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242 Cards in this Set

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What happens when the voice of an adolescent changes?
The change is associated with lengthening of the vocal chords, increase in structure and mass of the vocal chords
group identity vs alienation (Erikson)
adolescent struggling with relations, belonging to a group and trying to be less identified with the family
Abstract thinking/formal operation (Piaget)
Cognitive thinking culminates with the capacity for abstract thinking
moral development of the adolescent
part of their struggle is basing their decision on an internalized set of moral principle. They seriously question established moral codes, resulting from adults action as do as I say and not as I do
major causes of morbidity and mortality in adolescence
They not diseases but, health damaging behaviors, which includes injury, depression, violence, sexually transmitted infrections and pregnancy.
nurses role in exercise and acitivity
can encourage participation as a way to promote health and build self-esteem. They should not be encouraged to participate in any activities above their level of strength
nurses role in dental health
important to reinforce orhtodontist's directions regarding use and care of the appliances and to emphasize ccareful attention to tooth brushing during this time
nurses role in personal care
nurses are in aposition to help evaluate the relative merits of commercial products offered to young people in the media
nurses role in body art
it is the nurses responsibility to caution girls and boys against the practice of having peircing performed by friends, parents or themselves to prevent infection, cyst or keloid formation, bleeding, dermatitis or metal allergy, sharing needles can also cause HIV and Hep B transmissions
Sexuality Information and Education Council of the United States (SIECUS)
Covers six topics, biologic, social, health, personal adjustments and attitudes, interpersonal associations and the establishment of values
nurses role in sexual education and guidance
Nurses should use simple words, correct terminology, not street language or highly scientific terminology or evasive jargon.
nurses role in sports injuries
injury prevention is an ongoing part of nursing responsibility throughout the childhood years
Clinical signs of mono
headache, malaise, fatigue, chills, low-grade fever, lossof appetitie, puffy eyes
Signs of full blown mono
fever, sore throat, cervical adenopathy
Effects on organs from mono
splenomegaly, palatine petechiae, macular eruption, exudative pharyngitis/tonsillitis, hepatic involvement to some degree often asociated with jaundice
nurses responsiblity in care of mono pts
directed toward providing comfort measures to relieve symptoms and toward helping affected youngsters and families to determine appropriate for the stage of the disease. Q effort should be made to prevent secondary infection
nurses responsiblity in care of teenagers who smoke
prevention of regular smoking in teenagers is the mos effective way to reduce overall incidenceof smoking.
repetitive microtrauma
the same movements are performed over a long period, results in inflammation of the involved structure-c/o chronic pain, tenderness, swelling and disability eg are tendinitis and ostiochondritis from repetitive throwing, tennis elbow, repititive elbow strain
nurses role in care of
children and adolescents in sports
the best approach to counseling children andparents regarding sports participation is to encourage activities that are most likely to provide pleasure and physical benefits throughout childhood and into adulthood
diseases that cause delay in growth
asthma, cystic fibrosis, GI diseases s/a parasitic infections, malabsorption syndromes, cardiacn anomalies and chronic reanal distrubances
nurses responsiblity in care of children with growth delay or early growth spurt
Listening to distressed adolescents and conveying interests and concerns are very important, children who are shorter should not be treated as if they are younger and children who are taller should not be treated as if they are older
Turner syndrome
abscence of one X chromosome missing, girls who have this disorder are infertile, diag. at birth-webbed neck, spaced nipples edema of hands and feet. Imature
Klinefelter Syndrome
Presence of an additional X chromosome. Found mostly in males. Abscence of sperm in semen, small testes and defective development of secondary sex characteristics, cognitive impairment - frequent clinical finding
dysmenorhea
usually begins at menarche, painful menstruation, overproduction of uterine prostaglandins has been implicated in women with dysmenorhea
nursing considerations during menstruation
explain menstruation is normal, encourage balanced diet, recommend NSAID, continued support since they are so self concious and concerned about appearance
most obvious anamolies of the male repro sys.
hypospadias, hydrocele, phymosis, cryptorchidism
phymosis
a narrowing of the opening in the foreskin that prevents its being drawn back over the penis. This makes washing difficult or impossible and often leads to irritation and infection.
