Basic Nursing: Foundations of Skills and Concepts Chapter 24

Basic Nursing: Foundations of Skills and Concepts Chapter 24

Chapter13 Nursing Care of the Client: Reproductive and Sexual Health Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Anatomy and Physiology Review Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Anatomy and Physiology Review Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Common Diagnostic Tests Laboratory tests

Radiologic tests Biopsy Dilation and curettage (D&C) Laparoscopy Colposcopy Nocturnal tumescence penile monitoring Pelvic examination Schiller test

Ultrasound Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pelvic Inflammatory Disease (PID) Inflammatory process involving: uterus, fallopian tubes (salpingitis), ovaries (oophoritis) Chlamydia, gonococcus, streptococcus, staphylococcus, and herpes simplex virus II, Infections are usually ascending

(continued) Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pelvic Inflammatory Disease (PID) Incidence: 100,000 women become infertile Risk Factors: multiple sexual partners, frequent intercourse, IUDs, douching, childbirth. Symptoms: low-grade fever, pelvic pain, abdominal pain, backache, foul-smelling vaginal discharge, nausea/vomiting, dysmenorrhea

(painful menstruation), dyspareunia (painful intercourse), and intense pelvic tenderness upon examination. (continued) Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pelvic Inflammatory Disease (PID) Complications peritonitis pelvic abscesses infertility

ectopic pregnancies Acutely ill client may require hospitalization for IV antibiotic therapy. (continued) Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pelvic Inflammatory Disease (PID) Pharmacological-Antibiotics doxycycline monohydrate (Vibramycin) metronidazole (Flagyl) cefoxitin (Mefoxin)

clindamycin (Cleocin) gentamicin (Garamycin) (continued) Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pelvic Inflammatory Disease (PID) Nsg Mgt: nonjudgmental attitude, VS, I&O, BR BRP (semi-Fowler's) Teach proper pericare, hygiene, hand hygiene. Administer antibiotic Assessment: Unprotected intercourse, sexual

activity, number of partners, history of contraception, previous vaginal infection, obstetrical history, douching/tampon use. (continued) Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. PID Nursing Diagnoses Acute Pain related to inflammation of the pelvic structures caused by invasion of pathogens

Deficient Knowledge related to the etiology of the pelvic inflammatory process, treatment regimen, self-care, and preventive measures Hyperthermia related to physiologic responses to the inflammatory or infectious process (continued) Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Endometriosis Growth of endometrial tissue outside uterus Occurs women 30 years, tends to be familial.

progressive and recurrent career woman's disorder powder burns brownish or black lesions. chocolate cyst (ovary) Monthly symptoms: backache, painful intercourse, heaviness on the pelvis, and spotting. Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Endometriosis Assessment dyspareunia prolonged, excessive menstrual periods

frequency, comfort, duration, amount menstrual flow. future plans for childbearing. Assist physician during procedures. (continued) Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Endometriosis Nursing Diagnoses Acute Pain related to bleeding from endometrial implants in the pelvic cavity

Anxiety related to treatment options, possible side effects, and infertility Ineffective Sexuality Patterns, or Sexual Dysfunction, related to altered body function or structure (painful intercourse) Situational Low Self-Esteem, related to the inability to conceive Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Vaginitis Candida albicans (yeast infection)

Trichomnas vaginalis (a protozoan) Gardnerella vaginalis (a bacterium) Chlamydia trachomatis (a parasite) Other causes: streptococcus, staphylococcus, gonococcus, and herpes simplex II. Most infections have characteristic discharge, irritation, burning, itching (continued) Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Vaginitis Candidiasis (monilia)

Predisposing factors: obesity, diabetes, pregnancy, oral contraceptives, antibiotics, bubble baths, frequent douching. Symptoms: thick, white, cheesy/curd-like discharge, musty, sweet odor, itching, irritation. Treatment: miconazole (Monistat), clotrimazole (Mycelex-G, Gyne-Lotrimin), nystatin (Mycostatin). Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Vaginitis Trichomoniasis Frequently passed from partner to partner Symptoms: copious green-yellow, foulsmelling, frothy discharge, itching, burning, irritation. Treatment: Metronidazole (Flagyl) taken orally by both partners. abstain from intercourse Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Vaginitis Gardnerella

