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MedSurg 2 > Reproductive System > Flashcards

Reproductive System Flashcards

1
Q

ED Medication Administration

A

Oral OR injectable (Injectable only with documented androgen). Oral meds increase blood flow by relaxing smooth muscle. Topicals have a risk if children or women come in contact with it. Do NOT take nitrates because of a decrease in BP

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2
Q

ED Oral Medications

A

Do not take with nitrate-based drugs or alpha blockers

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3
Q

Testosterone Injections

A

Have less of a risk than with topicals

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4
Q

Hormone Replacement Therapy for ED

A

Can not use if the pt has prostate cancer (it increases proliferation of cancer cells)

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5
Q

Phimosis

A

Constriction of foreskin so that it cannot be retracted. High risk for infection. If too constricted it may interfere with voiding.

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6
Q

Priapism

A

Involuntary, sustained, painful erection. Can result in ischemia and fibrosis of penile tissue with subsequent impotence

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7
Q

Tx of Priapism

A

Iced saline enemas, IV ketamine, Spinal anesthesia, aspiration of blood from corpus (if aspiration, then it is followed by catheterization and pressure dressings to maintain decompression) If necessary, surgery to create vascular shunts to maintain blood flow is performed

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8
Q

Tx of Phimosis

A

Circumcision

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9
Q

Nursing Care for Disorders of the Penis

A

Assessment of penile tissue for blood flow (color change, degree of erection), monitoring urinary output, providing pain control with analgesics

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10
Q

Hydrocele

A

Collection of fluid in scrotal sac in the tunica vaginalis.

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11
Q

Intervention for Hydrocele

A

Anxiety reduction, comfort measure, aspiration of fluid.

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12
Q

Testicular Torsion

A

Twisting of spermatic cord resulting in scrotal swelling due to venous congestion, pain, N/V. Potentially a medical emergency (it can cause tissue to necrose).

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13
Q

Complications of Testicular Torsion

A

Vascular engorgement and Ischemia

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14
Q

Tx of Testicular Torsion

A

Detorsion of testicle, fixation to scrotum, orchiectomy if scrotal tissue or testes has become necrotic.

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15
Q

BPH

A

Nonmalignant enlargement of the prostate, common and age-related from cell proliferation forms nodules that grow and glandular cells enlarge. Growth happens in an inward pattern, pressing on urethra. Necessary preconditions are are of 48 or older and must have testes.

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16
Q

Manifestations of BPH

A

Urinary symptoms and decreased bladder control

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17
Q

Complications of BPH

A

Infection of the bladder and kidneys, hydroureter, hydronephrosis, renal insufficiency.

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18
Q

Interventions for BPH

A

Correcting or minimizing urinary obstruction, preventing/treating complications, avoid alcohol!

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19
Q

BPH Medication Therapy

A

Anti-androgen agents (cause prostate tissue to shrink), Apha-adrenergic antagonists (stop smooth muscle contraction of prostate that may be blocking urethra)

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20
Q

Transurethral Microwave Thermotherapy

A

Microwaves are used to heat and destroy excess prostate tissue. During the procedure, a cooling system protects the urinary tract. Take about an hour and is outpatient. It does not cure BPH but reduces urinary symptoms. Does not cause impotence or incontinence.

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21
Q

TUNA

A

Transurethral Needle Ablation. Uses low level radio frequency through twin needles to burn away a region of the enlarged prostate. Shields protect the urethra. Improves the flow of urine through the urethra. Does not cause impotence or incontinence.

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22
Q

TURP

A

Transurethral Resection of the Prostate. Most common surgery. Prostate tissue is removed using the wire loop of a resectoscope and electrocautery, inserted through the urethra. Risks include postop hemorrhage or clot retention, inability to void, and UTI, incontinence, impotence, and retrograde ejaculation. Postop with 3way catheter (typically 36-72 hours).

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23
Q

Three Way Catheter

A

Bag of fluid hanging will flow into bladder, and then it will flow back out into the foley bag. I&O will be calculated by subtracting what flowed in from output. Palpate the bladder if no output, can get blood clots.

24
Q

Normal Onset of Menopause

A

48-55 years of age

25
Q

Chemical Menopause

A

Chemotherapy - cytotoxic drugs arrest ovarian functions

26
Q

Climacteric/Perimenopausal Period

A

Reproductive function gradually ceases, lasts for several years, starts with decreased estrogen production. Menstruation cessation. ends on year after cessation of of meses.

