Female Reproductive disorders

Question 1

Coloscopy

Answer 1

• used to visulize uterine, ovaries via microscope via small incisiona t end of vigina-cervix
• inform pt incision will heal on own, no douching, expect some bleeding, nothinbg up there ( tampons, penises ect)
• easiest way to inspect the pelvic cavity
• knee chest or lithotomy position
• light sedation
• tissue samples may be taken
• may see fertility issues, ectopic pregnancies or tumor masses
  *

Question 2

Culdoscopy

Answer 2

*

Question 3

laparoscopy

Answer 3

• under local or general anesthesia
• through small abdominal incision
• tubal ligation may be used
• gas inserted co2 to visualize other organs- post abdominal pain expected

Question 4

Dilation and Curettage

Answer 4

• Diagnose uterine cancer or causes of abnormal bleeding
• cervix is dilated
• used for fibroid cleaning, post abortions, misscariages
• if endomitriosis to clean a bit
• tissue samples may be taken
• performed under general anesthesia
• pain meds given

Question 5

Mammography

Answer 5

• radiologic test to detect breast cyst or tumors
• obtained at age 40-50 then anually
• breast compressed as thinly as possible by machine
• if hx of breast cancer earlier age
• remind patient to notify if they have breast implants
  *

Question 6

self breast exams

Answer 6

• performed regularly, monthly starting in 20s
• perform same time each month
• better after periods as breast tissue not at sensitive
• easier in shower
• in front of mirror to check for dimples or discoloration
• layign in bed also because the flatten otu a bit
• circular motion
• also check in to armpits
  *

Question 7

Breast Biopsy

Answer 7

• Definite test for diagnosis breast cancer
• incisional, excisional or needle aspiration
• fluid filled cyst can be done by needle aspiration
• solid mass rewuires surgical approach
• nurse provides information and support
• pt might be depressed, in denial ect be supportive and non judgemental
  *

Question 8

Common therapeutic measures

Answer 8

• Douching- Flooding the vagina with fluid, not regularly recommended-washes away natural elements that maintain PH, causing irritation and allergioc reactions ect.
• antiseptic douching may be ordered prior to sx cauterization
• Heat application- relieve pain, increase blood flow, stimulate rupture of abscess
• Patient teaching- best way is mild soap and water daily. cotton pantie

Question 9

Drug therapy

Question 10

Creams

Answer 10

• Injectable creams
• suppositories
• pills
• topical creams
• drug absorption is very quick
• night time is best so patient ca be in bed and not moving around\
• may wear pad to protect clothing

Question 11

Different SX procedures

Answer 11

• Depends on what needs to be done
• laproscopic
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Question 12

key words

Answer 12

• Metrorrhagis- spotting between periods
• Menorrhagia- profuse or prolonged bleeding
• Amenorrhea- absence of menses
• reasons can be stress, pregnancy, exercise, meds or disorder

Answer 13

• hormone dysfunction\
• tumors
• infections
• contraseptive
• coagulation disorders
• systemic disease
• endometrial hyperplasia
• inflammatory process
• causes of amenorrhewa: excessive wt loss, physical activity

Question 14

vulvitis and viginitis

Answer 14

• vulvitis- inflammation of the vulva
• vaginitis- inflammation of vagina
• causes and risks- candida albicans ( fungus, or yeast infction)
• trichomonas vaginalis (protozoal infection)
• S/S- swelling, itchyness, discharge vulvitis
• vaginitis s/s:
• complications: ascending infection to other reproductive organ
• medical diagnosis- bsed on S/S and inspection of ulva and vagina
• avoid sex until symptoms and antibiotics have left
• cotton panties
• sitz bath
• clean everyday with sopa and water

Question 15

Bartholin Gland Abscess

Bartholintis

Answer 15

• Microorganisma occlude the duct
• S/S- perineal pain , chills, malaise, purulent discharge,labial edema, fever
• Complications-systemc infection
• tx: oral anal;gesics
• frequent sitz bath or hot wet packs
• sx incision and drainage
• broad spectrum antibiotics
• Nursing care:
• tach basic parineal care
• instruction to help patient comply eth treatment.

