Unit I

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Author:
tiffanydawnn
ID:
24516
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Unit I
Updated:
2010-06-22 14:25:20
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Reproductive
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Description:
nursing reproductive disorder
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  1. hysterectomy nursing care
    • routine postop care
    • bowel sounds
    • bleeding - check pad/inscision q 4 hrs
    • foley/encourage voiding when removed
    • leg exercises/TEDs
    • coughing/deep breathing
    • avoid tub baths until bleeding sos
    • avoid heavy lifting, douching, tampons, intercourse 4-6 weeks
  2. amenorrhea
    • absense of a period
    • pregnancy, menopause, lactation, hormonal imbalance, anorexia
  3. dysmenorrhea
    painful menstruation (cramps)
  4. menorrhagia
    • excessive menstruation
    • endocrine/reproductive disorders, anticoagulants
    • excessive blood loss, fatigue, anemia, hemorrhage, sexual dysfunction
  5. metrorrhagia
    • bleeding between periods
    • s/s of cervical/uterine cancer
  6. PMS
    • S/S of hormomal imbalance (estrogen/progesterone)
    • pituitary gland effects fluid levels causing bloating & weight gain
    • 10 days before/3 days after menses
  7. PMS S/S
    • irritibility/mood swings
    • depression
    • breast tenderness
    • abd distention
    • acne
  8. PMS Dx
    • made by exclusion
    • blood work for hormonal imbalances
  9. PMS Rx
    • duiretics
    • anti-depressants
    • analgesics
    • anti-anxieties
    • diet: low sodium/caffeine, B vitamins, calcium/mag
  10. menopause
    • no menses for one year
    • age 45-55
    • ovaries cease to function, atrophy
    • uterus returns to prepubescent size
    • vagina dries/thins
    • breast tissue & body hair decreases
  11. menopause S/S
    • hot flashes
    • night sweats
    • vaginal dryness
    • emotional changes
  12. menopause Dx
    symptoms, age, blood work
  13. menopause Rx
    • hormone replacement therapy - s/e edema, weight gain, phlebitis
    • selective estrogen receptor modulators (SERMs)
    • aromatherapy
    • herbs
    • meditation
    • vitamins D, E
    • soy protein
  14. impotence
    • inability to achieve an erection
    • spinal cord injury, radial prostatectomy, diabetes, COPD, anti-hypertensives, MS
  15. impotence Tx
    • treat underlying cause
    • erectile dysfunction meds: facilitate blood flow in the corpus caverosum
    • Viagra, Cialis, Levitra
    • can drop B/P w/nitrates
  16. infertility
    • inability to conceive a child
    • inadequate egg production, blockage of fallopian tube, hormonal imbalance, low sperm count/motility, STDs
  17. female infections
    • disturbance of normal flora of vagina
    • vaginitis is most common (caused by e-coli or yeast)
    • r/t antibiotics, birth control, improper hygiene, sexual intercourse, poor handwashing, douching
    • tx - vaginal suppositories
  18. PID
    • chronic infection of the cervix, uterus, fallopian tubes, ovaries
    • r/t gonorrhea/chlamydia, sex w/infected partners, abortion, irrigation, infection during pregnancy
    • scar tissue causes infertility
    • can spread to other organs
  19. PID S/S
    • pelvic pain
    • fever
    • malaise
    • vomiting
    • discharge
    • dysuria
  20. PID Dx
    • C&S
    • increased WBC
    • ultrasound
    • laparoscopy
  21. PID Tx
    • antibiotics
    • analgesics
    • IV fluids
    • surgery - adhesions, TAH-BSO
    • treat partner at same time
  22. PID nursing
    • pt teaching - inform sexual partners, hygiene, abstain during treatment
    • monitor VS (temp)
    • monitor vaginal drainage
  23. TSS
    • staph or strep infection
    • r/t tampon use, diaphragm, cervical sponge
    • change tampon at least every 8 hours
  24. TSS S/S
    • high fever
