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Unit 13 Nursing Care of the Client: Reproductive and Sexual Health.

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Presentation on theme: "Unit 13 Nursing Care of the Client: Reproductive and Sexual Health."— Presentation transcript:

1 Unit 13 Nursing Care of the Client: Reproductive and Sexual Health

2 Chapter 44 Reproductive Systems

3 Anatomy and Physiology Review Female and male reproductive systems consist of external and internal structures and organs

4 Common Diagnostic Tests Laboratory tests Radiologic tests Biopsy Dilation and curettage (D&C) Laparoscopy Colposcopy Nocturnal tumescence penile monitoring Pelvic examination Schiller test Ultrasound

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13 Benign Prostatic Hyperplasia (BPH) Progressive adenomatous enlargement of prostate gland that occurs with aging Symptoms: –Hesitancy, decreased force of stream, frequency, and nocturia Treatment: –Medications, balloon dilation, urethral stent, thermotherapy, transurethral resection (TURP), and transurethral needle ablation (TUNA) (continued)

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21 Prostate Cancer Second leading cause of cancer deaths in males Early symptoms: –Dysuria, weak urinary stream, and increased frequency Treatment depends on extent of disease and age of client: –Surgery, radiation, and hormone therapy

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25 Testicular Cancer Usually first symptom: –Small, hard, painless lump Males should perform testicular self- examination (TSE) monthly Treatment: –Surgery, chemotherapy, and radiation

26 Penile Cancer Bacteria harbored in foreskin of uncircumcised male are irritants to glans penis and prepuce –Thought to be carcinogenic Symptoms: –Painless nodular growth on foreskin, fatigue, and weight loss Treatment: –Surgery (continued)

27 Epididymitis, Orchitis, and Prostatitis Epididymitis –Inflammation of epididymis Orchitis –Inflammation of testes Prostatitis –Inflammation of prostate (continued)

28 Epididymitis, Orchitis, and Prostatitis Symptoms: –Pain, fever, chills, dysuria, nausea/vomiting, urethral discharge, warmth, and swelling Treatment: –Antibiotics, bed rest, scrotal support, and ice to area

29 Male Structural Disorders Hydrocele –Benign, non-tender collection of fluid within space of testes and spermatic cord Spermatocele –Benign non-tender cyst of epididymis or rete testis Varicocele –Dilation of veins of scrotum Torsion of spermatic cord –Twisting of vascular pedicle of testis

30 Hydrocele Palpable, round, non-tender mass in scrotum Most close by 1 year of age without intervention Surgery may be required

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37 Cryptorchidism Failure of one or both testes to descend into scrotal sac Most descend spontaneously by 1 year of age Surgery may be required

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41 Impotence Inability of adult male to have erection firm enough or to maintain it long enough to complete sexual intercourse Three types: –Functional –Atonic –Anatomic Treatment: –External devices to promote erection, surgery, and medications (continued)

42 Infertility Inability to produce offspring Basic infertility workup initiated when conception has not occurred after 6 to 12 months of unprotected intercourse Goal of treatment: –Successful achievement of pregnancy carried to full term that produces healthy offspring Treatment varies with cause (continued)

43 Chapter 44 Reproductive Systems

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51 Fibrocystic Breast Changes Symptoms: –Lumpy, nodular, glandular breast tissue Treatment: –Biopsy, aspiration, or surgical excision, breast self-examination, regular mammograms, Vitamin E, and elimination of caffeine from diet

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54 Fibroid Tumors Benign tumors growing in or on uterus Symptoms: –Menorrhagia, increasing pelvic pressure, dysmenorrhea, abdominal enlargement, and constipation Treatment: –Periodic reexamination, D&C, myomectomy, and hysterectomy

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56 Breast Cancer Key to cure: –Early detection by physical examination, mammography, and breast self-examination Most common symptom: –Painless mass or thickening All changes in breasts should be reported to physician (continued)

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73 Breast Cancer Treatment: –Lumpectomy, mastectomy, radiation, chemotherapy, medications, targeted therapy, immunotherapy, photodynamic therapy, gene therapy, hyperthermia, and antiangiogenesis therapy

74 Cervical Cancer Most preventable gynecological cancer with regular Pap smears Symptoms: –Abnormal bleeding, odor, pain in lower back or groin, difficulty voiding, hematuria, and rectal bleeding Treatment: –Varying degrees of surgery, radiation, and palliation

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76 Cervical Cancer

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81 Endometrial Cancer Cancer of lining of uterus Symptoms do not appear until cancer is advanced Routine Pap smears and pelvic examinations not adequate for early diagnosis Treatment: –Radiation, chemotherapy, and surgery

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85 Anatomy prior to D & C

86 Possible indication for D & C

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90 Cancer Treatment - Hysterectomy

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94 Ovarian Cancer Originates in epithelial tissue of ovary Symptoms do not appear until cancer is advanced at inoperable stage Treatment: –Combination of surgery, radiation, chemotherapy, immunotherapy, and palliation

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98 Pelvic Inflammatory Disease (PID) Pathogenic invasion of uterus, fallopian tubes, ovaries, and vascular/supporting structures within pelvis Symptoms: –Low-grade fever, pelvic pain, abdominal pain, bearing down backache, foul-smelling vaginal discharge, nausea and vomiting, dysmenorrhea, dyspareunia, and peritonitis (continued)

