Med Surge

  1. Prementsrual Syndrome
    PMS but more severe and 7 to 10 days b4 menstruation. Cause unkown

    S/S = weight gain, headache, nervousness, irritability, personality changes, depression, abd bloating pain, tenderness of the breasts, breast enlargement, cravings 4 sweets, swelling of ankles, feet, and hands, anxiety, or increased physical activity.

    Nurse does = tells pt 2 keep menstrual diary for @least 2months, tx depends on severity, supplement medical keep a regular schedule 4 meals, eating 6 small meals per day, avoid salt b4 menstrual, dont drink caffeine, don't drink alcohol, exercise 3 to 5x a wk 4 25 to 30mins, get sleep, manage stress

    Tx = hormonal therapy, short term tranquilizers, or antidepressants,
  2. Dysmenorrhea
    painful menstruation. Primary or Secondary. Primary is idiopathic and no abnormality is found. Secondary dysmenorrhea is result of disorders like endometriosis.

    S/S = lower abd pain and cramping, severe w/ fatigue, cold and tension.

    Nurse does= tx includes mild non-narcotics, 4 symptomatic relief of pain & discomfort local applications of heat like warm shower, heating pad, water bottle. Encourage client 2 get enough rest, nutrition, and relief from stress 2 facilitate coping with periodic discomfort.
  3. Amenorrhea & Oligomenorrea
    Amenorrhea = absence of mentstrual flow. Primary amenorrhea means a chick of reproductive age has never had a period. Secondary means if period stops after having a period b4 its secondary like pregos, menopause.

    Oligomenorrea = infrequent menses. Normal 4 adolescent femals 2 experience for 1yr or more b4 they get regular periods.

    Caused = endocrine imbalances resulting from pituitary disorders or hypothyroidism, stress response, or severely lean body.

    TX = focus on correction of underlying cause
  4. Premenstrual Ovarian Failure
    disorder in which the ovaries quit working in women younger thn 40yrs of age, some in their teens.

    S/S = irregular menses symptoms tht resemble natural menopause
  5. Premenstral Ovarian Failure
    disorder in which the ovaries quit working in women younger than 40yrs of age, some even in their teens.

    • S/S = irregular menses, and symptoms that resemble natural menopause.
    • dx by level of FSH in sample of blood
  6. Polycystic Ovarian Syndrome
    condition characterized by cluster of signs & symptoms tht include amenorrhea & oligomenorrhea, affects women btween 20 to 40yrs of age.

    S/S= interference w/ menstruation & ovulation, weight gain, excessive growth of body hair, acne, thinning hair or baldness, abnormal lipid levels, hypertensive.

    TX - oral contraceptives, oral hpoglycemic agents, lipid-lowering agents and antihypertensives
  7. Menorrhagia
    excessive bleeding @ time of normal menstruation lasts more thn 7days.

    Caused = endocrine, coagulation, or systemic disorder.

    TX = nsaids, progestins, oral contraceptives with combo of estrogen &progestin
  8. Metorrhagia
    vaginal bleeding @ a time other than mentrual period

    Cause = erratic stimulation of or response 2 pituitary or ovarian horomones, especially in adolescent girls and perimenopausal women, uterine malignancies, cervical irritation or breakthrough bleeding

    TX = depends on underlying cause.

    Nurse does = advises the client w/ unexplained bleeding 2 see dr., gather appropriate info, assist with gyno exam, offer suggestions 4 relieving discomfort, instruct clients about drug therapy, prepare clients 4 surgical interventions; care 4 them during recovery, and provide specific health teaching instructions
  9. Menopause
    Change of life, means you don't hv a period anymore. Usually around 45-55yrs of age but can happen from surgery removing ovaries @ any age

    Causes = occurs when ovarian function stops.

    S/S = at start of menopause irregular periods, scanty or copious menstrual flow. After period stops hot flashes, sweats, sleep disturbances, irritability, or depression, vaginal dryness, diminished lifido (;() , or dyspareunia(discomfort hving sex).

