Female reproductive disorders

Question 1

Dysmenorrhea

Answer 1

Painful menstrual flow
 Most common in young women
 Painful uterine cramping; lower abdomen and back pain
Underlying conditions: menopause, endometriosis.
 Tx: NSAIDS, oral contraceptives, heat packs, relaxation techniques, low-fat food choices

Question 2

Premenstrual Syndrome

Answer 2

Caused by changes in the level of serotonin and fluid shifts
 Physical and emotional symptoms
 Occurs in women age 20-40
 Symptoms include: depression, angry outbursts, anxiety, headache, bloating, unclear thinking
 Tx: counseling, exercise, change in eating habits, antidepressants (SSRI)
Risk factors: smoking, alcohol.

Question 3

Endometriosis

Answer 3

Uterine tissue implantation outside the uterine cavity (on an ovary)
 Monthly menstruation/bleeding occurs out of place causing scars; possibly infertility
 Affects women of all ages
 Symptoms include:pain(prior to mentruation), pelvic tenderness, painful sexual intercourse
 TX: like dysmenorrhea, endostatins, removal of adhesions

Question 4

Dysfunctional Uterine Bleeding

Answer 4

excessive bleeding  (> 80 ml of blood per cycle)
 Due to hormonal imbalance – no ovulation occurs → decrease progesterone → uterus overgrowth occurs →shedding of uterine lining (heavy bleeding)
 TX:  hormone manipulation, NSAIDS, D&C, endometrial ablation

Question 5

Menopause

Answer 5

Normal cessation of menstrual periods ( ahe 51)
 Amenorrhea for 12 months
 Ovaries no longer produce estrogen
 S/S: hot flashes, vaginitis, menstrual irregularity
 TX: HRT: hormonal replacement therapy (oral, transdermal, intravaginal), exercise, calcium supplements ( prone to osteoporosis)

Question 6

Toxic Shock Syndrome (TSS)

Answer 6

Exotoxins produced from bacteria cross the vaginal mucosa and enter bloodstream
 Related to use of tampons
 S/S: quick onset of fever, hypotension, sunburn-like rash in eyes/skin
 TX: remove infection source, fluid balance restoration, IV antibiotics, pressors ( constrict blood vessels - increase BP)

Question 7

Uterine Prolapse

Answer 7

Downward displacement of uterus
 Decrease of pelvic support
 Occur in stages ( 3 grades ; 3 - most severe )
 S/S: painful intercourse, backache, pressure on pelvis
 TX: pelvic support to elevate uterus (pessaries/spheres), Kegels exercises; estrogen therapy, surgery

Question 8

Pelvic Inflammatory Disease (PID)

Answer 8

1. infectious process of organism migration;
2. affects reproductive organs ( fallopian tubes)
3. sexually transmitted organisms - chlamydia, gonorrhea
4. spread during sexual intercourse, child birth, abortion
5. S/s: lower abdominal pain, tenderness, flue like symptoms, vaginal bleeding / discharge.
6. TX: oral antibiotics, education
7. Symptoms main remain silent - if left untreated infertility occurs

Question 9

Total vaginal hysterectomy (TVH)

Answer 9

Presence of small fibroids on uterus

 Removal of uterus & cervix through vagina

Question 10

Total abdominal hysterectomy (TAH)

Answer 10

Present of large leimyomas

 Removal of uterus & cervix via bikini incision

Question 11

Myoectomy

Answer 11

minimally invasive leiomyoma removal ;

laparascopic laser removal

Question 12

Surgery - POST-OP

Answer 12

Incision/site, bleeding, dressing assessment
 Assess pain, vital signs, labs (esp. H&H,) fluid intake (See p. 1697 74-4; 74-8)
 INTERVENTIONS
 Cough & deep breathing, incentive spirometry, early ambulation
 Emotional supports, community resources

Question 13

Endometrial cancer

Answer 13

• inner uterine lining
   Most common; slow growth; bleeding leads to early detection
   S/s: postmenopausal bleeding
  Cause of bleeding is tumor - adenocarcinoma (growing)

Question 14

Cervical cancer

Answer 14

squamous/columnar cells transform to cancerous cells (transformation zone)
 Caused by HPV exposure to cells on outside of cervix
 S/s: May present as warts, abnormal bleeding

Question 15

Ovarian cancer

Answer 15

tumors growing on ovary surface
 Rapid growing, spread quickly
 Metastasize to distant sites via blood/lymph circ.
 May be linked to excessive estrogen exposure
 Leading cause of death of reproductive cancers
 S/s: abdominal pain, GI disturbances
 Low survival rate - diagnosed in later stages (not always symptomatic)

Question 16

Cancer Treatments

Answer 16

Vary among cancers
 Chemotherapy
 Radiation
 Surgical procedures
 Palliative care
SUPPORT, SUPPORT, SUPPORT!!

Question 17

Assessment

Answer 17

Pap smears, abnormal bleeding, discharge,
Abdominal/back pain, gas, incontinence, external appearance
 Family support
 Knowledge of cancer and overall health
 Pelvic exam: speculum, lubricant
 Inspected for color, shape, dilation, herpes, discharge, nodules, masses, bleeding

Question 18

Nursing Diagnosis

Answer 18

Anxiety and Fear
 Acute Pain
 Anticipatory Grieving 
 Risk for Sexual Dysfunction
 Ineffective Coping
 Potential for Hemorrhage