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Adult Health I > Reproductive > Flashcards

Reproductive Flashcards

1
Q

What are tests used to identify and diagnose sexual and reproductive problems

A

Transrectal Ultrasound
PSA
Digital Rectal
Endometrial Biopsy
Hysterosalpingography
Mammography

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2
Q

What is BPH (Benign prostatic hyperplasia?

A

Enlargement or hypertrophy of prostate gland

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3
Q

What are some causes of BPH?

A

-Elevated estrogen levels
-Smoking
-Reduced activity level
-Western diet

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4
Q

What are manifestations of BPH?

A

-Increased urinary frequency
-Urinary urgency
-Nocturia
-Weak urinary stream
-Dribbling
-Straining

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5
Q

How to manage BPH

A

Catheterization

Cystostomy

Medication
-Alpha-adrenergic blockers
-antiandrogen agents
-herbal: Saw Palmetto

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6
Q

What are surgical management options for BPH?

A

-Transurethral microwave heat treatment
-TUNA (TRansurethral needle ablation)
-TURP (transurethral resection of the prostate
-Open prostatectomy

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7
Q

What are nursing interventions for BPH?

A

-Help reduce anxiety
-Relieve discomfort
-Provide instruction
-Maintain fluid balance

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8
Q

What are home care guidelines for a pt with BPH?

A

-Urinary control
-Avoid valsalva maneuver (straining heavy)
-Avoid bladder discomfort (spicy foods, alcohol, and coffee)
-Increase fluids

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9
Q

What is TURP?

A

Transurethral Resection of the prostate

-most common prcedure used to treat BPH
-Surgical and optical instrument goes through urethra to remove glandular

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10
Q

Pre-Op management for TURP

A

-Inform about procedure and expectations
-discuss complications
-incontinence or dribbling up to one year after surgery
-retrograde ejaculation
-bowel preparation is given
-optimal cardiac, respiratory and circulatory status should be achieved
-Prophylactic antibiotics are ordered

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11
Q

Post-op Management for TURP

A

-Urinary drainage maintained (observe for signs of hemorrhage)
-maintain patency of catheter
-Avoid overdistention of bladder
-Administer anti-cholinergic (reduce bladder spasms)
-best rest for 24 hours, then movement
-wound care
-administer pain meds
-Promote comfort
-Stool softeners
-reduce anxiety
-open discussion of anxiety and fear
-Educate

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12
Q

What are symptoms of prostate cancer

A

-may or may not have symptoms early on
-blood in urine
-need to pee at night
-weak or interrupted urine flow
-pain or burring while peeing
-inability to urinate
-regular pain in lower back, pelvis, or upper thighs

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13
Q

How to we find prostate cancer

A

-check PSA (prostate-specific antigen)
*know that other things can cause elevated PSA, but it is a good way how to screen

-DRE (Digital rectal exam)
*feeling for bumps, hard spots, and any other abnormalities

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14
Q

What are things that can elevate PSA level?

A

-Prostate cancer
-BPH (benign prostatic hyperplasia
-Age
-Prostatitis (infection of prostate gland - from stds, etc)
-Ejaculation (for short duration)

**man should not ejaculate for 2 days before taking the exam!

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15
Q

What is Cystocele (Bladder prolapse) ?

A

Bladder moves from its normal position and presses against the front wall of the vagina?

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16
Q

What causes Cystocele?

A

-Muscles and tissues that hold bladder in place are weak or damaged
*pregnancy / childbirth
*obesity
*frequency constipation

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17
Q

What are symptoms of cystocele?

A

-Urinary incontinence
-frequent voiding or urge to pass urine
-not feeling relief after voiding
-frequent UTI
-Pain in vagina, pelvis, lower abdomen, groin or lower back
-heaviness or pressure
-dyspareunia
-tissue sticking out of vagina (tender and/or bleeding)

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18
Q

How to manage cystocele?

A

No treatment if
-not causing any problems
-not blocking urine flow

Behavior therapy
-kegal exercises
-pelvic floor physical therapy
-Pessary (vaginal support device)

Medication
-Estrogen replacement therapy

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19
Q

What are surgical management options for cystocele?

A

-open surgery (incision made through abdomen)
-Minimally invasive surgery
-Laparoscopic
-Robot-assisted laparoscopic

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20
Q

What is Rectocele?