27
Q

Changes in sexual function associated with Perimenopause

A

Decreased estradiol levels, changes in nerve transmission and response in peripheral vascular system (why they don’t adjust to temp changes), change in timing and degree of vasocongestion during sexual response (vaginal dryness, hot flashes, insomnia, night sweats)

28
Q

Health Risks after Menopause

A

Heart disease, osteoporosis (because of decrease in estrogen), breast cancer, macular degeneration.

29
Q

Why increased risk of breast cancer in menopause

A

Taking estrogen replacement is why increases breast cancer risk….even higher risk if a family hx is present

30
Q

Uterine Prolapse

A

Uterus prolapses into vagina. Caused by weakened pelvic muscles. Most common cause is multiple pregnancies.

31
Q

Vaginal Fistulas

A

Involuntary leakage of urine or flatus, symptoms of infection.

32
Q

Nursing care for Vaginal Fistulas

A

Importance of perineal cleansing, suggest use of perineal pads (for chronic leaking), provide information on gas-forming foods to avoid.

33
Q

Cyst

A

a FLUID filled sac

34
Q

Polyp

A

SOLID vascular tumor

35
Q

Batholin’s Gland Cysts

A

Most common, caused by infection/obstruction of gland. Manifestations are pain, redness, perineal mass, dyspareunia (painful sexual intercourse)

36
Q

Cervical Polyps

A

Vaginal end of cervix, has stem, highly vascular. Oral contraceptive use is correlated with cervical polyps

37
Q

Polycystic Ovarian Syndrome

A

From an excess of androgens or long-term lack of ovulation.

38
Q

Manifestations of POS

A

Amenorrhea or irregular menses, obesity, acne, hypertension, sleep apnea (if obese), infetility (from not ovulating)

39
Q

Interdisciplinary Care for POS

A

Antibiotics for infection, oral contraceptives to decrease the amount of androgen. Surgery.

40
Q

Manifestations of Fibroid Tumors

A

Benign tumors that originate from smooth muscle of uterus. Small tumors are asymptomatic, large tumors can cause pelvic pressure and pain, dysmenorrhea, fatigue, and constipation and urinary urgency/frequency.

41
Q

Myomectomy

A

Removal of tumor without removing the entire uterus. The procedure of choice for young women with fibroid tumors who wish to retain their reproductive capability.

42
Q

Endometriosis

A

Multiple, small, usually benign implantations of endometrial tissue develop.

43
Q

Interdisciplinary care for Endometriosis

A

Medications (lower estrogen levels, such as oral contraceptives), surgery (laparoscopy, total hysterectomy depending on how bad they are and if you want to have more children)

44
Q

Hysterectomy

A

Surgical removal of the uterus. If premenopausal then the ovaries are left in place. Postmenopausal women get a Panhysterectomy where the uterus, fallopian tubes, and ovaries are removed.

45
Q

Breast screening recommendations

A

Self screen every month at the same time. Tissue changes with cycle so needs to be the same time each month.

46
Q

Fibrocystic Changes (FCC)

A

Physiologic nodularity and breast tenderness that increases and decreases with the menstrual cycle. Many different lesions and breast changes.

47
Q

FCC Manifestations

A

Pain or tenderness in the upper, outer quadrants of the breast. Breasts feel thick and lumpy week prior to menses. Nipple discharge. Increase in breast size.

48
Q

Candidiasis

A

“Yeast infection”. White curd like substance, intense itching, often cause by killing of the natural flora or changing of the pH by antibiotics, vaginal cleansers or douching, bubble baths, hot tubs.

49
Q

Bacterial Vaginosis (Gardnerella)

A

fishy odor watery discharge

50
Q

Risk factors for Vulvovaginal Infections

A

Premenarche, Perimenopause, Menopause, Low estrogen levels, pregnancy, oral contraceptive use, poor hygiene, tight garments, synthetic clothing, frequent douching, antibiotics, allergies, diabetes mellitus, intercourse with infected partner, oral-genital contact, HIV

51
Q

Interventions for Vulvovaginal Infections

A

Sitz baths to relieve discomfort, douching is usually avoided but therapeutic douching may be prescribed to reduce odors and remove excess drainage. Pt education includes hand washing, preventive strategies, measures to reduce risk, information regarding medications, and information regarding self-examination

52
Q

HIV and sexual intercourse teaching

A

Avoid sex during the prodromal period and for 10 days after lesions are healed

53
Q

PID Risk Factors

A

Multiple partners, STDs, substance abuse, frequent douching, IUD use

54
Q

S/S of PID

A

abdominal pain, purulent vaginal discharge, pain with intercourse, N/V, Pain on urination

55
Q

Interventions for PID

A

antibiotics, laparoscopic surgery for adhesions, STD testing, education, removal of IUD if IUD present

MedSurg 2 (2 decks)

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