Human Sexuality-NC3
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- What happens when the voice of an adolescent changes?
- The change is associated with lengthening of the vocal chords, increase in structure and mass of the vocal chords
- group identity vs alienation (Erikson)
- adolescent struggling with relations, belonging to a group and trying to be less identified with the family
- Abstract thinking/formal operation (Piaget)
- Cognitive thinking culminates with the capacity for abstract thinking
- moral development of the adolescent
- part of their struggle is basing their decision on an internalized set of moral principle. They seriously question established moral codes, resulting from adults action as do as I say and not as I do
- major causes of morbidity and mortality in adolescence
- They not diseases but, health damaging behaviors, which includes injury, depression, violence, sexually transmitted infrections and pregnancy.
- nurses role in exercise and acitivity
- can encourage participation as a way to promote health and build self-esteem. They should not be encouraged to participate in any activities above their level of strength
- nurses role in dental health
- important to reinforce orhtodontist's directions regarding use and care of the appliances and to emphasize ccareful attention to tooth brushing during this time
- nurses role in personal care
- nurses are in aposition to help evaluate the relative merits of commercial products offered to young people in the media
- nurses role in body art
- it is the nurses responsibility to caution girls and boys against the practice of having peircing performed by friends, parents or themselves to prevent infection, cyst or keloid formation, bleeding, dermatitis or metal allergy, sharing needles can also cause HIV and Hep B transmissions
- Sexuality Information and Education Council of the United States (SIECUS)
- Covers six topics, biologic, social, health, personal adjustments and attitudes, interpersonal associations and the establishment of values
- nurses role in sexual education and guidance
- Nurses should use simple words, correct terminology, not street language or highly scientific terminology or evasive jargon.
- nurses role in sports injuries
- injury prevention is an ongoing part of nursing responsibility throughout the childhood years
- Clinical signs of mono
- headache, malaise, fatigue, chills, low-grade fever, lossof appetitie, puffy eyes
- Signs of full blown mono
- fever, sore throat, cervical adenopathy
- Effects on organs from mono
- splenomegaly, palatine petechiae, macular eruption, exudative pharyngitis/tonsillitis, hepatic involvement to some degree often asociated with jaundice
- nurses responsiblity in care of mono pts
- directed toward providing comfort measures to relieve symptoms and toward helping affected youngsters and families to determine appropriate for the stage of the disease. Q effort should be made to prevent secondary infection
- nurses responsiblity in care of teenagers who smoke
- prevention of regular smoking in teenagers is the mos effective way to reduce overall incidenceof smoking.
- repetitive microtrauma
- the same movements are performed over a long period, results in inflammation of the involved structure-c/o chronic pain, tenderness, swelling and disability eg are tendinitis and ostiochondritis from repetitive throwing, tennis elbow, repititive elbow strain
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nurses role in care of
children and adolescents in sports - the best approach to counseling children andparents regarding sports participation is to encourage activities that are most likely to provide pleasure and physical benefits throughout childhood and into adulthood
- diseases that cause delay in growth
- asthma, cystic fibrosis, GI diseases s/a parasitic infections, malabsorption syndromes, cardiacn anomalies and chronic reanal distrubances
- nurses responsiblity in care of children with growth delay or early growth spurt
- Listening to distressed adolescents and conveying interests and concerns are very important, children who are shorter should not be treated as if they are younger and children who are taller should not be treated as if they are older
- Turner syndrome
- abscence of one X chromosome missing, girls who have this disorder are infertile, diag. at birth-webbed neck, spaced nipples edema of hands and feet. Imature
- Klinefelter Syndrome
- Presence of an additional X chromosome. Found mostly in males. Abscence of sperm in semen, small testes and defective development of secondary sex characteristics, cognitive impairment - frequent clinical finding
- dysmenorhea
- usually begins at menarche, painful menstruation, overproduction of uterine prostaglandins has been implicated in women with dysmenorhea
- nursing considerations during menstruation
- explain menstruation is normal, encourage balanced diet, recommend NSAID, continued support since they are so self concious and concerned about appearance
- most obvious anamolies of the male repro sys.
