Repro med Surge

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mandi
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205072
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Repro med Surge
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2013-03-05 01:28:48
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repro med surge
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  1. COLPOSCOPY
    • -Provides direct visualization to the cervix and vagina.
    • -Pelvic exam
    • -Can ovserve the color of the tissue, presences of growth and lesions, condition of the vasularity
  2. CULDOSCOPY
    • -Visualization of the uterus and the adnexa (overies and fallopian tubes)
    • -local,spinal, or general
    • -scope passes through vag. wall
    • -examine for tumors, cyst, and endometriosis
  3. LAPAROSCOPY
    • Visualization through a small incision in the abdomen just below the umbilicus.
    • Direct visualization of the uterus and adnexa.
    • Foley to keep bladder empty to avoid trauma and keep open veiw.
    • Examine fallopian tubes and ovaries for masses, ectopic pregnancy, adhesionsa nd PID as well as removal of ovarian cyst and tubal ligation
  4. Papanicolaou test (pap smear)
    • Examines stained exfoliative peeling and sloughed off tissue or cells.
    • Widely known for early detection of cervical cancer.
  5. PAP
    CLASS I
    • NEGATIVE
    • REPEAT ANNUALLY
  6. PAP
    CLASS II
    • INFECTIOUS ATYPICAL SQUAMOUS CELLS
    • TREAT INFECTION REPEAT PAP
  7. PAP
    CLASS III
    • LOW-GRADE SQUAMOUS INTAEPITHLIAL LEASIONS
    • TREAT INFECTION
    • REPEAT PAP IN 8-12 WEEKS
    • COLPOSCOPY
  8. PAP
    CLASS IV
    • HIGH-GRADE SZUAMOUS INTREPITHELIAL LESIONS
    • COLPOSCOPY
    • BIOPSY
    • TREATMENT
  9. PAP
    CLASS V
    • INVASIVE SQUAMOUS CELL CARCINOMA
    • COLPOSCOPY
    • BIOPSY
    • TREATMENT WITH CONIZATION
    • HYSTERECTOMY
  10. BREAST BIOPSY
    • USED TO DIFFERENTIATE BENIGN OR MALIGNANT TUMORS
    • NEEDLE BIOPSY - LOCAL
    • OPEN BIOPSY - GENERAL OR LOCAL
  11. INDICATIONS FOR A BREAST BIOPSY
    • PALPABLE MASS
    • SUSPICIOUS AREAS APPEAR ON MAMMOGRAM
    • PERSISTENT, ENCRUSTED, PURULENT, INFLAMED, OR SANGUINEOUS DISCHARGE FROM NIPPLES
  12. CERVICAL BIOPSY
    • EVALUATE CERVIASL LESIONS AND TO DIAGNOSE CERVICAL CANCER
    • USUALLY NO ANASTHESIA
    • COLPOSCOPE IS INSTRED THROUGH VAGINAL SPECULUM FOR DIRECT VISUALIZATION
    • CERVICAL SITE IS SELECTED, CLEANSED AND TISSUE IS REMOVED 
  13. ENDOMETIAL BIOPSY
    • collect tissue for diagnosis for endometrial cancer and analysis for infertility studies
    • generally performed at time of menstration, when the cervix is dialated the cells are more easily obtained
    • local
    • a curette is inserted and tissues is obtained from selected sites of the endometrium
  14. CONIZATION
    • freeze cells
    • indicated when eroded or infected tissue is to be removed or when there is a need for confimation of cervical cancer
  15. PROCEDURE FOR CONIZATION
    cone shaped section is removed when the mass is confoined to the epithelial tissue
  16. DILATION AND CURETTAGE
    • used to obtain tissue for biopsy, to correct ciervials sticture, and to treat dysmenorrhea
    • general
    • the cervix is dialated and the inside of the uterus scraped with a curette.
  17. Cultures and smears
    • enamin and identify infectious proscess, presence of abnormal cells, and hormonal cnanges of the repro system.
    • cultures are taken from exudates of the breast, vagina, rectum,and urethera
    • STD's and mastitis are diagonesd by isolation of the causative organisms 
  18. SCHILLER'S IODINE TEST
    • used for early detection of cancer cells and to guide the dr. in doing a biopsy
    • iodine is apllied tht ohte cerbic and produces a brown stain for nomal vaginal cells
    • a normal cell will stain brown 
    • immature cell will not absorbe the stain
  19. Hysterograms and systerosalpingograms
    • studies for visualizing the uterine cavity to confirm:
    • 1) tubal abnormalalities
    • 2) the presence of forign bodies
    • 3) congnital malfomation and leiomyomas   (fibroids)
    • 4) traumatic injuries
  20. PROCEDURE FOR HYSTEROGRAMS AND HYSTEROSALPINGOGRAMS
    • lithotomy position
    • a speculum is inserted into the vagina, a cannula is inserted trough the speculum into the cervical cavity, and a contrast medium is progressed therough the cavity, the uterus and fallopian tubes are veiwed by a flouroscope  and films are taken
  21. MAMMOGRAPHY
    X-ray of the soft tissue of the breast to allow identification of various benign and neoplastic processes, especially those not palpable on the physical exam.
  22. (RUBIN'S TEST)
    TUBAL INSUFFLATION
    • transuterian insufflation of hte fallopian tubes with cabon dioxide
    • enables evaluation of the patency of the fallopian tubes and may be part of a fertility study
  23. HCG
    pregnancy test
  24. SERUM CA-125
    • a tumor antigen associated with ovarian cancer
    • levels will decrease in the blood as cancer cells decrease
    • eondometiosis, PID, pregnancy, gynecological cancers, and cancer of the pancreas may also increase CA-125 levels
    • it is maily useful to signal recurrence of ovarian cancer and in following the response to treatment 
  25. AMENORRHEA
    absences of mesturaul flow for 3 mo after having a regulated period.
