nurs 128- reproduction
Terms
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- the 2 external structures of the female reproductive system
-
vulva
labia - The 5 internal genitalia of the female reproductive system
-
vagina
uterus
cervix
fallopian tubes
ovaries - the 3 female sex hormones
-
estrogen
progesterone
androgens - the first phase of the menstrual cycle
- Menstural phase
- the second phase of the menstrual cycle
- proliferative phase
- third phase of the menstrual cycle
- secretory phase
- fourth phase of the menstrual cycle
- ischemic phase
- male external genitalia
-
penis
scrotum - male internal genitalia
-
testes and spermatic cord
seminal vesicles/ ejaculatory duct
prostate gland
bulbourethral glands -
aging changes in the female include:
thinning of pubic hair
decrease size external genitalia
dry, thin vaginal walls
decrease size, internal structures
decrease tone of ________________ - breast tissues
-
aging changes in the male include:
thinning of pubic hair
increase pendulous scrotum
enlarged ____________ - prostate
-
management for endometrial cancer includes:
_______________
chemotherapy
sutgical - radiation
-
management for cervical cancer includes:
_____________, cryosurgery
radiation
chemotherapy
surgical - laser
-
management for ovarian cancer includes:
____________
radiation
surgical (TAH, BSO) - chemotherapy
- the medication given for BPH (benign prostate hyperplasia) is
- Proscar
-
post op care priorities for BPH (benign prostate hyperplasia) is
_________________
catheter care
risk for bleeding
urine ouput monitoring
pain management
health teaching/ follow-up care - continuous bladder irrigation
-
the manifestations for prostate cancer include:
___________________
recurrent bladder infections
hematuria - difficulty urination
-
screening for prostate cancer includes:
______, PSA, Ultrasound - DRE
- a side effect from a prostatectomy is ________________ or urinary incontinence
- sexual dysfunction
- main manifestation for testicular cancer is ______________-
- painless enlargement
-
the diagnosis for testicular cancer includes:
tumor markers (________)
CT
MRI - AFP
-
for testicular cancer a orchiectomy, lymph node resections operative concerns include:
prevention of complications r/t _______
pain mangement
immobility
psyhosocial issues
teaching/ follow up care - abdominal surgery
-
primary prevention for breast disorders include the following:
_____________
mammogram
monitoring for clients at risk -
BSE
(Breast self exam) -
with a radical mastectomy care issues include:
1)__________________
2) prevention of complications r/t lymphedema, infection, bleeding hematoma, cellulitis
3) mobility and diet
4) breast reconstruction - pain management
- these are highly important in young females, estrogen levels increase with age along with pregnancy.
- female sex hormones
- onset of 1st menstraul period- ranges from age 8-9 to 16-17
- menarche
- reduction of hormones
- menopause
- sac that protects the testes
- scrotum
- suspended in scrotum by spermatic cord
- testicles
- secretes milky fluid that enhances sperm motility
- prostate
- gland that secretes mucous type secretion
- bulbourethal glands
- assessment includes; establish health _____, identify potential problems, determine need for education/anticipatory guidance
- risks
- amenorrhea is related to __________
- malnutrition
- pelvic exam should routinely be done every ________years depending on age, risk factors, starting at age 18
- 1 to 3 years
- type of xray done to look for masses, tumors, cysts, and/or bone changes
- KUB
- hysterosalpingography views what organs
- cervix, uterus, and fallopian tubes
- test that should be done yearly after the age of 40, along with breast self exams
- mammography
- type of endoscopic study that looks at cervical epithelium tissue, vagina and volvus
- colposcopy
- type of endoscopic study that views the pelvic cavity. helps to detect ectopic pregnancy and any problems with the tubes in the ovaries
- laparoscopy
- diagnostic test for men, level of _____ found in prostate gland
- PSA- prostate specific antigen
- diagnostic test for men to evaluate fertility
- semen exam
- __________ of prostate for visualization and diagnosis
- ultrasonography
- diagnostic test used for bioposy of the prostate when increased PSA levels and potential neurologic problems
- cystoscopy
- painful menses, symptoms include pain, bloating, distention, headache, nausea and vomiting, constipation
- dysmenorrhea
- _________- (prostaglandins) causes smooth muscle to contract in uterus. causes muscle spasm and pain
- primary
- ____________-(underlying problem such as tumor, PID, endometriosis) there is something specific causing the pain
- secondary dysmenorrhea
- estrogen-progesterone imbalance of, causes ________. will see after tubal ligation. usually age 30-40
- PMS- premenstraul syndrome
- PMS will see a ________interaction that shows as retention of fluids (sodium retention), swelling, edema
- aldosterone
- management of ________includes, vitamin B6, eliminate caffeine, aldactone (diuretic) to decrease fluid, progesterone to help relieve psychological symptoms, parlodel to decrease breast tenderness, ane swelling and education and lifestyle changes such as
- PMS
- ________ absence of menses
- amenorrhea
- ________ amenorrhea- no period prior to age 16, related to congenital, ovarian disease, pituitary disorder
- primary
- __________amenorhhea- had period but then stopped for 3-6 months or more, related to underlying condition such as pregnancy, menopause, dietary (athletes) stress
- secondary
- _________= EXCESSIVE BLEEDING
- menorrhagia
- _______= bleeding inbetween. between menses, related to specific cause such as contraceptives, pregnancy, or malignancy
- metorrhagia
- _________- natural process with aging. may be physiological or surgically induced (hysterectomy)
- menapause
- increased ________level- attempt of pituatary gland to stimulate ovaries to produce estrogen
- FSH level
- ________ symptoms- hot flashes, night sweats, palpitations, dizziness, related to decreased levels of estrogen
- vasomotor
- __________- mucous membranes of vagina become dry, prone to scarring and lesions. sex very painful, urinary changes such as frequency and infections.