A

A bulge of tissue into the vagina (similar to hernia)

*also called posterior vaginal prolapse

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21
Q

Symptoms of Rectocele

A

-sometimes asymptomatic
-soft bulge of tissue that might come through opening of vagina
-trouble having bowl movements
-feeling pressure or fullness in rectum
-feeling rectum has not fully empties
-sexual concerns, embarrassed

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22
Q

Prevention of rectocele

A

-Perform kegal
-treat and prevent constipation
-avoid heavily lifting and lift correctly
-control coughing
-avoid weight gain

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23
Q

treatment options for rectocele

A

-Observation
-Pelvic floor pt
-pessary
-Surgery

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24
Q

What is uterine prolapse?

A

Part of uterus descends into vagina

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25
Q

What are symptoms of uterine prolapse?

A

-Feeling tissue bulge
-heaviness or pulling in the pelvis
-feeling like bladder is not empty all the way
-incontinence (leakage)
-trouble with BM
-feeling like sitting on a ball
-vaginal tissue rubbing on clothing
-pressure or discomfort in pelvis or lower back
-sexual concerns, too loose

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26
Q

What are causes of uterine prolapse?

A

weakened or damaged muscles and connective tissues such as ligaments allow the uterus to drop into the vagina.

Common causes: pregnancy, childbirth, hormonal changes after menopause, obesity, severe coughing and straining on the toilet.

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27
Q

What are risk factors that increase risk of uterine prolapse?

A

-Having vaginal birth
-being older when you have first birth
-large baby
-aging
-obesity
-prior pelvic surgery
-chronic constipation or often straying during bm
-family history
-being Hispanic or white
-chronic coughing, from smoking

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28
Q

What are treatment options for uterine prolapse?

A

Pessary

Surgery
-Hysterectomy
-Repair
-Mesh

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29
Q

What is a hysterectomy?

A

Surgical removal or the uterus

30
Q

Why would a woman need a hysterectormy?

A

-Cervical / Uterine cancer
-Endometriosis
-Uterine fibroids
-Extensive hemorrhage
-Rupture of uterus
-Intractable pelvic infection

31
Q

What are the different types of hysterectomys?

A

Subtotal
total
total with bilateral salpingo-oophorectomy
vaginal hysterectomy or laparoscopically
total pelvis exenteration (TPS)

32
Q

Menstruation

A

Average Age: 12.4 years old
Average Range: 9-17
Average days between cycles 28 days
average duration: 2-7 days
average amount of flow 30-80 ml
Normal color: dark red
normal odor: Marigolds…..????

33
Q

What are the different stages of the menstrual cycle?

A

Proliferative Phase
Secretory Phase
Ischemic Phase

34
Q

What is Dysmenorrhea?

A

-Painful menstruation

35
Q

What is Menorrhagia ?

A

Heavy menstrual flow (>80ml)

36
Q

WHat is metrorrhagia

A

Bleeding between menstrual periods

37
Q

What is Menometrorrhagia?

A

Excessive and prolonged uterine bleeding occuring at irregular and/or frequent intervals

38
Q

What is Mittelschmerz?

A

“Middle pain”
One-sided, lower abdominal pain associated with ovulation

39
Q

What is endometriosis?

A

A condition in which cells similar to lining of uterus, or endometrium, grow outside of the uterus

40
Q

What are S/S of Endometriosis

A

-painful periods (dysmenorrhea)
-pain with intercourse
-pain with bowel movements or urination
-excessive bleeding
-infertility

41
Q

What are caused of endometriosis?

A

Retrograde menstruation
Transformation of peritoneal cells
embryonic cell transformation
surgical scar implantation
endometrial cell transport
immune system disorder

42
Q

What are risk factors for endometriosis?

A

-Never giving birth
-starting period at young age
-menopause early
-short menstrual cycle
-heavy menstrual period
-higher levels of estrogen
-low BMI
-Family history
-Medical conditions that prevents passage of blood from body during periods
-disorders of reproductive tract

43
Q

Complications from endometriosis

A

infertility
increases uterine cancer risk

44
Q

What are treatment options for endometriosis

A

NSAIDS
Hormone Therapy
Surgery
-Conservative
-Hysterectomy
-Incl oophorectomy

45
Q

What is menopause?

