pelvic Ultrasound: Identifies luteal cysts or ovarian tumors
Edometrial Biopsy: For Histological Examination
Dysfunctional Uterine Bleeding: Lab Tests include..
CBC: Rules out systemic disease
Coagulant Factors pT and pTT: Rules out clotting disorders
Thyroid function studies and endocrine studies: Evaluates pituitary and adrenal function
Progesterone levels
Dysfunctional Uterine Bleeding: What can be done once caused is determines?
Hormal replacement with birth control or progesterone
Therapeutic Dilation and curregate: Cervical canal i dilated and uterine wall is scraped. Can still carry children here.
Endometrial Ablation: Endometrial layer of the uterus is destroyed by using a laser, thermal balloon, or electrocautery. Once completed, you cannot carry children
Hysterectomy: Surgical Removal of the uterus
Oral Contraception: Let them know that some antibiotics can cause some contraceptions to become ineffective. With surgery, clot can develop so monitor closely.
