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Reproductive System*
reproductive system and std's
| Question | Answer |
|---|---|
| Pelvic Inflammatory Disease | Patho:Inflammation of the fallopian tubes,ovaries or both. Ethiology: Infection. S/S:Low grade fever,pelvic pain,Dysmenorrhea(painful menstruation),Dysparenia(painful intercourse).Complications:infretility from scaring r/t inflammatory process.N.Dx:#1Pain |
| Amenorrhea | Absence of menstruation. Causes- anorexia nervosa,excessive exercise with a decrease in body fat. Tx.-Depo-provera is sometimes ordered for 5-10 days to help start a period. |
| Menopause | Happens appox.@age 50. Tx-esrogen replacement(Premarin,Esterase). Estrogen can have positive effects such as;protecting against Osteoporosis and Cardiovascular Disease,decreasing LDL's & increasing HDL's. |
| Endometriosis | Is a growth of endometerial tissue outside of the uterus.They call it the Career Women's disorder. Women with no children,high socioeconomic group, late 20's to 30's. Complication:Female infertility. |
| Benign Neoplasm's | Benign=not cancerous,Neoplasm=abnormal growth. Ex: Fibrocystic Breast Disease: S/S: Lumpy breasts. Increased potential for developing breast CA. Fibroid Tumors: Non cancerous tumors, called fibroids. |
| Leiomyomas(Benign Tumors) | Fibroid tumors of the uterus are common. Higher incidence in women who never had a baby(nullparous). S/S: menorrhagia(excessive menstrual flow), pelvic pain, dysmenorrhea,abdominal elargement and constipation as the tumors grow! |
| Leiomyomas Cont. | Growth of the tumors are stimulated by estogen whic increases during pregnancy. Complication: pre-term labor because the uterus is overcrowded. |
| Malignant Neoplasm's | Breast CA:early detection is the Goal,mammograms & self Breast Exams(SBE). TX:radiation,chemo,mastectomy. Mastectomy: Simple-removal of tumor. Modified-removal of breast & surrounding lymph nodes. Radical-removal of tumor,breast,lymph & pectoral muscl |
| Malignant Neoplasm's Cont.'d | The more removal the longer the recovery. |
| Breast Cancer Nursing Interventions | Monitor post-op vitals q ? Assess incision site.Assess pts readiness to look at surgical site.Encourage pt to look at site ONLY when pt is ready!Teach dressing changes & touching only after pt is comfortable with looking at site. |
| Breast Cancer | Goal-pt will be able to discuss feelings & pt will be able to accept change in breast appearance. |
| Breast Cancer Nursing DX: | Fear(with all CA),Body Image Disturbance,Ineffective Breathing r/t radical mastectomy(removal of the pectoral muscle).Self Care Deficit r/t decrease in ROM(the pt will gradually regain ROM) |
| Cervical Cancer | Dx-pap smear.-Dysplasia=change in size and shape of cervical cells.Is the most common Female CA.Risk Factors-women with HPV,genital herpes&multiple sex partners.Cryotherapy-Freezing of the cells with nitro. |
| Endometrial Cancer | Post-menopausal women are at greatest risk r/t the endometrial tissue not being sloughed amb no period.Risk factors-nullparity women & never having intercourse. S/S- bleeding,but not until CA is advanced. |
| Endometrial Cancer-TX | Total hysterectomy(removal of cervix and uterus). Sub-total Hysterectomy(removal of uterus). Radical Hysterectomy(cervix,uterus,ovaries,fallopian tubes,surrounding lymph nodes&part of the vagina.) |
| Endometrial Cancer-TX Cont'd. | Vaginal Hysterectomy:can be done by laparoscope one day in hospital. Abdominal Hysterectomy:is used if CA has spread beyond the uterus. |
| Ovarian Cancer | Causes more deaths then other Female Ca. Metastasis occurs in over 75% of the cases prior to DX(mets to the colon most common). Risk factors:nullparity,smoking,alcohol,infertility,& high fat diets. |
| Ovarian Cancer Cont'd | There is no screening tool or early diagnostic tests to detect Ovarian Cancer! |
| Benign Prostate Herplasia(BPH) | Enlargement of prostate gland,can be palpated through the anus.If enlarged can block the urethra.50% of men,over 50,and 75% of men over 70,can develop enlargement of the prostrate.Early S/S:hesitancy(difficulty starting stream). |
| BPH Cont'd | Tx:Surgery:TURP=Trans-Urethra-Resection of the Prostrate.Medications:Cardura&Hyrin. Post-op Care:Continous Bladder Irrigation(CBI):to decrease the formation of clots that would obstruct urinary flow. |
| BPH Cont'd | Post-op Meds: B & O(belladonna & Opium)Suppositories to decrease bladder spasms. |