A

no longer menstruates (for at least 12 years)

46
Q

What are symptoms of menopause?

A

-Vasomotor (hot flashes, night sweats)
-Problems sleeping
-Fatigue
-genito-urinary symptoms
-Vaginal dryness
-decreased libido
-joint pain
-weight gain and bloating
-migraine

47
Q

When do symptoms level out during menopause?

A

around 2 years

48
Q

What is perimenipause?

A

Can start as early as 35 years old
-steadily decreasing consistency of menstrual cycles
-often with some sx of menopause

49
Q

What is premature menopause?

A

-menopause before age 40

50
Q

How do we manage premenopause

A

OCP (birth control)
-can lead to thrombosos
-not used past age 50

HRT
-must have estrogen AND progesterone in uterur still
-without uterus, may have estrogen only
-Topical estrogen
-can increase thrombosis
-Slight increase in breast CA
-should stop after 5 years

51
Q

What are other management options for symptoms of perimenopause?

A

Clonidine (reduces vasomotor Sx and help with sleep)
-st johns wort
-SSRI
-Gabapentin
-Testosterone
-Black Cohosh (herbal supplement)
-Evening primrose oil
-Vaginal moisturizer and lube

52
Q

What is Fibrocystic breasts?

A

-thickening of breast tissue (fibrosis)
-fluid filled cysts
-affects >50% of women

53
Q

Symptoms of fibrocystic breasts

A

-Pain or discomfort (breasts and/or under arms)
-lumps (can be painful and are movable)
-breast that feel full, swollen, or heavy

54
Q

Management for fibrocysitc breasts?

A

-NSAIDS
-Heat / ice
-Sports bra for more support
-needle aspiration of cysts
-OCP (birth control)
-Reassurance

55
Q

What is a BSE (breast self exam)

A

-Recommend it monthly
-start in front of mirror
-detects majority of breast abnormities

56
Q

What to inspect during BSE

A

-Skin changes
-redness
-Visible bumps
-nipple crusting
-symmetry
-raise arms and watch for dimpling or retraction
-feel for lumps (marble in bag of rice)

57
Q

What part of the hand should a woman use to inspect

A

use middle of fingers (not finger tips)
small circles
make sure to get the “tail” of breast *into armpit
try to express nipple discharge

58
Q

What is a mammogram and when should they be done?

A

Smoosh the boobies to detect abnormalities
-start between age 40-50 *10 years prior to a first degree relative who received it
-once 50, every year

59
Q

What is cervical cancer?

A

-most common in age 21-35
-Risk decreases after age 30
-Causes by HPV

60
Q

Prevention in cervial cancer

A

-sexual abstinence
-HPV vaccine
-Regular pap
*every 3 years (age 21-30 if normal)
*every 5 years (30 and later if normal)
*stop screening at 65

61
Q

How to treat cervical cancer

A

leep
loop
cone
cervicectomy (take the whole cervix out)
hystoectomy
radiation
chemo

62
Q

When is Testicular cancer more common?

A

-Age 15-34
-most common form of cancer among young men
-cure rate over 98%

63
Q

What do testicles do?

A

-produce sperm and testosterone

64
Q

What does testosterone do?

A

-Body and facial hair
-low voice
-muscle development
-ability to have erection
-Libido
-Stamina
-mood and wellbeing

65
Q

What are the risk factors for developing testicular cancer

A

-undescended testicle
-family history
-ethnicity
-height
-marijuana

66
Q

What are MYTHS about causes of testicular cancer

A

-tight underwear
-other factors
-fertility
-injury
-Talc?

67
Q

What are symptoms of testicular cancer

A

-lump within the testicle
-ache or dragging sensation in scrotum
-swelling of the testicle

less common:
-back pain
breast swelling or tenderness

68
Q

What are treatment options for testicular cancer?

A

Orchidectomy (removal of testicle)
Surveillance
Chemo

69
Q

What is survivorship rate of testicular cancer?

A

98% will make a full recovery (65+ deaths per year)

70
Q

STIs

A
71
Q

Syphilis Symptoms

A

-painless ulceration on genitals
-may have ulcerations on other parts of the body (hands and feet)
-can cause significant neurological damage (and can get to the brain)

72
Q

Treatment for Syhilis

A

Penicillin

Adult Health I (10 decks)

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