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67 Cards in this Set
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- Back
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Premarin, conjugated estrogen
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Treats hot flashes and other symptoms of menopause or low amounts of estrogen. Prevents osteoporosis (thinning of the bones) after menopause. Also treats symptoms of advanced breast or prostate cancers.
potential for endometrial hyperplasia and carcinoma |
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Depo Provera, progestin
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Progestin only extended release injectible contraceptive
Most side effects of the progestin-only birth control methods go away after the first few months of use. SE: Irregular menstrual cycles. Spotting or bleeding between menstrual periods. Sore breasts. Headache. Nausea. Dizziness. Bloating or weight gain, especially with the birth control shot. No menstrual periods. Although mini-pill use can stop periods, the shot is most likely to do so. |
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Tamoxifen, SERM
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Treats advanced breast cancer in men and women, and early breast cancer in women. Also may prevent breast cancer in women who are at a high risk because of age, family history, or other factor
Estrogen Agonist, antagonist Risk to pregnancy |
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Chlomid, clomiphene
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Treats ovulation problems in women who want to become pregnant
Should not be used during pregnancy Common side effects of Clomid may be abnormal vaginal bleeding, breast discomfort, headache, and GI symptoms of nausea and vomiting. |
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Ortho Evra, estrogen-progestin combo
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transdermal contraceptive applied on the same day for 3 weeks
Not for women over 35, smoking increases risk of stroke, risk of thrombotic event, discontinue is jaundice occurs, risk for hypertension, headacbe, uterine bleeding |
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Provera, a progestin
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can cause breakthrough bleeding and is teratogenic
Other names for progestin-only oral contraceptives are minipills and progestin-only pills (POPs). Prevents a woman's egg from fully developing. Cause changes at the opening of the uterus, such as thickening of the cervical mucus. Progestins make it harder for the fertilized egg to become attached to the walls of the uterus. |
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Implanon, progestin
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Implanted extended release progestion contraceptive.
Implanon should be inserted between Day 1 (first day of menstrual bleeding) and Day 5 of the menstrual cycle, even if the woman is still bleeding Contraindications: Known or suspected pregnancy Current or past history of thrombosis or thromboembolic disorders Liver tumors, benign or malignant, or active liver disease Undiagnosed abnormal genital bleeding Known or suspected breast cancer, personal history of breast cancer, or other progestin-sensitive cancer, now or in the past Allergic reaction t |
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Mirena, levonorgestrel T
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Intrauterine device with some progestin release
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Cytotec, misoprostol
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prostaglandin analog used with RU 486 for emergency contraception
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Fibroadenoma
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common benign solid unilateral tumor more common in young women
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Leiomyoma
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common benign tumor and leading reason for hysterectomy
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Good advice for relief of menopause symptoms:
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"Avoid drinking alcohol and caffeine"
Healthy lifestyle contributes to over all well being |
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Amenorrhoea
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absence of a menstrual period in a woman of reproductive age
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Coitus Interruptus
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Rejected sexual intercourse, withdrawal, pullout
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Dysfunctional Uterine Bleeding (DUB)
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Abnormal bleeding from vagina due to changes in hormone levels
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Dysmenorrhea
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pain during menstruation
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Dysparunia
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Painful intercourse
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Huhner Test
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Fertility test used to evaluate compatibility of sperm and cervical mucus
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Menopause
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When a womans menstrual period stops permanently
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Nidation
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Implantation of early embryo
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Perimenopausal
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"around menopause" - time period during which a womans body makes natural transition towards infertility
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Oophorectomy
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surgical removal of an ovary
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Salpingoectomy
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surgical removal of a fallopian tube
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Spinnbarkeet test
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formation of a thread by mucus from the cervix when spread between a coverglass and a slide -- test describes how much mucus stretches -- sign of ovulation
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Surgical menopause
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Menopause induced by surgery. Induced when ovaries are surgically removed or damaged by radiation therapy
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When to refer an individual for menstrual counseling/condition:
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1. Menses not begun with in 3 years of puberty onset
2. Not by 13 yrs and no puberty signs 3. Not by 14 yrs and hirsutism 4. 14yrs and hx excessive exercise or eating disorder 5. 14 yrs and concern obstruction of anomaly 6.Not by 15 yrs 7. Regular then irregular periods 8. <21 day or > 45 day menstrual cycle 9. 90 days apart for even one cycle 10. Longer than 7 days 11. Frequent pad / tampon changes (soaked every 1 - 2 hours) |
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Hirsutism
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Growing hair in excess or not normal areas for a female
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Female Health Teaching -- Young Girl
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Teaching about menstruation, sexuality, personal responsibility, safety, and hygiene (handwashing, front to back wipe)
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Female Health Teaching -- Teens
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Reproductive choices, safe sexual activity, health care practicies (nutrition, BSE, pap smears after 21, then 3 years after mens starts)
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Female Health Teaching -- Mature women
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Reminders for self care issues, preparation for physical changes with childbirth and/or aging. Teratogens
Males: education about changes /expectations, TSE, reproductive capability (lifespan), safer sex |
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Advantages of natural family planning
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avoid side effects of introducing chemicals or drugs into the body, acceptable for religious groups, helpful for planning pregnancy
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Disadvantages of natural family planning
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working with humans and they will make mistakes -- need to keep records of menstruation for several months, diligent recording for accuracy, initial and ongoing counseling in use; restriction of sexual spontaneity; abstinence of another contraceptive in considerable portion of cycle
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When does menstruation occur?
