infection and inflammation of the female reproductive organs
Pelvic inflammatory disease
risk for PID?
miltiple partners, frequent intercourse, douche, IUD and childbirth
low grade fever, pelvic pain, foul discharge, n/v, dysmenorrhea, dyspareunia
S/S of PID?
if PID spreads through the ABD cavity what are you at risk for?
peritonitis, pelvic abscess
what are treatments of PID
oral antibiotic, iv and hyterectomy
how PID diagnoses?
during a pelvic exam or pelvic ultrasound
how should the pt be lying to facilitate drainage of the pelvis?
semi fowlers
if vaginal suppository is inserted how long should we lie supine?
30 min
the growth the endometrial tissue, the normal lining of the uterus, outside of the uterus within the pelvic cavity?
endometriosis
career womans disorder
endometriosis
common in women over 30, who have delayed childbirth, higher in socioeconomic classes of caucasian women?
endometriosis
where does enodometriosis implants outside where?
the uterus wall
S/S of endometriosis
servely monthy symptoms, lower backache, painful intercourse, feelings heaviness in the levis, spotting,
can cause infertility?
endometriosis that can cause scar tissue and adhesions
treatments of endometriosis
pelvic palpation exam, laparoscopy, could be hysterectomy or cauterization
narfarelin acetate inhibits cyclic hormone release, nasal administration
endometriosis
danazol inhibits release of gonadotropin; given after surgery to relieve symptoms of residual disease
endometriosis
gardnerella vagninalis is the type of bacteria found?
bacterial vaginitis
S/S of bacterial vaginitis
discharge (white or gray), dysuria, itching in vagina
caused by a parasite
trichomoniasis
infection of urogenital tract
trichomoniasis
most common plan for trichomoniasis infection in men and women?
women- vagina men- urethra canal
appears in 5-28 days
trichomoniasis
heavy ywlloe-green or gray discharge, discomfort in sex, vaginal odor, dysuria, itching and low abd pain
S/S of tric
men S/S of trich?
discharge, painful urination and ejaculation
Vulvovaginal candidiasis?
vaginal yeast infection
the fungus in a yeast infection?
candida albicans
what increases a yeast infection?
pregnancy, DM, antibiotics or contraceptives, douches, hygiene sprays, weak immune
S/S of yeast infection?
itching, burning, dysuria, painful intercourse, discharge some(cottage chees) a musty sweet odor
treatment of yeast infection?
Monistat, clotrimazole or diflucan
most associated with staphlococcus aureas?
TSS
what can cause TSS?
birth control or tampons
high fever, faint feeling, watery diarrhea, HA and muscle aches
TSS
how is TSS diagnosed?
through blood, urine, GU and throat cultures
what is the goal of TSS?
control BP, replace fluids, stop infecton and maintain ventilation
Chronic cystic mastitis or lumpy breast syndrome?
Fibrocystic Breast disease
the cause of this disease is benign cahnges with ovarian hormones that subsides with menopause.
fibrocystic breast disease
most common in women ages 30-50 and rare in postmenopausal women
FBD
lumps moveable, yellow-green discharge from breast ?
S/S of FBD
what is done for FBD?
a pap smear to R/O cancer cells, needle aspiration of lumps and surgical breast biopsy
treatment of FBD?
eliminate caffeine including chocolate, wear fitted bra, Vit E (breaks down the tissue) and low fat diets
2nd major cause of death in women?
breast cancer
survival rate for localized cancer?
98%
survival rate for all stages of cancer?
89%
most common presenting symptom in breast cancer?
painless mass or thickening
where does breast cancer most commonly occur?
most frequent in the upper outer quadrant of the breast and may extend into the tail of the breast and spread upward into the axilla
stage 1 of breast cancer?
tumor smaller than 2 cm, no lymph or mets involved
stage 2 of breast CA?
tumor 2-5cm, 1-3 lymph test pos for ca and not mets involved
stage 3 of breast ca?
tumors larger than 5 cm, no lymph, no mets involved or tumor 0-5 cm, lymph test pos and no mets
stage 4 breast ca?
tumor of any size growing in chest wall or skin, lymph nodes may or may not be postive and mets are evident
Pumpectomy?
surgical removal of the canerous mass
simple mastectomy?
removes the tumor mass and small portion of the adjacent tissue
modified mastectomy?
entire breast tissue and nearby lymph nodes are removed; muscles of chest wall are left intact
radical mastectomy?
entire breast, lymp, and pectoralis muscles are removed
Complications of lymph node removal?
more lymp removed the great chance of lymphedema, elastic sleeve can be worn, ROM exercises reduce edema and Na restricted diet
if cancer cells respond to estrogen then what drugs are used?
antiestrogen used to treat breast cancer
if the estrogen does not respond then what is it used for?
used as a chemotherapy
nursing management of breast cancer?