| Prostate Cancer | 2nd leading cause of death in men(Lung CA#1). Tumors are slow growing but spread int the lymph system. S/S-similar to BPH,dysuria & hematuria.DX:Prostate Serum Antigen(PSA) blood test.Screening Tool: rectal exam,all men over 40,every year& PSA blood test! |
| Testicular Cancer | Common between the ages of 15-35! S/S:hard,painless lump,usually the 1st symptom to appear.TX:surgery,removal of one or both testis.Penile Cancer:rare. |
| Structural Disorders-Female | Cystocele:cyst=bladder:bladder falling into the vaginal wall.Urethrocele:urethra falling into the vagina.Rectocele:rectum falling into the vaginal wall.Prolaosed Uterus:uterus falling into the vaginal wall. TX:surgery. |
| Structural Disorders-Male | Cryptochidism:the testicles fail to descend into the scrotum.TX:hormonal therapy,surgery.Hydrocele:fluid in the testis,may resolve w/o intervention.Hypospadias:the urethral opening on front(ventral)surface of the penis. |
| Structural Disorders-Male Cont'd | Epispadias:the urethral opening on back (dorsal) of the penis. TX:surgery before the child is one year. |
| Structural Disorders-Male Cont'd | Spermatocele:cyst w/fluid & sperm,usually dose not require TX. Varicocele:dilation of the veins in the scrotum,seldom requires TX. Torsion of the Spermatic Cord:the testis twist,resulting in venous occlusion. |
| Structural Disorders-Male Cont'd | -Whenever you have an occlusion it is usually serious! S/S:abdominal & scrotum pain. TX:immediate surgery to un-twist! |
| Functional Disorders-Male | Impotence:inability to have an erection or maintain erection long enough to complete intercourse. TX:Viagra! |
| Infertility-Male & Female | Inability to produce children.Effects 1 in 4 couples in the U.S. Tx:Medications: Clomid-used to induce ovulation in women! N.Dx:Health Seeking Behaviors R/T reproductive functioning. |
| Contraception | Used to prevent pregnancy. Norplant: is 6 small progestin filled pellets inserted under the skin of the upper arm under local anesthetic.Effective up to 5years. Depo-Provera:IM injection given q12 weeks.Vasectomy:surgical sterilization male. |
| Contraception Cont'd. | Tubal Ligation:surgical sterilization female. |
| Sexually Transmitted Diseases(STD's) | Nurses Role:ask "embarrassing"questions. Assess physical & emotional potential and actual problems. Teach,educate pts.-The incidence(frequency)of STD's has been increasing worldwide. |
| Causes of the Increase of STD's | Causal sex among teens.Asymptomatic carriers.Non-barrier methods of birth control. Lack of Knowledge of preventative methods!Increased consumption of alcohol & drugs r/t less inhibitons.Trading sex for drugs.Sharing needles. |
| Genital Herpes | Nurses need to teach that the virus can be spread even if the pt is experiencing no s/s! Pts will require frequent Pap smears! |
| Chlamydia | Caused by a bacteria not a virus & can be treated with antibiotics(Doxycycline or Zithromax). |
| Gonorrhea | A more serious bacteria infection.Caused by gram-negative bacteria.Can be passed to the newborn's eyes if the baby passes through the birth canal! |
| Gonorrhea Cont'd | In the U.S. ALL babies are treated w/antibiotic ointment w/in 1-2hrs after birth to prevent a serious Gonorrhea eye infection. |
| Syphilis | Also caused by a bacteria.S/S take 10-90 days to appear.A chancre(painless ulcer),usually at the site of contact & usually just one chancre.Can usually be easily seen on the male,but may be hidden on the female.If left untreated called secondary syphilis. |
| Secondary Syphilis | S/S:headache,fever,seizures& stroke symptoms,penny sized brown sores(rash)on the palms of the hands& soles of the feet! S/S appear in 3-4wks after the chancre. 3-7% of pts will develop Neurosyphilis. |
| Herpes Simplex | Caused by a virus.TypeI:causes sores on the lips(fever blisters,cold sores).TypeII:causes genital sores.80% of pts w/genital herpes are unaware of their disease.NO CURE!Tx:antivirals(Zovirix,Famivir). |
| Herpes Simplex Cont'd | Tx for Discomfort: mild soap&water,hydrogen peroxide or barrows solution,keep area dry with blow dryer & cornstarch powder. |
| Cytomegalovirus(CMV) | Virus in the herpes family.Found in saliva,urine,semen & vaginal secretions.S/S-Rare.NO CURE.Acquired during childhood of adolescence.80-100% of adults develop antibodies to the virus! |
| Human Papillomavirus (HPV) | Causes Genital Warts. Predisposes women to Cervical Cancer.Abnormal pap smear may be the 1st indication of HPV! |
