MedicalSurgical Nursing Concepts Practice 3 rd edition Chapter

Female Reproductive System Female reproductive organs—internal, external structures, and accessory organs Female reproductive cycle

Female Reproductive System (Cont. ) Fetal development Sexual maturation Menopause Effects of aging Copyright

Female Reproductive System (Cont. ) Menstruation and normal menstrual bleeding Normal vaginal discharge Breasts

Contraception and Fertility Contraceptive options Emergency contraception Legal and ethical considerations: the “morning -after”

Proper Application of a Condom Modified from Leifer G: Introduction to maternity and pediatric

Proper Application of a Diaphragm Modified from Leifer G: Introduction to maternity and pediatric

Contributing Factors to Infertility in Women Problems with ovulation An abnormality in the pathway

Causes of Repeated Pregnancy Loss An abnormality in fetal chromosomes that result in spontaneous

Infertility Emotional impact of infertility Patient teaching and communication Herbal products and fertility Assisted

Some Assisted Reproductive Therapies In vitro fertilization (IVF-ET) Zygote intrafallopian transfer (ZIFT) Therapeutic donor

Health Risks of Menopause Osteoporosis Ø Fosamax Coronary heart disease Treatment options during menopause

Activities that Increase the Risk of Osteoporosis Inadequate lifetime intake of calcium and vitamin

Health Screening and Assessments Primary prevention decreases the probability of becoming ill. Secondary prevention

Health Screening and Assessments (Cont. ) Breast self-examination Vulvar self-examination Diagnostic tests Ø Ø

Menstrual Dysfunctions Premenstrual syndrome Premenstrual dysphoric disorder Dysmenorrhea Primary dysmenorrhea Secondary dysmenorrhea Copyright ©

Pelvic Relaxation Syndrome Cystocele, rectocele, and enterocele Etiology and pathophysiology Signs and symptoms Diagnosis

Treatment of Pelvic Relaxation Syndrome Nonsurgical management Kegel exercises Lifestyle changes Pessary Biofeedback and

Disorders of the Female Reproductive System Polycystic ovarian syndrome Dysfunctional uterine bleeding Ø Ø

Leiomyoma Medical management Uterine artery embolization Myomectomy Copyright © 2017, Elsevier Inc. All rights

Endometriosis Endometrial tissue is found outside the uterus, particularly on the ovaries, in the

Inflammations of the Lower Genital Tract Etiology and pathophysiology Signs, symptoms, and diagnosis Treatment

Toxic Shock Syndrome Risk factors include the prolonged use of high -absorbency tampons, cervical

Cancer of the Female Reproductive Tract Vulvar cancer Cancer of the cervix Cancer of

Warning Signs of Ovarian Cancer Abdominal pain Feeling full quickly when eating Feeling a

Benign Disorders of the Breast Fibroadenoma Fibrocystic breast changes (FBCs) Ø CAM therapy for

Breast Cancer Etiology and pathophysiology Signs, symptoms, and diagnosis Prevention Treatment Ø Ø Surgery

Breast Reconstructive Surgery Reduction mammoplasty Augmentation mammoplasty Reconstructive mammoplasty Nursing management Preoperative care Postoperative

Lymphedema Do not assess blood pressure in the affected arm. Do not give injections

Lymphedema (Cont. ) Teach the patient to avoid heavy lifting. Wear a compression garment

Risk Factors for Breast Cancer Family history of relative with breast cancer Early menarche,

Stages of Breast Cancer Stage 0 Stage IIIA Stage IIIB Stage IIIC Stage IV

Comparisons of Bacterial Vaginosis and Yeast Infection Primary causative organism(s) Onset Odor Itching Discharge

Nursing Management of a Woman with a Reproductive Disorder Care of a patient after

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Female Reproductive System Female reproductive organs—internal, external structures, and accessory organs Female reproductive cycle Ø Ø Ovarian cycle Menstrual cycle Copyright © 2017, Elsevier Inc. All rights reserved. 2

Contraception and Fertility Contraceptive options Emergency contraception Legal and ethical considerations: the “morning -after” pill Infertility Ø Ø Primary infertility Secondary infertility Menopause Copyright © 2017, Elsevier Inc. All rights reserved. 5

Contributing Factors to Infertility in Women Problems with ovulation An abnormality in the pathway between the cervix and fallopian tube An abnormality in the endometrium of the uterus, or malformation of the uterus Tumors in the reproductive tract Vaginal or cervical environment that is inhospitable to sperm motility or viability Copyright © 2017, Elsevier Inc. All rights reserved. 8

