Med Surg Chapter 47 Female Reproductive Disorders

Front 1

What is the pH of the vagina?

Back 1

3.5-4.5

Front 2

What effect does estrogen have on the pH?

Back 2

it lowers it
(with a dec in estrogen during menopause, there is an increase in pH causing more infections)

Front 3

What is vaginitis and what are the s/s?

Back 3

Inflammation of the vagina
itching, odor, redness, burning, edema

Front 4

What may also occur with vaginitis?

Back 4

urethritis

Front 5

What are risk factors for vulvovaginal infections?

Back 5

premenarche, preg, menopause, poor hygiene, tight underwear, synthetic clothing, douching, allergies, antibodics, DM, intercourse with infected partner, oral-genital contact, HIV

Front 6

What is candidiasis and the s/s?

Back 6

fungal or yeast infection
vaginal discharge, itching, irritation, white cottage cheese like discharge

Front 7

What is bacterial vaginosis and the s/s?

Back 7

over growth of bacteria, inc pH
fish-like odor esp during intercourse and menstruation, heavier then normal yellow/gray discharge

Front 8

What are the risk factors and complications for vaginosis?

Back 8

STD, smoking, multiple sex partners, sex toy use
premature labor, endometritis, recurrent UTI

Front 9

What is the treament for vaginosis?

Back 9

anti infectant (flagyl)

Front 10

What is trichomoniasis and its complications?

Back 10

sexually transmitted vaginitis caused by protozoan
HIV contraction, cervial neoplasm, postop infections, adverse preg, PID, infertility

Front 11

What are the s/s and treatments for trichomoniasis?

Back 11

yellow-green vaginal discharge, burning itching, red spots on vaginal and cervix
antiinfectant-flagyl

Front 12

What are the most common strains of HPV?

Back 12

6, 11
cause condylomata (warty growths)

Front 13

What strains of HPV are associated with cervical cancer and how are they found?

Back 13

16, 18, 31, 33, 45
colposcopy

Front 14

What is dysplasia?

Back 14

changes in cervical cells

Front 15

What are the s/s of HPV?
What increases recurrence?

Back 15

none, warty growths
stress, sunburn, dental work, inadequate rest, inadequate nutrition

Front 16

What is herpes genitalis?

Back 16

life long recurrent viral infection that causes herpetic lesions on external genitalia, vagina, cervix

Front 17

How is herpes genitalis transmitted?

Back 17

sexual contact or touching a cold sore then touching genitalia

Front 18

What are the 6 types of herpes viruses?

Back 18

HSV 1-cold sores
HSV 2- genital herpes
HSV 3- shingles
HSV 4- epstein barr
HSV 5- CMV
HSV 6- human B-lymphotrophic virus

Front 19

What are the s/s of herpes genitalis?

Back 19

itching, pain, red, edmatous, macules, papules, vesicles, ulcers, blisters, coalesces, ulcerates, encrusts, flu-like symptoms, lymphadenopathy, dysuria

Front 20

What are potential complications of herpes genitalis?

Back 20

fetal mortality, aseptic meningitis, neonatal trasmission, emotional stress

Front 21

What is the treatment for herpes genitalis?

Back 21

relieving symptoms

Front 22

What is endocervicitis?

Back 22

inflammation of the mucosa and glands of the cervix caused by organisms in cervical glands after intercourse, abortion, intrauterine manipulation, or vag delivery

Front 23

What is mucopurulent cervicitis?

Back 23

inflammation of the cervix with exudate related to chlamydia

Front 24

What are the most common causes of endocervicitis?

Back 24

chlamydia and gonorrhea

Front 25

What are the s/s and complications of chlamydia?

Back 25

none, cervical discharge, dyspareunia, dysuria, bleeding
ectopic pregnancy, infertility, PID, conjunctivitis, periheopatitis, still birth, cervial cancer

Front 26

What are the s/s and complications of gonorrhea?

Back 26

none, urethritis, epididymtis, discharge
HIV infection, PID, tubal infertility ectopic preg, chronic pelvic pain

Front 27

What is the treatment for chlamydia and gonorrhea?

Back 27

antibiodics
zithromax, doxycycline, erthromyocin

Front 28

What is pelvic inflammatory disease?

Back 28

inflammation of pelvic cavity usually caused by bacteria, may be viral, or fungal

Front 29

Describe the patho of PID

Back 29

organism enters the body thru vagina, into cervial canal, into uterus, may go to fallopian tubes and ovaries and pelvis

Front 30

What causes PID?

Back 30

sexual transmission, invasive procedure, hysteroscopy, surgical abortion, IUD

Front 31

What are the s/s of PID?

Back 31

vaginal discharge, dyspareunia, lower pelvic pain, tenderness, fever, N/V, headache

Front 32

What are the complications of PID?

Back 32

peritonitis, abscesses, strictures, fallopian tube obstruction, ectopic preg, sterility, pelvic pain, septic shock, thrombophlebitis

Front 33

How is PID treated?