- hypospadias, hydrocele, phymosis, cryptorchidism
- phymosis
- a narrowing of the opening in the foreskin that prevents its being drawn back over the penis. This makes washing difficult or impossible and often leads to irritation and infection.
- hydrocele
- an accumulation of watery liquid in a body cavity, especially in the sac around the testes. It is a painless condition that can be treated surgically by draining the fluid
- hypospadias
- Hypospadias is a birth defect in which the male urinary opening is misplaced on the penis;
- The most frequent problems related to the reproductive organs in later male children are
- 1)infections, s/a Urethritis; 2) hematuria; 3)penile problems s/a nonretractable foreshin in uncumcised males, carcinoma and trauma 4)scrotal condition s/a varicocele (elongation, dilation and tortuosity of the veins wuperior to the testicle 5) testicular torsion
- torsion
- the twisting of something, or a twisted state
- nursing considerations with an adolescent boy
- The adolescent is extremely conscious of self, matter a fact approach is best, explain exactly what you will do,
- normal testicle
- firm, smooth eegg shaped contour, the epididymis is palpated as a rased swelling on the superior aspect s/n/b confused as an abnormality
- morbidity
- diseased state: the presence of illness or disease
- nursing considerations with a pregnant teen
- careful assessment, teach how to cope with stress, guidance from adults, info on options, given a a nonjudgmental manner, encourage prenatal care, nutrition info very important
- nursing considerations with teens and STDs
- teach safety, efforts s/b towards primary prevention, tertiary prevention should include, reducing the medical and psychological effect, support groups, seeking treatment for STDs
- PID presenting symtoms
- generalized fever, abdominal pain, UTI, vague influenza type manifestations, s/a malaise, nausea, darrhea or constipation. Pelvic exam is indicated for Q sexually active female who c/o abd. pain to r/o PID
- short term complications of PID
- acute abscess formation in the falopian tube,
- Long term complications of PID
- chronic pelvic pain, dyspareunia adhesion formation, increased r/o ectopic pregnancy
- 2 things to communicate initially to a rape victim
- 1) he/she is all right, 2) he/she is not to blame for the situation
- nursing consideration with male practioner examination
- female must be present when a female is being examined by a male practitioner
- rape trauma syndrome
- refers to the victim's reation to a sexual assault. 1) the acute phase of disorganization of lifestyle 2) a long-term process of reorganization. These phases encompass behavioral, somatic and psychologic reactions to the stressfull event
- Primary goal of nursing care of a rape victim
- avoid inflicting further stress on the youngster, who is often angry, confused, frightened, embarrassed, and filled with self blame
- Therapeutic Tx of Anorexia Nervosa
- 1)reinstitution of normal nutrition or reversal of malnutrition, 2) resolutin of disturbed paterns of family interaction and 3) individual psychotherapy to correct deficits and distortions in psychologic functioning.
- Therapeutic mgt of anorexia nervosa
- hospitalization for k+ depletion, esophageal damage, IV fluids for k+ replacement, cardiac monitoring and nutritional consultant
- Nusing care of AN
- monitoring IV fluids, electrolyte alterations and ovservationfor signs of cardian complications, relaxation techniques and telephone support network
- ADHD
- developmentally inappropriate degrees of inattention, impulsiveness, and hyperactivity
- Learning Disabilities
- heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of llietening, speaking, reading, writing, reasoning or mathemathecal skills
- Nursing considerations with ADHD AND LD
- Take meds in the morning to mazimize its effectiveness in the classroom and to decrease it insomnia-producing potential. If decreased appetite is a concern giving the medication (psychostimulant) with or after meals rather before is helpful
- methylphenidate
- stimulant that increases dopamine and norepinephrine levels that lead to simulation of inhibitory system of the CNS
- SE of Ritalin
- nausea, anorexia, decreased appetite and insomnia
- Goal of children with LDs
- to help them identify their ares of weakness and learn to compensate for them
- Nursing considerations in ADHD and LD
- Teach to take stimulant medication in the am, to maximize effectiveness in the classroom and to decrease it insomnia-producing potential
- Environmental manipulation in ADHD children
- set limits, keep a regular routine, decrease external stimuli and distractions- to encourage designed pattern of behavior.