Symptoms: asymptomatic or gray-white discharge, strong odor Treatment: Flagyl, tetracycline hydrochloride (Achromycin), ampicillin (Omnipen). Sulfa-based creams Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Vaginitis Chlamydia Asymptomatic (associated with infertility) Treatment: oral antibiotics for at least 7 days.

repeat culture recommended Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Vaginitis Assessment Onset symptoms, menstrual history, contraceptive methods, use of antibiotics, other meds, illnesses, DM, sexual/pregnancy history, hygiene practices. Emphasize the significance of hand hygiene before and after applying vaginal medications.

Notify client that her sexual partner should also be treated. Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Vaginitis Nursing Diagnoses Acute Pain, related to irritation, excoriation, or ulceration of vaginal tissue Deficient Knowledge, related to the origin of the infection, prevention, and treatment options Impaired Tissue Integrity, related to the presence of

vaginal discharge, itching, or irritation Sexual Dysfunction, related to discomfort during intercourse or fear of transmitting the infection to the sexual partner Risk for Impaired Skin Integrity, related to internal and external irritation from discharge and itching Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Toxic Shock Syndrome (TSS) Rare, life-threatening condition Staphylococcus aureus

Group A streptococcus Incidence: women under 30 Symptoms: sudden can be fatal-high temperature, vomiting, diarrhea, hypotension, flulike symptoms; malaise, muscle soreness, sore throat, HA, macular erythematous, peeling of the palms/soles. (continued) Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. TSS Medical Mgt Cultures, blood pressure, IVF, mechanical

ventilation, CPAP, dialysis Pharmacological: dicloxacillin sodium (Dynapen), clexacillin sodium (Tegopen), nafcillin sodium (Nafcil), and methicillin sodium (Staphcillin). -for at least 2 weeks Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. TSS Assessment Use of tampons, contraceptive sponges, sore throat, headache, myalgia, and fatigue, rash,

edema, peeling of palms and soles, hypotension, fever, level of consciousness Nsg Mgt: BR, antipyretics, antibiotics, vital signs, I&O Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. TSS Nursing Diagnoses Hyperthermia related to inflammatory process Deficient Fluid Volume related to diarrhea, vomiting, fever, and decreased intake

Risk for Impaired Skin Integrity related to dehydration and effects of circulating toxins Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Epididymitis Sterile or Nonsterile Inflammation Symptoms: sudden severe scrotal pain, warmth, redness, swelling, tenderness, dysuria, pyuria, chills, fever, discharge, blood Treatment: BR, antibiotics, scrotal support, ice

Bilateral: can cause sterility. Untreated: tissue necrosis, septicemia, death. Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Orchitis Inflammation Testes Causes: gonorrhea, trauma, surgical manipulation, TB, mumps Unilateral: does not cause sterility. Symptoms: sudden scrotal pain/edema, chills,

fever, N&V Treatment: BR, scrotal support, ice Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Prostatitis Inflammation Prostate Complication of chlamydia/gonorrhea urethritis. May be acute or chronic Difficult to differentiate from prostate cancer Symptoms: perineal pain, fever, dysuria, discharge.

Medical Mgt: NO urinary catheter Pharmacological: antibiotics, analgesics, stool softeners. Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Prostatitis Assessment History of recent bacterial or viral infection Pain, discharge, dysuria, arthralgia, back pain, scrotal edema, constipation, nausea, emotional needs. Vital signs (especially temperature) Nsg Mgt: BR, scrotum elevated, cold packs, sitz

baths, assess pain, athletic support (Amb) Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Epididymitis, Orchitis, Prostatitis Nursing Diagnoses Risk for Injury related to worsening of the inflammatory process Deficient Fluid Volume related to nausea and vomiting Acute Pain related to Inflammation

