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NURS 401 > Week 7: Female Disorders > Flashcards

Week 7: Female Disorders Flashcards

1
Q

Menopause

A

Menstrual periods stop permanently

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2
Q

Perimenopause

A

-Time before menopause

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3
Q

What happens during perimenopause?

A
  • More frequent periods at first then occasional missed periods.
  • Periods that are longer or shorter
  • Changes in the amount of menstrual flow.
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4
Q

When do most women experience menopause?

A

Around age 50; usual age range of 45-55.

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5
Q

What happens during menopause?

A
  • Ovaries stop making the hormones estrogen and progesterone.
  • Ovaries stop releasing eggs (ova, oocytes)
  • No periods for one year.
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6
Q

What happens to the reproductive system as hormone levels fall?

A
  • Vaginal walls become thinner, dryer, less elastic, and possibly irritated.
  • Risk of vaginal yeast infections increases.
  • External genital tissue decreases and thins.
  • Breasts lose fat, tissue, and mammary glands.
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7
Q

What are other common changes of the female reproductive system as women age?

A
  • Menopause symptoms
  • Problems with short-term memory
  • Decrease in breast tissue
  • Increased risk of bone loss (osteoporosis)
  • Urinary system changes such as frequency and urgency of urination, increased risk of UTI and incontinence
  • Loss of tone in the pubic muscles, resulting in the vagina, uterus or urinary bladder falling out of position
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8
Q

Menopause symptoms include

A
  • Hot flashes
  • Moodiness
  • Headaches
  • Trouble sleeping
  • Night sweats
  • Breast pain
  • Insomnia
  • Vasomotor
  • Vaginal Atrophy
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9
Q

Characteristics of Perimenopause

A
  • May take 3-5 years before menses actually ends
  • Menses become irregular
  • Still at risk for pregnancy!
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10
Q

Characteristics of Menopause

A
  • End of reproduction
  • Average age of 51
  • Absence of menstruation for 1 year
  • Increase in FSH/LH
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11
Q

What causes menopause?

A

Decreased estrogen

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12
Q

Psychological Symptoms of Menopause include

A
  • Mood changes
  • Depression
  • Irritability
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13
Q

Vaginal Atrophy

A
  • Regression of the reproductive organs
  • Dyspareunia
  • Atrophic vaginitis
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14
Q

Treatment for Menopause: Pharmacological

A

-Hormone Replacement therapy

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15
Q

Medication options for Menopause

A

-Venlafaxine (Effexor XR) or Paroxetine (Paxil) for vasomotor.
New: Ospemifene (Osphena) oral medication indicated for treatment of dyspareunia.
Alternative- OTC Black Cohosh or Estroven not so effective.

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16
Q

How is menopause related to cardiovascular disease?

A

Absence of estrogen = adverse changes in serum lipids.

  • LDL which carries cholesterol to blood vessels increase.
  • HDL which carries cholesterol to the liver and protects against CAD decrease.
17
Q

Why are women more likely than men to die from CAD?

A

…

18
Q

Signs and Symptoms of CAD in women

A
  • Fatigue, weakness, unexplained anxiety
  • Angina pectoris, or pain with rest
  • Dyspnea
  • Dizziness
    -Upper abdominal pain
  • Nausea, vomiting, sweating
  • Pain in the upper body other than chest
19
Q

Osteoporosis

A
  • Increased risk during menopause

- Major health concern

20
Q

What bone sites are most commonly fractured?

A

…

21
Q

Risk Factors for Osteoporosis in Women include

A
  • Hx of fractures
  • Family hx
  • Ethnicity- Caucasian & Asian
  • Physical status
  • Dietary- ↓ Calcium & Vitamin D
  • Meds- corticosteroids; Levothyroxine (Synthroid)
  • Lifestyle- smoker, ETOH
  • Sedentary lifestyle
22
Q

Osteopenia

A

Measurable bone loss

T-score= -1 to -2.5

23
Q

Osteoporosis T-score

A

> -2.5

24
Q

Symptoms of Osteoporosis

A
  • Fracture
  • Height
  • Kyphosis
  • Can felt teeth and jaw
25
Q

Prevention of Osteoporosis: Screening

A

DEXA Scan “Gold standard” for screening

26
Q

Osteoporosis Lifestyle Recommendations: Dietary

A

-Dairy Sources

27
Q

Osteoporosis Lifestyle Recommendations: Supplements

A
  • Calcium 1,200-1,500 mg/day
  • Calcium carbonate with food; Calcium citrate if H2O blocker use
  • Vitamin D 1,000 I.U./day
28
Q

Osteoporosis: Other Lifestyle Recommendations

A
  • Weight-bearing exercise 3-5 times weekly
  • Sunlight exposure although limited due to skin cancer risk
  • Avoid smoking, ETOH, excess caffeine including soda
29
Q

Medications for Osteoporosis include

A
  • Estrogen(short term) due to risks
  • Bisphosphonates: (Actonel, Boniva, Fosamax)
  • SERMs: (Raloxifene/Evista)- protects from breast CA
  • Calcitonin- nasal spray
  • Forteo - injection
  • Zometa - IV
30
Q

Breast Cancer: Risk Factors

A
  • Early menarche (<12 years); late menopause (> 55 years)
  • Nulliparity after 30 years of age
  • Personal or family history (First Degree)
  • Genetic
  • Long-term HRT (> 5 years)
  • Previous irradiation of the chest
  • Previous abnormal breast biopsy
  • Obesity
  • ETOH; smokers
31
Q

Breast Cancer Pathophysiology

A
  • Approx. 65-80% are infiltrating ductal carcinomas; becomes invasive when no longer confined within the mammary duct.
  • 10-14% invasive breast cancer assoc. with mil-secreting ducts of breast tissue.
  • 1-2% inflammatory breast carcinoma has cutaneous findings with invasive involvement in the dermis.
  • 40-50% have axillary lymph node involvement at the time of diagnosis.
32
Q

Breast Cancer Screening

A

Teach BSE
Annual clinical breast exam
Mammogram- screening with palpable mass (3-D imaging more sensitive)
ACOG recommendation annual by age 40

33
Q

Risk Factors for Breast Cancer

A

…

34
Q

Surgical Management of Breast Cancer

A
  • Lumpectomy-conservative
  • Removal of axillary nodes to stage cancer
  • Modified radical mastectomy-preserves pectoralis
  • Radiation therapy
  • Chemotherapy
  • Hormone and immunotherapy are adjuvant Rx
  • Breast reconstruction option
35
Q

Psychosocial Concerns for Breast Cancer

A
  • Fear of death
  • Quality of life
  • Sexuality
  • Body image changes

NURS 401 (26 decks)

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