Back 33

antibiodics, bed rest, IV fluids, analgesics
may require removal of uterus, fallopian tubes and ovaries

Front 34

What are the two types of fistulas of the vagina?

Back 34

vesicovaginal (bladder and vagina)
rectovaginal fistula (rectum and vagina)

Front 35

What is cystocele? It's s/s and treatment?

Back 35

-downward displacement of the bladder
-pelvic pressure, incontinence, fatigue
-kegel ex, pessaries (plastic device to keep organ aligned), colporrhaphy (repair of ant vaginal wall)

Front 36

What is rectocele? It's s/s and treatment?

Back 36

-bulging of the rectum into the vagina
-pelvic pressure, rectal pressure, back pain
-kegels, pessaries, pos. colporrhaphy

Front 37

What is enterocele, s/s, treatment?

Back 37

-protrusion of intestinal wall into vagina
-kegels, pessaries, surgery

Front 38

How is a perineal laceration treated?

Back 38

perineorrhaphy surgery

Front 39

What is prolapse and the treatments?

Back 39

-cervix, uterus, vaginal walls, bladder and rectum may protrude from the vagina
-pessaries, hysterectomy, surgery to suture back into place

Front 40

What is vulvitis and its s/s?

Back 40

-inflammation of vulva (maybe caused by DM, poor hygiene, etc)
-erythema, swelling, candidal infections, itching, burning

Front 41

What is vulvodynia the s/s and the 2 types?

Back 41

-chronic vulvar discomfort
-burning, itching, stingin, irritation
-vulvar vestibulitis, dysesthetic vulvodynia

Front 42

What is a bartholin's cyst, the s/s, treatment?

Back 42

-causes obstruction of a duct in one of vestibular glands
-discomfort, asymptomatic
-all cysts can be treated with incision, drainage, antibodics, lanced

Front 43

What is vulvar dystrophy, s/s, treatment?

Back 43

-dry, thickened skin on vulva with papules, fussures, macules
-itching, pain, asymptomatic
-topical corticosteriods

Front 44

Describe a dermoid cyst?

Back 44

arise from ovum, thick, yellow, sebacous, may develop differently
treatment based on severity

Front 45

Describe polycystic ovary syndrome?

Back 45

endocrine condition-hypothalamic-pituitary/ovarian disorder that results in chronic anovulation and adrogen excess

Front 46

What are the s/s of PCOS?

Back 46

insulin resistance, hyperandrogenism, irreg periods, infertility, obesity, hirsutism, met. syndrom

Front 47

What is the treatment for PCOS?

Back 47

surgical removal of cyst, oral contraception, hysterectomy

Front 48

Define fibroid tumors, s/s?

Back 48

aka myomatous, usually benign, arise from muscle tissue of the uterus
abn vaginal bleeding, pain, backache, pressure, bloating, constipation, urinary problems, infertility

Front 49

What is the treatment for fibroids?

Back 49

hysterectomy, myoectomy, hysteroscopic resection of myomas, laparoscopic myomectomy/myolysis/cryomyolis, uterine artery embolization, monthly injections, antifibric agents

Front 50

Describe endometriosis?

Back 50

benign lesions growing aberrantly in the pelvic cavity (misplaced endometrial tissue), tissue bleeds and has no outlet, causes cysts, adhesions, can be caused by backflow of menses or via surgical instruments

Front 51

What are the s/s and stages of endometriosis?

Back 51

dysmenorrhea, dyspareunia, pelvic discomfort, dyschezia (pain with bowel movement), infertility
Stage 1-superficial/minimal lesions
Stage 2-mild involvment
Stage 3-mod involvment
Stage 4-extensive involvment and dense adhesions

Front 52

What is the treatment for endometriosis?

Back 52

analgesics, prostaglandins, hormone therapy, oral contraception, GnRH agonists, laparoscopy, laser surgery, endocoagulation and electrocoag, hysterectomy, oophorectomy, appendectomy

Front 53

Describe chronic pelvic pain, adenomyosis, endrometrial hyperplasia?

Back 53

->6 months pelvic pain
-tissue from endometrium invades uterine wall
-buildup of endometrial tissue caused by estrogen

Front 54

Describe cervical cancer

Back 54

squamous cells or adenocarcinomas (often caused by HPV), most spread to pelvic lymph nodes or reoccurance if not treated promptly

Front 55

What are the risk factors for cervical cancer?

Back 55

multiple partners, early sexual age, sex with uncircumcised male, sex with male whoses partners has had cervical cancer, early childbearing, HPV, HIV/immunodefiency, smoking, DES exposure in utero, low socioeconomic class, nutritional def, chronic cervical infections, overweight

Front 56

What are the s/s of cervical cancer?

Back 56

early-non, thin watery discharge
advanced- discharge, bleeding, pain, foul smelling discharge from necrosis of tumor, leg pain, dysuria, rectal bleeding, edema
more adv- infection, fever, fistula formation, abcess

Front 57

What are the diagnostic techniques and classification of cervical cancer?

