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Nursing 531 (Womens Health) > Week 2: (Menstural Abnormalities) > Flashcards

Week 2: (Menstural Abnormalities) Flashcards

Part 1 (62 cards)

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1
Q

What is the normal menstrual cycle?

A
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2
Q

What are some abnormalities related to the menstrual cycle?

A
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3
Q

How does the NP correct these abnormalities related to the menstrual cycle?

A
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4
Q

How does having menstrual problems impact the chronically ill client?

A
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5
Q

How does having menstrual problems impact the disabled client?

A
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6
Q

Abnormal uterine bleeding

A
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7
Q

dysmenorrhea

A
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8
Q

PMS

A
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9
Q

Menstrual Cycle:

Normal cyclic event

A

starts at age 11-50 y/o

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10
Q

Thelarche

A

Breast development starts first in cycle

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11
Q

Adrenarche

A

Increase adrenal androgen release starts 2nd

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12
Q

How many cycles does a woman have in her lifetime?

A

300-400 cycles

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13
Q

True or False the menstrual cycle varies

A

True (can be different)
-stress
-hormone levels etc

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14
Q

How long does a cycle last?

A

21-40 (or 35 days even)

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15
Q

How much blood loss is there in a menstrual cycle?

A

30-80 ml’s

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16
Q

How many phases does the menstrual cycle have?

A

3 phases

  1. menstruation
  2. follicular (proliferative phase)
  3. luteal & secretory phase

M-F-L

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17
Q

What are the 3 phases in the menstrual cycle?

A
  1. Menstruation
  2. Foliicular or Proliferative phase
  3. Luteal or secretory phase
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18
Q

The start of the menstrual cycle is?

A

Menarche

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19
Q

The end of the menstrual cycle is?

A

Meno-pause (it pauses or ends)

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20
Q

What 2 organs go through changes in the menstrual cycle?

A
  1. The ovaries
  2. The uterus

O-U! WE change!!

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21
Q

What starts cycle day 1?

A

Menstruation/bleeding

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22
Q

How long does menstruation last?

A

3-7 days

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23
Q

Then the follicular or proliferative phase (2nd phase)

What part of the body does this happen in?

A

Ovary & Uterus

This happens at the same time!

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24
Q

The follicle releases ____ hormone which stimulates the anterior pituitary gland to release ____ & ____

A

Gonadotropin (this hormone helps regulate ovarian & testicular function)

FSH (follicle stimulating hormone) (this hormone helps stimulate the ovaries to produce eggs)

&
LH (luteinizing hormone)
This helps control the menstural cycle & triggers the release of an egg from the ovary

