logging in or signing up Reproductive Health as001 Download Post to : URL : Related Presentations : Let's Connect Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Copy embed code: Embed: Flash iPad Dynamic Copy Does not support media & animations Automatically changes to Flash or non-Flash embed WordPress Embed Customize Embed URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 4828 Category: Science & Tech.. License: All Rights Reserved Like it (2) Dislike it (0) Added: May 23, 2009 This Presentation is Public Favorites: 5 Presentation Description No description available. Comments Posting comment... By: as002 (59 month(s) ago) its really nice stuff... Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript Reproductive Health : Reproductive Health Ricci Chapters 4-9 Amenorrhea : Amenorrhea Absence of menses Primary- menses not established by 14 no secondary sex, or 16 with secondary sex Primary causes- wgt, fat, stress, pregnancy Secondary causes- pregnancy, tumors, BF Nursing – unusual characteristics, causes, concerns, explain tests Treatment depends on cause Cause of Discomfort/Primary Dysmenorrhea : Cause of Discomfort/Primary Dysmenorrhea Pain during menses Role of prostaglandin Interventions Oral contraceptives Diet- Vitamins Rest exercise Heat Anti-prostaglandin Secondary Dysmenorrhea : Secondary Dysmenorrhea Define- pain with menses after menses well established. Etiology: reproductive tract pathology Assess- reproductive hx Interventions: DX and treat cause Abnormal Bleeding : Abnormal Bleeding Amenorrhea- lack of menses Menorrhagia- excessive bleeding- 5 days Metrorrhagia- bleeding between cycles Oligomenorrhea-infrequent periods Polymenorrhea-too frequent Menometrorrhagia-irregular with heavy flow Risk for anemia- causes-hormones, fibroids, weight Dysfunctional Uterine Bleeding : Dysfunctional Uterine Bleeding Extremes of reproductive years Progesterone- estrogen imbalance Tx- hormones, OC,NSAIDS IUD Nursing- Education, information, if untreated can lead to infertility PMS : PMS Exact etiology unknown Thought to be: Hormonal imbalance Nutritional deficiency Prostaglandin excess Serotonin Symptoms of Syndrome : Symptoms of Syndrome DX takes 3-5 months Physical symptoms include: fluid retention-weight gain-H/A- backache-N/V- diarrhea-constipation- craving- sleep disturbance Emotional- Mood changes-hostility- depression-labile-anxiety- lethargy Resolves with onset of menses Endometriosis : Endometriosis Endometrial tissue outside of endometrium Hormonal changes cause bleeding and inflammation, scarring S/S- pain, bleeding, painful intercourse. Tx- remove tissue, OC Nursing- explain tests, pain management Infertility : Infertility Definition unable to conceive after 1 yr Female - blocked tubes, endometriosis, 40% of cases attributed to women Dx-hystosalpingography Tx- surgery medications Male- sperm problems, 40% attributed to male DX- semen analysis Tx- artificial insemination- donor Health promotion Related to Infertility : Health promotion Related to Infertility Physiological Psychological- self esteem, scheduled intercourse, expense Sociocultural expectations Developmental expectations Spiritual- grieving Behavioral Contraception : Behavioral Contraception Abstinence- other activities beside intercourse Fertility awareness-know cycle and S/S of fertility BBT-post ovulation increase in temp,temp before rising Sympothermal- BBT,cervical mucosa+ positioning Behavioral Contraception : Behavioral Contraception Coitus Interuptus-withdraw before ejaculation. First few drops of sperm have high concentration of sperm Lactation Amenorrhea-prolactin inhibits gonadatropin Effectiveness depends on exclusivity of BF Barrier Methods : Barrier Methods Condoms-placed correctly, STI protection Diaphragm- covers cervix Must be refitted for weight loss or gain Cervical cap-smaller, insert 12 hours before intercourse Sponge- no protection against STI Hormonal Contraceptive : Hormonal Contraceptive Oral-combination of estrogen or progestin Suppresses FSH- LH makes mucosa hostile Take at same time each day Contraindicated- women over 35 & smokers Can take for up to 3 months Report to HCP if side effects occur Hormonal Contraceptives : Hormonal Contraceptives Lunelle injection- once a month Depo provera-progesterone every 12 weeks Vaginal Ring-place for 3 weeks Norplant-implantable- last 5 years, same S/E as the pill IUD- endometrium hostile to implantation Emergency Contraception- within 72 hrs Permanent Sterilization : Permanent Sterilization Tubal ligation- dissect piece of fallopian tube Trancervically- coil blocks fallopian tube Vasectomy-cut vas defrens Need 2 ejaculates with no sperm Use alternative form of birth control Termination of Pregnancy : Termination of Pregnancy Physiological Surgical vs. medical Mode of termination dependent upon gestation Psychological tasks of the trimester Informed consent Legal parameters Age Religious ethical Nursing Considerations : Nursing Considerations Cost Will both use Religion- Culture Medical History Reproductive History Consent Menopause : Menopause Ovaries decrease production of estrogen Cessation of menses before menopause Peri menopausal 3-5 years Average age is 51 Estrogen produced by fat replaced by estrone Characteristics of Menopause : Characteristics of Menopause Physiologic Hot flashes-CV-osteoporosis-skin-urogenital changes Psychological- empty nest-new beginning- not hot flashes------power surges Physiological Changes R/T Menopause : Physiological Changes R/T Menopause Osteoporosis- bone loss related to aging Risk factors- familial hx, steroids, smoking, lack of exercise Nursing-Increase calcium (1200mg), exercise, eval for height change Cardiovascular- loose protection of estrogen Nursing- Promote healthy lifestyle Interventions : Interventions Estrogen replacement at risk for Ca Hormonal replacement at risk for breast Ca Calcium- 1200mg-1500mg Natural sources of estrogen STI : STI Vulvovaginal candidiasis-change in flora Nsg-hygiene, cotton underwear, douching Trichamonis-bacterial Nsg-condoms, do not share towels BV-alteration in flora Nsg- treat partner for reoccurrence STI : STI Chlamydia-men/women asympomatic Nsg- treat both, no intercourse until TOC Genital Herpes-itching/burning lesion Nsg-need C/S for outbreak Syphilis-progressive -at risk for HIV Nsg- RPR, VDRL,Pen G Pelvic Inflammatory Disease : Pelvic Inflammatory Disease Bacterial infection of pelvic organs Leading cause of infertility S/S-cramping, painful intercourse, temp, bleeding, foul smelling discharge Nsg- assess for sexual activity, risk for infection, STI, full course ABX HIV : HIV World wide epidemic Women of color at risk Dx based upon CD4 count less than 200 Antiviral decrease of transmission to newborn Nsg- understand illness, stay on meds, help with side effects STI : STI HPV- genital warts, most common viral infection Some strains=95% relationship with cervical ca Nsg- can have removed, virus remains Hep A/B-viral infection Nsg- safe sex, immunizations Scabies/ lice- tx with OTC meds Breast Disorders : Breast Disorders Fibrocystic breast- common benign tumor S/S- lumpy, pain tenderness Nsg-Diet changes, analgesic Fibroadenoma-moveable cyst, benign Nsg- mammogram, biopsy Intraductal papilloma- may be cancerous S/S- discharge from nipple Nsg-excision to r/o ca. Breast Disorders : Breast Disorders Mammary duct ectasia-inflammation of duct Common in women with children, have not breast feed S/S- discharge, pain, puritis Nsg- take ABX, warm compress Breast Cancer : Breast Cancer Hereditary component Usually over 50- under 50 aggressive Ca Upper outer quadrant Family hx- prolonged exposure to estrogen-nullipara-early menarche- late menopause- HRT-ERT- breast d/o-obesity- alcohol Detection : Detection Breast self exam- one week past menses Ab. Finding- lump –dimpling-vein-nipple discharge or retraction Mammogram- biopsy Baseline at 40 1-2 years 40-50 Yearly past 50 Earlier if family hx Cancer Staging : Cancer Staging Stage 1- less than 2cm and in breast only Stage 2- less than 5cm, mobile lymph node- not attached Stage 3-greater than 5 cm/ fixed lymph/ local extension Stage 4- distant metastases Treatment Options : Treatment Options Surgical Radical vs. partial Lumpectomy Chemotherapy Radiation Hormonal suppression Immunotherapy Nursing- Mastectomy : Nursing- Mastectomy Preoperative- Discuss tx options Support decision Reduce