Premenstrual Syndrome (PMS)
- symptoms occur between ovulation and menstruation
- abdominal bloating, breast tenderness, irritability, appetite changes, fatigue, mood swings, and a fear of losing control.
premenstrual dysphoric disorder (PMMDD)
- the result of abnormal serotonin responses to normal changes in estrogen levels during the menstrual cycle
- depressed mod; anxiety; irritability; difficulty in concentrating; change in appetite and sleep; breast tenderness, bloating, weight gain and headaches
primary dysmenorrhea
- 6-12 months after the menarch
- often affects adolescent girls
- high levels of prostaglandins in the ovulatory cycle, causes uterine contractions and vasoconstriction that result in abdominal cramps
treatment for primary dysmenorrhea
heat to abdomen, effleurage, pelvic rock, aromatherapy, medication, balanced low fat diet, NSAIDS
SECONDARY DYSMENORRHEA
- typically occurs after 25 years of age
- caused by pelvic pathology
- full lower abdominal pain radiates to the back or thighs
- pain may occur before the menstrual period and last throughout the days of menstrual flow
which nursing interventions would hep relieve symptoms of dysmenorrhea?
- pelvic rock exercises
- effleurage
- low fat diet
- prostaglandin inhibitors
primary infertility
inability to conceive a child after at least 1 year of a active, unprotected sexual relations without contraceptive
secondary infertility
inability to conceive after having once conceived or to maintain a pregnancy long enough to deliver a viable infant
factors contributing to infertility in women
- problems with ovulation
- an abnormality in the pathway between the cervix and fallopian tube
- an abnormality in the endometrium of the uterus, or malformation of the uterus
- tumors in the reproductive tract
causes of repeated pregnancy loss
- an abnormality in fetal chromosomes that result in spontaneous abortion
- abnormalities of the cervix or uterus
- disorders of the endocrine or immune system
- infections
health risks of menopause
- osteoporosis
- Coronary heart disease
- treatment options during menopause
activities that increase the risk of osteoporosis
- inadequate lifetime intake of calicum and vitamin D
- smoking
- excess alcohol intake
- excess caffeine, cola, or soft drink intake
pelvic relaxation syndrome
lack of estrogen results in weakening of tissue structures causing pelvic relaxation
S/S of pelvic relaxation syndrome
- rectocele may result in constipation, soiling, or painful defecation
- uterine prolapse my result in dyspareunia:uterus may protrude from the vaginal orifice
- a sense of fullness in the pelvis and backache
- stress incontinence
disorder of the female reproductive system
polycystic ovarian syndrome
congenital condition in which many cysts develop on one or both ovaries and produce excess estrogen
disorder of the female reproductive system
dysfunctional uterine bleeding
- oligomenorrhea: decreased menstruation
- amenorrhea: absences of menstruation
- menorrhagia: excessive menstrual bleeding
disorders of female reproductive system
abnormal uterine bleeding
bleeding not related to the menstrual period
leiomyoma
aka - fibroids
- benign tumors of the uterine muscle
- medical management: nonsteroidal antiflammatory drugs or oral contraceptives, uterine artery embolization, myomexctomy, and hysterctomy
S/S of leiomyomas
may range from none to back aches, urinary frequency, abnormal uterine bleeding
Endometrisosis
disease in which tissue similar to the lining of the uterus grows outside the uterus
-leading to severe pain in the pelvis and possibly make it harder to get pregnant
inflammations of the lower genital tract
inflammation or infections of the vulva, vagina, or cervix most often occur when he acid enviorment of the vaginal secretions changes, enabling the survival of the pathogenic organisms
S/S of inflammation of the lower Genital tract
genital lesions, dysuria, and vaginal discharge and pruritus
treatment for inflammation of the lower genital tract
- local creams, vaginal suppositories, or systemic antimicrobials
- hand hygiene is important
- wearing loose cotton underwear
- psychological support
Toxic shock syndrome risk factors
the prolonged use of absorbency tampons, cervical caps, or diaphragms
symptoms of toxic shock syndrome
sudden spiking fever, flu like symptoms, hypotension, generalized rash resembling a sunburn, and peeling skin on the palms or soles
treatment for toxic shock syndrome
hospitalization and intensive care with supportive treatments and intravenous antimicrobials
cancer of the female reproductive tract
vulvar cancer
- rare and occurs most commonly in older women
- treatment includes surgical removal of the pathologic tissue
cancer of the female reproductive tract
cancer of the cervix
risk factors for cancer of the cervix include having had multiple sex partners, sexual intercourse with uncircumcised males, starting intercourse at a young age.
Cancer of the cervix treatment
cryosurgery, electrosurgical excision or surgical ionization of the cervix
cancer of the female re[productive system
cancer of the uterus
most common malignant tumor of the female productive tract
-treatment is a hysterectomy
cancer of the female reproductive tract
cancer of the ovary
majority of ovarian cancer is known as a "silent cancer" because signs and symptoms are often nonspecific or vague
benign disorders of the breast
fibroadenoma
firm, rubbery, mobile nodules of fibrous and glandular tissue that may not be tender on Palpation
benign disorders of the breast
fibrocystic breast changes (FBC"s)
palpable thickening of portions of the breast tissue associated with pain and tenderness
benign disorders of the breast
intraductal papiloma
development of small elevations in the epithelium of the ducts of the breasts under the areola
the patient reports finding multiple smooth, well-delineated cysts in her breasts that are tender during the presentrual phase. the nurse should provide which instructions?
