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21 Cards in this Set
- Front
- Back
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Menstrual Disorders may include:
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premenstrual syndrome (PMS)
dysmenorrhea amenorrhea excessive bleeding irregular bleeding between cycles or irregular bleeding unrelated to cycles |
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Menstrual related disorders have been reported in as many as
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19% of women who report feeling:
more anxious sad nervous restless hopeless worthless smoke cigarettes drink to excess oveweight |
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Dysmenorrhea may result from
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endometriosis or anatomic abnormalities
or a normal variation |
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Amenorrhea may be related to
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pregnancy
thyroid disorders anatomic abnormalities eating disorders |
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Excessive bleeding may be caused by
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fibroids
clotting disorders thyroid disorders miscarriage |
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Irregular bleeding may be SECONDARY to
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hormonal changes in adolescence or perimenopause or
may result from pregnancy, threatened abortion or a variety of other factors |
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Premenstrual symptoms are common in
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OVULATING WOMEN and can influence quality of life
Symptoms occur in the LUTEAL PHASE and disappear with the ONSET OF MENSES PMS is a combination of bothersome symptoms Premenstrual DYSPHORIC disorder is a SEVERE type of premenstrual disorder and significantly impairs normal activity |
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The cause of these conditions is unknown; they are diagnosed if symptoms occure
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during the 5 days prior to the onset of menses , disappear within 4 days of the onset of menses and occur through several cycles
PMS tends to become less symptomatic with menopause |
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Major symptoms of PMS include:
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headache
fatigue low back pain painful breasts feeling of abdominal fullness BEHAVIORAL/EMOTIONAL General irritability Mood swings Fear of losing control Binge eating Crying spells |
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A generally stressful life and
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problematic relationships may be related to the INTENSITY of physical symptoms
Some women report moderate to severe life disruption secondary to PMS that negatively affects their interpersonal relationships |
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PMS may also be a factor in reduced
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productivity, work-related injuries, absenteeism
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Because there is no single treatment or known cure for PMS
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women should chart their symptoms so they can anticipate and cope with them
Regular exercise No proof that vitamins B, E, magnesium, oil of evening primrose are effective |
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Pharmacologic therapies (PMS)
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Selective Serotonin Reuptake Inhibitors
PROZAC SARAFEM GnRH Agonists Prostaglandin Inhibitors IBUPROFEN NAPROXEN (ALEVE) DIURETICS ANTIANXIETY CALCIUM SUPPLEMENTS Oral contraceptives containing DROSPIRENONE (a synthetic progestin) |
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Many women have some symptoms, but PMS affects
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2 to 5% of women and is a complex of symptoms
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Affective Symptoms
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Depression
Anger irritability Anxiety Confusion |
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PMS treatment:
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Social support/family
Nutritious diet: whole grains, fruits, vegetables, increased water SSRIs Alprazolam (Xanax) effective but RISK of dependence Spironolactone, a diuretic, fluid retention Exercise program Stress reduction |
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The nurse obtains a health history,
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noting the time when symptoms began and their nature and intensity
determines if the symptoms occur before or shortly after the menstrual flow begins shows patient how to record the timing and intensity |
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A nutritional history is elicited to determine if the diet is high in
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salt, caffeine or alcohol or low in essential nutrients
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The patient's goals may include
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reduction of anxiety, mood swings, crying, binge eating, fear of losing control, improved coping with day to day stress, improved relationships with family and coworkers, increased knowledge of PMS
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If the patient has severe symptoms (PREMENSTRUAL DYSPHORIC DISORDER, the nurse assesses her for
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SUICIDAL, UNCONTROLLABLE, AND VIOLENT BEHAVIOR
IMMEDIATE PSYCHIATRIC EVALUATION IN SOME CASES, VIOLENCE TOWARD FAMILY MEMBERS |
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Primary DYSMENNORHEA is a PAINFUL menstruation,
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with no identifiable pelvic pathology
OCCURS at the time of menarche or shortly therafter Crampy pain that begins before or shortly after the onset of menstrual flow for 48 to 72 hours Pelvic Exam findings are NORMAL Cause: Excessive production of PROSTAGLANDINS which causes |