BSE, mammograms, TCDB, dressing changes and keep affected arm above to encourage blood flow
benign tumors that grow in or on the uterus?
Fibroid Tumors
non cancerous tumors that develop within or attach to the wall of the uterus, a female reproductive organ
uterine fibroids
how do fibroids grow?
slow and estrogen increases growth that can cause pre term labor
what kind of diet do we encourage with fibroids?
high iron and supplements to prevent anemia
treatments of fibroids?
hysterectomy, myomectomy or D&C
S/S of fibroids?
menorrhagia, pelvic pressure, dysmenhorrhea, abd enlargment, constipation and urinary frequency
risk of cervical cancer?
early sexual activity, multi sex partner, history of STI or HIV, African, hispanic, chronic inflammation
abnormal bleeding, bleeding with intercourse, odor, lower back pain, difficulty voiding, hematuria, rectal bleed
S/S of cervical cancer
cervical ancer is most often seen in the ages of?
30-50
CIS means?
cancer cells remain in the cervix
Conization?
excision of a cone shaped section of thee abnormal cervical tissues, perferable at child bearing age
crysurgery?
used in cervical cancer and is a freezing of the cells with liquid nitrogen
treatments of cervical cancer?
laser, cryosurgery, hysterectomy, radical pelvic surgery, palliative measures, chemo, radiation, conization
to shrink tumor and slow growth?
chemotherapy
pt on radiation should be on complete bed rest? true or false?True False
TRUE
HRT in 2002 noted that it should be stopped due to what?
increased risk of breast cancer
earliest sign is vaginal bleeding and a risk factor is being jewish or caucasian
endometrial cancer
treatment of endometrial cancer?
IV fluid and possible blood transfusion, could be hysterectomy, chemo, radiation or HRT to supress growth
causes more deaths than any other cancer?
ovarian cancer
silent killer?
oarian cancer
cancer seen most often in women 45-65
ovarian cancer
what is the percentage of mestastaisis spreading beyond the pelvis in ovarian cancer?
75%
most frequent spot ovarian cancer starts?
colon then moves to stomach an diaphragm
what is the reoccurence in ovarian cancer? so what are th follow up visits and how often?
2 years, and seen every 2 mo for 2 years with survival of 45%
ovarian cancer diagnostic tools?
pelvic exam, followed by ultrasound, CT scan to determine if mass is solid or fluid filled, GI studies, chest exray, IVP, laparoscopy and blood test CA
treatment of ovarian cancer?
TAH and BSO with possible omentectomy, radiation, chemo, immunotherapy, surgery
Chemo drugs used for ovarian cancer?
Cytoxan, adriamycin, taxol percutaneous or intraarterial
Bromptons mixture? and who gets it?
cocaine, morphine, alcohol and flavoring for pain in ovarian cancer pt
menstrual cramps of painful menstration?
dysmenorrhea
this is more common in nullipara women and women not involved in intercourse
dysmenorrhea
spasms of the uterus, carvical stenosis, uterine fibroids, emotions, endometriosis, PID or IUD
dysmenorrhea
Primary symptom is levic pain before and at onset of menses
dysmenorrhea
treatment of dysmenorrhea?
aceetaminphen, oral contraceptive, aleve
ansence of menstruation
amenorrhea
primary diagnosis if no menses by 16, primary cause is turner syndrom or incomplete x chromosome
amenorrhea
what can cause amenhorrhea?
anatomic abnormalities, nutritional deficits, excessive exercise, endocrine dysfunction, pregnancy or lactation
whats the progestin challenge?
takes depo for 5 days. period for 4-5 days. where the prolactin levels exceed 400 due to tumors and should not be above 15
S/S of PMS occur when?
