CH 20: Reproductive System Health

Question 1

effects of Aging on the Reproductive System in women

Answer 1

Hormonal changes _ vulva atrophy
Flattening of labia & loss of SQ fat and hair
Drier vaginal environment and thin vaginal epithelium _ uncomfortable intercourse
Atrophy of cervix, uterus, fallopian tubes, and ovaries atrophy
Uterus and ovaries decrease in size
Replacement of mammary glands by fat tissue _ Breasts sag and are less firm
Nipple retraction from shrinkage and fibrotic changes

Question 2

Effects of Aging on the Reproductive System on men

Answer 2

Seminal vesicles have thinner epithelium _ Reduction in sperm count
Atrophy of testes _ decrease mass of testes
Slightly decreased testosterone
More time to achieve an erection and lost easily
Enlargement of the prostate gland

Question 3

Reproductive System Health Promotion

Answer 3

Annual gynecologic exam for women
Women > 65 with 3 normal PAPs don’t need a PAP test unless
they have HIV, immunocompromised, exposed to
diethylstilbestrol (DES) before birth, or cervical cancer
Men with prostatic hypertrophy get exams Q6months
PSA testing routinely for history of prostate CA
Self-breast and self-testicular exams monthly
Complete physical exam

Question 4

Women: age related vulva disorders can lead to:

Answer 4

irritation and infection
indicates serious disease

Question 5

what is vulvitits

Answer 5

inflammation of the labia majora and labia minora — the outer folds of the vulva and the parts of a woman’s genitals that are outside her body, rather than inside

Question 6

causes of vulvitis

Answer 6

Poor hygiene and incontinence

Question 7

s/s of vulvitis

Answer 7

pruritis
blisters
redness
swelling

Question 8

tx of vulvitis

Answer 8

treat cause
good nutritional status
sitz baths
local application of saline compresses and
steroids
keep incontinent client clean and dry

Question 9

vulvular cancer commonly diagnosed when

Answer 9

in the 70s
biopsy any mass of lesion

Question 10

tx of vulvular cancer

Answer 10

radical vulvectomy
radiation (less
common)
counseling on sexual activity and body
image

Question 11

reasons behind vaginitis

Answer 11

Increased fragility of vagina causes it to be more
irritated  increased risk of vaginitis

Question 12

s/s of vaginitis

Answer 12

soreness
pruritis
burning
reddened vagina
foul-smelling discharge that is brown/clear/white

Question 13

tx of vaginitis

Answer 13

local estrogens (with teaching on med
admin)

Question 14

things the pt can do at home to avoid vaginitis

Answer 14

• Avoid douches, perfumed soaps and spray to area
• If using a douche, measure solution temp. first; altered
  sensory perception can cause injury
• Wear cotton underwear
• Keep genital area clean and dry
• Use lubricants during sex
• Good hygiene

Question 15

prevalence of cancer of the vagina

Answer 15

half of cases in women >60

Question 16

risk factors of cancer of the vagina

Answer 16

HPV
smoking
previous radiation therapy to vagina
hx of cervical cancer
DES

Question 17

treatment for cancer of the vagina

Answer 17

radiation
therapy
chemo

Question 18

signs of cervical cancer in aged women

Answer 18

Vaginal bleeding
leukorrhea
generally no pain

Question 19

ACS suggested screening >65

Answer 19

had regular screen in the last 10 years can stop cervical screening if nothing found in last 20 years

Question 20

tx of cervical cancer

Answer 20

radium or surgery

Question 21

risk factors of endometrial cancer

Answer 21

late onset of periods
infertile
PCOS
obesity
family history
estrogen without progesterone use

Question 22

tx of endometrial cancer

Answer 22

surgery
radiation
prompt identification

Question 23

prevalence of ovarian cancer

Answer 23

increase after 60
most deadly when it occurs

Question 24

early nonspecific symptoms of ovarian cancer

Answer 24

GI discomfort
difficulty eating
bloating
constipation
abd pain

Question 25

late symptoms of ovarian cancer

Answer 25

vaginal discharge bleeding ascites masses

Question 26

tx of ovarian cancer

Answer 26

surgery chemo hormone therapy radiation

Question 27

Common problem from stretching and tearing of muscles at childbirth and age-related changes

Answer 27

perineal herniation

Question 28

s/s of perineal herniation

Answer 28

lower back pain pelvic heaviness pulling sensation incontinence x2 retention constipation difficulty with intercourse

Question 29

tx for perineal herniation

Answer 29

surgery

Question 30

painful intercourse

Answer 30

Dyspareunia

Question 31

cause of dyspareunia

Answer 31

hormonal changes take measures to improve sexual satisfaction

Question 32

second leading cause of cancer death in women

Answer 32

brest cancer

Question 33

prevalence and screening for breast cancer

Answer 33

* Get regular breast exams * Incidence increases with age * Older women are less likely to receive mammograms and breast exams * Women with average risk should have annual breast exams at 50 * Mammograms annually for women 45-54 and every other year or annually for women >55

Question 34

erectile dysfunction in older adults

Answer 34

* Affects half of men >70 * NOT a normal outcome of aging * Several causes * Be aware of contraindications with drugs for treatment * Ask specific questions to clarify symptoms

Question 35

tx of erectile dysfunction

Answer 35

oral erectile agents drugs injected into the penis penile implants vacuum pumps penile artery reconstruction

Question 36

Benign Prostatic Hyperplasia s/s

Answer 36

hesitancy frequency decreased force of urinary stream nocturia dribbling overflow incontinence bleeding urinary retention  increased risk of UTI

Question 37

tx of benign prostatic hyperplasia

Answer 37

prostatic massage urinary antiseptics TURP ( Transurethral Resection Of The Prostate) * Most common prostatectomy approach is transurethral * Care for client after TURP

Question 38

S/S of prostate cancer

Answer 38

hesitancy, frequency, decreased force of urinary stream, nocturia, dribbling, overflow incontinence, bleeding, urinary retention  increased risk of UTI with mets  back pain, anemia, weakness, weight loss

Question 39

how to detect prostate cancer

Answer 39

DRE PSA biopsy

Question 40

tx for prostate cancer

Answer 40

active surveillance radical prostatectomy radiation

Question 41

signs of tumors of the penis

Answer 41

rare resembles a growth/wort leads to misdiagnosis biopsy

Question 42

tx of tumors of the penis

Answer 42

radiation local incision partial/total penile amputation

Question 43

signs of tumors of testes

Answer 43

testicular enlargement pain breast enlargement

Question 44

tx of tumors of testes

Answer 44

chemo radiation orchiectomy Testicular self-exams

Question 45

tumors of scrotom

Answer 45

usually benign come from hydrocele spermatocele hernia; treat the underlying cause