hydrocele
an accumulation of watery liquid in a body cavity, especially in the sac around the testes. It is a painless condition that can be treated surgically by draining the fluid
hypospadias
Hypospadias is a birth defect in which the male urinary opening is misplaced on the penis;
The most frequent problems related to the reproductive organs in later male children are
1)infections, s/a Urethritis; 2) hematuria; 3)penile problems s/a nonretractable foreshin in uncumcised males, carcinoma and trauma 4)scrotal condition s/a varicocele (elongation, dilation and tortuosity of the veins wuperior to the testicle 5) testicular torsion
torsion
the twisting of something, or a twisted state
nursing considerations with an adolescent boy
The adolescent is extremely conscious of self, matter a fact approach is best, explain exactly what you will do,
normal testicle
firm, smooth eegg shaped contour, the epididymis is palpated as a rased swelling on the superior aspect s/n/b confused as an abnormality
morbidity
diseased state: the presence of illness or disease
nursing considerations with a pregnant teen
careful assessment, teach how to cope with stress, guidance from adults, info on options, given a a nonjudgmental manner, encourage prenatal care, nutrition info very important
nursing considerations with teens and STDs
teach safety, efforts s/b towards primary prevention, tertiary prevention should include, reducing the medical and psychological effect, support groups, seeking treatment for STDs
PID presenting symtoms
generalized fever, abdominal pain, UTI, vague influenza type manifestations, s/a malaise, nausea, darrhea or constipation. Pelvic exam is indicated for Q sexually active female who c/o abd. pain to r/o PID
short term complications of PID
acute abscess formation in the falopian tube,
Long term complications of PID
chronic pelvic pain, dyspareunia adhesion formation, increased r/o ectopic pregnancy
2 things to communicate initially to a rape victim
1) he/she is all right, 2) he/she is not to blame for the situation
nursing consideration with male practioner examination
female must be present when a female is being examined by a male practitioner
rape trauma syndrome
refers to the victim's reation to a sexual assault. 1) the acute phase of disorganization of lifestyle 2) a long-term process of reorganization. These phases encompass behavioral, somatic and psychologic reactions to the stressfull event
Primary goal of nursing care of a rape victim
avoid inflicting further stress on the youngster, who is often angry, confused, frightened, embarrassed, and filled with self blame
Therapeutic Tx of Anorexia Nervosa
1)reinstitution of normal nutrition or reversal of malnutrition, 2) resolutin of disturbed paterns of family interaction and 3) individual psychotherapy to correct deficits and distortions in psychologic functioning.
Therapeutic mgt of anorexia nervosa
hospitalization for k+ depletion, esophageal damage, IV fluids for k+ replacement, cardiac monitoring and nutritional consultant
Nusing care of AN
monitoring IV fluids, electrolyte alterations and ovservationfor signs of cardian complications, relaxation techniques and telephone support network
ADHD
developmentally inappropriate degrees of inattention, impulsiveness, and hyperactivity
Learning Disabilities
heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of llietening, speaking, reading, writing, reasoning or mathemathecal skills
Nursing considerations with ADHD AND LD
Take meds in the morning to mazimize its effectiveness in the classroom and to decrease it insomnia-producing potential. If decreased appetite is a concern giving the medication (psychostimulant) with or after meals rather before is helpful
methylphenidate
stimulant that increases dopamine and norepinephrine levels that lead to simulation of inhibitory system of the CNS
SE of Ritalin
nausea, anorexia, decreased appetite and insomnia
Goal of children with LDs
to help them identify their ares of weakness and learn to compensate for them
Nursing considerations in ADHD and LD
Teach to take stimulant medication in the am, to maximize effectiveness in the classroom and to decrease it insomnia-producing potential
Environmental manipulation in ADHD children
set limits, keep a regular routine, decrease external stimuli and distractions- to encourage designed pattern of behavior.
audio perceptual deficit (LD)
unable to follow directions or to comprehend large amts of verbal teaching
visual perceptual deficit (LD)
may have difficulty reading, lining up numbers for math operation or judging distance.