- audio perceptual deficit (LD)
- unable to follow directions or to comprehend large amts of verbal teaching
- visual perceptual deficit (LD)
- may have difficulty reading, lining up numbers for math operation or judging distance.
- integrative deficit (LD)
- difficulty sequencing data or storing and retrieveing sensor data
- dysgraphia (LD)
- dificulty with writing
- therapeutic techniques to mange enuresis
- medications, bladder training, restriction or eliminaiton of fluids after the evening meal, interruption of sleep to void, apparatus designed to trigger some reflex to prevent wetting
- meds for enuresis
- Tofranil -tricyclic antideppresant, oxybutynin reduces uninhibited bladder contractions, Desmopressin, nasal spray, reduces nighttime urine output to a volume less than functional bladder capacity
- primary encopresis
- by age 4 when the child has not achieved fecal continence
- secondary encopresis
- fecal incontinence occurring in a child older than 4yrs after a period of established fecal continence.
- Cause of encopresis
- constipation, precipitated by environmental changes. chronic severe constipation impars the usual movement and contractions of the colon, which can lead to fecal obstruction.
- Post traumatic stress disorder PTSD
- development of characteristic symptoms after exposure to and extremely traumatic experience ot catostrophic event
- Stages of PTSD
- initial response, second phase and third phase
- conversion reaction
- hysteria, hysterical concersion reaction and childhood hysteria is a psychophysioogic disorder with a sudden onset that can usually be traced to a precipitating environmental event.
- manifestations of converstion reaction
- sx include abd. pain, fainting pseudoseizures, paralysis, headaches and visual field restriction.
- childhood schizophrenia
- severe deviations in ego functioning and is generally reserved for psychotic disorders that appear in children under 15yo
- childhood schizophrenia is characterized by
- lack of contact with reality, impaired cognition, perception, emotion, language and physical motor control, language disturbances, impaired interpersonal relationship, inappropriate affect
- CNS effects of inhalants
- rapid lossof consciousness and respiratory arrest, may cause visual scanning problems, language deficiencies, motor instability, memory deficits and attention and concentration problems
- Hallucinogens
- psychedelic, psychotomimetic, psychotropic or illusionogenic are drugs that produce vivid hallucinations and euphoria, no physical dependence
- suicidal ideation
- preoccupation with thoughts about committing suicide
- Nurse alert - items to not make available four suicidal teens
- adolescents who express suicidal feelings and have a specific plan should be motniored at all times. They should not have access to firearms, prescription or over the counter drugs, belts, scarves, shoestrings, sharp objects, matches, or lighters if they are intoxicated they must be restrained or placed in a protective environment until a psychiatrist or psychologist can assess them
- nurse alert- things not to ignore in a suicial teen
- no threat of suicide should be ifnored or challenged. Threats are a symptom that must be taken seriously. Too often, suicidal threats or mi nor attempts are confused with bids for attention. It is also a mistake to be lulled into a false sense of security when the adloescent's depression is apparently relieved. The impovement in attitude may mean that the youngster has made the decision and found the means to carry out the threat
- culture and menstruation in India
- it is an event of embarrassment that should be hidden and not discussed.
- normal menstrual cycle lenght
- 21-35 days
- Mentrual flow averages
- 25-60ml per period
- mentrual length
- 2-5 days
- Virginity in Arab women
- Among Arab people a girl's virginity is highly valued, As a result unmarried Arab women do not use tampons during menstruation for fear of breaking the hymen.