99 PID Treatment: –Antibiotic therapy, bed rest, pain management, and possible hysterectomy

100 Endometriosis Growth of endometrial tissue outside uterus within pelvic cavity Symptoms: –Low backache, painful intercourse, feeling of heaviness on pelvis, spotting, and possible infertility (continued)

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102 Endometriosis Treatment: –Medication and/or surgical removal of lesions and hysterectomy

103 Vaginitis Inflammation of vagina Causes: –Candidiasis (fungus) –Trichomoniasis (protozoan) –Gardnerella vaginalis (bacterium) –Chlamydia trachomatis (parasite) (continued)

104 Vaginitis

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106 Also causes painful periods

107 Vaginitis Symptoms: –Discharge with burning/itching Treatment: –Vaginal application of creams and medications

108 Toxic Shock Syndrome Rare, life-threatening condition where Staphylococcus aureus enters bloodstream with tampon use Symptoms: –Temperature of 102º F or greater, vomiting, diarrhea, hypotension, flulike symptoms, flat/red rash that peels in one to two weeks, and disorientation (continued)

109 Toxic Shock Syndrome Treatment: –IV fluids, antibiotics, bed rest, and possible mechanical ventilation or dialysis

110 Menstrual Disorders Dysmenorrhea –Painful menstruation Amenorrhea –Absence of menstruation Polymenorrhea –Menstrual cycles of less than 21 days (continued)

111 Menstrual Disorders Oligomenorrhea –Diminished menstrual flow that is not amenorrhea Treatment based on cause of disorder

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113 Premenstrual Syndrome (PMS) Often occurs after ovulation More than 150 related symptoms reported Symptoms vary Treatment: –Counseling, medications, dietary changes, and regular exercise

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119 Menopause Climacteric cessation of menstruation and end of reproductive capability Decreasing level of ovarian hormone production affects females in variety of ways Treatment: –Estrogen replacement therapy, dietary changes, and exercise

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121 Female Structural Disorders Cystocele –Downward displacement of bladder into anterior vaginal wall Urethrocele –Downward displacement of urethra into vagina Rectocele –Anterior displacement of rectum into posterior vaginal wall Prolapsed uterus –Downward displacement of uterus into vagina (continued)

122 Female Structural Disorders (continued)

123 Female Structural Disorders Treatment focused on relief of discomfort and restoration of structure and function of pelvic organs: –Pessary, surgery, and Kegel exercises

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125 Contraception Prevention of pregnancy When choosing method, consider: –Safety –Ease of use –Effectiveness –Cost (continued)

126 Contraception Sterilization –Permanent and effective

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132 Prior to Tubal Ligation

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136 Chapter 45 Sexually Transmitted Infections

137 Anatomy and Physiology Review Major system affected by sexually transmitted diseases: –Reproductive system Males generally more symptomatic than females –Seek medical care more readily (continued)

138 Anatomy and Physiology Review Any area of sexual contact may also exhibit signs and symptoms of disease

139 Chlamydia Caused by Chlamydia trachomatis Most infections asymptomatic If untreated, can cause tissue inflammation, ulceration, and scar tissue formation in both females and males (continued)

140 Chlamydia Treatment of choice: –Doxycycline Test and treat both partners

141 Gonorrhea Caused by Neisseria gonorrhea Symptoms may occur within 2 to 10 days Males more symptomatic than females Symptoms: –Burning and purulent discharge from penis Treatment: –Cipro and Vibramycin

142 Syphilis Caused by Treponema pallidum Primary, secondary, latent, and tertiary stages Antimicrobial therapy destroys Treponema pallidum at any stage –But damage irreversible Treatment: –Penicillin G benzathine and other antibiotics

143 Syphilis

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146 Genital Herpes Caused by herpes simplex virus Symptoms of first episode: –Itching and burning sensations and blisters at site of infection Recurrences common No cure Treatment based on relieving symptoms

147 Herpes

148 Cytomegalovirus (CMV) Virus Rarely causes symptoms Can cause congenital infection of infants –Produces mental retardation, blindness, deafness, or epilepsy (continued)

149 CMV Can become life-threatening in clients with poorly functioning immune systems No treatment

150 Genital Warts Caused by human papillomavirus (HPV) Symptoms: –Painless, soft, fleshy growths in genital area Appears to play role in development of cervical cancer (continued)

151 Genital Warts Treatment: –Remove warts But may recur at any time

152 AIDS Mode of transmission: –Sexual contact Not curable Fatal Results in severe disorder of bodys immune system –Leads to inability of body to fight off disease

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155 Trichomoniasis Caused by Trichomonas vaginalis Only 10 percent of females present classic symptoms: –Severe itching of vulva, redness, swelling of vulva, pain on intercourse and urination, and grayish, malodorous discharge (continued)

156 Trichomoniasis Treatment: –Metronidazole (Flagyl) and avoid alcohol Treat both partners

157 Hepatitis B Caused by hepatitis B virus Spread through sexual contact Symptoms: –Inflammation of liver, anorexia, vague abdominal discomfort, nausea, vomiting, fatigue, and jaundice No specific therapy Treatment based on relieving symptoms


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