- atropic vaginitis
- muscular skeletal changes seen are __________ (backache, joint pain)
- osteoporosis
- urinary changes seen are ________ in frequency, urinary tract infections
- increased
- management of ___________- HRT (hormone replacement therapy) alleviate symptoms, decrease risk for osteoporosis, protective of heart
- menopause
-
alternative methods- _____ products have estrogen effect- dont take with breastfeeding.
-education and support - soy products
- ______- prevents osteoporosis, decrease cholesterol, risk for blood clots, hot flashes
- Evista
- _______- pelvic infection involving upper genital tract (beyond the cervix) usually related to untreated bacterial infection, sexually transmitted
- PID- pelvic inflammatory disease
-
causes of ________-
-untreated bacterial infection
-results in pelvic abscess, inflammation, scarring,infertility
-usually sexually transmitted
-increased incidence with IUD (intra uterine device) - PID
-
signs and symptoms of _________-
fever, chills, nausea and vomiting, seen with advancing infection
-pelvic pain increases with urination and defecation
-purulent vagina discharge
-occassional bleeding
-difficulty getting pregnant - PID
-
Management of ________- culture cervix, vagina and urethra.
-antibiotics
-surgery (laparatomy) or (hysterectomy)
-semi-fowlers position to help decrease drainage
-pain management with sitz baths, analgesics, support, education, IUD us - PID
-
_________- tissue that normally lines uterus is located in other sites of the reproductive area.
-family predisposition
-commonly seen in white females in 30's with no children
-mostly confined to pelvic cavity but can be throughout reprod - endometriosis
-
________menstruation- where lining of uterus is shed- some of this tissue is deposited in other parts and starts to grow and cause inflammation and scarring.
-could be spread by lymph system- ovaries most common site for endometriosis. - retrograde
-
causes of ______________-
-retrograde menstruation
-tissue spread by lymph vascular system
-misplaced tissue responds to hormonal stimulation and bleeds
-inflammation, scar tissue, adhesions
manifestations- pain prior to and duri - endometriosis
-
management of _________- treatment depends on symptoms, age of the patient, children , extent of disease. hormones can help to inhibit. laser approach to clean up tissue or abdominal hysterectomy
with pregnancy, tissue decreases, tissue also decreas - endometriosos
- most frequently occuring tumor of reproductive tract, slow growing, tumors composed of muscle and fibrous connective tissue, increased with approaching menopause, may be estrogen stimulated, fibroids increase with age, 2-3 times greater in African-Americ
- Benign uterine tumors
-
manifestations-
-often asymptomatic related to size, location and number, usually have more than one and are classified by size, location and where they are lying - benign uterine tumors= leiomyomas, fibroids
-
signs and symptoms-
uterine bleeding, dysmenorrhea (painful menses), pelvic pressure, urinary frequency and retention, vaginal discharge - benign uterine tumors
- ________-most conservative management for benign uterine tumors. involves removing fibroid with removing uterus. may need hysterectomy if increased amounts of fibroids.