- Four causes of Amenorrhea
- Hypothalamic dysfuntion, Pituitary dysfunction, Ovarian failure, Anatomic abnormalities
- hypothalamic dysfunction -Amenorrhea
- failure of the structures of the hypothalamus, weight loss triggered by anorexia, bulimia, fad dieting, excessive exercise- runners, dancers, severe prolonged stress
- Pituitary dysfunction in Amenorrhea
- Pituitary disease, tumors, increase in prolactin levels from psychiatric meds, low prolactin levels from pituitary failure, head trauma, Sheean's syndrome
- Ovarian Failure- amenorrhea
- genetic disorders eg Turners syndrome (defective chromosome) radiation, chemotherapy, viral infection, surgical removal of
- Anatomic abnormalities
- congenital absence of the uterus, ovaries, or vagina; congenital obstruction; or imperforate hymen
- Secondary dysmenorrhea
- associated with pathology the reporductive tract and usually appears after menstruation has been established
- hypomenorrhea
- regular uterine bleeding in decreased amounts
- hypermenorrhea
- abnormally long menstrual flows
- oligomenorrhea
- irregular periods 40 day intervals
- polymenorrhea
- irregular/regular intervals of 22 days
- menorrhagia
- excesibe bleeding in amt and duration at regular intervals
- metrorrhagia
- bleeding or normal amts at irregular intervals
- menometrorrhagia
- excessive bleeding in duration and amount regular or irregular
- intermenstrual bleeding
- bleeding between periods
- premenstrual dysphoric disorder (PMDD)
- symptoms are more psychotic, related to mood and severe enough to interfere with work
- culture and menopause in the Philipines
- menopause is viewed as positive and liberating. Women are respected and admired for their years of experience
- vasomotor disturbance
- hot flash- heat rising from the chest and spreading to the face
- cognitive function
- learning, memory, concentration, and planning ability
- Reason for prescribing HRT
- stop hot flashes, night sweats, reverse atrophic vaginal changes, prevent osteoporosis, also helsp with viginal dryness, dyspareunia, dysuria, urinary urgency frequent urination and recurrent UTI, also protects against colorectal CA and Alzheimers disease
- Disadvantages of HRt
- increased heart attack or CVA, DVTs, brease CA, colorectal CA and hip fracture, as well as gall bladder disease
- Administration of Actonel
- taken on an empty stomach, with a large glass of H20, sit upright or stand for about 30 minutes after taking the med and before eating.
- sings of cardiac arrest, MI in women
- pain in the neck, back or epigatric region, loss of appetite, SOB, N/V, weakness in shoulder, arms and chest
- Foos high in phytoestrogen
- carrots, yams and soy products
- foods that trigger menopausal symptoms
- caffeine, alcohol and spicy foods
- spinnbarkheit
- stretchable mucous from the vagina
- cervial mucus method aka
- ovulation method and billings method
- symptothermal method
- cycle length, coitus, cervical mucus change and secondary signs s/a increased libido, abdominal bloating, mittelschmerz 9midcycle abdominal pain and BBT , these signs indicate ovulation
- Problems to report in the use of IUD for conceptive
- late period, abnormal spotting or bleeding, dyspareunia,m abdominal pain, abnormal discharge, signs of infection-feer chills, malaise or missing string. If pregnant with IUD remove immediately
- How do hormonal conceptive work
- they work by inhibiting the release of an ovum, by creating an atrophic edometrim and by maintaining a thick cervical mucus that slows sperm transport and inhibits the process that allows sperm to penetrate the ovum
- combined oral contraceptive aka
- birth control pills
- side effects of combined oral contraceptives
- weight gain, acne, breast tenderness, bloating.
- contratindication for COGs
- hx of DVTs, pregnancy, chronic liver disease, heavy smoker, dependent carcinomas, undiagnosed uterine bleeding, diabetes, hyperlipidemia
- women who need close monitoring with COC's
- women with history of migraine headaches, epilepsy, depression, oligomehorrhea and amenorrhea.
- Benefits or COCs
- diminished cramps, regular cycles, mittelschmerz eliminated, funtional ovarian cysts diminished, reduction in ectopic pregnancy, edometrial cancer, colorectal cancer, iron difiency anemia, benigm breast disease
- warning signs to report with COCs
- breast lump, becomes jaundiced, severe abdominal pain, severe chest pain, SOB, severe headaches, dizziness, changes in vision, vision loss or blurring, speech problems, or severe leg pain
- how does norplant (contraceptive work)
- Prevents ovulation, stimulates the production of thickcervical mucus, which inhibits sperm penetration (implanted for 5 years)
- side effects of norplant
- spotting, irregular bleeding, amenorrhea, increased incidence of ovarian cysts, weight gain, headaches, fluid retention, acne, hair loss, mood changes and depression
- Two types of oral contraceptives
- estrogen-progestin (the pill)and the progestin only product (the mini pill)
- how do estrogoen-progestin work
- they suppress the pituitary release of FSH and LH which are needed to mature a graafian agent, it also changes the endomitrium, making it unfavorable for implantation of a fertilized ovum
- how do progetin only products work
- alters the cervical mucus and secondarily by altering the endometrium to inhibit implantation. (some clients experience no ovulation)
- half life of combination products for oral contraceptives
- 6-20hours
- porphyria
- medical condition caused by the body's failure to metabolize porphyrins. Symptoms of the hereditary form include abdominal pain, sensitivity to sunlight, confusion, and excretion of porphyrins in the urine.