Question 16

Cervicitis

Answer 16

• inflammation of cervix
• causes:
• infectious organisms
• birthing
• tampon use
• acute or chronic from HPV
• S/S:
• usually asymptomatic
• discharge
• pain

Question 17

Mastitis

Answer 17

• inflammation of breast tissue in lactating women
• S/S: redness, inflammation, pain, hard breast, fever, malaise, headache and tenderness.
• causes: inefective emptying, microorganisms
• tx: hot showers, draining breast, pumping breast , analgesics, rest, antibiotics 1019 pt teaching box look at it.

Question 18

Fibrocystic breast changes

Answer 18

• exagerated response to hormones
• common among women
• who never given birth
• had spotaneous abortion
• Smooth round balls, possible discharge
• S/S: during premenapausal phase, usually improves afterm menstrual cycle is over.
• no specific cure
• Danazol can be given but has bad side effects- reducing symtoms– acne, edema hair growth is side effects
• resticting chocolate, cofee vitamin D, low sodium diet, good support bra and reduce stress in life.
• can be sx removed or aspirated

Question 19

PID

Answer 19

• affects all structures in pelvic area
• tends to move up reproductive tract
• moves up from vulva-in to fallopian tubes
• major reproductive health issue
• major cause for infertility
• females have increased risk the more sexual partners they have
• may be asymptomatic at fisrt
• gradual discomfort
• pain, foul odors, skin breakdown, pain during intercourse,
• may be discovered during sx during ectopic pregnancy, ovarian cyst removal
• complications- ectopic pregnancy, infertility, disconfort
• tx: analgesics. antibiotics , no sex for 3 wks
• pg 1021 teaching box
• warm compress, heating pad, analgesics

Question 20

Endometriosis

Answer 20

• Endometrioum tissue grows too much out of pelvic area occurs in 10% of women
• S/S:
• abnormal periods, pain and discomfort, dyemenorrhea, dysparenuia
• complications: hardening od endometrium
• constriction of the bowels, ureters, can cause partial or complete obstruction
• tx: NSAID’s
• gonadothroph releasing hormone agonist
• synthetic androgenic steroid
• hysterectomy
• SAS_ side effects– inhibits production of gonadotrophic, facial hair growtth

Question 21

cyst

Answer 21

• 1024-1025 table 52.3 cysts
• fluid filled sac usually on fallopian tube
• can grow
• common on fertility drugs
• usually resolve on their own
• tendency to form after ovulation
• may burst
• S/S; abnormal periods, dull aching feeling

Question 22

• Fibroid tumors

Answer 22

• benign
• 25% will develop
• usually full of blood
• kinda like vampires- they take blood from system
• can grow in uterus linig or attached by a tail
• most women are asymptomatic
• menstrual changes in flow

abdominal enlargement

• many need no tx
• tumors atrophy after menstruation
• IUD is contraindicated
• BC may stimulate growth

Question 23

Cystocele

Answer 23

• Bulging of the bladder in to the vaginal wall
• post op- must abstain fromm sex
• foley or suprapubic catheter
• cold packs
• sitz bath
• inform pt that vaginal sensation will return in a few months

Question 24

rectocele

Answer 24

• pelvic floor muscles are weak, kegels
• S/S: observation, palpation, pelvic disconfort. bladder infection, painful intercourse
• medical tx:
• kegels
• pessary
• anterior and posterior colporrhaphy to tighten vaginal wall
• low residue diet
• stool softners
• increase fluids

Question 25

uterine prolapse

Answer 25

• cervix clearly visible from vagina
• 1st degree visible from vagina opening
• 2nd degree vagina opened and visible
• 3rd degree it is hanging out
• cause:
• supporting ligaments may be congenitally weak or become streched during pregnancy or injured during childbirth
• S/S:
• dyspareunia
• backache
• pelvic heavieness
• complications:
• trauma an dnecrosis in 2nd and 3rd degree
• medical tx:
• hysterectomy
• pessaries
• interventions
• pesaries_ assessment by 24 hrs of placemetn
• frequent examinations
• report any discomfort
• frequent care and cleaning