    TX= Hormone replacement therapy.

    Nurse does= get history, helps get client ready for exams, labs, diagnostic tests, teach topics about change, Use creams 4 dryness 4 skin and ky 4 vaginal dryness, exercise, up CA, Discuss benefits/risks of HRT, Routine exams gyno/breasts, Contact DR if breakthru bleeding happens on HRT, Get new hobbies or interests.
  10. Vaginitis
    Your Pan kk is inflamed ouch!!

    Caused = chemical or mechanical irritants like feminine hygeine products

    S/S = discharge with itching, burning, redness, swelling of surrounding tissue, fishy odor.

    Medical tx = antifungal, antiprotozoal, antibiotics, sometimes sex partner needs 2 be treated 2, If DB peeps have it regulate blood glucose cuz important prt of tx.

    Nurse does= Informs client don't douche b4 examand no sex b4 exam, tells client over the counter drugs usually work but should still see dr first, tell peep make sure take all the drugs, avoid douching whn asymptomatic but can douche daily 10-14days with a slolution of 1 to 2 tbsp of white vinegar in 1pint water, sitz bath can help with itching, burning, swelling, offer suggestions 4 preventing getting it again, wear cotton undies, bath daily, wipe front 2 back, avoid femine products or douching more than 1x a wk, stop wearing layers of clothes, like pantyhose under pants, change from wet swimsuit asap, wash hands, change pads/tampons, use condom
  11. Cervicitis
    Inflammation of cervix

    cause = infectious microorganisms, decreased estrogen level from menopause, or trauma, or tampons, vaginal meds, streptococcal, staphylococcal, gonorrheal, chlamydial

    S/S = spots or bleeds intermenstrually or vanginal discharge, dyspareunia (pain during sex), slight bleeding after sex, sever cervicitis cause sensation of weight gain in pelvis,

    TX = douches, local or systemic antibiotics, chronic tx with electocautery

    Nurse does = schedule tx procedures 5-8days after end of period, after electrocautery instruct rest for 1-2days, avoid straining or heavy lifting, rest in bed and rpt bleeding, expect grayish-green discharge about 3wks, anticipate bleeding about 11th day, return 4 f/up appt in 2 to 4wks, dont hv sex until healed (cochina), heal in 6to8wks
  12. Pelvic Inflammatory Disease
    PID is an infection of the pelvic organs other thn the uterus, include ovaries, follopian tubes, pelvic vascular system, and pelvic supporting structures.

    Cause= bacterial w/ gonococci & C trachomatis

    S/S = stinky odor discharge, backache, severe or aching abd and pelvic pain, a bearing down feeling, vever, dyspareunia, nausea and vomiting, menorrhagia, & dysmenorrhea

    TX = hospitalization w/ bed rest, parenteral or oral antibiotics, IV fluids r ordered if client is dehydrated but a ruptured pelvic abscess requires emergency surgery.

    Nurse does = get gyno hx, rd page830, this is contact precautions!!
  13. Toxic Shock Syndrome
    type of septic shock, life threatening systemic reaction 2 the toxin produced by several kinds of bacteria. TSS also occurs in men and in nonmensturating chicks w/ soft tissue and posop infections

    Cause = superabsorbent tampons tht r not changed frequently, internal contraceptives tht remain too long in place, virulent bacteria produced in body.

    S/S = high fever, chills, tenderness or pain in muscles, nausea, vomitting, diarrhea, hypotension, hyperemia (increased redness & congestion) of vaginal mucous membranes, disorentation, headaches, skin warm, rash on palms of hands, shedding of skin, pulse rapid and thready

    TX = IV fluids and IV antibiotic therapy. O2

    Nurse does = frequently assesses v/s, I&O rpt sudden decrease in urine 500ml/day or less, teach about preventative measures, use diaphram, vaginal sponge, or cervical cap 4 birth control 2 remove w/in 24hrs, emphasize handwashing & keep vagina clean.
Card Set
Med Surge
Ch 53 prt 1