- myomectomy
- _______hysterectomy- removal of uterus and cervix and also can remove tubes and ovaries
- total
- ________hysterectomy- total along with lymph nodes and upper 1/3 of vagina (usually deals with malignancy- cancer has spread)
- radical
- most common malginancy of female genital reproductive system, related to pelvic, radiation, reproductive cancer, diabetes, HTN, obesity, hyperestrongism, infertility, abortion, postmenapausal bleeding, good survival rate with early detection.
- endometrial uterine cancer
- hallmark symptom is abnormal uterine bleeding, especially post-menapausal (no menses for 1 year) can be early sign.
- endometrial (uterine) cancer
- usually ___________- highly malignant, slow growing, grows with help of vascular blood vessels and lymph system. if invades cervix, muscles of uterus or increases size of uterus or cancer goes outside uterus- prognosis is much worse. will determine treat
- adenocarcinoma
-
mangement of ________________-
-total abdominal hysterectomy (removal of uterus, tubes and ovaries)
-usually radiation (internal and/or external)
-hormones
-precancerous= progesterone helps to manage
late stages- tamoxifen (block - endometrial (uterine) cancer
-
_____ cancer- related to variety of risk factors, exact etiology unknown.
risk factors: HPV (human patholone virus) sexually transmitted diseases, history of chronic cervical irritation
-multiple sex partners
-early intercourse, smoking, S - cervical cancer
-
signs and symptoms of __________-
no early symptoms with in situ
late stages- vaginal bleeding(increased douching and intercourse may tend to cause greater frequency of bleeding), watery, dark, foul smelling vaginal discharge, as progresses- bo - cervical cancer
-
management of _____________-
squamous cell type can easily spread through pelvic area, pap smear is primary diagnosis, colposcopy, biopsy, conization(take out piece of tissue for biopsy), cautery or cryosurgery (freezing via scope) early mangement i - cervical cancer
- Vaginal __________- abnormal tube like passage from vagina to bladder. Frequent uti's
- fistulas
- __________- descent of bladder
- cystocele
- ____________- prolapse of urethra
- urethrocele
- ________- protrusion of posterior vaginal wall that supports rectum, difficulty with defecation
- rectocele
- _____________- descent of uterus into vaginal canal
- vaginal prolapse
- ____________- various shapes and sizes of devices that are placed in pelvic area to push and hold the organs that are beginning to prolapse. these can be curative and prevent surgery
- pessory
-
Benign ______________- enlargement of prostate- common symptoms are urinary problems.
-abnormal increase in # of cells in prostate
-increased contraction of smooth muscle prostatic tissue enlargement
-pathophysiology- not clear, can be rel - Benign prostatic hyperplasia (BPH)
-
primary symptoms of ________-
-bladder outlet obstruction
-urine flow restricted
-back flow
-accumulates in bladder (stays in bladder after urination causing thickening, swelling of urinary wall)
-loss of kidney function
-at - BPH (benign prostatic hyperplasia)
- Finasteride (_________)- slows tissue growth. Blocks conversion of testosterone to decrease hyperplasia that causes enlargement. side effects are erectile dysfunction, decreased PSA and decreased libido which may mask occurrence of prostatic cancer
- Proscar
- __________ blocking- relax muscle. drugs such as hytrin, minipress, cardera, flomax (help to relax prostate muscle and relieve pressure- helps to cause more normal urine flow)
- alpha-adrenigic
-
surgical treatment for _________-
prostectomy- only part of gland causing obstruction is removed. depends on age and overall health of patient and size of prostate.
TURP- transurethral resection is most common and is done through urethra. - BPH- benign prostatic hyperplasia
-
Post-op care for BPH-
maintain ____________ irrigation- biggest complication to surgery is bleeding (clotting) prevent complication with irrigation with normal saline for 24 to 48 hours - continous irrigation
- secondary side effect after surgery for BPH is
- erectile dysfunction
- _________cancer- second most common cause of cancer death in US. risk increases with age, BPH not a precursor, family history (increase in African-Americans), hormonal changes, sexually transmitted virus, diet (increased fat, vitamin D deficiency),enviro
- PROSATE CANCER
- foods that decrease prostate are foods that contain __________- such as cooked tomatoes
- lycopenin
- _________- slow growing, often asymptomatic, early symptoms are difficult, painful and weak urination, bladder infections, hematuria
- Prostate cancer
-
Diagnosis of _____________ is
increase PSA (prostate specific antigen)
abnormal rectal exam- will feel hard nodule and uneven surface of the prostate - Prostate cancer
-
mangement for ________cancer includes:
aggressive treatment
radical prostatectomy- removing entire gland, vas deferens, lymph nodes and bladder neck.
