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What happens to a woman's reproductive system as it ages?
Estrogen secretion decreases
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Decrease in estrogen causes:
- 1. Ovulation and menstruation to stop
- 2. Atrophy of vaginal epithelium
- 3. Increased cholesterol = increased risk for coronary artery disease
- 4. Atrophy of urinary meatus = increased incontinence
- 5. Increased bone loss = risk for osteoporosis and fractures
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the definite end to reproductive capability = occurs when menses have ceased for 12 months
Menopause
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What happens to the male as the reproductive system ages?
there is a decrease in testosterone secretion
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A decrease in testosterone secretion leads to what?
- 1. hypertrophy of the prostate gland = urinary retention
- 2. increased bone loss = risk for fracture
- 3. Gradual decrease in muscle size and strength
- 4. decreased spermogenesis
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What is some subjective data to collect when doing a physical exam on a female?
- - personal history
- - menstrual history
- - obstetric/gyno history
- - sexual history
- - family history
- -psychological history
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Objective data to collect for a female physical exam?
- - clinical breast exam
- - external genitalia
- - vagina
- - perineum
- - anus
- - inguinal nodes
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G (gravida)
# of pregrancies
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Breast Self Exam
- 1. to be done monthly; 1 week after menses
- 2. puckering, asymmetrical movement, different pointing position of the nipple should be reported
- 3. exam should cover all areas of the breast
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Ultrasound Exam
done by bouncing high frequency sound waves off the tissues within the breast to determine the density of tissues
= mainly useful for distinguishing fluid filled (cysts) lumps from solid tumors
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Mammography
radiographic x-ray exam of the breasts
a special machine is used to spread and flatten the breast tissue to a thin layer to more effectively show benign tumors or growths
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American Cancer Society Screenings
A MAMMOGRAM EVERY 1 YR AFTER 40
CLINICAL BREAST EXAM EVERY 3 YRS DURING 20S/30S
OPTIONAL BREAST SELF EXAM STARTING IN 20S
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Patient teaching for mammogram
patient should bathe but not apply deodorant, powder or any other substance to upper body
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MRI
uses radio frequency radiation and magnetic fields to map the breast tissue
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Patient teaching for MRI
Ask the patient if they have any metal inside their bodies (pace maker, metal sutures)
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Biopsy
- Confirms diagnosis
- involves removing a small portion of tissue, fluid or cells, from the breast or lymph nodes for microscopic examination
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the study of cells taken as tissue samples
cytology
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Pap smear
one or more small samples of cells are gently scraped away from the surface of the cervical canal using a small wooden spatula and smeared on a microscopic slide
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Gonorrhea and chlamydia smear
uses charcoal
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Patient teaching/nurse interventions for pap smear
monitor and teach patient to look out for bleeding, swelling or inflammation after procedure
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Exams that are done to visually inspect internal areas to diagnose reproductive disorders
endoscopic
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performed to see inside the fallopian tubes
salpingoscopy
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performed to see the inside of the uterus
hysteroscopy
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binocular microscope introduced into the vagina and through a small incision in the vagina into the cul - de - sac of douglas
culdoscopy
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microscope introduced in to the vagina to closely study lesions on the cervix
Colposcopy
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Nursing care for patient with endoscopic procedure
postoperatively: provide comfort measures, keep the patient lying flat for a couple hours to decrease discomfort
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Testicular self exam
- palpation of testes by the patient
- teach
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