Back 57

Pap smear, biopsy, coposcopy, x-ray, CT, MRI, urograph, cystography
T-extent for primary tumor
N-lymph noid involvment
M-metastasis

Front 58

What are the treatments for cervical cancer?

Back 58

cryotherapy, loop electrocautery excision procedure (laser), conization, hysterectomy (uterus, cervix, ovaries), radiation, surgery, radical hysterectomy (uterus, ovaries, fall tubes, proximal vagina, bilat lymph nodes) radical vaginal hysterectomy (uterus, ovaries, fall tubes, prox vag), bilateral, pelvic lyphadenectomy (iliac, hypogastric, lymphatic vessels and nodes), pelvic exenteration (bladder, rectum, pelvic lymph nodes, diversional conduit, colostomy, vagina), radial trachelelectomy (cervix, nodes)

Front 59

Describe uterus cancer

Back 59

cancer of endometrium (fundas or corpus), endometrioid (originate in lining of uterus)

Front 60

What are the risk factors for uterine cancer?

Back 60

55-61 years, postmenopausal bleeding, obesity, unopposed estrogen therapy, nulliparity, late menopause, tamoxifen, infertility, DM, HYN, gallbladder disease

Front 61

How is uterine cancer diagnosed and treated?

Back 61

-ultrasonography, biopsy, aspiration
-hysterectomy, radiation, bilateral salpingo-oophorectomy and node sampling, surgery

Front 62

Describe cancer of the vulva

Back 62

pruritus, soreness, bleeding, fouls smelling discharge, lump, mass, redness, lesion that will not heal

Front 63

What are risk factors for vulva cancer?

Back 63

smoking, HPV, chronic vulvar irritation, HIV, postmenopause

Front 64

How is vulvar cancer treated?

Back 64

local excision, laser ablation, chemotherapeutic creams, cryosurgery, vulvectomy, radiation, chemo

Front 65

What can cause vagina cancer?

Back 65

malignant melanoma, sarcomas
DES, previous cancer, radiation therapy, HPV, pessary use (chronic irriation)

Front 66

What are the s/s of vagina cancer and what is the treatment?

Back 66

bleeding, vaginal discharge, pain, urinary or rectal symptoms
radiation, chemo, local excision, radical vaginectomy, laser

Front 67

Describe ovarian cancer and risk factors

Back 67

-germ cell tumors, stromal cell tumors, epithelial tumors-most common
-heredity, nulliparity, infertility, talcum powder

Front 68

What are the s/s of ovarian cancer?

Back 68

inc in abdominal girth, pelvic pressure, bloating, back pain, constipation, abdominal pain, urinary urgency, indigestion, flatulence, GI symptoms

Front 69

What is the treatment for ovarian cancer?

Back 69

surgery, hysterectomy, tumor debulking, biopsies, chemo, radiation

Front 70

What is the most common s/s of ovarian cancer and following treatment?

Back 70

ascites and pleural effusion

Front 71

Describe the 4 stages of ovarian cancer

Back 71

Stage 1- cancer is contained within ovary
Stage 2- cancer is in 1 or both ovaries and in another organ within pelvis
Stage 3- cancer is 1 or both ovary, spread to lining of abdomen, or lymph nodes
Stage 4- cancer in 1 or both ovary, metastasis in liver, lungs, or other organs--end stage cancer in pleural cavity

Front 72

What is a hysterectomy and when is it used?

Back 72

surgical removal of uterus to treat cancer, dysfunctional uterine bleeding, endometriosis, nonmalignant growth, persistant pain, pelvic relaxatio, prolapse, previous injury to uterus

Front 73

Describe total hysterectomy

Back 73

removal of uterus and cervic

Front 74

Describe radical hysterectomy

Back 74

uterus, surrounding tissues, upper third of vagina, and pelvic lymph nodes are removed

Front 75

How are hyterectomies performed?

Back 75

abdominal incision or laparoscopically

Front 76

What are the post op nursing management?

Back 76

DVT, infection, hemorrahage, loss of bladder tone, voiding problems, hormone imbalance, edema, pain
avoid heavy lifting, straining, sitting for long periods

Front 77

When is radiation therapy used?

Back 77

cervical, uterine, ovarian cancers
used in combo with surgery and chemo

Front 78

What are the 3 types of radiation?

Back 78

external radiation, intraopearative radiation (IORT), internal irradiation

Front 79

What are basic radiation safety techniques?

Back 79

minimize amout of time near radioactive source, max distance, use shielding, wear film badge to monitor exposure, wear rubber gloves, dispose of soiled matter properly, keep patient restricted to room, explain discharge instructions throughly

Front 80

What are side effects of radiation therapy?

Back 80

diarrhea, abdominal cramping, radiation cystitis, urinary frequency, urgency, dysuria

Front 81

How is chemo administered?

Back 81

IV- ttaxol, paraplatin, liposomal therapy

Front 82

What are the common side effects of chemo?

Back 82

neutropenia, thromobocytopenia, nephrotoxicity, neurotoxicity, hair loss, hypersensitivity, N/V