Linda S. Williams / Paula D. Hopper Copyright © F.A. Davis Company Understanding Medical Surgical Nursing, 4th Edition Chapter 42 Nursing Care of Women with Reproductive System Disorders

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Benign Breast Disorders  Cyclic Breast Discomfort  Fibrocystic Breast Changes  Mastitis

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Breast Cancer  Risk Factors  Age  Family History  High Fat Diet  High Alcohol Intake  Estrogen Treatment  Early Menarche  Late Menopause  Late or No Pregnancies  No Breastfeeding

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms  Lump or Thickening  Dimpling  Clear or Bloody Discharge  Swelling  Tenderness  Discoloration

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Prevention  Caution  Fat Intake  Alcohol Intake  Hormone Use  Breastfeeding  Early Identification

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diagnosis  BSE  Clinical Breast Exam  Mammography  Biopsy

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Lumpectomy  Mastectomy  Partial  Simple  Radical  Radiation  Chemotherapy  Hormonal Therapy  Targeted Therapies

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Mastectomy Reconstruction

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nursing Diagnoses: Mastectomy  Anxiety  Risk for Ineffective Breathing Pattern  Risk for Ineffective Tissue Perfusion and Integrity  Risk for Ineffective Coping

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Other Breast Modification Surgeries  Mammoplasty  Breast Reduction  Mastopexy  Augmentation  Reconstruction

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Breast Reduction

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Breast Implants

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Menstrual Flow/Cycle Disorders  Amenorrhea  Hypermenorrhea  Hypomenorrhea  Menometrorrhagia  Menorrhagia  Oligomenorrhea  Polymenorrhea

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diagnostic Tests  Pap Smear  Culture  Laparoscopy  Ultrasound  Pregnancy Testing  Urine and Blood Testing

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Dilatation and Curettage (D&C)  Laser Ablation  Hysterectomy

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Dysmenorrhea  Painful Menstruation  Diagnostic Tests  Hormone Levels  Laparoscopy  Biopsy  Culture  Interventions  Aspirin  NSAIDS  Hormone Replacement  D&C  Correct Cause

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Premenstrual Syndrome  Signs and Symptoms  Water Retention  Headache  Discomfort  Change in Affect  Change in Concentration  Interventions  Medications  Exercise  Stress Management  Limitation of  Alcohol  Caffeine  Nicotine  Salt  Simple Sugars

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Endometriosis  Endometrial Tissue Outside Uterus  Signs and Symptoms  Pain  Swelling  Organ Damage  Scar Tissue  Infertility  Interventions  Surgical Intervention  Estrogen Reduction  Medications  Oopherectomy  Relaxation Exercises  Heat to Abdomen or Back

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Endometriosis Sites

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Menopause  Perimenopause Signs and Symptoms  Erratic Menses  Tissue Atrophy  Decreased Lubrication  Hot Flashes  Night Sweats  Mental Changes  Treatment  HRT – Controversial  Dietary Phytoestrogens  Calcium/Vitamin D  Dress in Layers  Vaginal Lubricant  Healthy Diet

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Disorders of the Vagina and Vulva  Overgrowth of Organisms  Candidiasis  Bacterial Vaginosis  Cytolytic Vaginitis  Trichomoniasis  Medications  Oral  Cream  Suppository  Douche

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Toxic Shock Syndrome (TSS)  Systemic Infection  Staphylococcus aureus  Streptococcus  Causes  Highly Absorbent Tampons  Other Packing

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms  Fever  Sore Throat  Headache  Dizziness  Confusion  Redness of Palms and Soles  Skin Rash  Blisters  Petechiae

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Prevention  Change Tampon Every 4 hrs  Substitute Pads  Wash Hands  Caution with Barrier Contraceptives  Report Symptoms Promptly

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Genital Organ Development Disorders  Agenesis  Hypoplasia  Imperforate openings

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Displacement Disorders  Cystocele  Rectocele  Uterine Position Disorders  Uterine Prolapse

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Displacement Disorders (cont’d)