- eliminate alcohol and caffeine
- reduce fat in the diet
- consult a physician immediately
breast cancer- etiology
related ti estrogen and progesterone
-BRCA1 and BRCA2 gene mutations
breast cancer S/S
- lump in the breast
- nipple discharge or change in the skin patterns such as "dimpled skin"
breast cancer treatment
- surgery
- radiation therapy
- surgical removal of tumor and or/breast
- chemotherapy
breast cancer prevention
a healthy lifestyle that includes exercise and a diet rich in antioxidants and phytoestrogens (fruits, veggies, wine and tea)
-mammography screening
-tamoxfin to prevent recurring breast cancer
lymphedema
swelling caused by a buildup of lymph fluid in the body between the skin and muscle
-lymph fluid is part of the lymph system, which plays a role in your body's ability to fight infection and disease
lymphedema
DO NOT'S
- do not assess blood pressure in the affected arm
- do not give injections or do venipuncture in the affected arm
- provide meticulous skin care
female reproductive system
primary external structures
- vuvla
- mons pubis
- labia majora
- labia minora
- clitoris
- urethral meatus
- vaginal vestibule
- perineum
phases of the female reproductive cycle during the childbearing years
ovarian cycle (follicular phase)
follicle-stimulating hormone (FSH) AND luteinizing hormone (LH) stimulate the maturation of the ova in preparation for fertilization
-estrogen peaks when the ovum is released
ovarian cycel
Luteal phase
- LH and progestrone are the primary hormones released in this phase.
- the blood supply to the uterus increases in preparation for possible implantation of a fertilized ovum
- if fertilization and implantation do not occur, the lining of the uterus will degrade and be shed during menstruation and the cycle begins again
sexual development In the fetus
- during the first weeks of pregnancy, the male nd female sexual organs are undifferentiated
- after the 7th week, rapid changes occur
- by the 12th week the external genitalia are formed and fully differentiated as male and female
sexual maturation
PUberty
- period of sexual maturation
- usually occurs between ages 9-17 years for girls; the average onset is 12 years of age.
- menses
- menarche
- menstruation
menopause
perimenopausal
- entering the phase known as the climacteric period
- menses become irregular in both pattern and flow and eventually stop altogether
normal menstruation
- a regular menstrual cycle is approximately every 28 days
- a healthy view of menarche as a natural physiologic process marking reproductive maturity should be encouraged
the menstrual cycle
- stage 1- menstrual cycle
- stage 2- days 6-14
- stage 3- ovulation
- stage 4- secretory stage
the nurse taking the gynecologic history of a postmenopausal Mexican American patient can help develop rapport by
- involving family members
- using a polite tone of voice
- respecting her privacy
normal vaginal discharge
contains cervical mucus, endometrial fluid, exudate
-bartholin glands and skene ducts, and products of normal flora
the normal breasts made of adipose tissue, milk-producing glands ducts and fibrous tissue that rest on the chest muscle.
(T/F)
true
female health screening and assessment
breast self-examination
- may be done monthly, about 1 week after menstruation begins, or on a specific date each month after menopause
- mammography and magnetic resonance imaging (MRI) for women at high risk
- tomosynthesis (three-dimensional mammography) is a more advanced form of traditional mammography
female health screening and assessment
vulvar self-examination
using both touch (to palpate for lumps or thickening beneath the skin) and visualization
the pelvic examination
- inspection of vagina and cervix
- Pap test- women between the ages of 21 and 65 should have a Pap test every 3 years
- HPV testing
- Pelvic exam
male reproductive system
- testes (gonads)
- scrotum- testes, the epididymis, and the vas deferens
- penis
- prostate gland
- bulbourethral (Cowper) glands
function of the organs of the male reproductive system
scrotum
holds the testes, the epididymis, and the vas deferens
functions of the organs of the male reproductive system
the spermatic cord attaches the testes to the body
it contains the blood vessels and nerves that supply the testes
functions of the organ of the male reproductive system
epididymis
a long tube that conducts sperm from the testes to the vas deferens
functions of the organ of the male reproductive system
the vas deferens
stores sperm and then carries it to the ejaculatory duct by peristaltic movements
functions of the organs of the male reproductive system
seminal vesicles
produce a fluid that is thick and contains fructose to nourish the sperm and provide energy
functions of the organ of the male reproductive system
prostate gland
produces thin, milky, alkaline secretions that contribute to the seminal fluid and enhance the mobility of the sperm
functions of the organs of the male reproductive
secretions of the bulbourethral glands
neutralize the acid of residual urine in the urethra
what is necessary for fertility?
- sexual function
- metabolism and transport of sex hormones
- cognitive and sensory centers in the brain
- sexual desire (libido)
- ability to respond to sexual stimulation with a penile erection
male contraception
reversible
- spermicidal creams, gels, or foams
- male condom
male contraception
permanent contraception
vasectomy
male health screening and assessments
testicular self- examination
regular self exams are encouraged for early detection of cancer