  26. ASSESSMENT FOR AMENORRHEA
    • 1) number of periods missed
    • 2) whether amenorrhea was previously present 
    • recent use of medicatios and drugs needs to be determined
  27. Diagnostic tests for amenorrhea
    • if pregnancy not  a possibility:
    • pelvic ecamination
    • blood, urine, and hormonal analysis
    • determination of existing tumors
    • pap test
  28. DYSMENORRHEA
    • uterine pain with menstruation
    • can be r/t eindocrince imbalance; and increase in prostaglandin secreations; or chronic illnesses, fatigue, and anemia 
  29. DIAGNOSTIC TEST OF DYEMENORRHEA
    • pelvic exam
    • laproscopy
    • D&C
    • hysterosalpingography
  30. MENORRHAGIA
    EXCESSIVE BLEEDING IN AMOUNT AND DURATION AND DURING THE REGULAR MENSTRUAL FLOW
  31. CAUSES OF MENORRHAGIA
    endocrine disorders, inflammatory disturbances, uterine tumors
  32. METRORRHAGIA
    • bleeding between regualar menstrual period and after menopause
    • may indicate cancer or benign tumors of the uterus
  33. PMS s/s
    • irritability, lethargy, and fatigue
    • sleep disturbances and depression
    • headache, backache, depression
    • vertigo
    • abdominal distention
    • acne
  34. PMS medical management
    • analgesics, duretics, progetsterone
    • diet:
    •  -high in complex CHO
    •  -moderate protien
    •  -low in refined sugar and Na
    •  -limit caffine
    • reduce or elimanate smoking
    • ecercise, adequate rest, sleep and relalxation
  35. MENOPAUSE
    • normal declin og ovarian function resulting from the aging process
    • may be induced bye irradilation of he ovaries or surgical rmival of both ovaris
    • not considered complete until 1 year after last mestural period
  36. S/S OF MENOPAUSE
    • decrease in frequency, amount, and duration of normal mestural flow
    • shrinkage of vulval structures. shortening of the vagina
    • dryness of the vaginal wall, pelvic relaxation (bladder falls)
    • loss of skin turgor and elasticity
    • increased subq fat; decreased breast tissue; thining of hair (r/t estrogen)
    • osteoporosis
    • hot flashes
  37. MEDICAL MANAGEMENT/NURSING INTVENTIONS OF MENOPAUSE
    • estrogen therapy
    •  - premarin & provera (short term for hot flashes, increase risk of breast cancer)
    • calcium supplements and vitamin d
    • depression meds help with pain management
  38. Male climacteric
    gradual decrese if testoterone levels and seminal fluid production; age 55 - 70
  39. Male climacteric S/S
    • decreased erections; decreased seminal fluid
    • endlarged prostat glad; decreased muscle tone
    • loss or thinning of hair R/T decreased testoterone
  40. causes of Male climacteric
    S/E fo meds, DM, COPD, heart failure, renal failure
  41. treatment for male climateric
    • emotional support; treatment of impotence
    • trestoterone cream daily
  42. IMPOTENCE
    • inability of an adult man to achieve penile erection
    • functional; anatamical; atonic
  43. treatment for impotence
    • remove cause if possible
    • treat disease
    • viagra
    • mechanical devices; penile prosthesis
  44. INFERTILITY
    inability to conceive after 1 year of sexual intercourse withouth birth control
  45. DIAGNOSTIC TEST OF IMPOTENCE
    • routine pelvic exam
    • sonogram
    • smear men and women
    • hystogram to look at tubes
  46. TREATMENT OF IMPOTENCE
    • depends on the cause
    • hormone therapy
    • repair occulsion
    • intrauterine insemination
    • in vitro feritilization
  47. SIMPLE VAGINITIS CAUSES
    • common vaginal infection
    • causitive organisms: E. coli, C albicans, Gardneella
  48. S/S OF SIMPLE VAGINITIS
    • inflammation of the vagina
    • yellow, white, grayish white, curd-like discharge
    • pruritis and vaginal burning
  49. S/S OF SIMPLE VAGINITIS
    • inflammation of the vagina
    • yellow, white, grayish white, curd-like discharge
    • pruritis and vaginal burning
  50. TREATMENT OF SIMPLE VAGINITIS
    • souching
    • vaginal suppositories, ointments, and creams
    •  - organism specific
    • sitz baths
    • abstain from sexual intercourse during treatment
    • treat partner if necessary
  51. TREATMENT OF STD'S
    • gonorrhea - cipro
    • clamydia - zithromax
    • trich. - flagylle
    • yeast - diflucan, monostat
  52. CERVICITIS
    infection of the cervix
  53. S/S of CERVISITIS
    • backache
    • whitish exudate
    • menstrual irregularities
  54. TREATMENT of CERVICITIS
    vaginal suppositories, ointments and creams; organism-specific
  55. PID
    • any acute, subacute, recurrent, or chronic infection of the cervix, uterus, fallopian tubes, and ovaries that has extended to the connective tissue
    • most common causitive organisms:
    •  - gonorrhea, streptococcous, staphylococcus, chlamydia, tubercule bacilli
    • High risk: surgical and examination procedures, sexual intercourse (especially with multiple partners), pregnancy

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