- porphyrins
- a metal-containing pigment in animal and plant tissue, consisting of four pyrrole rings linked by methylene groups, e.g. hemoglobin
- side effects by an excess of estrogen (COCs)
- N/V, diziness, fluid retention, edema, bloating, breast enlargement, breast tenderness, chloasma (slightly more in dark-skinned clients exposed to sunlight on higher dose tablets) leg cramps, decreased tearding, corneal curvature, visual changes vascular headache and hypertension
- side effects caused by deficiency in estrogen
- vaginal bleeding (breakthrough bleeding), oligomenorrhea, nervousness, dysparunia secondary to atrophic vaginitis
- side effects by an excess of progestin
- increased appetite, weight gain, oily skin, and scalp acne, depressin, vaginitis from yeast (candida) excess hair growth, decreased breast size and amenorrhea after cessaton of use
- side effects caused by progestin dificiency
- dysmenorrhea, bleeding late in the cycle, heavy menstrual flow with clots and amenorrhea
- ACHES
- A-ABD. PAIN (SEVERE), C-CHEST PAIN OR SOB, H-HEADACHES THAT ARE SEVERE, DIZZINESS, WEAKNESS, NUMBNESS, SPEECH DIFFICULTIES, E-EYE DISORDERS INCLUDING BLURRING OR LOSS OF VISION, S-SEVERE LEG PAIN OR SWELLING IN THE CALF OR THIGH
- serious side effects of Depo-Provera
- chest pain, hemoptysis, abdominal pain, SOB and numbness in the extremities
- Lunelle a COC works by
- inhibiting secretion of gonadotropin, preventing maturation and ovulation. Given IM
- Adminsitration of Lunelle
- IM, Q 28-30 days, not to exceed 33 days, 1st dose given in 1st 5 days of menses, do not administer if more than 33 days, to rule out pregnancy, smokers do not take
- Side effects of NuvaRing
- viginal discharge, irritation, or infection
- severe side effects of NuvaRing
- Risk of blood clots or heart attacks -increased in clients who smoke
- How does the IUDs ParaGard and Progestasert work
- ParaGard releases copper that interferes with sperm motility and fertilization as a result of inflammation of the endometrium. Progestawert reduce the viability of sperm through release of progesterone.
- PMS occurs in which phase of the menstrual cycle
- Luteal phase (15-28 days)
- PMS decreases in which phase
- the folicular phase (1-14 days)
- Endometriosis
- abnormal locationo of endometrial tissue outside of the uterus in the pelvic cavity.
