Topic 8: Endometriosis, Ovarian Cysts, Cervical... Flashcards
endometriosis
A condition which endometrial tissue accumulates outside the endometrium of the uterus, not life-threatening but can cause considerable pain.
clinical manifestations of endometriosis
Secondary dysmenorrhea
· Infertility
· Pelvic pain
· Dyspareunia
· AUB
Backache, painful bowel movements, dysuria
Diagnostic Assessment endometriosis
· Laparoscopy with a biopsy is needed for definitive diagnosis
· Pelvic exam
· Pelvic ultrasound
· MRI
ovarian cysts
Usually soft and surrounded by a thin capsule, may occur with PCOS and are not cancerous.
Polycystic ovary syndrome (PCOS)
disorder that includes ovulatory dysfunction, polycystic ovaries, and hyperandrogenism
Clinical Manifestations of Ovarian Cysts
Often asymptomatic until they are large enough to cause pressure in the pelvis
· Constipation, menstrual irregularities
· Urinary frequency
· Full feeling in the abdomen
· Anorexia
· Increase in abdominal girth
· Peripheral edema
Clinical Manifestations of PCOS
· Irregular menstrual periods
· Amenorrhea
· Hirsutism
· Obesity (80% of women)
Untreated PCOS can lead to CVD and abnormal insulin resistance with type 2 diabetes
what is the diagnostic test for ovarian cysts
Pelvic ultrasound can determine diagnostic
what are used to regulate menstrual cycles in PCOS
OCPs
Hyperandrogenism can be treated with
flutamide and GnRH agonist (leuprolide)
what medication reduces hyperinsulinemia, improves hyperandrogenism, and can restore ovulation for PCOS
metformin
nursing management for PCOS
· Teaching about the importance of weight and exercise to decrease insulin resistance
· Monitor lipid profile and fasting glucose levels
For hirsutism explore measures to remove unwanted hair
incidence rate for cervical, endometrial and ovarian cancer is highest among…
Hispanic women, mortality rare are twice as high among black women
cervix
lower third of the uterus that projects into the vagina
clinical manifestations of cervical cancer
· Often no symptoms
· Unusual discharge (usually watery and thin but then becomes dark and foul smelling)
· Vaginal bleeding (first presents as spotting)
· AUB
· Postcoital bleeding
Pain is a late symptom followed by weight loss, anemia, and cachexia
diagnostics for cervical cancer
Papanicolaou (Pap) test (helps find changes in cervical cells) and HPV test
when should women begin cervical cancer screening
at age 21
Women ages 21-29 should have a Pap test every
3 years
Women ages 30-65 should have Pap test every
5 years
when does vaccination for HPV usually begin
between age 11-12
Endometrial cancer arises from
the lining of the endometrium within the uterus.
what is a major risk factor for endometrial cancer
Major risk factor is exposure to estrogen and obesity because adipose cells store estrogen
early manifestations of endometrial cancer
· AUB, especially in post-menopausal women
late manifestations for endometrial cancer
· Dysuria
· Dyspareunia
· Unintentional weight loss
Pelvic pain
treatment for endometrial cancer
Total hysterectomy
Bilateral salphingo-oophorectomy with lymph node biopsies
ovarian cancer risk factors
· Family history, or history of breast or colon cancer.
· Women who have mutation of the BRCA genes
· Women who have never been pregnant
· Increasing age, high fat diet
· Increased number of ovulatory cycles
clinical manifestations for ovarian cancer
· No obvious symptoms
· Pelvic or abdominal pain
· Bloating
· Urinary urgency or frequency
· Difficulty eating or feeling full quickly
late stage ovarian cancer manifestations
abdominal enlargement with ascites, unexplained weight loss or gain, menstrual changes
diagnostic assessment for ovarian cancer q
· Pelvic exam
· Abdominal and transvaginal US
· CA-125 level
Laparotomy for diagnostic staging
what is a prophylactic treatment for ovarian cancer
· Prophylactic removal of ovaries and fallopian tubes and use of OCPs
what is the initial treatment for ovarian cancer
· Initial treatment is total abdominal hysterectomy and bilateral salpingo-oophrectomy
