Menopause/Osteoporosis Flashcards
What is climacteric?
Physical and emotional changes occurring at the end of a woman’s reproductive period. Also informally called menopause, although this term does not encompass all changes.
What is Premenopause? Give an example.
The early part of the climacteric, before menstruation ceases but after the woman experiences some of the climacteric symptoms, such as irregular menses.
What is Perimenopause?
It’s the time of premenopause, menopause, and at least 1 year after menopause.
What is post menopause?
The phase after menopause, when menstrual periods have ceased altogether.
(T/F) Once a woman is postmenopausal, unplanned vaginal bleeding should always be investigated
True, it is highly suggestive of endometrial cancer.
What is the difference between menopause and climacteric?
Menopause simply means “the end of menstruation,” usually 2 consecutive months without menses. Climacteric encompasses everything to do with menopause and is the correct term.
When does the women’s reproductive function fall?
Ages 45-50, the ovarian hormones decline and then cease
(T/F) Low estrogen causes bone density loss
True
What does vasomotor instability cause?
Hot flashes
What two medication/supplements are important to have for osteoporosis?
Calcium supplements to help bones, and Vitamin D to help absorption of calcium.
What is osteoporosis?
Increased spaces in bone; increases after menopause
What are the two most common sites for bone fractures?
The vertebrae and hips
What age do you commonly reach peak bone density?
Around 30
What are risk factors associated with osteoporosis? There are 7, 3 of which is from class review (and also found in textbook)
Family history of the disease, late menarche (first occurrence of period), early menopause, and a sedentary lifestyle. Smoke, drink alcohol, or consume excessive amounts of caffeine
What are early signs and symptoms of osteoporosis?
Loss of height and back pain that occurs when the vertebrae collapse
What are later signs of osteoporosis? There are two, one from review.
The “dowager’s hump,” which occurs when the vertebrae can no longer support the upper body in an upright position. Secondary to this, the waistline disappears and the abdomen protrudes because the rib cage moves closer to the pelvis.
A woman older than 50 needs how many mg of calcium daily?
1200
(T/F) Estrogen alone can be used for women who have an uterus
False, estrogen alone is used for women without an uterus
(T/F) Liver disease is a contraindication for hormone replacement therapy
True
A postmenopausal woman presents with constipation, flatulence, and difficulty defecating.
Palpation of the posterior wall of the vagina reveals a soft bulge of tissue. Which intervention would the nurse anticipate for this patient?
Insertion of a pessary
Anterior colporrhaphy
Referral to an oncologist
Elimination of bladder irritants
Insertion of a pessary; These are symptoms of rectocele (supportive wall of tissue between a woman’s rectum and vaginal wall weaken). With rectocele, bowel elimination can be facilitated by putting pressure on the posterior vaginal wall to prevent the rectocele from protruding during bowel movement.
A patient reports constant, dull, bilateral pain that usually begins the day before menstruation. This is indicative of which disorder?
Mittelschmerz
Endometriosis
Premenstrual syndrome (PMS)
Primary dysmenorrhea
Endometriosis; Mittelschmerz is unilateral pain associated with ovulation.
Which nursing consideration would be included in the plan of care for a postmenopausal woman presenting to the clinic with abnormal vaginal bleeding?
Screening for human papillomavirus (HPV)
Assisting with colposcopy
Teaching about hysterectomy
Laparoscopic removal of ovariess
Teaching about a hysterectomy; Abnormal vaginal bleeding near or after menopause is a primary symptoms of endometrial cancer. The highest cure rate is with surgery (hysterectomy)
Which course of action would the nurse typically suggest for a patient with premenstrual syndrome who states, “I’ve had depression, anxiety, irritability, breast tenderness, and headaches before my period for the last 3 months”?
Teaching about laser ablation
Administering fluoxetine as prescribed
A diet rich in protein and low in carbohydrates
Heat application to the lower abdomen or back
Administering fluoxetine as prescribed; This patient may have premenstrual dysphoric disorder (PDD), which is associated with abnormal serotonin response to estrogen level changes during menses. Diagnosis is based on five or more symptoms like depression, anxiety, irritability, breast tenderness, and headaches occurring before menstruation for at least 3 months. Treatment includes use of selective serotonin reuptake inhibitors like fluoxetine.
Which screening tool would be added for a female patient older than 65 years of age who is underweight, physically inactive, and is a chronic smoker?
Tuberculosis testing
Bone-density testing
Thyroid-stimulating hormone testing
Mammography with ultrasonography
Bone density testing
What is the reproductive period?
Refers to the first menstrual period (puberty( and the permanent stopping of menstrual cycles (around age 50)
What are the two hormones that affect the reproductive system? (Regarding menstrual cycle)
FSH and LH
Which hormone inhibits FSH? When during the menstrual period?
Estradiol, the 1st 2 weeks
Which hormone inhibits LH and when during the menstrual period?
Progesterone, during the 2nd two weeks.
How much vitamin D is needed for patients 50 years and older?
600 IU
Name 3 lifestyle factors that contribute to bone loss.
Excessive alcohol, smoking, caffeine
What items are considered part of the personal history when obtaining a females’ health history. Select all that apply.
Reason for visit
Number of sexual partners
Allergies
Age of 1st menstrual period
Medications
Patterns of elimination
Exercise patterns
Reason for visit
Allergies
Medication
Patterns of elimination
Exercise patterns(?)
What items are considered part of the menstrual history when obtaining a females’ health history? Select all that apply.
Age of 1st period
Use of tampons
Regularity of cycle
Relief measures for menstrual discomfort
Birth control used
Age of 1st period
Regularity of cycle
Relief measures for menstrual discomfort
What items are considered part of the sexual history when obtaining a females’ health history? Select all that apply.
Number of sexual partners
Breast cancer history
Age when first sexually active
Previous sexually transmitted diseases and treatments
Marital Status
Method of Contraception
Number of sexual partners
Age when first sexually active
Previous STDs and treatments
Method of contraception