Anxiety related to concerns about possible sterility or impotence Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Fibrocystic Breast lumpy, nodular, glandular tissue, single or multiple cysts, frequently fluid-filled, yellow-greenish, sticky discharge Common between 30 and 50 years of age familial tendency development breast cancer Difficult to differentiate: cysts, fibroadenomas,

and carcinomas (routine mammograms, breast self-examination) Treatment: biopsy or aspiration, frozen section Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Fibrocystic Breast Surgical Treatment: aspiration or surgical excision diagnostic or therapeutic nurse labels specimen for lab Pharmacological: vitamin E

Diet: limit or eliminate caffeine (teas, colas, coffee, chocolate) Nsg Mgt: BSE, mammogram, firm/supportive bra Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Fibrocystic Breast Nursing Diagnoses Deficient Knowledge related to the cause of fibrocystic breast changes and method of breast self-examination Anxiety related to the underlying potential and risk of breast cancer

Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Fibroid Tumors Fibroids (leiomyomas) Benign tumors in/on uterus Incidence: nulliparous women, more than 35 yo (Prevalant African-American, Mediterranean) Symptoms: menorrhagia, pelvic pressure, dysmenorrhea, abdominal enlargement, constipation

Diagnosis: pelvic ultrasound or laparoscopy Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Fibroids Medical Mgt: wait-and-see observe the growth pattern. Reexamination every 6 months. Surgical: D&C, myomectomy, hysterectomy Diet: iron rich foods Assessment: menstrual flow, dysmenorrhea, pain, pressure, abdominal enlargement, constipation, urinary frequency/urgency.

Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Fibroids Risk for Deficient Fluid Volume related to excessive blood losses Acute Pain related to pressure on pelvic structures caused by growing tumors and cramping during the menses Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Benign Prostatic Hyperplasia (BPH) Progressive adenomatous enlargement of the prostate gland that occurs with aging. Incidence: 90% men older age 70 have BPH Symptoms: partial/complete obstruction, hesitancy decreased force- stream, urinary frequency, nocturia, atony, bacterial growth leads to UTI, eventually lead kidney damage. (continued)

Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. BPH Medical Mgt Diagnostic tests digital rectal examination (DRE), PSA, post-void bladder scan, cystoscopy, rectal ultrasonography, prostate biopsy. Monitor for: hesitancy, urgency, hematuria, UTI. Surgical alternatives: balloon dilation, urethral stent, TUMP, TUNA, retropubic prostatectomy, perineal prostatectomy

Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. BPH Surgical Mgt TURP traditional surgical intervention for 90% resectoscope, general or spinal anesthetic bladder is continuously irrigated Open Surgery suprapubic resection retropubic prostatectomy perineal prostatectomy

Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. BPH Surgical Mgt Surgical Complications: hemorrhage, water intoxication, infection, thrombosis, damage to surrounding structures, sexual dysfunction, urinary incontinence. Laser prostatectomy (TULIP) Pharmacological: Finasteride (Proscar) aterazosin hydrochloride (Hytrin), doxazosin mesylate (Cardura), alfuzosin (Uroxatral),

tamsulosin Hcl (Flomax). Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. BPH Nsg Mgt Post-op Assessment Pain, emotional needs, information or reassurance, vital signs Report hemorrhage, hyperthermia, hypotension, tachycardia immediately TURP continuous bladder irrigation (CBI) I&O (subtract irrigant), post void residual,

water intoxication, Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. BPH Nursing Diagnoses Stress or Urge Urinary Incontinence related to poor sphincter control after catheter removal after surgery Sexual Dysfunction related to surgery Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Malignant Neoplasms breast, cervical, endometrial, ovarian, prostate, testicular, penile cancers Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Breast Cancer Incidence Key to cure is early detection Painless mass or lump common symptom Symptoms: masses, lumps, thickening, swelling,

dimpling, redness, scaliness, irritation; pain, retraction, discharge, unilateral change size, orange-peel appearance (peau d'orange) of the skin (continued) Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Breast Cancer Risks Family hx Never had children First child after 30

Never breast-fed Hx fibrocystic breast changes Menstruating before age 10 Obese Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Breast Cancer Staging system provides standardized method American Joint Committee on Cancer's TNM system.