integrative deficit (LD)
difficulty sequencing data or storing and retrieveing sensor data
dysgraphia (LD)
dificulty with writing
therapeutic techniques to mange enuresis
medications, bladder training, restriction or eliminaiton of fluids after the evening meal, interruption of sleep to void, apparatus designed to trigger some reflex to prevent wetting
meds for enuresis
Tofranil -tricyclic antideppresant, oxybutynin reduces uninhibited bladder contractions, Desmopressin, nasal spray, reduces nighttime urine output to a volume less than functional bladder capacity
primary encopresis
by age 4 when the child has not achieved fecal continence
secondary encopresis
fecal incontinence occurring in a child older than 4yrs after a period of established fecal continence.
Cause of encopresis
constipation, precipitated by environmental changes. chronic severe constipation impars the usual movement and contractions of the colon, which can lead to fecal obstruction.
Post traumatic stress disorder PTSD
development of characteristic symptoms after exposure to and extremely traumatic experience ot catostrophic event
Stages of PTSD
initial response, second phase and third phase
conversion reaction
hysteria, hysterical concersion reaction and childhood hysteria is a psychophysioogic disorder with a sudden onset that can usually be traced to a precipitating environmental event.
manifestations of converstion reaction
sx include abd. pain, fainting pseudoseizures, paralysis, headaches and visual field restriction.
childhood schizophrenia
severe deviations in ego functioning and is generally reserved for psychotic disorders that appear in children under 15yo
childhood schizophrenia is characterized by
lack of contact with reality, impaired cognition, perception, emotion, language and physical motor control, language disturbances, impaired interpersonal relationship, inappropriate affect
CNS effects of inhalants
rapid lossof consciousness and respiratory arrest, may cause visual scanning problems, language deficiencies, motor instability, memory deficits and attention and concentration problems
Hallucinogens
psychedelic, psychotomimetic, psychotropic or illusionogenic are drugs that produce vivid hallucinations and euphoria, no physical dependence
suicidal ideation
preoccupation with thoughts about committing suicide
Nurse alert - items to not make available four suicidal teens
adolescents who express suicidal feelings and have a specific plan should be motniored at all times. They should not have access to firearms, prescription or over the counter drugs, belts, scarves, shoestrings, sharp objects, matches, or lighters if they are intoxicated they must be restrained or placed in a protective environment until a psychiatrist or psychologist can assess them
nurse alert- things not to ignore in a suicial teen
no threat of suicide should be ifnored or challenged. Threats are a symptom that must be taken seriously. Too often, suicidal threats or mi nor attempts are confused with bids for attention. It is also a mistake to be lulled into a false sense of security when the adloescent's depression is apparently relieved. The impovement in attitude may mean that the youngster has made the decision and found the means to carry out the threat
culture and menstruation in India
it is an event of embarrassment that should be hidden and not discussed.
normal menstrual cycle lenght
21-35 days
Mentrual flow averages
25-60ml per period
mentrual length
2-5 days
Virginity in Arab women
Among Arab people a girl's virginity is highly valued, As a result unmarried Arab women do not use tampons during menstruation for fear of breaking the hymen.
