Module 16 women's assessment Flashcards
Gravida
total number of pregnancies
F/P/A/L
F: # of full term delivered
P: # of pregnancies delivered preterm
A: # of abortions; spontaneous or induced
L: # of living children
menstrual abnormalities
no periods by 14 with hirsuitism signs
no periods by 14 with hx of eating disorder
no period by 15
more frequently than 21 days or more than 45 days
change tampon every 1-2 hours
older women reasons for visit
vaginal irritation dyspareunia decreased libido urinary problems pelvic pain menopausal symptoms
perimenopause s/s
intermittent vasomotor symptoms
menstrual changes
reduced fertility - need contraception for a year
menopause s/s
dec. estrogen levels
increased body fat
total and low-density lipoprotein cholesterol increase
vaginal dryness, dec. libido, mood swings
sleep disturbances
induced menopause
cessation of menstruation due to surgical removal of both ovaries
- oophorectomy
iatrogenic menopause
ablation of ovarian function due to chemotherapy or pelvic radiation
premature menopause
occurs before the age of 40
older adult changes
labia flatter and smaller skin is drier and shinier gray and sparse pubic hair clitoris is smaller urinary meatus may appear as an irregular opening or slit vaginal opening may be constricted vagina is narrower and shorter smaller less-mobile cervix smaller uterus nonpalpable ovaries diminished rectal tone
preconception hx
tobacco use rubella immunization? chronic health issues glucose control nutrition habits medications that may affect fertility or birth outcome
breast pain
timing of occurrence proximity to menstrual cycle intensity of pain associated symptoms precipitating factors medication hx hormones, caffeine, fibroids
Breast mass
timing of occurrence with cycle
associated symptoms
changes in mass
medication hx
nipple drainage
color characteristics associated symptoms associated factors medications meds
inspection of breasts
size symmetry contour retractions or dimpling skin color changes venous patterns lesions supernumerary nipples
Inspection of areolae and nipples
shape symmetry color smoothness size nipple position
5 D’s of the nipple exam
discharge depression or inversion discoloration dermatologic changes deviation: compared to the other breast
changes during pregnancy
- alveoli inc in size and number
- breast enlarge 2x/3x pre-pregnancy size
- areolae inc. in pigmentation and diameter
- montgomery tubercles develop as sebaceous glands hypertrophy
- mammary vascularization inc
older women breast changes
- grandular tissue atrophies and is replaced by fat
- breasts hang more due to tissue changes and relaxation of the suspensory ligaments
- nipples becomes smaller and flatter, losing their erectile ability
- finer, granular feel with fluid filled cysts (HRT)
fibrocystic changes to breast
benign fluid-filled cyst formation caused by ductal enlargement
fibroadenoma
benign tumors composed of stromal and epithelial elements that represent a hyperplastic or proliferative process in a single terminal ductal unit
malignant breast tumors
ductal carcinoma: arises from the epithelial lining of ducts
lobular carcinoma: from glandular tissue of the lobules
fat necrosis
benign breast lump that occurs as an inflammatory response to local injury
mastitis
inflammation and infection of the breast tissue
intraductal papillomas and papillomatosis
benign tumors of the subareolar ducts produce nipple discharge
duct ectasia
benign condition of the subareolar ducts that produces nipple discharge; green and sticky
galactorrhea
lactation not associated with childbearing
paget disease
surface manifestation of underlying ductal carcinoma