T = Tumor (the size and how far has it spread within the breast and to nearby organs) N = Nodes (spread to lymph nodes) M = Metastasis (spread to distant organs) Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Breast Cancer Treatment Surgical Removal Lumpectomy or mastectomy Radiation and chemotherapy

Targeted therapy Immunotherapy Photodynamic therapy Gene therapy Hyperthermia Antiangiogenesis therapy Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Breast Cancer Treatment Lumpectomy Simple mastectomy

Modified mastectomy Radical mastectomy Lymphedema Reconstructive surgery Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Breast Cancer Pharmacology Antiestrogens Androgens

Chemotherapy Agents Alkylating agent Anti-tumor antibiotic Antimetabolites Steroids Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Breast Cancer Nsg Mgt BSE Mammogram Fears/concerns -support groups

Postoperative care Vital signs Incisional site Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Breast Cancer Fear related to breast cancer, possible metastasis, surgery, and disfigurement Disturbed Body Image related to removal of the breast

Self-Care Deficit related to limited use and range of motion on the affected side and postoperative discomforts Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Cervical Cancer Dysplasia change in size/shape of cervical cells mild, moderate, severe Abnormal Papanicolaou (Pap) smear Associated Factors: Sexual habits, smoking, oral

contraceptives, immunosuppression, multiple pregnancies, family history, diet low in fruits/vegetables, obesity Incidence: 30-50 year olds Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Cervical Cancer Symptoms: asymptomatic or abnormal bleeding, thin, watery, blood-tinged discharge to frank bleeding. Contact bleeding after intercourse. Advanced disease is indicated by odor, pain in the

lower back and groin, difficulty in voiding, hematuria, and rectal bleeding Two types squamous-cell carcinoma and adenocarcinoma Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Cervical Cancer Staging from I to IV Carcinoma in situ (CIS) means that the cancerous cells remain within the cervix

The greater the number on the staging table, the more the cancer has metastasized to other structures. Surgical Treatment: conization Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Cervical Cancer Surgery Laser surgery Cryosurgery (freezing with liquid nitrogen) Cauterization (burning)

Hysterectomy or radical pelvic surgery Radium implants or radiation therapy Chemotherapy Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Cervical Cancer Nsg Diagnoses Anxiety related to unknown outcome and possible treatments Sexual Dysfunction related to vaginal bleeding, discomfort, and procedures

Impaired Urinary Elimination related to sensory motor impairment from radiation effects Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Endometrial Cancer Risks Postmenopausal women, Caucasian, middle class Family history Estrogen replacement therapy Oral contraceptives Never having a child, never having intercourse

Obesity Diabetes Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Endometrial Cancer Treatments: radiation, radium implants, chemotherapy, surgery, blood transfusion Surgical Interventions: Hysterectomy Subtotal hysterectomy

Radical or pan hysterectomy (laparoscopic or abdominal approach) Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Ovarian Cancer The silent killer Symptoms: vague, ignored, advanced, inoperable stage. Bloating, abdominal or pelvic pain, difficult eating, feeling full quickly, urinary urgency or frequency

Incidence: 45 and 65 years old. Nulliparity (never having borne a child), smoking, alcohol use, infertility, high-fat diet Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Ovarian Cancer Diagnostics Lower GI series, transvaginal pelvic US, CA-125 paracentesis for cytology, Pap smear, biopsies, D&C, CXR, IVP, KUB, CBC,Schiller's test, colposcopy, laparoscopy, barium enema, bone

scan. Recurrent disease is common 5-year survival rate is 45% Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Ovarian Cancer Treatment: Total abdominal hysterectomy bilateral salpingo-oophorectomy or omentectomy Combination of: radiation, chemotherapy, immunotherapy,

surgery -palliative Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Ovarian Cancer Pharmacological Chemotherapy drugs Intraperitoneal chemotherapy Combination chemotherapy PCA pump (continuous low-dose narcotics) Transdermal patches Brompton's mixture, elixir, or cocktail

tranquilizers, antiemetics, laxatives Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Ovarian Cancer Nursing diagnoses Preoperative Fear related to tentative diagnoses, pending surgical procedures, cancer treatment and its side effects, incapacitating or extended illness with resulting dependence, and possible death Postoperative