fear- improve coping Postoperative Pain control Maintain skin integrity Self care Coping Sexual adjustment Prevent lymph edema Promote screening and prevention Types of Prolapse : Types of Prolapse Cystocele-posterior bladder protrudes towards ant wall of vagina Rectocele-rectum sags into post. Wall of vagina Enterocele- Sm. intestine bulges posterior wall of vagina Uterine prolapse- through pelvic floor and out vagina Risk Factors : Risk Factors Children Gravity Atrophy Weak muscles Lifting, coughing, straining can exacerbate Nursing : Nursing Assess degree of discomfort Degree of incontinence Diet and lifestyle-Kegels, straining,fiber, weight, girdle, no lifting Pessary- can support structures Surgical-colporrhaphy-hysterectomy Incontinence : Incontinence Embarrassing, reluctance to discuss, can cause emotional problems Cause- weakness in pelvic floor- aging Urge-urgency, frequency, nocturia Stress- coughing, laughing, exertion Tx- Kegels, anticholinergic,estrogen lifestyle changes Polyps/Fibroids : Polyps/Fibroids Appear on reproductive organs-benign Will remove with forceps or laser Fibroids- masses inside uterus Pain, pressure, bleeding, infertility Tx- hormones, myomectomy, hysterectomy Female Reproductive Surgeries : Female Reproductive Surgeries Hysterectomy- vaginal vs. abdominal Laproscopic- visualize abdominally remove through vagina Abdominal more trauma and longer recovery Nursing Care : Nursing Care Nursing Diagnosis Pre-op- pain, deep breath, and cough Give information, loss of childbearing Post operative interventions Pelvic rest, no lifting, S/S of infection, rest, good diet Cysts : Cysts Follicular cyst-failure of ovarian follicle to rupture Corpus luteum-failure of C.L to degenerate Theca Lutein-high levels of hCG Polycystic ovaries-hyperandrogenism, insulin resistance, hirsituism, infertile OC to suppress androgen, restore reproductive fx Reproductive Cancers : Reproductive Cancers Cervical- most preventable-Pap smear R/T-HPV, early intercourse, multiple partners, STI, HIV Coploscopy- stained cells sent for biopsy Cone biopsy-remove precancerous cells LEEP-heated or electrical current Laser Endometrial Cancer : Endometrial Cancer Most caught early- post menopausal bleeding Risk factors- nulliparity, obesity, infertility Dx- biopsy-UTZ Tx- hysterectomy, ovaries and tubes Need follow-up chance or reoccurence Ovarian : Ovarian Bad outcomes due to late diagnosis Risk factors-nulliparity, late menarche and menopause, obesity Postmenopasusal cyst- must evaluate Tx- hysterectomy Nursing is primary prevention-early symptoms Vaginal/Vulvar : Vaginal/Vulvar Rare slow developing Risk factors-HPV, HIV, age S/S- painful intercourse, discharge, pain Tx- laser, radiation, hysterectomy Vulvar-ext genitalia Risk factor- HPV, smoking, age Tx-laser, cryo, may need skin graft Violence : Violence Not always physical Abusers are from all SES Violence is learned and perpetuated Children develop mistrust of world Phases of Violence : Phases of Violence Tension building- unresolved issues Violence-physical and emotional abuse Reconciliation-apologetic Types of abuse Mental-threatening, demeaning, controlling Physical- hitting, grabbing Sexual- forced sex Violence During Pregnancy : Violence During Pregnancy Can escalate during pregnancy Should screen during PNC and ER Spouse may feel threatened She is vulnerable More likely to have mental health issues Sexual Violence : Sexual Violence May be under reported Sexual violence is about power and control Person abused more likely to abused again Incest- forced by family members Aquaintance rape- under reported, feel guilty Female Genital Mutilation : Female Genital Mutilation Female circumsicion- practiced in other countries Leave opening for urine and menstrual flow May need reconstructive surgery Violence : Violence Human trafficking-mostly children, sold into prostitution, porn PTSD-re-experience event, flashbacks, avoidance Nursing : Nursing Evaluate for injuries Is partners behavior suspicious Use non-judgmental approach Educate Support decisions Use community resources Help to develop coping skills Help to break cycle of violence You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.