- Drug therapy for endometriosis
- danazol (Danocrine), leuprolide acetate for depot suspension (Lupron Depot), nafarelin acetate (Synarel Nasal Solution)
- danazol (Danocrine)
- pituitary gondotropin inhibitory agent, suppresses and atrophies intra and extrauterine tissue, menses cease during drug therapy
- Adverse effects of danazol (Danocrine)
- thrombocytopenia, hypertension, depression, headache, hot flashes, wgt gain, androgenic effects, hemorrhagic cystitis, hematura, hepatotoxity, cholestatic hepatitis, acne, rashes, oily skin, hirsutism, bloating, muscle cramps, voice deepening, (irreversible) hearing loss, mood swings, anxiety, fatigue, nausea, vomiting, diarrhea, constipation
- (Lupron)leuprolide acetate for depot suspension
- an agonist, initially stimulates FSH and LH, but over time creates prolonged suppression, which causes decreased ovarin secretion of estrogen/progesterone, resulting in a hypoestrogenic statel, Lack of hormonal stimulation causes regression of displaced endometrial tissue
- Lab values altered with the admin. of danazol (Danocrine)
- decreased HDL, increase LDL, can increase insulin requirements, if given with coumadin, cause a prolonged PT
- side effects of Lupron
- hot flashes, headaches, decreased libido, dry vagina, night sweats, mood changes, mild bone loss (usually regained within six months of treatment)
- nafarelin acetate (Synarel Nasal Solution)
- hypoextrogenic,-therapeutic state reduces endometriosis
- side effects of nafarelin acetate (Synarel Nasal Solution)
- hot flashes, viginal dryness, decreased libido, headaches, and emotional lability
- female climateric
- non reproductive stage of a female's life- 3 stages, premenopause, menopause and post menopause
- What causes menopause
- decreased ovarian function
- Premarin
- Estrogen replacement therapy (conjugated estrogen) to relieve vasodilation, hot flashes, and viginal dryness and to prevent cardiovascular disease and osteoporosis
- premarin should be used with caution in individuals with
- CAD, severe renal or hepatic disease, smoking hx and DM
- Drug and Lab interactions of premarin
- increase effects of corticosteroids, decrease effects of anticoagulants, oral hypoglycemics, decrease effects of rifampin, anticonvulstants, barbiturates, toxicity with tricyclic antidepressants
- Side Effects of Premarin
- N/V, fluid retention, breast tenderness, leg cramps, and breakthrough bleeding, chloasma
- Adverse reactions of premarin
- jaundice, thromboembolic disorders, depression hypercalcemia, gallbladder disease
- Life threatening effects of premarin
- Thromboembolism, crebrovascular accident, PE, MI and endometrial cancer
- testosterone
- induces and preserves the male sex characteristics
- PLISSIT
- P-PERMISSION, L-LIMITED IMFORMATION, S-SPECIFIC,S-SUGGESTIONS, I-INTENSIVE,T-THERAPY
- DRG
- Digital rectal exam
- PSA is described in ml as
- nanograms per mL
- TRUS
- transrectal ultrasound
- prostadynia
- pain in the prostate
- prostatism
- increased frequency of urination, nocturia, urgency, hesitancy in starting ruination, abdominal straining with urination, a decrease in the bolume and forceof the urinary stream, interruption of the urinary stream, dribbleing, a sensation that the bladder has not been completely emptied, recurrent UTI
- What is a major complicatiom of prostate surgery
- hemorraging
- transurethral needle ablation
- uses low-level radiofrequencies to produce localized heat to detry prostate tissue while sparing the urethra, nevers, muscles, and membranes.
- microwave thermo therapy
- heat is applied to the hypertrophied prostatic tissue. a transurethral probe is inserted into the urethra and microwaves are carefully directed to the protate tissue. A water colling system helsp sto minimize damage the urethra and decreases the discomfort from the procedure, the tissue becomes necrotic and sloughs
- When d symptoms of prostate CA develope
- Later in the disease- urinary obstruction
- azotemia
- accumulation of nitrogenous waste products in the blood
- nursing considerations fluid imbalance in prostatectomy
- must monitor fluid balance, monitor electrolyte imbalance, (hyponatremia) rising blood pressure, confusion and respiratory distress. Increased risk for respiratory fluid imbalance in the elderly with preexisting cardiac and respiratory disease
- What is the first thing done after a prostectomy
- the patien is assisted to sit and angle his legs over the side of the bed on the day of surgery.