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First week of 28 day cycle
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Calendar Rhythm Method
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Standard: regular 24 to 18 day cycle. Abstain or avoid unprotected sex days 6 - 17 (11 days total)
Woman's calendar method: keep calendar 6mo - 1yr of menstrual cycle. Subtract 18 days from shortest cycle, and 11 from the longest. Avoid intercourse for (shortest to longest) |
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Chemical Barriers
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78- 87% effective when used correctly or in addition to something else
When used alone typical failure rate is 20 - 50% Vaginal spermicides: foams, tablets, suppository, cream, gel, contraceptive film |
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Disadvantage of chemical barriers:
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may cause irritation for some women or allergic reactions. Nonoxynol - 9 may increase transmission of HIV and cause lesions
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Condom Information
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Alone does not protect completely from STIs
good for 5 years from date of manufacture avoid wallet, extreme heat, or extreme cold Recommend lubricated - less friction, only water based Check for cushion of air Open gently, handle minimally Put on erect penis Roll needs to be on outside No air pockets |
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"Non-Methods" of sexual protection
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Coitus Interruptus: withdrawal method. Sperm reaches egg in 20 seconds so really not reliable,
Breast Feeding: pt will ovulate before menstruation and consequently will not know if she is capable of getting pregnant - need to use additional/other method Post-coital douche: not recommended and does not work. May force sperm into cervix and disrupt ph of vagina |
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Ductal Carcinoma in SITU
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occurs strictly in the breast's ductal system. This early stage of breast cancer may grow for years, forming a large lump in one area or spreading within the duct
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Infiltrating ductal carcinoma
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Accounts for most (75%) of breast cancers. Breaks through the duct wall. Once outside the cells have the ability to metastasize through the lymph system or the blood stream. Commonly metastasizes through the axillary lymph nodes
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Lobular carcinoma in situ
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starts with the cells that line the lobules. This type of cancer is considered a risk factor for developing cancer in the other breast, rather than a precursor of invasive Ca in the same location
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Infiltrating lobular carcinoma
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Begins in lobules and breaks through to other parts of the breast. This type of cancer is uncommon (5 - 10%). Presents as a subtle thickening and often occurs in both breasts. Likely to metastasize to axillary nodes.
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Situ cancers
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Lobular and Ductal - non-invasive, but appear to increase the risk for invasive CA of the breast
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Inflammatory carcinoma
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Known as systemic disease. Most malignant form of breast cancer. Pt presents with diffuse skin erythema, warmth, and induration of the breast. Orange peel skin usually present. 1/2 pt report pain and tenderness. Often inflammation mistaken for infection. Prognosis poor regardless of treatment.
