female reproductive problems Flashcards
Infertility
you can’t pregnant and you been trying for a 1 year
Abortion
Any loss or termination
Spontaneous abortion
Natural loss before 20 weeks gestation (miss carriage)
-lose the baby naturally before 20 weeks
Induced abortion
Intentional or elective termination of pregnancy
-you chose to do it
Premenstrual Syndrome
Group of physical and psychological symptoms that occur a few days prior to menses
-symptoms that occur right before menstraul cycle
Dysmenorrhea
Abdominal cramping associated with menstrual flow;
Ectopic Pregnancy
Implantation of fertilized ovum outside of the uterine cavity
-the planting the fertilized ovum outside of the uterine cavity
Pelvic Inflammatory Disease
Infectious condition of the pelvic cavity
-an infection of a woman’s reproductive organs
Oligomenorrhea
long intervals between menses; generally, longer 35 days
amenorrhea
absence of menstruation
Menorrhagia:
excessive or prolonged menstrual bleeding
-a lot of bleeding
Metrorrhagia:
Irregular uterine bleeding or bleeding between menses
-Irregular bleeding
perimenopause
begins with the first changes in menstruation
Menopause
physiological cessation of menses; it is considered complete after 1 year
Postmenopause
is the time after menopause
Clinical manifestation - perimenopause
irregular menses, vasomotor instability (temp instability), stress/urges incontinence, breast tenderness, mood changes
Clinical manifestation - Postmenopause
cessation of menses, atrophy (deprogression of muscle or nerve tissue), osteoporosis
Endometriosis
-similar uterus lining grows outside the uterus
-Presence of normal endometrial tissue in sites outside of the endometrial cavity
Endometrisosis manifestation
secondary dysmenorrhea, infertility, pelvic pain, dyspareunia (pain during sexual intercourse) and irregular bleeding
Treatment for Pre and Post menopause
Treatment might include hormone replacement, drug therapy, and alternative therapies.
Perimenopausal symptoms
symptoms include hot flashes, irregular vaginal bleeding, and gain weight.
PID treatment
antibiotics
LEIOMYOMAS
benign smooth muscle tumours that occur most
commonly within the uterus.
Leiomyomas symptoms
abnormal uterine bleeding, pain, and symptoms associated with pelvic pressure.
Leiomyomas treatment
Treatment depends on the symptoms, the patient’s age, her desire to preserve her fertility, and the location and size of the tumour or tumours, and may include surgery.
endometrial cancer risk
estrogen, especially unopposed
estrogen.
Endometrial cancer treatment
abdominal hysterectomy (surgical removal of the uterus) and Radiation and chemotherapy may also be given.
Ovarian cancer greatest risk
Family history
Ovarian cancer Treatment
Treatment includes surgery, chemotherapy, and radiation
UTERINE PROLAPSE
Uterine prolapse is the downward displacement of uterus into the vaginal canal.
-uterus facing downwards
Uterine prolapse symptoms
dyspareunia, dragging or heavy pelvic feeling, backache, and bowel or bladder problems if cystocele or rectocele is also present.
Cystocele
anterior wall prolapse, occurs when support between the vagina and the bladder is weakened
Rectocele
posterior wall prolapse, results from weakening between the vagina and the rectum.
Treatment for Uterine prolapse
Therapy depends on degree of prolapse and can include strengthening exercises, and a pessary (a device that is placed in the vagina to help support the uterus).
PCOS
a genetic, hormonal, metabolic, and reproductive disorder
PCOS - signs and symptoms
irregular periods, excess facial and body hair, severe acne, small cysts on ovaries, weight gain, infertility and male pattern hair loss
Cervical cancer risk
human papillonmavirus infection
Cervical cancer - Manifestation
Precancerous changes
leukorrhea and intermenstrual bleeding
Cervical signs and symptoms
pain, weight loss, anemia (low red blood cells) and cachexia (loss of skeletal or muscle fat)
Cervical cancer - diagnosis
cervical cancer screening (sexual active between age 21 and 69)
-Pap test every 1 - 3 years
FOLLOW up on positive test
-colposcopy, biopsy
Endometrial or uterine cancer - diagnosis
endometrial biopsy
Endometrial or uterine cancer - collaborative care
Surgery, radiation, progesterone therapy, chemotherapy
Ovarian Cancer
Malignant neoplasm of the ovaries
Ovarian cancer - diagnosis
No screening test exist
risk for women aged 55 - 65
Hysterectomy
Removal of the uterus and cervix
-will be infertile after surgery
Hysterectomy - Nursing intervention
Relieve anxiety, relieve pain, assess hemoorhage, DVT, bladder
Hysterectomy - teaching
waiting about 4 weeks before intercourse, check for infection
Fistula
Abnormal opening between internal organs or between an organ and the exterior of the body
Benign Prostate Hyperplasia
Enlargement of prostate gland
Benign Prostate Hyperplasia - cause
Caused by increase in number of epithelial cells and
stromal tissue
Benign Prostate Hyperplasia - risk factors
Family history
* Obesity
* Physical activity level
* Alcohol consumption, smoking
* Diabetes
BPH - Obstructive symptoms (Symptoms due to urinary retention)
Decrease in calibre of force of urinary stream
* Difficulty in initiating urination
* Intermittency
* Dribbling at end of voiding
BPH - Irritative symptoms (Symptoms associated with inflammation or infection)
Urinary frequency and urgency
* Dysuria
* Bladder pain
* Nocturia
* Incontinence
BPH - Drug therapy
5α-Reductase inhibitors
* Example: finasteride, duragen
* ↓ size of prostate gland
* Takes 3 to 6 months for improvement
* Side effects: decreased libido, decreased volume of ejaculation, ED
α-Adrenergic receptor blockers
* Examples: Flomax
* Promote smooth muscle relaxation in prostate; facilitate urinary flow
* Improvement in 2 to 3 weeks
* Side effects: orthostatic hypotension and dizziness, retrograde ejaculation, nasal
congestion
BPH - Treatment / Collaborative care
Transurethral microwave therapy (TUMT)
Outpatient procedure: delivers microwaves directly to prostate through a transurethral probe
* Heat causes death of tissue and relief of obstruction.