cryosurgery ablation- freezing to remove tumor, confined to prostate itself, good prognos - prostate cancer
-
_______cancer- most common, serious, solid tumor affecting men age 15-35
etioloy is unknown, DES taken during pregnancy, undescended testes, family history (3 times higher in Jews) - Testicular cancer
-
_______cancer manifestations:
-painless enlargement- described as dragging heavy sensation
-testis do not transilluminate
-metastasis occurs thru lymphatics
-c/o back pain, abdominal pain, nausea and vomiting, bowel/bladder changes, r - TESTICULAR CANCER
-
managment of ________cancer-
usually unilateral
radical ordniectomy
retroperitoneal lymph node dissection
radiation
chemotherapy - testicular cancer
-
Testicular _________- (twisting)
-common in children
-goes along with herniation - torsion
- ________- secondary to infection, STD, mumps , trauma
- orchitis
- ________- infection in urethra, prostate or bladder related to catheter, surgery or STD
- epididymitis
- ________- problem with lymph drainage, swelling and collection of fluid
- hydrocele
- ________- enlarged veins that cause engorgement, pain and discomfort
- varocele
- Penile (______,phimosis)-seen more in children, can be congenital or caused by injury or inflammation.
- urethritis
- dietary fat and _______fat increase risk of cancer. alcohol increases cancer risks, the more alcohol the more risk, limit alcohol intake to 1 drink or less per day
- saturated fat
-
____ foods bind to estrogen receptors and block from entering, decrease risk for cancer.
eat broccoli, fruits and vegetables to decrease risk - soy
-
_____cancer is most common malignancy in women, cause is unknown. 70% of women have no risk factors.
known risk factors include:
age (at age 85 risk is 1 out of 8) mortality less in caucasion and increased in african-americans, early menarche o - Breast cancer
- alcohol alters ________metabolism, and _______ embeds in fat tissue and this increases level in obese patients. caffeine consumption related to fibrocystic disease
- estrogen
- Tomoxifen, Raloxifene (______) drugs that high risk patients are put on to decrease chance of cancer
- Evista
- _________- drug with chemo preventive properties, also helps with osteoporosis and cholesterol levels. can cause blood clots
- Evista
-
_______mastectomy- with strong family history or cancer in other breasts or presence of BRCA I and II gene
lifestyle changes include decrease fat intake, decrease alcohol consumption, and increase exercise to decrease fat storage - prophlactic
- screening mammograms biggest prevention of breast cancer. Age for baseline is ____. females younger than this age their breast tissue is thicker and may have normal fibrostitic changes along with menstrual cycle.
- age 40
- breast cancer typically begins in ________ epithial cells and spread via lymphatic system.75% of all breast cancer extends to axillary nodes and then spreads to lung, liver, bone and brain.
- ductal-lobular epithelial cells
- most primary breast tumors originate in upper outer quadrant also called the _____________.
- tail of spence
- __________in situ- cells confined to ductal, lobular units with permeation of basement membrane.
- carcinoma
- inflammatory- characterized by skin redness and induration (rapid growing, poor prognosis) Nipple may be ______, skin very hard and dry. looks like theres a problem with inflammation.
- inverted
- most breast cancers are ______, non-tender, hard, irregulary shaped, non-mobile. Edema-sign of malignancy. any drainage, nipple discharge or swelling is sign of malignancy and advanced stage.
- painless
-
mangement for breast cancer-
carcinoma in situ- _______ incision - local
- stage I or II breast cancer- management will be _________ preserving procedures.
- breast
- tumors in nipple area that are large in size and extent- radiation risk, _________.
- mastectomy
- medical management for breast cancer is radiation by beam or implants for _____ weeks
- 5-8
- following remission of breast cancer- patient needs to have follow up for rest of their life, continue with BSE and every ____ months by MD.
- 3-6 months
- 80% of all local recurrences of breast cancer will happen within first ____ years, these years are the most critical
- 5 years
- _______ breast disease- occurs in younger 20-40 year olds. related to hormonal imbalances. usually disappears at menopause. is usually round, fluid filled (not irregular), movable
- Benign
- _________- related to caffeine consumption
- fibrocystic
- fibro_______- can be aspirated and fluid removed
- fibroadenoma
- anything irregular and fixed is probably____________.
- cancer
-
anything round and movable is usually
____________ breast cancer - benign
- with men, breast cancer usually involves older men over age ____
- 60
- with men, breast cancer is identified at advanced stage and is usually around _______ area, looks inflammed and swollen.
- nipple