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25
FSH & LH (IN the Follicular or Proliferative Phase) 2nd phase!
Both stimulate the ovaries for the follicule to grow and mature (the egg)
26
How long does the follicular (growth of the egg) Last in the cycle?
1-14 days In a 28 day cycle
27
In the 3rd phase of the menstural cycle (LH) luteinizing hormone acts on the ovary to stimulate ___?
Ovulation (the release of the egg (ovum) from the ovaries
28
In the 3rd phase (Luteal or secretory) The corpus luteum produces progesterone
Progesterone is a hormone released by the corpus luteum in the ovary. Its role is to help the menstrual cycle & maintain the early stages of pregnancy
29
Where is progesterone mainly secreted?
This is secreted in the corpus luteum
30
What is the corpus luteum?
During the menstrual cycle an egg is released from the ovary at ovulation (day 14 approx) The left overs of the ovarian follicle that encase the developing egg is called the corpus luteum. So the corpus (encloses the egg) to help support it through releases a hormone called progesterone (oestradiol)
31
What is the role of progesterone?
This hormone prepares the body for pregnancy if/when the egg is released & fertilized.
32
If the egg is not fertilized?
The corpus luteum breaks down/dies really Since it breaks down progesterone also falls & a new menstrual cycle begins again
33
If an egg is fertilized?
Progesterone helps stimulate the growth of blood vessels that supply the lining of the womb (the endometrium) Progesterone also helps stimulate glands in the endometrium to release nutrients that feed the early embryo (baby)
34
___ hormone prepares the tissue lining of the uterus to allow the fertilized egg to implant & helps to maintain the endometrium (lining of the womb) throughout pregnancy
progesterone
35
During early stages of pregnancy progesterone is still produced by the corpus luteum & is essential for supporting ___ & ___
pregnancy & the placenta
36
good source yourhormones.info
Will be tested on the menstrual cycle!! ***
37
A-menorrhea
The absence of periods Causes: -menopause -pregnancy -use of birth control -side effects from meds -delayed puberty -stress
38
Oligo-menorrhea
Infrequent periods/little to scant amount (fewer than 6-8 periods in a year) May > 35 days between periods Causes: -hormone imbalances -PCOS- 75-85% experience oligo BECAUSE causes body to produce androgens (testosterone) that can interrupt ovulation, time of cycle & when ovaries release an egg -Hyperthyroidism- The thyroid gland triggers pituitary gland to make too much prolactin & too little estrogen -Untreated PID (STI) infection/inflammation disrupts menstrual cycle -DM (overweight vs underweight) -Eating disorders -Extreme physical activity
39
Poly-menorrhea
-frequent periods/menstruation -frequent bleeding -Menstrual cycles are shorter than 21 days
40
Causes of poly-menorrhea
-Perimenopause (almost entering menopause) -PCOS -BC pills -Excessive exercise -Eating disorders -Thyroid disorders -short follicular phase -Inadequate luteal phase
41
Hyper-menorrhea/menorrhagia
Heavy periods (prolonged vaginal bleeding)
42
Causes of hyper-menorrhea/menorrhagia
-endometriosis -hormonal imbalance (obesity, thyroid problems) -cancer- cervical cancer -fibroids -meds -genetic bleeding disorders -If no egg is released to make progesterone (this can cause heavy periods)
43
Metro-rragia/meno-mentro-rrhagia
Metrorrhagia light to heavy bleeding BETWEEN/METRO regular periods Meno-metrorrhagia Increased uterine bleeding irregular & more frequent
44
Hypo-menorrhea
scant amount of blood or less bleeding during period
45
Inter-menstrual bleeding
Bleeding in between periods
46
Patho of primary Ammenorrhea
-dysfunctional hormonal axis -defects in CNS -lesions of CNS -Genitalia defects -Gonadal defects
47
Examples of primary Amenorrhea
1. Prader- willa- a genetic condition with chromosome 15 abnormalities 2. turners syndrome 3. hydrocephalus 4. absence of vagina or uterus 5. trauma, tumors, infections
48
patho secondary to Amenorrhea
1.hysterectomy 2.uterine adhesions 3.decreased ovarian secretion 4.tumors 5. weight loss 6.intra-uterine pregnancy (IUP) 7. menopause 8. endocrine disorders
49
What should you know about Amenorrhea?
-If hormone levels are present & WNL (within normal limits) suspect structural abnormalities or hysterectomy -If increased ovarian steroid hormones - you can inhibit ovulation -If there are decreased ovarian steroid hormones-you can have inhibited ovulation
50
Anovulation can be caused by a decreased/irregular secretion of
gonadotropins
51
Hyperprolectinemia (look this up) effects the feedback loop
52
What should you see clinically/need to do a full workup for amenorrhea?
1.no breast development or pubic hair by 13 y/o 2.no menses by age 15 3.normal onset of breast development & pubic hair is (7-13) BUT no period within 5 years
53
Subjective data for Amenorrhea
-chart review & history -age -menstrual history or absence of periods -associated symptoms -reproductive health history -sexual history -pregnancy & breastfeeding history -medical & surgical history -meds & allergies -social history -ROS (review of systems)
54
Subjective data Amenorrhea associated symptoms:
-hyerprolactinemia or prolactinoma -PCOS -ovarian insufficiency -outflow tract obstruction or asherman syndrome -hypothalmic amenorrhea
55
Objective data for Amenorrhea:
-vital signs -height & weight (BMI) -thyroid -tanner staging -pelvic exam: for physical cause of amenorrhea -signs of endocrine/nervous system disorder **visual field exam defects can show pituitary adenoma -analysis: probable? amenorrhea differential dx includes: secondary amenorrhea from pregnancy, lactation, med use, BC pills, PCOS, hypothalmic dysfunction, thyroid disease,prolactinemia, primary ovarian insufficiency, cushing syndrome,asherman syndrome with intrauterine adhesions or cervical stenosis, exogenous androgens, neoplasms, med/substance abuse,genetic factors, adrenal hyperplasia plan: see figure 7-2 Tharpe p. 409 *** come back to (midwifery book) -lab tests? -meds? -referrals? -surgeries?
56
Dysfunctional uterine bleeding
Abnormal uterine bleeding from a disturbance in the menstrual cycle.
57
____ uterine bleeding is NOT associated with disease tumors or infections
dysfunctional 15-20% dysfunctional during a lifetime *accounts for 25% of surgery like D&C's or ablations
58
___ occurs with anovulatory cycles and occurs during perimenopause ** usually does not have dysmenorrhea associated with it
dysfunctional uterine bleeding
59
Dysfunctional uterine bleeding? Subjective data? Questions? What do you expect?
**the general subjective data in women's historys -chart review & history -age -menstrual history or absence of periods -associated symptoms -reproductive health history -sexual history -pregnancy & breastfeeding history -medical & surgical history -meds & allergies -social history -ROS (review of systems)
60
Differential dx for dysfunctional uterine bleeding?
-fibroids -coagulation defects -thyroid dysfunction
61
testing for dysfunctional uterine bleeding?
-cbc -pap smear -pregnancy test -if pregnancy test is negative (you can order an ultrasound) -you can check coagulation studies if there is a family history coagulation studies: platelet, PTT, bleeding time, TSH **all normal you can do an endometrial biopsy if endometrial biopsy comes back normal- have the MD follow up with a hystersoscopy
62
plan for dysfunctional uterine bleeding?
Psychosocial interventions? -discuss plan -meds Medications? -low dose BC pills BUT if a woman is trying to get pregnant you would not try low dose birth control pills Surgeries? -D&C -hysteroscopy Referrals? -follow up in 3 months Follow up?

Nursing 531 (Womens Health) (10 decks)

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