Four causes of Amenorrhea
Hypothalamic dysfuntion, Pituitary dysfunction, Ovarian failure, Anatomic abnormalities
hypothalamic dysfunction -Amenorrhea
failure of the structures of the hypothalamus, weight loss triggered by anorexia, bulimia, fad dieting, excessive exercise- runners, dancers, severe prolonged stress
Pituitary dysfunction in Amenorrhea
Pituitary disease, tumors, increase in prolactin levels from psychiatric meds, low prolactin levels from pituitary failure, head trauma, Sheean's syndrome
Ovarian Failure- amenorrhea
genetic disorders eg Turners syndrome (defective chromosome) radiation, chemotherapy, viral infection, surgical removal of
Anatomic abnormalities
congenital absence of the uterus, ovaries, or vagina; congenital obstruction; or imperforate hymen
Secondary dysmenorrhea
associated with pathology the reporductive tract and usually appears after menstruation has been established
hypomenorrhea
regular uterine bleeding in decreased amounts
hypermenorrhea
abnormally long menstrual flows
oligomenorrhea
irregular periods 40 day intervals
polymenorrhea
irregular/regular intervals of 22 days
menorrhagia
excesibe bleeding in amt and duration at regular intervals
metrorrhagia
bleeding or normal amts at irregular intervals
menometrorrhagia
excessive bleeding in duration and amount regular or irregular
intermenstrual bleeding
bleeding between periods
premenstrual dysphoric disorder (PMDD)
symptoms are more psychotic, related to mood and severe enough to interfere with work
culture and menopause in the Philipines
menopause is viewed as positive and liberating. Women are respected and admired for their years of experience
vasomotor disturbance
hot flash- heat rising from the chest and spreading to the face
cognitive function
learning, memory, concentration, and planning ability
Reason for prescribing HRT
stop hot flashes, night sweats, reverse atrophic vaginal changes, prevent osteoporosis, also helsp with viginal dryness, dyspareunia, dysuria, urinary urgency frequent urination and recurrent UTI, also protects against colorectal CA and Alzheimers disease
Disadvantages of HRt
increased heart attack or CVA, DVTs, brease CA, colorectal CA and hip fracture, as well as gall bladder disease
Administration of Actonel
taken on an empty stomach, with a large glass of H20, sit upright or stand for about 30 minutes after taking the med and before eating.
sings of cardiac arrest, MI in women
pain in the neck, back or epigatric region, loss of appetite, SOB, N/V, weakness in shoulder, arms and chest
Foos high in phytoestrogen
carrots, yams and soy products
foods that trigger menopausal symptoms
caffeine, alcohol and spicy foods
spinnbarkheit
stretchable mucous from the vagina
cervial mucus method aka
ovulation method and billings method
symptothermal method
cycle length, coitus, cervical mucus change and secondary signs s/a increased libido, abdominal bloating, mittelschmerz 9midcycle abdominal pain and BBT , these signs indicate ovulation
Problems to report in the use of IUD for conceptive
late period, abnormal spotting or bleeding, dyspareunia,m abdominal pain, abnormal discharge, signs of infection-feer chills, malaise or missing string. If pregnant with IUD remove immediately
How do hormonal conceptive work
they work by inhibiting the release of an ovum, by creating an atrophic edometrim and by maintaining a thick cervical mucus that slows sperm transport and inhibits the process that allows sperm to penetrate the ovum
combined oral contraceptive aka
birth control pills
side effects of combined oral contraceptives
weight gain, acne, breast tenderness, bloating.
contratindication for COGs
hx of DVTs, pregnancy, chronic liver disease, heavy smoker, dependent carcinomas, undiagnosed uterine bleeding, diabetes, hyperlipidemia
women who need close monitoring with COC's
women with history of migraine headaches, epilepsy, depression, oligomehorrhea and amenorrhea.
Benefits or COCs
diminished cramps, regular cycles, mittelschmerz eliminated, funtional ovarian cysts diminished, reduction in ectopic pregnancy, edometrial cancer, colorectal cancer, iron difiency anemia, benigm breast disease
warning signs to report with COCs
breast lump, becomes jaundiced, severe abdominal pain, severe chest pain, SOB, severe headaches, dizziness, changes in vision, vision loss or blurring, speech problems, or severe leg pain
how does norplant (contraceptive work)
Prevents ovulation, stimulates the production of thickcervical mucus, which inhibits sperm penetration (implanted for 5 years)
side effects of norplant
spotting, irregular bleeding, amenorrhea, increased incidence of ovarian cysts, weight gain, headaches, fluid retention, acne, hair loss, mood changes and depression
Two types of oral contraceptives
estrogen-progestin (the pill)and the progestin only product (the mini pill)
how do estrogoen-progestin work
they suppress the pituitary release of FSH and LH which are needed to mature a graafian agent, it also changes the endomitrium, making it unfavorable for implantation of a fertilized ovum
how do progetin only products work
alters the cervical mucus and secondarily by altering the endometrium to inhibit implantation. (some clients experience no ovulation)
half life of combination products for oral contraceptives
6-20hours
porphyria
medical condition caused by the body's failure to metabolize porphyrins. Symptoms of the hereditary form include abdominal pain, sensitivity to sunlight, confusion, and excretion of porphyrins in the urine.
