Reproductive Flashcards
Chlamydia and Gonorrhoea
Sexually transmitted bacterial infections that left untreated can result in pelvic inflammatory disease as well as infertility and preterm labor complications
These infections are asymptomatic and people often don’t know they are infected and infected other people
Chlamydia and Gonorrhoea Symptoms
When Symptoms are present they can include dysuria which is painful urination as well as discharge from the vagina or penis and possibly the patient could have symptoms of pelvic inflammatory disease
Chlamydia and Gonorrhoea Diagnosis
Urine Test
Swabbing the female cervix or male urethra
Chlamydia and Gonorrhoea Treatment
Antibiotics - Doxycycline for chlamydia
Cephalosporins for gonorrhoea
Chlamydia and Gonorrhoea Nursing interventions
Disease reporting requirements for reportable infections
Chlamydia and Gonorrhoea Patient teaching
Abstinence during treatment
Partner notification and treatment
Safe sex practices
Re-screening. months after treatment
Pelvic Inflammatory Disease
Key complication that can result from a chlamydia or gonorrhoea infection
With PID sexually transmitted bacteria spreads from the vagina to the uterus, Fallopian tubes or ovaries this can lead to infertility as well as sepsis and death
Pelvic Inflammatory Disease Symptoms
Often asymptomatic but when symptoms are present they can include
lower abdominal pain
pelvic pain
mensural irregularities
painful urination
possibly a fever
Pelvic Inflammatory Disease Treatment
Antibiotics as well as analgesics for pain
Heating pad for comfort measures
*Patient teaching
Syphilis
Bacterial infection that left untreated can result in systemic complications as well as death
Stages of Syphilis
Primary stage: appearance of a Genital shanker, this is an ulcer that is typically non-tender
Secondary Stage: Flu-like symptoms, fever, soar throat, rash on hands/feet
Latent stage: Visible signs and symptoms of the infection
Tertiary (Late) Stage: Severe neurological and cardiovascular damage, including vision loss, hearing loss as well as damage to the heart and blood vessels
Syphilis Diagnosis
Blood test
Swab off the ulcer
Syphilis treatment
The administration of antibiotics such as doxycycline
Syphilis Nursing interventions
Nationally notifiable disease as the nurse you need to preform disease reporting requirements and provide patient education
Human Papilomavirus (HPV)
Certain strains of HPV can cause genital warts and others can lead to cancer
Primary risk factor for cervical cancer
Preventable with vaccination, vaccines should be administered prior to first sexual (First dose usually administered Age 11-12 second given 6 months after)
Human Papilomavirus (HPV) Symptoms
Usually Asymptomatic
If genital warts are caused, you may see, white or flesh coloured growths in the anogenital region or oral cavity
Human Papilomavirus (HPV) Diagnosis
Diagnosed using a Pap test, patients who are positive for HPV a colposcopy and cervical biopsy can be used to assess for cancerous or pre-cancerous cells in the cervix
Human Papilomavirus (HPV) Treatment
NO CURE
Wort removal can be done using prescription creams
patient teaching: More frequent Pap tests, yearly
Endometriosis
Endometriosis is a disease in which tissue similar to the lining of the uterus grows outside the uterus. It can cause severe pain in the pelvis and make it harder to get pregnant. Endometriosis can start at a person’s first menstrual period and last until menopause
Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis.
Endometriosis Symptoms
pelvic pain, often associated with menstrual periods.
Although many experience cramping during their menstrual periods, those with endometriosis typically describe menstrual pain that’s far worse than usual.
Pain also may increase over time.
Painful periods
Pain with intercourse
Pain with bowel movements or urination
excessive bleeding
Infertility
Endometriosis Risk factors
Starting period at early age
Menopause at an older age
one or Moree relatives with endometriosis
Endometriosis Complications
Main causes is impaired fertility
Cancer : Ovarian Cancer
Endometriosis Diagnosis
Pelvic Exam
Ultrasound
MRI
Laparoscopy
Endometriosis Treatment
medication or surgery
Hormone therapy
Hormonal contraceptives
Fertility treatment
Uterine Prolapse
Uterine prolapse occurs when pelvic floor muscles and ligaments stretch and weaken until they no longer provide enough support for the uterus. As a result, the uterus slips down into or protrudes out of the vagina
Uterine prolapse most often affects people after menopause who’ve had one or more vaginal deliveries.
Uterine Prolapse Symptoms
Mild uterine prolapse is common after childbirth. It generally doesn’t cause symptoms.
Symptoms of moderate to severe uterine prolapse include:
Seeing or feeling tissue bulge out of the vagina
Feeling like the bladder doesn’t empty all the way when you use the bathroom
incontinence
Feeling as if you’re sitting on a small ball
Uterine Prolapse Causes
Vaginal delivery
Age at first delivery (older women are at higher risk of pelvic floor injuries compared with younger women)
Difficult labor and delivery or trauma during childbirth
Delivery of a large baby
Being overweight
Lower estrogen level after menopause
Uterine Prolapse Treatment
Surgery
Sexual Assault
Crime of violence where sexual contact happens with out consent
Number of labs we want to collect
blood
hair samples
Genital Swabs
anal Cultures
Scrapping of material from underneath the victims fingernails
STI screening
Pregnancy testing
We can give
Emergency contraceptives
Post exposure HIV prophylaxis as well as STI prophylaxis
Always get informed consent prior to collected forensic evidence, assess for signs of PTSD, rape trauma syndrome, referrals to mental health specialist
Benign Prostate Hyperplasia
Enlargement of the prostate gland very common disorder in older men and associated with a change in hormone levels
Benign Prostate Hyperplasia Symptoms
Can block outflow of urine and can cause urinary symptoms such as:
Urinary frequency
urinary Incontinence
Urinary urgency
Urinary retention
Post void dribbling
Hematuria
Frequent UTIs
BPH Diagnosis
Digital Rectal Exam, inserts finger into rectum to palpate the prostate to check for enlargement
Prostate specific antigen level will be drawn (expected levels under 4) Over 4 may mean BPH however may also be elevated in the presence of prostate cancer
WBCs may be elevated
Creatinine and BUN may also be elevated
BPH Treatment
Three medications that may be used in the treatment of BPH include
fInasteride: helps decrease size of prostate gland
Tamsulosin: relaxes muscles of prostate gland to help with urine flow
Tadalafil: Erectile dysfunction medication
If medications are unsuccessful then surgery is an option
Purpose of the Mensural Cycle
to release an egg for potential fertilization (from the ovary) so it can implant into the endometrium…hence help develop a baby. If this doesn’t happen, the 28 day cycle starts all over (note cycle days vary among women).
Menstrual Cycle
2 cycles in one working together
Ovarian cycle: hormonal changes trigger the ovaries to release an egg (ovulation)
Uterine cycle: uterus thickens to prepare to house a fertilized egg. If the egg is not fertilized within 14 days the uterus beings to shed causing bleeding
How long is an average cycle
28 days
Follicular Phase
before ovulation
6-14
Hypothalamus releases
GnRH (Gonadotropin releasing hormone)
which releases…
FSH (follicle stimulating hormone)
LH (Luteinizing Hormone)
All these hormones cause ovulation with help of increase estrogen
Luteal phase
After ovulation
Day 15-28
egg goes down into uterus with hopes of being fertilized
Body releases estrogen and progesterone
Ovulation
occurs day 14-28
Two structures that play a vital role in the woman’s reproductive cycle:
Ovary & Uterus (they work together)
Each structure has three cycles (and these cycles correspond with each other)
Sperm life
sperm live approximately 5 days and the egg lives for 24 hours (so fertile cycle days would be days 9 -16).