    • N&V, abd pain, diarrhea
    • muscle pain
    • sore throat
    • HA
    • dizziness, low BP
    • red rash
    • conjunctivitis
    • peeling skin on palms/soles
    • altered mental status
  25. TSS Tx
    • antibiotics
    • IV fluids to correct eletrolyte imbalance/hypotension
    • corticosteroids
  26. endometriosis
    • benign uterine tissue grows outside uterus
    • cause unknown
    • women in 20s, 30s, no pregnancies
  27. endometriosis S/S
    • pain
    • menorrhagia/metrorrhagia
    • painful intercourse
    • HA
    • backache
    • painful defecation
    • infertility
  28. endometriosis Dx
    • ultrasound
    • laparoscopy
  29. endometriosis Tx
    • hormones to stop ovarian function (BCP)
    • Danzol: causes pseudomenopause
    • surgery - removal of endometrial tissue, TAH-BSO
  30. endometriosis nursing
    • post-op surgical care
    • pain management
    • patient teaching - med side effects
    • anemia
  31. relaxed pelvic muscle disorders
    • uterine prolapse: uterus moves down through vagina
    • rectocele: front wall of rectum moves into vagina
    • cystocele: bladder falls into vagina

    treated surgically - preop kegels
  32. fibroids (uterine leiomyomas)
    • benign tumors of the uterus
    • 20-30% of women over 30, AA, premenopausal
  33. fibroids S/S
    • menorrhagia/metrorrhagia
    • increased pelvic pressure
    • constipation
    • urinary retention
    • weight gain
    • enlarged abd
    • infertility
    • painful intercourse
  34. fibroid Dx
    adb/transvaginal ultrasound
  35. fibroids Tx
    • HRT
    • uterine artery embolectomy - occludes blood supply to fibroid
    • myomectomy - removal of fibroids
    • hysterectomy (abd or vaginal)
    • endometrial ablation - cauterization of lining of uterus
  36. ovarian cysts
    • benign tumors of the ovaries
    • Dx: palpation, ultrasound
    • Tx: laparoscopic removal
  37. cervical cancer risk factors
    • HPV
    • early sexual experience
    • multiple partners
    • HIV
    • unprotected sex
    • smoking
    • poor diet
  38. cervical cancer S/S
    • asymptomatic in beginning
    • spotting between periods/after sex
    • dark foul discharge
    • leukorrhea - white discharge
    • leg pain/swelling
    • flank pain/pelvic pain
    • weight loss
    • hematuria
    • rectal bleeding
  39. cervical cancer Dx
    • abnormal pap x2 --> colpopscopy/biopsy
    • MRI
    • HPV test
  40. cervical cancer Tx
    • preinvasive - conization (removal of cone shaped section of cervix)
    • no metastasis - hysterectomy/intracavity radiation
    • metastasis - radical hysterectomy (removal of ovaries, tubes, lymph nodes)
  41. intracavity radiation
    • supine position/legs extended
    • Lovenox/antibiotics prophylactically
    • pain management
    • nurse must wear doximeter badge/lead apron
    • no pregnant women/children under 16
    • visitors remain 6 feet away
    • if discharged, handle with forceps and place in lead container
  42. uterine (endometrial) cancer risk factors
    • age (50-70 yrs)
    • family history
    • diabetes
    • obesity
    • uterine polyps
    • late menopause
    • smoking
  43. uterine cancer S/S
    moderate to large amounts of abnormal bleeding after menopause (usually painless)
  44. uterine cancer Dx
    • endometrial biospy
    • liver & bone scans
    • IVP (renal involvement)
    • barium enema (rectal involvement)
  45. uterine cancer Tx
    • surgery - TAH-BSO, lymph nodes
    • chemo
    • radiation
  46. ovarian cancer
    • leading cause of death among female cancers
    • usually Dx after symptomatic/metastasized (stage 3 or 4)
    • less than 20% survival
  47. ovarian cancer risk factors
    • older age
    • early menarche
    • late menopause
    • infertility
    • Clomid tratment
    • family Hx of breast/ovarian cancer
  48. ovarian cancer S/S