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Mammary Paget's Disease
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rare. Involves infiltration of the nipple epithelium. Initial sx include itching or burning of nipple with superficial erosion, crusting, and ulceration. Dx with biopsy, often mistaken for infection. Changes confined to nipple, excellent prognosis
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Breast Cancer - early signs
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Unilateral, small palpable mass
Tender or non tender Fixed, non mobile Hard, stone like Irregular shape, poorly delineated Half upper outer quadrant Ductal may see discharge Peau d' orange skin Retraction often present |
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Breast Cancer - later signs
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Color change
Prominent unilateral veins Nipple retraction Dimpling/puckering Breast fixed to chest wall or ulceration |
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Post Mastectomy Nursing Care (Test Q)
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Elevate affected side with distal joint higher than proximal joint
No BP, injections or venipunctures on affected side Watch for S & Sx of edema on affected arm Lymphedema can occur anytime after axillary node disection Limited arm exercises 24 hours post op Abduction and external rotation arm exercises after wound has healed Assess dressing for drainage Assess wound drain for amount and color Provide privacy when client looks at incision Chemotherapy Radiation Therapy Psychological concerns: altered body image, altered sexuality, fear of disease outcome |
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Stage 1 Lymphedema (reversible)
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Pitting edema, swelling reduced by elevating the limb a few hours. Little or no fibrosis (hardening) so reversible
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Stage 2 Lymphedema (spontaneously irreversible)
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Swollen area pressed, does not pit, not reduced much by elevation. Untreated, tissue gradually hardens and becomes fibrotic
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Stage 3 Lymphedema
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e.g. elephantiasis, exclusively in legs after progressive, long term, untreated lymphedema. Gross changes to skin and may protrude and bulge, and some leakage of fluid through tissue if a cut or sore. Responds to treatment but rarely reversible
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Lymphedema Tx
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Elevation - preventive
Exercise - improves drainage Bandage - compression Diet - eating a well balanced diet and controlling body weight is an important part of tx. |
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Obstruction of lymph flow
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Lymphedema is caused by malignancy in lymphatic system, removal of lymph nodes or infection in the lymphatic channels and lymph nodes. Lymph osmotically moves plasma proteins and other large particles that cannot be reabsorbed through the pores in the capillary membrance
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Primary Amenorrhea
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lack of menstruation by age 16 or 17. Cause: congenital or ovarian, pituitary, or hypothalmic disease
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Secondary Amenorrhea
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cessation of menses. Pregnancy, lactation, menopause common causes. Usually not dx until none for 3 - 6 mo. Amenhorrhea is one of the classic signs of anorexia nervosa. A certain % of body fat is required to menstruate
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HMB (Heavy menstrual bleeding)
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Blood flow > 80ml or more than 7 days. In adolescent may be functional. In adult may be symptom of ovarian tymor. Uterine myoma or PID, HPMB
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HPMB
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Heavy prolonged menstrual bleeding
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IMB (Intermenstrual Bleeding)
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Bleeding between periods. Midcycle bleeding can occur but rarely noted by woman. Warrants early dx and rx since it may be symptomatic of cervical or uterine cancer.
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AUB (Abnormal Uterine Bleeding)
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abnormal in amount, duration of time of occurrence. AUB usually related to hormonal imbalances or pelvic tumors, either benign or malignant. Most often anovulation thats unrelated to anotherillness.
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Progestins Therapeutic Uses
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Primarily as a contraceptive (sager for cardiac risk)
Suppress ovarian function in endometriosis, dysmenorrhea, and uterine bleeding Treatment of amenorrhea Treatment of endometrial cancer and hyperplasia |
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Estrogen Therapeutic Uses
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Hormone replacement therapy (HRT)
Breast CA: palliative and to prolong life Hyperandrogenism: excessive male hormone production Prostate: estrogen suppress androgen production. Reserved male advanced Ca Hirsutism Endometriosis |
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Endometriosis
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Implantation of endometrial tissue outside the uterine cavity. Most commonly affects nulliparous women, caucasian
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Rectocele
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Protrusion of rectum into vaginal wall.
May occur during childbearing during difficult delivery, second stage, or operative vag delivery, or congenital defect of tissue. Sx: Rectal pressure, constipation, heaviness, hemorrhoids Nursing intervention: dont strain with BM, stool softners OTC, sitz to promote cleaning and comfort Medical Interventions: surgery, post colporrhaphy |
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Cystocele
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Protrusion of bladder into the vaginal wall by weak pelvic musculature structures, can be caused by obesity, advanced age, childbearing, genetic predisposition.
Sx: voiding problems, stress incontinence |
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Infection Prevention Strategies
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Cotton, loose fitting underwear
Avoid bubble baths, hygiene sprays, douching Wipe front to back Wash after intercourse Urinate after intercourse Avoid petroleum lubricants If more than one partner discriminate carefully and use condoms Maintain healthy lifestyle |
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Major Goals of Infection Management
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Cure infection
Prevent reinfection Prevent complications Prevent infection of sexual partner or partners |
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Vaginal Fistulas
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Abnormal opening between two adjacent organs. May develope when malignant lesion has spread, after radiation, or trauma from surgery or delivery
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