* Patient sent home with catheter for 2 to 7 days
* Side effects: bladder spasm, hematuria, dysuria, and retention
BPH - Treatment / Collaborative care
Transurethral needle ablation (TUNA)
↑ temperature of prostate tissue for localized necrosis
* Low-wave frequency used
* Only tissue in contact with needle affected
* Outpatient uses local anaesthesia and sedation.
* Complications include urinary retention, UTI, and irritative voiding symptoms.
* Some patients require a catheter.
BPH - Treatment / Collaborative care
Laser prostatectomy
Delivers a laser beam transurethrally to cut or destroy parts of the prostate
* Common procedure: visual laser ablation of the prostate (VLAP)
* Takes several weeks to reach optimal results
* Urinary catheter inserted
* Contact laser techniques
* Minimal bleeding during and after procedure
* Fast recovery time
* Patients may take anticoagulants.
BPH - Treatment / Collaborative care
Transurethral resection (TURP
Removal of obstructing prostate tissue
* Performed under spinal or general anaesthesia and requires hospital stay
* Bladder irrigated for first 24 hours to prevent mucus and blood clots
* Complications include bleeding, clot retention, dilutional hyponatremia, retrograde ejaculation.
* Patients must stop anticoagulants before surgery.
PROSTATE CANCER
Malignant tumour of prostate
Prostate Cancer - spread
Spreads by three routes:
Direct extension
* involves seminal vesicles, urethral mucosa, bladder wall, and external sphincter
Through lymph system
* system to the regional lymph nodes.
Through bloodstream
* Veins from the prostate seem to be a mode of spread.
Prostate Cancer - Clinical manifestations and complications
Usually asymptomatic in early stages
* Eventually the patient may experience symptoms similar to BPH:
* Dysuria
* Dribbling
* Frequency
* Urgency
* Hematuria
* Nocturia
* Retention
* Interruption of urinary stream
* Inability to urinate
Prostate Cancer - Diagnostic
Two primary screening tools:
* DRE (digital rectal examination)
* PSA (prostate-specific antigen) blood test
- Biopsy of prostate tissue is necessary to confirm the diagnosis.
- Elevated PSA is just an indicator of cancer - Does not mean patient has cancer
- Cancer cannot be diagnosed without biopsy
Prostate Cancer - collaborative Care
Watchful waiting when:
* Life expectancy is less than 10 years
* Presence of significant co-morbid disease
* Presence of low-grade, low-stage tumour
Surgical therapy
* Radical prostatectomy
* Nerve-sparing surgical procedure
* Cryosurgery
Radiation therapy
* External beam irradiation
* Most widely used method of radiation for prostate cancer
* Brachytherapy
Drug therapy
* Hormone therapy
* Luteinizing hormone–releasing hormone agonists
* Orchiectomy = removal of 1 or both testes = removing the testosterone
* Chemotherapy
Prostatis
Broad term that describes a group of acute or chronic inflammatory conditions affecting the prostate gland
* Usually results from infection
Prostatis - manifestation
4 categories
* Acute bacterial prostatitis
Fever; chills; back pain; perineal pain; acute urinary symptoms
Chronic bacterial prostatitis and chronic prostatitis–pelvic pain syndrome
* Similar symptoms but milder
* Obstruction symptoms are uncommon
* Clinical features may mimic UTI
- Asymptomatic inflammatory prostatitis
prostatis - diagnosis
Diagnostic studies
* Urinalysis and urine culture are indicated
* White blood cell count and blood cultures in presence of fever
* PSA test to rule out prostate cancer; levels may be elevated with prostatic inflammation
* Microscopic evaluation and culture of expressed prostate secretion
Vasectomy
Bilateral surgical ligation of the vas deferens
* Does not affect the production of hormones, ability to
ejaculate, or mechanism related to erection or orgasm
Erectile Dysfunction
Inability to attain or maintain an erect penis
Erectile Dysfunction - manifestation
Self-report of problems associated with sexual function
* Major complications: inability to perform sexually; personal issues
Erectile Dysfunction - collaborative care
Collaborative care
* Oral drug therapy
* Vacuum constriction devices
* Intraurethral devices
* Penile implants
* Sexual counselling
HYPOSPADIAS
Males are born with an opening of the urethra on the bottom/underside of the penis
EPISPADIAS
Males are born with an opening of the urethra on the top of the penis; this is more rare
PHIMOSIS
The inability of the foreskin to retract; skin over the head of the penis and won’t move down
PARAPHIMOSIS
Foreskin is retracted in uncircumcised males and you cant get it back over the head of the penis; skin is strangling/ constricting blood flow