porphyrins
a metal-containing pigment in animal and plant tissue, consisting of four pyrrole rings linked by methylene groups, e.g. hemoglobin
side effects by an excess of estrogen (COCs)
N/V, diziness, fluid retention, edema, bloating, breast enlargement, breast tenderness, chloasma (slightly more in dark-skinned clients exposed to sunlight on higher dose tablets) leg cramps, decreased tearding, corneal curvature, visual changes vascular headache and hypertension
side effects caused by deficiency in estrogen
vaginal bleeding (breakthrough bleeding), oligomenorrhea, nervousness, dysparunia secondary to atrophic vaginitis
side effects by an excess of progestin
increased appetite, weight gain, oily skin, and scalp acne, depressin, vaginitis from yeast (candida) excess hair growth, decreased breast size and amenorrhea after cessaton of use
side effects caused by progestin dificiency
dysmenorrhea, bleeding late in the cycle, heavy menstrual flow with clots and amenorrhea
ACHES
A-ABD. PAIN (SEVERE), C-CHEST PAIN OR SOB, H-HEADACHES THAT ARE SEVERE, DIZZINESS, WEAKNESS, NUMBNESS, SPEECH DIFFICULTIES, E-EYE DISORDERS INCLUDING BLURRING OR LOSS OF VISION, S-SEVERE LEG PAIN OR SWELLING IN THE CALF OR THIGH
serious side effects of Depo-Provera
chest pain, hemoptysis, abdominal pain, SOB and numbness in the extremities
Lunelle a COC works by
inhibiting secretion of gonadotropin, preventing maturation and ovulation. Given IM
Adminsitration of Lunelle
IM, Q 28-30 days, not to exceed 33 days, 1st dose given in 1st 5 days of menses, do not administer if more than 33 days, to rule out pregnancy, smokers do not take
Side effects of NuvaRing
viginal discharge, irritation, or infection
severe side effects of NuvaRing
Risk of blood clots or heart attacks -increased in clients who smoke
How does the IUDs ParaGard and Progestasert work
ParaGard releases copper that interferes with sperm motility and fertilization as a result of inflammation of the endometrium. Progestawert reduce the viability of sperm through release of progesterone.
PMS occurs in which phase of the menstrual cycle
Luteal phase (15-28 days)
PMS decreases in which phase
the folicular phase (1-14 days)
Endometriosis
abnormal locationo of endometrial tissue outside of the uterus in the pelvic cavity.
Drug therapy for endometriosis
danazol (Danocrine), leuprolide acetate for depot suspension (Lupron Depot), nafarelin acetate (Synarel Nasal Solution)
danazol (Danocrine)
pituitary gondotropin inhibitory agent, suppresses and atrophies intra and extrauterine tissue, menses cease during drug therapy
Adverse effects of danazol (Danocrine)
thrombocytopenia, hypertension, depression, headache, hot flashes, wgt gain, androgenic effects, hemorrhagic cystitis, hematura, hepatotoxity, cholestatic hepatitis, acne, rashes, oily skin, hirsutism, bloating, muscle cramps, voice deepening, (irreversible) hearing loss, mood swings, anxiety, fatigue, nausea, vomiting, diarrhea, constipation
(Lupron)leuprolide acetate for depot suspension
an agonist, initially stimulates FSH and LH, but over time creates prolonged suppression, which causes decreased ovarin secretion of estrogen/progesterone, resulting in a hypoestrogenic statel, Lack of hormonal stimulation causes regression of displaced endometrial tissue
Lab values altered with the admin. of danazol (Danocrine)
decreased HDL, increase LDL, can increase insulin requirements, if given with coumadin, cause a prolonged PT
side effects of Lupron
hot flashes, headaches, decreased libido, dry vagina, night sweats, mood changes, mild bone loss (usually regained within six months of treatment)
nafarelin acetate (Synarel Nasal Solution)
hypoextrogenic,-therapeutic state reduces endometriosis
side effects of nafarelin acetate (Synarel Nasal Solution)
hot flashes, viginal dryness, decreased libido, headaches, and emotional lability
female climateric
non reproductive stage of a female's life- 3 stages, premenopause, menopause and post menopause
