Female Reproductive Challanges Flashcards
(40 cards)
Infertility
-The inability to achieve pregnancy after at least 1 year of regular unprotected intercourse.
Infertility: etiology and patholophysiology
-Most frequent female cause is factors associated with ovulation, tubal obstruction, uterine or cervical factors.
Infertility: diagnostic studies
-Hormonal levels
-Ovulatory Studies
-Tubal latency studies
-Postcoital studies
Nursing and collaborative management: Infertility
-Depends on the cause
-Drug therapy
-Intrauterine inseminination (IUI) with partner or donor sperm
-Assistive reproductive technologies (ARTS)
-IVF; GIFT; ZIFT
-Ethical, legal, and social concerns
-Emotional suppourt
ABORTION
-Loss of terminal pregnancy before viability
-Spontaneous abortion (natural loss before 20 weeks gestation)
-Induced abortion (intentional or elective termination of pregnancy)
-Techniques depend on gestational age, woman’s condition and preference
-Menstrual evacuation, suction curttage, dialation and evacuation (D&E) drug therapy.
Problems related to menstriation
-Premenstrual Syndrome
-Dysmenorrhea
-Abnormal vaginal bleeding
-Ectopic Pregnancy
-Perimenopause and post menopause
-Conditions of the vulva, vagina, and cervix
Premenstrual syndrome
-Group of physical and psychological symptoms that occur a few days prior to menstruation
-Etiology and Pathophysiology
•Not well understood; serotonin is implicated
•Premenstrual dysphoric disorder
-Clinical Manifestations
•Breast discomfort, peripheral edema, abdominal bloating , weight gain, binge eating, migraine headache, mood swings
PMS; Collaborative Care
Diagnostic
-History and physical examination
-Symptom diary
-Diagnosis done via elimination of other causes
-Focused health history and physical exam
Collaborative Therapy
-Aerobic exercise
-Drug therapy
•Combined oral contraception
•Diuretics
•Prostaglandin inhibitors (ie Advil)
•Selective serotonin reuptake inhibitors (Zoloft)
-Nutritional Therapy
-Stress management and relaxation therapy
Dysmenorrhea
-Abdominal cramping associated with menstrual flow (Primary and Secondary)
Dysmenorrhea; etiology and pathophysiology
-Primary dysmenorrhea is not a disease; it is caused by excess prostaglandin
-Secondary dysmenorrhea is caused by endometriosis, pelvic inflammatory disease (PID), uterine fibroids
Dysmenorrhea; Clinical manifestations
-Starts 12-24 hours before period
-Lower abdominal pain (colicky), nausea, diarrhea, fatigue, loose stools, headache
-Special attention to menstrual and gynaecological history
-Treatment: heat, exercise, and drug therapy
-Teaching and supportive therapy
Dysmenorrhea; nursing management
-Primary role is client teaching
-Supportive therapy
•relief may be obtained by laying down for short periods
•drinking hot beverages such as herbal teas
•applying heat to abdomen or back
•Taking warm baths
•Taking NSAID’s for analgesia
Abnormal vaginal bleeding
Types of abnormal bleeding:
-Oligomenorrhea and amenorrhea
-Menorrhagia
-Metorrhagia
Diagnostic studies and collaborative care vary, depending on the cause
-Surgical therapy
Abnormal vaginal bleeding; nursing management
-Focus on Client teaching
-Toxic shock syndrome
-When there is excessive bleeding, the following should be assessed
•Amount
•Number of pads or tampons being saturated
•level of fatigue
•variations in pulse or blood preassure
Ectopic Pregnancy
-Implantation of fertilized ovum of the uterine cavity
-Majority occur in fallopian tube
-Life-Threatening
Ectopic Pregnancy; Etiology and Pathophysiology + CM
Clinical Mnaifestaitons
-Abdominal or pelvic pain
-Missed menses
-Irregular vaginal bleeding
-If rupture, pain is intense; referred shoulder pain
Diagnostic studies
-Pregnancy test
-Bhcg levels, Vaginal Ultrasound
Ectopic pregnancy; nursing and collaborative management
-Primary approach is surgery
-IM methotrexate
-Nurse alert to signs of rupture
-Vital signs monitored frequently
-Pre- and post operative care
-Emotional suppourt
Perimenopause and postmenopause
-Perimenopause begins with the first changes in menstruation
-Menopause is the physiological cessation of menses; it is complete after 1 year
-Postmenopuase is the time after menopause
-Age ranges from 44-55 years; average age is 51 years
-Ovarian changes begin events that result in menopause
Perimenopause and post-menopause; Clinical manifestations
Perimenopause: irregular menses, vasomotor instability, atrophy, stress/urge incontincence, breast tenderness, mood changes
Postmenopause: cessation of menses, occasional vasomotor symptoms, atrophy, stress and urge incontinence, osteoporosis
Perimenopause and post-menopause; collaborative care
-Diagnosis made on basis of exclusion
-Drug therapy
-Nonhormonal therapy
-Nutritional therapy
Culturally competent care
-Nurses in key role to help women understand changes and to present options
-Teaching and reassurance
Pelvic inflammatory disease
Etiology and pathophysiology
-Infectious condition of the pelvic cavity
-Often result of untreated cervicitis
-Chlamydia and gonococcal infection most common
Clinical manifestations
-Lower abdominal pain
-Fever, chills, vaginal discharge
Complications
-Septic shock
-Fitz-Hugh-Curtis syndrome
-Ectopic pregnancy
-Infertility
-Chronic pelvic pain
Endometriosis
-Presence of normal endometrial tissue on sites outside of the endometrial cavity
-Etiology not well understood; many theories
-Wide range of clinical manifestations and severity
-Chocolate cysts
Collaborative care
-“Watch and wait” drug and surgical therapy
Endometriosis; diagnostic
-History and physical examination
-Laprascopy
-MRI
-Pelvic examination
-Pelvic ultra sonography
Endometriosis; drug therapy
-Danazol (cyclomen)
-GnRH agonists
-NSAIDs
-Oral contraceptives