Causes of Repeated Pregnancy Loss An abnormality in fetal chromosomes that result in spontaneous abortion Abnormalities of the cervix or uterus Disorders of the endocrine or immune system Infections Environmental factors, such as toxic agents Copyright © 2017, Elsevier Inc. All rights reserved. 9

Some Assisted Reproductive Therapies In vitro fertilization (IVF-ET) Zygote intrafallopian transfer (ZIFT) Therapeutic donor insemination (TDI) Intracytoplasmic sperm injection Surrogate mother Copyright © 2017, Elsevier Inc. All rights reserved. 11

Health Risks of Menopause Osteoporosis Ø Fosamax Coronary heart disease Treatment options during menopause Hormone therapy Ø Bioidentical hormones Alternative therapies Diet, exercise, and support groups Copyright © 2017, Elsevier Inc. All rights reserved. 12

Activities that Increase the Risk of Osteoporosis Inadequate lifetime intake of calcium and vitamin D Smoking Excess alcohol intake Excess caffeine, cola, or soft drink intake Copyright © 2017, Elsevier Inc. All rights reserved. 13

Health Screening and Assessments Primary prevention decreases the probability of becoming ill. Secondary prevention focuses on early detection of specific at-risk diseases and early treatment like annual mammograms. Tertiary prevention minimizes the impact of an already-diagnosed condition. Copyright © 2017, Elsevier Inc. All rights reserved. 14

Health Screening and Assessments (Cont. ) Breast self-examination Vulvar self-examination Diagnostic tests Ø Ø Pelvic examination and Papanicolaou (Pap) smear Older adult considerations for screening Nursing management Copyright © 2017, Elsevier Inc. All rights reserved. 15

Pelvic Relaxation Syndrome Cystocele, rectocele, and enterocele Etiology and pathophysiology Signs and symptoms Diagnosis Treatment Nursing management Copyright © 2017, Elsevier Inc. All rights reserved. 17

Treatment of Pelvic Relaxation Syndrome Nonsurgical management Kegel exercises Lifestyle changes Pessary Biofeedback and transcutaneous electrical nerve stimulation (TENS) Surgical management Copyright © 2017, Elsevier Inc. All rights reserved. 18

Disorders of the Female Reproductive System Polycystic ovarian syndrome Dysfunctional uterine bleeding Ø Ø Oligomenorrhea Amenorrhea Metrorrhagia Menorrhagia Abnormal uterine bleeding Copyright © 2017, Elsevier Inc. All rights reserved. 19

Endometriosis Endometrial tissue is found outside the uterus, particularly on the ovaries, in the rectovaginal septum, and in the pelvis and abdomen. Continuous hormonal contraceptive therapy Copyright © 2017, Elsevier Inc. All rights reserved. 21

Toxic Shock Syndrome Risk factors include the prolonged use of high -absorbency tampons, cervical caps, or diaphragms. Symptoms Ø Sudden spiking fever, flu-like symptoms, hypotension, generalized rash resembling a sunburn, and peeling skin on the palms or soles Treatment Copyright © 2017, Elsevier Inc. All rights reserved. 23

Warning Signs of Ovarian Cancer Abdominal pain Feeling full quickly when eating Feeling a frequent or urgent need to urinate Increased abdominal girth Copyright © 2017, Elsevier Inc. All rights reserved. 25

Breast Reconstructive Surgery Reduction mammoplasty Augmentation mammoplasty Reconstructive mammoplasty Nursing management Preoperative care Postoperative care Collaborative care Home and community care Copyright © 2017, Elsevier Inc. All rights reserved. 28

Lymphedema Do not assess blood pressure in the affected arm. Do not give injections or do venipuncture in the affected arm. Provide meticulous skin care. Teach the patient to wear gloves in the kitchen and when gardening to prevent skin irritation or injury. Copyright © 2017, Elsevier Inc. All rights reserved. 29

Lymphedema (Cont. ) Teach the patient to avoid heavy lifting. Wear a compression garment during strenuous activities. Elevate and exercise the arm daily. Copyright © 2017, Elsevier Inc. All rights reserved. 30

Risk Factors for Breast Cancer Family history of relative with breast cancer Early menarche, late menopause Late first pregnancy or no children Abnormal cells in previous breast biopsy Obesity Environmental exposure to hormonemodulating chemicals, polycyclic aromatic hydrocarbons Inherited BRCA 1 or BRCA 2 gene Copyright © 2017, Elsevier Inc. All rights reserved. 31

Comparisons of Bacterial Vaginosis and Yeast Infection Primary causative organism(s) Onset Odor Itching Discharge Sexually transmitted Vulvar signs Vaginal signs Treatment Copyright © 2017, Elsevier Inc. All rights reserved. 33