Impaired Skin Integrity related to surgical interventions, radiation, and chemotherapy side effects Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Prostate Cancer Incidence (increases with age) Detection: serum prostate-specific antigen (PSA), transrectal ultrasonic examination, DRE, prostatic biopsy. Adenocarcinomas: slow-growing tumors

Early symptoms: dysuria, weak stream, frequency. Later symptoms: obstruction or hematuria, anemia Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Prostate Cancer Treatment Depends on extent, age of client. Radiation is the traditional alternative to surgery Complications: diarrhea, bowel obstruction, lymphocele formation, edema of the extremities, pulmonary embolism, wound infections,

infection, impotence, incontinence, or radiation cystitis. Transrectal assisted radioactive seed implant Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Prostate Cancer Treatment Surgical treatment removal prostate gland orchiectomy urethra is anastomosed perineal or retropubic approach

robotic-assisted laparoscopic radical prostatectomy da Vinci system Pharmacological : Chemotherapy drugs, Hormonal agents Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Prostate Cancer Nsg Mgt Annual rectal examination, PSA serum level. back pain, sciatica, frequency, dysuria, nocturia. Post op: Report hyperthermia, hypotension, tachycardia, increased incisional drainage

Monitor catheter drainage-color, amount, presence of clots Risk Factors: age over 55 years, family hx, African American, high serum testosterone Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Prostate Cancer Nursing diagnoses Urinary Retention related to urethral obstruction, secondary to urethral anastomosis. Bowel Incontinence related to loss of rectal sphincter control because of perineal incision

Risk for Impaired Skin Integrity related to incontinence Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Testicular Cancer Incidence: 1% of all cancer in men most common ages of 15 and 35. 5-year survival rate 96% Etiology unknown Symptom: small, hard, painless lump

Early diagnosis: TSE Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Testicular Cancer Surgical removal: testis, spermatic cord, inguinal canal Pharmacological: chemotherapy and radiation Nsg Mgt: TSE, anxiety or depression, gynecomastia Risk for Injury due to infection and

hemorrhage related to surgery Deficient Knowledge related to surgery and post operative care Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Penile Cancer Rare, high correlation poor hygiene uncircumcised Chronic irritation carcinogenic. Risk Factors: Hx of STIs Symptoms: painless, nodular growth (foreskin), fatigue, weight loss.

Treatment: penectomy (perineal urethrostomy) Nsg Mgt: emotional support, Elevate, assess pain Post-op Complications: low BP, tachy, incision drainage, redness, swelling; bright red or low urinary output Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Penile Cancer Nursing Diagnoses Risk for Injury due to infection and hemorrhage related to surgery Anxiety related to surgery

Ineffective Sexuality Patterns related to the altered body function or structure Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Menstrual Disorders Dysmenorrhea menstrual cramps Attitude, analgesics, oral contraceptives Amenorrhea absence of menstruation primary or secondary pelvic examination, pregnancy test

Depo-Provera (continued) Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Menstrual Disorders Menorrhagia metrorrhagia Polymenorrhea Oligomenorrhea Treatment: dilation and curettage (D&C) blood transfusion, supplemental iron

Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Menstrual Disorders Assessment Nsg Mgt: Hypertension, tachycardia. Monitor labs Acknowledge, Explain, Encourage, Emphasize Nursing diagnoses Acute Pain Decreased Cardiac Output Fatigue Disturbed Body Image

Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Premenstrual Syndrome (PMS) women between 20 and 50 years of age Risk factors multiple life stressors, inappropriate nutritional status, reaction to or side effects oral contraceptive use, sedentary lifestyle, marital status, Hx preeclampsia, multiparity. Symptoms: more than 150 reported Pharmacological Mgt Diet: sugar, salt, caffeine, chocolate

Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Premenstrual Syndrome (PMS) Nursing Diagnoses Excess Fluid Volume related to hormonal imbalance and increased sodium or sugar intake Health-Seeking Behaviors, related to finding methods to cope with symptoms of PMS Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Menopause Climacteric: cessation of menstruation. change of life range of onset is from 45 to 60 years old, onset is usually gradual Reproductive capability is lost Postmenopause time period Symptoms: vaginal dryness, weight gain, dry skin, stress incontinence, osteoporosis, depression, nervousness, insomnia, hot flashes Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Menopause Pharmacological: ERT Diet: calcium-rich products Herbal teas, vitamin E, magnesium, primrose oil Activity: 30-minute 3 times week Nursing diagnoses Health-Seeking Behaviors Decisional Conflict Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Structural Disorders Female Cystocele, Urethrocele , Rectocele, Prolapsed Uterus Treatment: restoration structure and function, pessary, hysterectomy, A&P repair, Marshall-Marchette-Krantz Activity: Client Teaching-Kegel exercise Nursing diagnoses: Stress Urinary Incontinence Constipation Risk for Infection Sexual Dysfunction (continued)

Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Structural Disorders Male Hydrocele: benign, nontender collection fluid, scrotal swelling, surgical excision Spermatocele: benign nontender painless cyst epididymis or rete testis. surgical aspiration or excision (continued)

Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Structural Disorders Male Varicocele : dilation of veins-scrotum Symptoms bluish discoloration , wormlike mass Complication infertility Torsion Spermatic Cord Symptoms: abdominal/scrotal pain, scrotal edema, nausea/vomiting, slight fever. Treatment: surgical detorsion (untwisting)

(continued) Copyright 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Recently Viewed Presentations

  • Working with Your Trustees & Friends

    Working with Your Trustees & Friends

    The Queens Library Foundation is the fundraising arm of the Queens Library. Incorporated in 1988, the mission of the Queens Library Foundation is to raise funds from foundation, corporation, and private individuals to support the tens and thousands of the...
  • Overton High School School for the Creative and Performing Arts

    Overton High School School for the Creative and Performing Arts

    The Only Optional School for the Creative and Performing Arts in Memphis. Focused study in the Fine Arts. School-within-a-school design. Safe and supportive learning environment. Active and involved parent organization and community adopters. Numerous academic, social, athletic, and other extracurricular...
  • Chapter 3: Human-wildlife Conflict and Wildlife Abundance ...

    Chapter 3: Human-wildlife Conflict and Wildlife Abundance ...

    CHAPTER 3: HUMAN-WILDLIFE CONFLICT AND WILDLIFE ABUNDANCE: ASSESSING WILDLIFE DENSITY AND ABUNDANCE ON MAUNGU RANCH * Wildlife Abundance in Kasigau An Integral Part of CBE Dispersal area for wildlife (Maina 2004) Tsavo East and West National Parks Mt. Kasigau, an...
  • r je ika l i m n nde

    r je ika l i m n nde

    Helen Timperley identifierar några viktiga principer som kan underlätta beslutet. Det som observeras har en direkt koppling till det professionella lärandets fokusområde och innefattar lärarens lärandemål. Fokusområdena ska beslutas gemensamt av den person som observerar och den som blir observerad.
  • urgenciasbidasoa.files.wordpress.com

    urgenciasbidasoa.files.wordpress.com

    Akahata W, Yang ZY, Andersen H, et al. A virus-like particle vaccine for epidemic Chikungunya virus protects nonhuman primates against infection. Nat Med 2010; 16:334. Roy CJ, Adams AP, Wang E, et al. Chikungunya vaccine candidate is highly attenuated and...
  • The Circular Flow of Economic Activity

    The Circular Flow of Economic Activity

    The Circular Flow of Economic Activity The two flows--of incomes and of expenditures--are equal: all expenditures on products are ultimately someone's income, and every piece of total income is also expended in some way ADAM SMITH It is an account...
  • EDUC 2010 - Gordon State College

    EDUC 2010 - Gordon State College

    Gordon Alum. Why This Course? To better understand the structure, nuance, and complexity of the teaching profession and the Education Enterprise ... Paper due, The best teacher I ever had and WHY? Foundations of Education. ... 10 minute rule -...
  • Medication Delegation Role and Responsibility of the Teacher

    Medication Delegation Role and Responsibility of the Teacher

    Epinephrine is the only medication that a teacher may administer by syringe because it is an auto-injector and only to a student with a known allergic reaction and appropriate licensed provider order and medication administration /parent consent form. ... Show...