7-10 days proir to menstration and end when flow beings
treatment for PMS?
NSAIDS and SSRI
Diet for PMS?
limit sugar, caffeine, dairy, acidic fruits or vegetables. increase whole grain, nust, pasta, legumes, root vegetables fruits (apples, pears, poultry and seafood)
inflammation of the tubular structure that connects the testicle with the vas deferns
epididymitis
the spread of infection from the urethra or the bladder: most common from gonorrhea and chlamydia, e coli, homosexual urinary reflux
epididymitis
if epididymitis is left untreated what can be caused?
testicular tisue necrosis, septicemia and death, can lead to sterilyity
treatment of epididymitis?
antibiotics and procaine injection around spermatic cord
inflammation of one or both testes caused by infection
orchitis
causes of orchitis?
gonorrhea, trauma, surgical mainuplation, tuberculosis and mumps
sudden scrocal pain radiating down the inguinal cancal, scrotal edema, chills, fever, n/v
orchitis
in unilateral inflammation does sterility occur?
NO
in bilateral involvement does sterility occur?
usually yes!
treatment of orchitis?
bed rest, scrotal support, ice to area, antibiotics and prcaine injection around spermatic cord
inflammation of the prostate ?
prostatitis
common complication of urethritis caused by chlamydia or gonorrhea
prostatits
S/S of prostatits?
perineal pain, fever, dysuria, urethral discharge
what can happen by putting in a cath of suspected urethritis pt?
spread of infection
management for prostatitis?
bed rest, elevate scrotum, cold packs, fluid intake, sitz baths, massage of prostate by physician, antibiotic, analgesics and stool softeners
progressive enlargment of the prostate gland that occurs with aging?
BPH
hesitancy, nocturia, decreased stream force of urination, urinary frequency, UTI risk
S/S of BPH
first test done for BPH?
DRE or digital rectal examination
other test for BPH?
Prostate specifice antigen, residual urine, cystoscopy, IVP, ultrasoundography
treatment of BPH?
TURP transurethral resection of the prostate used in 90%
what instruement is used in TURP? how is it used?
resectoscope, inserted thru the penis includes cutting and cauterization device, to slice pieces of the prostate enlarging the urethra and cauterizes the blood vessels as well
what is hung during TURP?
NS or glycine to irrigate the bladder
abd incision?
prostatectomy
risk or prostatectomy
hemorrhage, water intoxication, infection, thrombosis, damage to surrounding structures, sexual dysfunction, urinary incontinence
what is Proscar (Finasteride) used for?
shrinks the prostate in some men
other meds used in prostate cancer in men?
Hytrin and Cardura (used to treat hypertension and relax smooth muscles along urinary tract)
whats used to treat postop bladder spams?
Belladonna or opium suppositories and narcotic analgesics
If a foley is inserted how much should be drained initially?
1000 cc
2nd leading cause of cancer death in men?
prostate cancer
70% of cancer is diagnosed in men older than what?
65
Diagnosis of prostate cancer?
PSA (prostate specific antigen), transrectal ultrasonic exam, prostatic biopsy
how often should a mans prostate be examined?
yearly and digital rectal exam
dysuria, weak urinary stream, urinary frequency, complete urethra; obstruction, hematuria
S/S of Prostate cancer
may be performed to decrease the androgenic effect and decrease tumor growth
orchiectomy
Pharacology for prostate cancer?
DES, lutenizing releasing hormone, lupron, eulixin, chemo
caring for the pt with prostate cancer?
NO rectal temp, I&O, PSA level, urine bleeding, pain, peri area clean and dry
less than 1% of cancers in men but most common in young 15-35
testicular cancer
causes in men with undescended testicles or mothers who took hormones during pregnancy
testicular cancer
when protein and AFP (alphafetoprotein and HCG) levels are up indicates?
testicular cancer
treatment of testicular cancer?
Biopsy, orchiectomy, chemo, radiation
rare but in correlation with poor hygiene and delayed or no circumcision
penile caner
painless, nodular growth on foreskin, fatigue and weight loss
S/S of penile cancer
treatment of penile cancer?
penectomy, if radiation or chemo is used must be used together not effective alone
