Female Reproductive Problems Flashcards
What is pelvic inflammatory disease(PID)?
- Inflammatory condition of the pelvic cavity (May involve uterus, fallopian tubes (salpingitis), ovaries (oophoritis), pelvic peritoneum)
- Often result of untreated cervicitis
- Most commonly caused by sexual transmission
-caused by bacteria, may be from virus, fungus, parasite
What is the S&S of PID?
- Lower abdominal pain
- Vaginal discharge
- Fever, chills
- Dyspareunia - painful intercourse
- Tenderness after menses
What is the complications of PID?
Septic shock, Fitz-Hugh-Curtis syndrome, ectopic pregnancy, infertility, chronic pelvic pain
What is the collaborative care for PID?
Broad-spectrum antibiotics (ie. Cefoxitin)
What is endometriosis?
Presence of normal endometrial tissue in sites outside of the endometrial cavity
-Typical client with endometriosis – late 20’s-early thirties, white, never had full-term pregnancy
What is the S&S of endometriosis?
dysmenorrhea, infertility, dyspareunia, pelvic pain
Chocolate cysts – nodules in ovaries
What is the collaborative care of endometriosis?
- Laparoscopy for definitive diagnosis
- Treatment based on age, desire for pregnancy, severity of symptoms and extent of disease
- Watchful waiting, drug and surgical therapy
–> NSAIDS, oral contraceptives (Depo-Provera)
–> Pregnancy may help as ovulation and menstruation do not occur
–> Surgery – hysterectomy, oophorectomy, bilateral salpingo-oophorectomy
What is benign ovarian tumours?
- Acute or chronic pain
- Ruptured cysts mimic appendicitis or ectopic pregnancy
What is polycystic ovary syndrome?
- Chronic anovulation and androgen excess
- Infertility, obesity, hirsutism (excessive hairiness)
- If untreated may develop cardiovascular, abnormal insulin metabolism, ovarian or endometrial cancers
What is a uterine prolapse and the symptoms?
- Downward displacement of the uterus into the vaginal canal as a result of impaired pelvic support
- May be due to weakened structures that support the uterus from childbirth
symptoms: Pressure, bladder incontinence or retention - problems w/ pelvic support
What is a cystocele in the pelvis?
- Anterior wall prolapse; occurs when support between the vagina and the bladder is weakened
Bladder bulges into the vagina - problems w/ pelvic support
What is a rectocele in the pelvis?
- problems w/ pelvic support
- Posterior wall prolapse; results from weakening between the vagina and rectum
**Rectum will pressing into the vagina **
What is the S&S of cystocele in the pelvis?
- Patient may report: pelvic pressure, fatigue, urinary problems – urinary incontinence, frequency, and urgency.
- Back pain and pelvic pain may occur as well.
What is the S&S of rectocele in the pelvis?
- Rectal pressure
- Constipation, uncontrollable gas, fecal incontinence (pt with complete tears)
What is stress incontinence?
The involuntary loss of urine during activities that increase abdominal and pressure.
What is urinary incontinence?
involuntary loss of urine caused by the gradual weakening and “falling down” of the pelvic floor.
What are the types of urinary incontinence?
- stress
- urge
- reflex
- overflow
- mixed
- functional
What is urge incontinence?
cannot hold
What is reflex incontinence?
problem with CNS system (stroke, Parkinson’s, tumors, spinal cord injuries)
What is overflow incontinence?
bladder fills too full and urine passively leaks (enlargement of prostate gland)
What is mixed incontinence?
combination of stress and urge incontinence
What is functional incontinence?
unable to reach the toilet in time
what is a fistula?
- Abnormal opening between internal organs or between an organ and the exterior of the body
- Excoriation and irritation of the vaginal and vulvar tissues occur and may lead to severe infections due to urine, flatus, or feces leaking into vagina
What is the pre-op for surgical procedures for problems with pelvic support?
- NO Food – from midnight before day of surgery.
- No Blood Thinners – 5 days prior.
- Water with meds, if taking any – bring a list.
What is surgical management of problems with pelvic support?
- teach Kegel exercises
- Pessaries can be used to avoid surgery
- Pre- and postoperative vaginal surgery care
- discharge teaching
What is post-op care for problems with pelvic support?
- Prevent infection and pressure on suture lines.
- Void within a few hours after surgery (many will have a foley catheter) – or use bladder scanner currently
- lab values: electrolytes and CBC
- IV and Foley
What is a hysterectomy?
Surgical removal of the uterus to treat cancer, dysfunctional uterine bleeding, endometriosis, nonmalignant growths, persistent pain, pelvic relaxation and prolapse, and previous injury to the uterus
three approaches:
1. Laparoscopic
2. Vaginal
3. Abdominal
What are the three types of hysterectomies?
- total
- subtotal
- radical
What is a total hysterectomy?
removing the body of uterus and cervix. NOT removing ovaries
What is a subtotal hysterectomy?
(partial) involves removing the body of the uterus, but leaving the cervix in place.
What is a radical hysterectomy?
done with Ca(cancer), is the same procedure as a total hysterectomy but also involves the removal of the upper part of the vagina
What is an salpingectomy?
Removal of fallopian tube
What is an oophorectomy?
- Removal of ovary
**Bilateral oophorectomy ** - both ovaries removed, results in surgical menopause
What is the potential problems of a hysterectomy?
hemorrhage, DVT, bladder dysfunction
What is chocolate cysts in endometriosis?
nodules in ovaries