What causes menopause
decreased ovarian function
Premarin
Estrogen replacement therapy (conjugated estrogen) to relieve vasodilation, hot flashes, and viginal dryness and to prevent cardiovascular disease and osteoporosis
premarin should be used with caution in individuals with
CAD, severe renal or hepatic disease, smoking hx and DM
Drug and Lab interactions of premarin
increase effects of corticosteroids, decrease effects of anticoagulants, oral hypoglycemics, decrease effects of rifampin, anticonvulstants, barbiturates, toxicity with tricyclic antidepressants
Side Effects of Premarin
N/V, fluid retention, breast tenderness, leg cramps, and breakthrough bleeding, chloasma
Adverse reactions of premarin
jaundice, thromboembolic disorders, depression hypercalcemia, gallbladder disease
Life threatening effects of premarin
Thromboembolism, crebrovascular accident, PE, MI and endometrial cancer
testosterone
induces and preserves the male sex characteristics
PLISSIT
P-PERMISSION, L-LIMITED IMFORMATION, S-SPECIFIC,S-SUGGESTIONS, I-INTENSIVE,T-THERAPY
DRG
Digital rectal exam
PSA is described in ml as
nanograms per mL
TRUS
transrectal ultrasound
prostadynia
pain in the prostate
prostatism
increased frequency of urination, nocturia, urgency, hesitancy in starting ruination, abdominal straining with urination, a decrease in the bolume and forceof the urinary stream, interruption of the urinary stream, dribbleing, a sensation that the bladder has not been completely emptied, recurrent UTI
What is a major complicatiom of prostate surgery
hemorraging
transurethral needle ablation
uses low-level radiofrequencies to produce localized heat to detry prostate tissue while sparing the urethra, nevers, muscles, and membranes.
microwave thermo therapy
heat is applied to the hypertrophied prostatic tissue. a transurethral probe is inserted into the urethra and microwaves are carefully directed to the protate tissue. A water colling system helsp sto minimize damage the urethra and decreases the discomfort from the procedure, the tissue becomes necrotic and sloughs
When d symptoms of prostate CA develope
Later in the disease- urinary obstruction
azotemia
accumulation of nitrogenous waste products in the blood
nursing considerations fluid imbalance in prostatectomy
must monitor fluid balance, monitor electrolyte imbalance, (hyponatremia) rising blood pressure, confusion and respiratory distress. Increased risk for respiratory fluid imbalance in the elderly with preexisting cardiac and respiratory disease
What is the first thing done after a prostectomy
the patien is assisted to sit and angle his legs over the side of the bed on the day of surgery.
color of irrigation fluid after a prostectomy in CBI
starts out ats reddish-pink and then clears to a light pink within 24hours after surgery
nursing management in prostectomy
monitor vs, Is & Os, administer meds, IV fluids and blood component therapy, monitor drainage for accurate out flow of urine
Assessment of obstructed catheter
overdistended bladder presents a distinct rounded swelling above the pubis, overdistended bladder is avoided b/c it can induce secondary hemorrhage by stretching the coagulated blood vessels in the prostatic capsule
Name one clinical manifestation of testicular cancer
enlargement of the testis without pain is a significant diagnostic finding
At what rate does testicular cancer metastisize
they metastisize early to the lymph nodes, lungs and retroperitoneum
long-term side effects associated with tratmen for testicular cancer
kidney damage, hearing problems, gonadal damage, neurological changes and sometimes secondary CA
Postoperatively what is the major complication of hydrocele
hematoma in loose scrotal tissue, postoperatively a patient wears an athletic supporter for comfort and support
phimosis
a condition in which the foreskin is constricted so that it cannot be retracted over the glans.