| Trichomoniasis | Caused by a Parasitic Protozoan.Common STD.3 million new cases a year.TX:Flagyl,this antibiotic is affective against bacteria & protozoan infections. |
| Hepatitis B | Recognized as an STD. The ONLY STD that we have a vaccine for! |
| Nursing Diagnosis | Anxiety R/T unknwon procedures & embarrassment. Knowldge Deficit(STD's) R/T modes of transmission,prevention & risk for STD's! |
| Signs and Symptoms of Gonorrhea in Men | The initial site of infection is usually the urethra.Symptoms of urethritis consist of dysuria,and profuse,prulent urethral discharge developing 2 to 5 days after infection.Painful or swollen testicles may also occur.Symptoms are usually obvious. |
| Signs and Symptoms of Gonorrhea in Women | Symptoms are asymptomatic or have minor symptoms.May complain of vaginal discharge,dysuria,or frequency of urination.Changes in menstruation may be a symptom.After incubation period,redness and swelling at the site of contact,the cervix or the urethra. |
| Signs and Symptoms of Gonorrhea in Women Cont'd. | A greenish yellow purulent exudate often develops w/potential for abscess formation.The disease may remain local or can spread by direct tissue extension to the uterus,fallopian tubes,and ovaries. |
| Gonorrhea Diagnostic | History and physical examination,Gram stained smears of urethral or endocervical exudate,Culture for Neissera gonorrhoeae,Nucleic acid amplification test(NAAT)to detect N.gohorrhoeae,testing for other STDs(syphilis,HIV,chlamydia). |
| Collaborative Therapy | Uncomplicated gonorrhea:cefixime(Suprax) or ceftriaxone(Rocephin),ciprofloxacin(Cipro),ofloxacin(Floxin),levofloxacin(Levaquin).If coexisting w/chlamydial(Zithromax)or doxycycline(Vibramycin) |
| Signs and Symptoms of Syphilis | Can mimic other diseases.In primary stage,chancres appear(painless indurated lesions on the penis,vulva,lips,mouth,vagina,and rectum.Occur 10-90days after inoculation,last 3-6wks.Genital ulcers may also be present. |
| Signs and Symptoms of Syphilis Cont'd | Secondary stage:is systemic,begins a few wks after the chancers are first seen.Flu-like symptoms,fever,soar throat,headaches,fatigue,and generalized adenopathy.Cutaneous eruptions,symmetrical mucocutaneous lesions,alopecia,brittle and pitted nails. |
| Signs and Symptoms of Syphilis Cont'd | Late stage:Benign-gumma lesion found on any bone or organ,Aortic insufficiency,meningitis,Arm and leg weakness. |
| Signs and Symptoms of Chlamydia in Men | Urethritis(dysuria,urethral discharge),procitis(rectal discharge and pain during defecation)and epididymitis(unilateral scrotal pain,swelling,tenderness,fever). |
| Signs and Symptoms of Chlamydia in Women | Cervicitis(mucopurulent discharge,hypertrophic ectopy{area that is edematous and bleeds easily}),urethritis(dysuria,frequent urination,pyuria),bartholinitis(purulent exudate),dyspareunia(pain w/intercourse),PID(abdominal pain,nausea,vomiting,fever) |
| Signs and Symptoms of Chlamydia in Women | malaise,abnormal vaginal bleeding,menstrual abnormalities),and perihepatits(fever,nausea,vomiting,R.U.Q pain). |
| Signs and Symptoms of Genital Herpes | In primary episode fo genital herpes the patient may complain of burning or tingling at the site of inoculation.Multiple sm all,vesicular lesions may appear on the penis,scrotum,vulva,perineum,perianal region,vagina,or cervix. |
| Signs and Symptoms of Genital Herpes | Urination may be painful from the urine touching active lesions.Urinary retention may occur as a result of HSV urethritis or cystitis.A purulent vaginal discharge may develop w/HSV cervicitis. |
| Signs and Symptoms of Endometriosis | Most common manifestations are secondary dysmenorrhea,infertility,pelvic pain,dyspareunia,and irregular bleeding.Less common manifestations include backache,painful bowel movements,and dysuria. |
| Signs and Symptoms of Ovarian Cancer | In early stages,clinical manifestations are vague and may include a pattern of general abdominal discomfort(gas,indigestion,pressure,bloating,cramps),sense of pelvic heaviness,loss of appetite,feeling of fullness,and change in bowel habits. |
| Signs and Symptoms of Ovarian Cancer Cont'd. | Pain is not an early symptom.As the malignancy grows,a variety of manifestations can occur,including and increase in abdominal girth,bowel and bladder dysfunction,persistent pelvic or abdominal pain,menstural irregularities,and ascites. |
Created by:
LauraHall
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