TLO 2.10 Reproductive Flashcards
Obtaining sexual history and consideration
Requires skill and tact Considerate -cultural components -confidentiality -trust -start out with less invasive questions -use words client understand
Obtaining sexual history
Male, common questions
Any changes in erections Difficulty urinating Medications Medial history Lifestyle
Obtaining sexual history
Female, common questions
Menstrual or menopause Childbirth history STI's Bleeding after intercourse Family history of cancer Contraceptive use Painful intercourse Medical history
Gender Identity define the following
Agender?
Cisgender?
Gender fluid?
Agender: person who identifies with having no gender
Cisgender: person whose sex and gender identity align. Someone who is assigned male at birth and identifies as male/masculine
Gender fluid: person whose gender identity is not fixed. Person who is gender fluid may always feel like a mix of female/male or may feel they are more one gender some days and another gender another day
Gender Identity define the following
Gender non-conforming?
Genderqueer?
Non-binary?
Gender non-conforming: umbrella term, gender expression that differs from a given society’s norms or only male and female
Genderqueer: person whose gender identity falls outside the traditional gender binary of male and female
Non-binary: umbrella term, any gender identity that does not fit within the gender binary of male and female
Gender Identity define the following
Transgender man?
Transgender female?
Two-spirit?
Transgender male and female: person whose gender identify as opposite of birth gender
Two-spirit: Native American/Alaskan Native LGBTQ people, stemming from language meaning to have both female and male spirits within one person. Different meaning in different communities
Sexual orientation define the following
Asexual?
Bisexual?
Gay?
Asexual: person who experiences little or not sexual attraction to others
Bisexual: person who is emotionally and sexually attracted to people of their own gender and of people of the other binary gender
Gay: man who is emotionally and sexually attracted exclusively to other men
Sexual orientation define the following
Lesbian?
Pansexual?
Queer?
Lesbian: woman who is emotionally and sexually attracted exclusively to other women
Pansexual: person who is emotionally and sexually attracted to people of gender identities throughout the gender spectrum
Queer: umbrella term, people who think of their sexual orientation or gender identity as outside of societal norms. some view the term queer as more fluid and inclusive than traditional categories. NOT embraced or used by LGBTQ community
Nurse’s role
Expand your knowledge Know key LGBTQ definitions Deepen your LGBTQ knowledge Create welcoming environment Ask relationship status, not marital status Asking preferred names on forms Use inclusive language and gender neutral language Therapeutic communication Respect
Physical assessment
Female age related changes
Breast atrophy with sagging
Labia flattened, hair decreases
Decreased vaginal lubrication
Uterus and fallopian tubes shrink, uterine prolapse
Menopause- estrogen production decreases causing wrinkling and growth of facial hair
Physical assessment
Male normal
Urinary meatus should be midline
Breast tissue not swollen, tender or enlarged
Foreskin easily retractable
No redness, swelling, drainage or lesions
Physical assessment
Male age related changes
Many have some degree of BPH
Reduced sperm count in men
Vascular changes of penis causes increased time in achieving an erection and ejaculation
Urinary hesitancy
Self assessment exams
Breast self exam: 7-10 days from 1st day of period, post menopausal choose day of the month. Important to know your normal and report changes
Clinical breast exam yearly at age 40 and every 3 year in 20-30’s
Testicular exam done monthly
Diagnostic testing
Mammogram?
Breast US?
Mammogram
- yearly at age 40
- x-ray detect tumors
- no deodorant, powder, ointments prior
Breast US
- used in conjunction with mammography
- differentiates solid mass from cystic mass
- aides in visualizing of mass to biopsy
- used to evaluate mass in pregnant women when mammography is contraindicated
Diagnostic tests: PAP
Papanicolaou test (PAP)
- <30 yr, every 2-3 yrs
- > 65 yr, only if they are high risk
- microscopic study of cells from the cervix
- diagnose malignant and premalignant lesions
- no douching, vaginal meds or intercourse 24-48 hr prior
- void prior to exam
Diagnostic test: Pelvic US
Pelvic US
- abdominal or vaginal
- high frequency waves detects fibroid tumors, cysts, abscesses, neoplasms
- need full bladder
- men: used for testicular torsion or masses
Diagnostic test: Colposcopy
Colposcopy
- done when pap test shows cells changes
- direct visualization of cervix microscope
- no douche or intercourse 48 hr
- NSAIDS for pain/cramping post procedure
- slight vaginal bleeding several days after
Diagnostic test: Laparoscopy
Laparoscopy
- surgical procedure done as outpatient
- used in assessment of uterus, tubes, ovaries and perform tubal ligation
- common to have shoulder pain from gas
- follow surgical prep procedures: NPO, enema, shower
- vaginal bleeding may occur post-op shouldn’t be heavy lifting
Diagnostic test: D&C
Dilation and curettage (D&C)
- cervix is dilated and curette is used to scrape uterine lining
- to remove tissue after miscarriage, abortion or removal of placental pieces
- diagnose or treat abnormal uterine bleeding
- uterine tissue examined for abnormal cells
- cramping, spotting, bleeding post op
- avoid anticoagulants
- no intercourse until discharge stopped
- avoid tampons 2 wk post op
- avoid heavy lifting 2 wk post op
Diagnostic test: CT or Pelvis with or w/o contrast
Used to detect tumors within the pelvis
If contrast is used, check for allergies to iodine/shellfish
Contrast accentuates differences in tissue density
Flushing feeling common with contrast
Contrast contraindicated in renal/hepatic disease
Terminology Menarche? Menorrhagia? Metrorrhagia? Amenorrhea?
Menarche: age 1st started menstruation
Menorrhagia: excessive or prolonged bleeding
Metrorrhagia: bleeding between menstrual periods
Amenorrhea: absence of menstruation