luteinizing hormone
responsible for stimulating progesterone production
follicle-stimulating hormon
stimulates the ovaries to secret estrogen
proliferative phase
beginning of the menstrual cycle just after menstruating
secretory phase
near the middle portion of the cycle 14-28
luteal phase
begins after ovulation and is characterized by the secretion of progesterone from the corpus luteum
chadwick sign
bluish cervix - early sign of pregnancy
sign of neoplasm in the cervix
hardness and immobility of the cervis may reflect invasion by a neoplasm
Androgens
male sex hormones
Drugs for Androgens
Duratest 100, Depo-testosterone, Virilon, Testred Cypionate
Contra indications for androgens
pregnancy, nephrosis, hypercalcemia, hepatic dysfuntion, prostate CA, hx of MI, prepubertal status, pituitary dysfunction
Drug lab interactions of androgens
increases effects of anticoagulants, decreases effect with barbiturates, dilantin, phenylbutazone, antogonizes-calitonin, parathyroid, corticosteroids, exacerbate edema, decrease blood sugar in DM, increases serum cholesterol, thyroid, liver fuction and hemotcrit
administration of androgens
IM
Other uses for androgens
treatment of refractory anemias in men and women, the hereditary autosomal clotting disorder andioneurotic edema, tissue wasting assoc. /c severe or chronic illness, advanced carcinoma of vreast in women and endometriosis, also for severe menopausal symptoms
SE of adrogen therapy
abd. pain, Nausea, insomnia, diarrhea or constipation, hives, or rednes at the injection site, increased salivation, mouth soreness and increased or decreased sexual desire.
Adverse reactions of adrogens
development of secondary male characteristics, when the man is not hypogonadal, women who use this risk these manifestations as well, including acne,, skin oiliness, facial hair growth, and vocal huskiness, menstrual irregularity, hypertrophy of the clitoris in women, vocal changes are permanent, others slowly reverse themselves if the pt is not a CA pt receiving long
virilization
feminization
Less freq. adverse effects of androgens
dizziness, weakness, changes in skin color, freq. headaches, confusion, resp distress, depression, pruritus, allergic skin rash, edema of the LE, jaundice, bleeding, presthesias, chills, polycethemia, muscle cramps, NA+ and H20 rentension
paresthesia
an unusual or unexplained tingling, pricking, or burning sensation on the skin
anabolic steroids
testerone derivatives developed to maximize the anabolic effects of androgens and to minimize their androgenic effects
antiandrogens
block the synthesis or action of androgens
antiandrogen use
used to treat male-pattern baldness, acne, hirsutism, virilization syndrome in women, precocious puberty in boys (they inhibit the sex drive in men)
Two types drugs to block testosterone action
androgen-receptor antagonists and agents that block conversion of testosterone to its active form dihydrotestosterone
cyproterone acetate
an orally active progesterone is a poten androgen antagonist, It also suppresses LH and FSH secretion and has proegestational qualities
SE of cyproterone acetate
can stunt growth in young people, acne and baldness
finasteride
used to treat benign prostatic hypertrophy
Adverse effects of finasteride
impotence, decreased libido and decreased ejaculate
signs of hypercalcemia
n/v, lethargy, decreased muscle tone, polyuria, increased urine and serum calcium
Inadequate pituitary function
results in hypgonadism, prepubertal boy-results in lack of secondary sex characteristics and infertility, adult ment may experience testicular atrophy and decreases in libido, potency, beard growth and muscle tone.