Question 26

retroversion and retroflexion

anteversion and anteflexion of uteres

Answer 26

• normally sits 45degree angle of vagina
• retroversion-tilts back
• retroflexion bends on itsself so like a king
• anteversion- tilts foward
• anteflexion leans foward on itself-folds
• considered a tipped uterus- hard to get pregnant or infertility
• common: weak pelic floor muscles
• usually asymptomatic maybe pain with intercourse
• medical tx: seldom possibly a pessaary
• complications:
• usually from another medical condition like PID or endometriosis
• nursing care:
• pessary care if one inserted

Question 27

vaginal fistulas

Answer 27

• pathway that does not belong
• vesicovaginal fistula- between vagina and bladder
• urehtroveginal- from bladder to urethra
• rectovaginal- rectum to vagina
• management of odor and drainage
• sx often needed but not always effective
• post op:
• fol;ey
• increase fluids

Question 28

breast cancer

Answer 28

• risks:
• being white
• african american die more
• fam hx
• being 50 or older
• menarche at 11 or younger
• having n1st child 30 or older
• mutation of gene BRCA1 ort BRCA 2
• 1 in every 8 or 9 women
• prognosis:
• 5 yr when confined is 96.8%
• if spread to sorrounding tissue 75.9%
• if metastazised 20.6 %
• S/S: usually painless unless effecting sorrounding tissue
• late symtpms:
• dimpling of skin
• nipple discharge
• nipple/skin retraction
• edema
• dilated blood vessels
• ulceration
• hemorrhage
• medical tx:
• lupectomy, simple masectomy, and radical masectomy
• SERMS_ selective estrogen receptor modulators
• used with ER-

Question 29

Cervical Cancer

Answer 29

• HPV or HIV
• S/S early is asymptomatic
• advanced cancer may also be asymptomatic until it causes
• bloody discharge
• medical tx:
• depends on stage
• mild dysplasia: loop electrosurgical exicion’localized carcinoma (in Situ) with lasert destructon, cryosurgery
  *

Question 30

ovarian cancer

Answer 30

• depends on stage

Answer 31

• rarest
• unknown reason
• most visible
• causes:
• sti’s hpv, diabetes, hypertension
• S/S: itching, pain and bleeding
• tx: localized lesion
• removradical sx, bilateral dissection of groin lymph nodes or vulvectomy

Answer 32

• Causes: STI’s, cervical/vulvar cancers, previous radiation therapy, intrauterine xposure to estrogen
• S/S:
• medical tx:
• cryosurgery, topical chemo,
• intervention

Answer 34

• conception depends on number of factors
• timing and technique used for sexual intercourse
• production and release of a healthy ovum and numerous healthy sperm
• anatomically and physiologically correct female and m,ale reproductive system
• biochemical compatibility between female vaginal cervical fallopian environment and male sperm
• medical diagnosis:
• based on data from both partners
• males: semen specimen
• femalesL: basal body temp, cervical mucous,

Question 35

Fertility Drugs

Answer 35

• stimulate pituitary hormones
• increase the chance of ceonceiving
• clomiphine citrite (clomid)
• side effects:
• hot flashes, breast tenderness, hair loss, fatigue, weight gain, increased chance of twins

Question 36

Menopause

Answer 36

• Cessation of menstration, ends of reproductive capacity
• natural menopause is part of aging
• sx menopause occurs from removal of the ovaries
• may begin as early as 35 but more commonly occurs 40-55
• process from earliest signs to complete cessation of menstruation usually is 2 yr or less
• S/S:
• hot flashes
• vaginal dryness
• insomnia
• jjoint pain
• headache
• nausea
• without estrogen the uterus becomes smaller, vagina shortens and becomes dry
• breast tissue may loose its firmness and pubic and axillary hairs becomes sparce
• tx: hormonal therapy
• estrogen
• clonodine patches, bellergal-s, venlafaxine and paroxetine for hot flashes
• progestrins
• alternative:
• vitamin E, B complex, calcium with vitamin D at least 1500 mg