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diagnostic Tests  Ultrasonography  Hystersalpingography  CT scan  MRI  Endoscopy

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Pessary  Surgical Correction  Kegel Exercises  Squeeze Pubococcygeal Muscle  Hold 10 Seconds  Relax  Repeat 15 Times Daily

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Uterine Position Disorders

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Uterine Prolapse

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Pessary  Kegel exercises  Surgery

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Fertility Disorders  Male  Anatomic  Hormonal  Genetic Defect  Inflammatory  Immune  Sexual Dysfunction  Psychological  Exogenous  Female  Ovulation  Tubal  Uterine  Other

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Reproductive Life Planning  Oral Contraceptives  Contraceptive Implants  Depot Medications  Contraceptive Ring  Transdermal Patch  Barrier Methods  Spermicides  Intrauterine Devices  Natural Family Planning  Lactational Amenorrhea Method

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Female Condom Application

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diaphragm

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Sterilization  Tubal Ligation  Vasectomy

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Pregnancy Termination  Ethical Issues  Therapeutic vs. Routine  Risks

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Methods  Chemical  Menstrual Extraction  Vacuum Aspiration  Dilatation and Curettage  Dilatation and Evacuation  Saline or Urea Injection  Hysterotomy

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Post-Abortion Care  Monitor for Bleeding  Teach  Report Bleeding, Signs of Infection  Abstain from Intercourse  Birth Control  Grief Counseling

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Benign Growths  Fibroids/Leiomyomata  Polyps  Cysts  Bartholin’s  Dermoid

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Polycystic Ovary Syndrome (PCOS)  Endocrine Imbalance  Infertility  Obesity  Menstrual Disturbance  Masculinization  Diabetes Mellitus  Hypertension  CAD  Endometrial Cancer

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition PCOS Interventions  Antihypertensives  Antihyperlipidemics  Oral Hypoglycemics  Oral Contraceptives  Antiandrogen Agents  GnRH Agonists  Diet  Exercise

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Malignant Disorders  Vulvar Cancer  Cervical Cancer  Endometrial Cancer  Ovarian Cancer

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Vulvar Cancer  Risk Factors  STD  Immunce Suppression  Smoking  Signs and Symptoms  Persistent Itching  White or Red Patches  Skin Ulcers  Wart-like Growths

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Destruction of Cancerous Cells  Radical Vulvectomy  Skin Grafting

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Cervical Cancer  Risk Factors  Early Sexual Activity  Multiple Sex Partners  Several Pregnancies  Smoking  HPV  HSV-II  Signs and Symptoms  Serosanguinous Discharge  May be Asymptomatic

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Cervical Cancer (cont’d)  Diagnosis  Pap Smear  Schiller’s Test  Biopsy  Interventions  Cryotherapy  Laser Therapy  Surgical Excision  Hysterectomy  Radiation Implant  Chemotherapy

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Endometrial Cancer  Risk Factors  Estrogen Excess  Estrogen Therapy  Obesity  Signs and Symptoms  Abnormal Bleeding  Interventions  Hysterectomy  Radiation  Chemotherapy

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Ovarian Cancer  Risk Factors  Low Fertility  Late Menopause  Family History  High Fat Diet  Signs and Symptoms  None until Late  Interventions  Oopherectomy  Radiation  Chemotherapy

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Gynecological Surgery  Endoscopic Surgery  Laparoscopy  Culdoscopy  Hysteroscopy

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Postoperative Care: Endoscopic Surgery  Monitor  Vital Signs  Bleeding  Temperature  Pain  Instruct to Lie Flat  Administer Analgesics  Teach

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Hysterectomy  Types  Total Abdominal Hysterectomy (TAH)  TAH with Bilateral Salpingo-Oopherectomy  Methods  Abdominal  Vaginal  Laparoscopic  Robotic

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Rationale  Menstrual Problems  Benign Tumors  Prolapse  Cancer

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nursing Diagnoses: Hysterectomy  Risk for Ineffective Tissue Perfusion  Risk for Urinary Retention  Risk for Constipation  Anxiety  Body Image Disturbance  Risk for Ineffective Coping