menotropins (pergonal)
stimulates testosterone production when injected IM
adverse effects of menotropins (pergonal)
nausea, vomiting, diarrhea, gynecomastia and fever
addison's disease-
deficit of cortisol and mineralocorticoid aldosterone, may experience inhibited sexual desire, erictile dysfuntion or diminished fertility
inhibited sexual desire results from
androgen deficiency
erectile dysfunction caused by
cause by psychoemotional problems, vascular insufficiency, neurologic disorders, androgen deficiency or resistance, or diseases of the penis
ejaculatory dysfunction caused by
result of drug therapy, androgen deficiency, or sympthetic degeneration, reduction of penile swelling (detumescence)
Other uses of Levodopa (L-Dopa)
effective in stimulating libido and treating erectile dysfunctions in non-Parkinson's clients
SE of Viagra (Sildenafil citrate)
flush, headache, dyspepsia, nasal congestion and diarrhea, other SE blurred vision, photosensitivity, changes in color perception, urinary tract symptoms,
adenocarcinoma
a malignant tumor with cells arranged in patterns similar to those of a gland
drugs that cause sexual dysfunction
anticholinergics, antidepressants, antihistamines, antihyperntensives, antipsychotics, sedatives and social drugs others-baclogen, steroids, ethionamide, digoxin, chemotherapeutic drugs, perhexiline
drugs androgen replacment,delayed puberty, senile or postmenopausal ostioporosis
testosteron (histerone, tesamone, testopel pellets, testosterone aqueous, testosterone powder
drugs for carcinoma of the breast
testosteron (histerone, tesamone, testopel pellets, testosterone aqueous, testosterone powder
drugs androgen replacment,delayed puberty
testosterone cypionate (Andro-Cyp, Andronate, depAndro, Depotest, Depo-Testosterone, Duratest, Testred cypionate, Virilon IM)
Androgen deficiency, carcinoma of the breast drugs
fluoxymesterone (Halotestin)
Androgen dificiency drugs
methyltestosterone (Android, Oreton Methyl, Testred Virilon)
metronidazole (Flagyl)
antiprotozoal and antibacterial agent- treats T Vaginalism bacterial vaginosis, endometritis, endomyometritis, tubo-ovarian abscess and postsurgical vaginal cuff infection
Contraindications in Flagyl
blood dyscrasias, breastfeeding (drug secreted in breast milk) impaired kidney or liver function, active CNS disease
SE of Flagyl
convulsive seizures, weakness, peripheral neuropathy insomnia, N/V, HA, Anorexia, diarrhea, Epigastric pain, abd cramping, constipation, metallic tase in mouth, dizziness, vertigo, uncoordination, ataxia, confusion, irritability, cystitis, dysuria, reversible neutropenia, thrombocytopenia, flattening T Wave on ECG, polyuria, incontinence, pelvic pressure, proliferatio of candida in the vagina and mouth, jnt pain, decreased libido, dryness in the mouth, vagina and vulva, dysparunia, depression
vulvovaginal candidiasis
moniliasis or yeast infection
candida strains
c glabrata, c tropicalis and c krusei
ketoconazole effects on the liver
hepatotoxicity
trichomonas vaginalis
a microscopic motile protozoan that thrives in alkaline environment
effects of trichomoniasis in pregnant women
may be at increased risk for premature rupture of membranes, preterm birth and low birth weight
effects when taking metronidazole with alcohol
Antabuse- abdominal pain, nausea, flushing or tremors
sequelae
a disease/disorder ie caused by a preceding disease/injury in the same individual
friable cervix
bleeds easily
gonorrhea caused by bacterium
Neisseria gonorrhoeae
two STD's that occur together
chlamydia and gonorrhea
syphilis caused by spirochete
treponema pallidum
primary stage of syphilis
painless chancre appears, symptoms include, fever, lossof weight and malaise > 4 weeks
secondary period of syphilis
skin eruption called condylomata lata, which resemble wartlike plaques-very infectious, appears on the vulva, other secondary Sx, acute arthritis, enlargement of the liver and spleen, nontender enlarged lymph nodes iritis, and a chronic sore throat /c hoarseness
condylomata acuminata
genetal warts
organism most frequently identified with PID
chlamydia trachomatis and Neisseria gonorrheoea
ASB
asymptomatic bacteriuria
Causative pathogens of UTI
staphylococcus saprophyticus, klebsiella, proteus, enterobacter and pseudomonas
classic symptoms of cystitis
acute dysuria, urgency and frequency, suprapubic and low back pain, occasional hematuria
risks of pyelonephritis and pregnant women
increased risk of preterm labor, preterm birth, development of ARDS and septicemia and in some instances intrauterine growth restriction, A
Acute pyelenophritis sx
high temperatures, sudden onset of chills
what side is most affected in pregnant women in pyelenophritis
the R side b/c the lrg bulk of intestines to the L pushes the uterus to the R putting pressure on the R ureter and kidney
Diseases that may cause uterine bleeding
thyroid dysfunction, coagulation disorders and cirrhosis, may result from trauma including accidental injury, sexual abuse or intercourse related trauma