    • asymptomatic in beginning
    • abd pain/swelling
    • indigestion/GI symptoms
    • abd mass
    • 30% have abnormal pap
  49. ovarian cancer S/S
    • biospy
    • elevated CA-125
    • CAT scan
  50. ovarian cancer Tx
    surgery - TAH-BSO
  51. ovarian cancer nursing
    • emotional support
    • post op care
    • pt teaching
    • hospice
  52. fibrocystic breast disease
    • benign tumors of the breast due to increased estrogen
    • ages 30-50
    • increased risk for breast cancer
  53. fibrosystic breast disease Dx
    • palpation
    • mammogram
    • ultrasound
    • biopsy
  54. fibrosystic breast disease Tx
    • reduce caffeine intake
    • vitamins C, E, B-complex
    • oral contraceptives to suppress estrogen
  55. breast cancer
    • most common dx malignancy in women (1 in 8)
    • 2nd leading cause of cancer deaths
    • survival - 97% if localized, 79% if lymph, 23% if other organs
  56. breast cancer risk factors
    • white females over 50
    • family Hx (mom, sister)
    • endometrial cancer, fibrocystic breast changes
    • early menarche/late menopause
    • late births (after 30)
    • multiple CXRs
    • 2+ alcoholic drinks daily
    • obesity
    • smoking
    • breast trauma
  57. infiltrating ductal carcinoma/adenocarcinoma
    • 80% of all breast cancers
    • originates in mammary ducts
    • upper outer quadrant of breast
    • 5-9 years of growth before can be palpated
    • high cure rate if non-invasive (still in duct)
    • most found after invasive (infiltrated other tissues/palpable)
    • causes dimpling of breast
  58. breast cancer Dx
    • phyical exam (mass > 1cm can be palpated)
    • mammogram (mass > 0.5cm)
    • ultrasound to distinguish between benign (fluid) vs cancerous (solid)
    • biopsy to confirm
    • MRI/PET scan
  59. breast cancer S/S
    • palpable mass that is small, irregularly shaped, firm, non-tender, non-mobile
    • discoloration of the nipple
    • breast/axilla tenderness
  60. TNM staging
    • T: tumor size
    • N: lymph involvement
    • M: metastasis
    • G1-4: grade of tumor cells
  61. simple mastectomy
    removal of the breast
  62. radical mastectomy
    removal of the breast, chest muscles, lymph nodes
  63. modified radical mastectomy
    removal of the breast, lymph nodes (chest muscles intact)
  64. lumpectomy
    removal of the tumor/small margin of surrounding tissue
  65. mastectomy nursing
    • wound care
    • emotional support
    • CSM of affected arm
    • no BP/blood work affected arm
    • arm exercises - wall climbs, over head pulley, rope turns, arm swings
    • patient teaching
    • risk for infection
    • pain management
  66. epididymitis
    • infection of the epididymis (contracts during orgasm/moves sperm)
    • Hx of STDs, UTIs
  67. epididymitis S/S
    • pain
    • scrotal swelling
    • fever
    • malaise
  68. epididymitis Dx
    • urinalysis
    • CBC
    • exam
    • symptoms
    • semen specimen
  69. epididymitis Tx
    • antibiotics
    • ice packs
    • scrotal support
  70. epididymitis nursing
    • bed rest
    • patient teaching - antibiotics
    • complication - abscess
  71. testicular cancer
    • age 15-35
    • non-aggressive cancer
  72. testicular cancer S/S
    • scrotal pain
    • edema
    • palpable lump in scrotum
  73. testicular cancer Dx
    • ultrasound
    • elevated serum alpha fetoprotein (AFP) and HCG
    • CXR/CAT scan (metastasis)
  74. testicular cancer Tx
    • orchiectomy
    • chemo
    • radiation
  75. self testicular exam
    • roll testes between thumb and fingers
    • after bath/shower, use soap
    • monthly exam
  76. STDs
    • infections transmitted though vaginal or oral intercourse, mother to fetus
    • causes infertility, cancer, chronic infection, death
  77. STDs nursing
    • patient education
    • support groups

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