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25 Cards in this Set

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PMS
define
the appearance of 1 or more of a large number of physcial or psychological symptoms that occure BEFORE the menses and SUBSIDE with the onset of menstrual flow
occurs with such a degree that it interfere with lifestyle, job
Theories of why woman get PMS
increased estrogen and decreased progesterone in leutal phase
unidentified hormones
serotonin defeciency
dietary factors
Symptoms of PMS
fluid retention
bloating-edema
breast tenderness
wt gain
crying
depression
irritability
trouble concentrating panic attacks
cravings increased appitte
DX of PMS
3 criteria
nn detailed hx, asked to keep log of s/s and moods
1-symptoms in leuteal phase and subside when menses begins
2-symptom free during follicular phase
3-symptoms recurrents
management of PMS
decrease consumption of red mean
limit refined sufar
limit etoh and caffiene
supplements0b6
naural dieuretics such as rasp tea, cran juice, peaches
Mag&Vit E
Cal 1200mg/day
exercise and stress reduction
oral contraceptives
SSRI Nsaid such as ponstel
motrin
diuretics
DYSMENORRHEA
PRIMARY
occur at time of menarche or shortly after. painful menstration with no identifiable pelvic pathology
MORE PHYSIOLOGIC
DYSMENORRHEA
SECONDARY
ORGAINC BASIS FOR PAIN
treatment of dysmenorrhea
nsaids
oral contraceptives
heat/ice
increase physcial exercise
limit fat
AMENORRHEA
PRIMARY
abscence of mentrual flow
>16 and not begun menstration but has signs of sexual maturation OR
by age 14 no period and NO sex maturation
Give emotional support to both
variations in genetics, body build, environment, dietary, mental/emotional
AMENORRHEA
SECONDARY
ABSCENSE OF MENSTRUAL FLOW FOR 3 CYCLES OR 6 MONTHS AFTER A NORMAL MENARCHE
ETIOLOGY-PREGNANCY, STRESS, OBESITY, EATING DISORDERS, PITUITARY OR THYROID DISORDERS
HYPOGONDOTROPIC AMENORRHEA
type of secondary amenorrhea
rarely pituitary lesion
genetic inability to produce FSH/LH
r/o preg
TSH
brain CT
DYSFUNCTIONAL UTERINE BLEEDING
DUB
abnormal bleeding that does not have a know organic cause
any atypical bleedings needs to be evaluated
occurs mostly in v. young and old
DUB
MENORRHAGIA
Prolonged or excessive bleeding at the tome of the regular menstral flow.It is a regular cycle but doesn't end in expected time or flow is excessive
suspected causes of menorrhagia
young
emotioanl
endocrine
inflammatory process
tumor
hormone imblalnce
management of menorrhagia
try to ge objective measure of bleeding by doing a PAD COUNT and SATURATION
DUB

METRORRHAGIA
MOST SIGNIFICANT!!!
warrants early dx and tx
vaginal bleeding between regular menstral periods
causes of metrorrhagia
CA
benign
tumors
infection
trauma
DUB

ENOMETRORRHIAGIA
combo of both/ rq evaluation
heavy vaginal bleeding between and during menstrual periods
dub
POSTMENOPAUSAL BLEEDING
bleeding 1 year after menses stop at menopause
needs evaluation RED FLAG
Dilation & Curettage
dianostic or therapeutic
dx- specimen of cervical canal or endometrius
therapeutic-control abnormal bleeding and often stops abn bleeding
RN considerations for D&C
explain, support, void before and after, inspect perineal bed, no sex for 2 weeks after due to risk of infection or bleeding
CYSTOCELE
bladder displaced in downward position
causes: childbirth primary cause
s/s pelvic pressure, fatigue, feeling of heaviness, incont-freq-urgency back and pelvic pain
RETOCELE
rectum displaced
pushes toward post-partum of vagina
results from tear below vagina and weaking of pelvic floor during childbirth. same s/s but rectal. fecal incont, increased flatus and rectal pressure
Medical management for cystocele/rectocele
medical management-pessaries (hold uterus in place) Kegels
SURGICAL-cystocele-anterior colporrhapy
Rectocele-posterior colporrhaphy
RN considerations for medical/surgical management
exam peri pads for drainage, lap site for drain, encourage to void and empty