- color of irrigation fluid after a prostectomy in CBI
- starts out ats reddish-pink and then clears to a light pink within 24hours after surgery
- nursing management in prostectomy
- monitor vs, Is & Os, administer meds, IV fluids and blood component therapy, monitor drainage for accurate out flow of urine
- Assessment of obstructed catheter
- overdistended bladder presents a distinct rounded swelling above the pubis, overdistended bladder is avoided b/c it can induce secondary hemorrhage by stretching the coagulated blood vessels in the prostatic capsule
- Name one clinical manifestation of testicular cancer
- enlargement of the testis without pain is a significant diagnostic finding
- At what rate does testicular cancer metastisize
- they metastisize early to the lymph nodes, lungs and retroperitoneum
- long-term side effects associated with tratmen for testicular cancer
- kidney damage, hearing problems, gonadal damage, neurological changes and sometimes secondary CA
- Postoperatively what is the major complication of hydrocele
- hematoma in loose scrotal tissue, postoperatively a patient wears an athletic supporter for comfort and support
- phimosis
- a condition in which the foreskin is constricted so that it cannot be retracted over the glans.
- luteinizing hormone
- responsible for stimulating progesterone production
- follicle-stimulating hormon
- stimulates the ovaries to secret estrogen
- proliferative phase
- beginning of the menstrual cycle just after menstruating
- secretory phase
- near the middle portion of the cycle 14-28
- luteal phase
- begins after ovulation and is characterized by the secretion of progesterone from the corpus luteum
- chadwick sign
- bluish cervix - early sign of pregnancy
- sign of neoplasm in the cervix
- hardness and immobility of the cervis may reflect invasion by a neoplasm
- Androgens
- male sex hormones
- Drugs for Androgens
- Duratest 100, Depo-testosterone, Virilon, Testred Cypionate
- Contra indications for androgens
- pregnancy, nephrosis, hypercalcemia, hepatic dysfuntion, prostate CA, hx of MI, prepubertal status, pituitary dysfunction
- Drug lab interactions of androgens
- increases effects of anticoagulants, decreases effect with barbiturates, dilantin, phenylbutazone, antogonizes-calitonin, parathyroid, corticosteroids, exacerbate edema, decrease blood sugar in DM, increases serum cholesterol, thyroid, liver fuction and hemotcrit
- administration of androgens
- IM
- Other uses for androgens
- treatment of refractory anemias in men and women, the hereditary autosomal clotting disorder andioneurotic edema, tissue wasting assoc. /c severe or chronic illness, advanced carcinoma of vreast in women and endometriosis, also for severe menopausal symptoms
- SE of adrogen therapy
- abd. pain, Nausea, insomnia, diarrhea or constipation, hives, or rednes at the injection site, increased salivation, mouth soreness and increased or decreased sexual desire.
- Adverse reactions of adrogens
- development of secondary male characteristics, when the man is not hypogonadal, women who use this risk these manifestations as well, including acne,, skin oiliness, facial hair growth, and vocal huskiness, menstrual irregularity, hypertrophy of the clitoris in women, vocal changes are permanent, others slowly reverse themselves if the pt is not a CA pt receiving long
- virilization
- feminization
- Less freq. adverse effects of androgens
- dizziness, weakness, changes in skin color, freq. headaches, confusion, resp distress, depression, pruritus, allergic skin rash, edema of the LE, jaundice, bleeding, presthesias, chills, polycethemia, muscle cramps, NA+ and H20 rentension
- paresthesia
- an unusual or unexplained tingling, pricking, or burning sensation on the skin
- anabolic steroids
- testerone derivatives developed to maximize the anabolic effects of androgens and to minimize their androgenic effects
- antiandrogens
- block the synthesis or action of androgens
- antiandrogen use
- used to treat male-pattern baldness, acne, hirsutism, virilization syndrome in women, precocious puberty in boys (they inhibit the sex drive in men)
- Two types drugs to block testosterone action
- androgen-receptor antagonists and agents that block conversion of testosterone to its active form dihydrotestosterone
- cyproterone acetate
- an orally active progesterone is a poten androgen antagonist, It also suppresses LH and FSH secretion and has proegestational qualities
- SE of cyproterone acetate
- can stunt growth in young people, acne and baldness
- finasteride
- used to treat benign prostatic hypertrophy
- Adverse effects of finasteride
- impotence, decreased libido and decreased ejaculate
- signs of hypercalcemia
- n/v, lethargy, decreased muscle tone, polyuria, increased urine and serum calcium
- Inadequate pituitary function
- results in hypgonadism, prepubertal boy-results in lack of secondary sex characteristics and infertility, adult ment may experience testicular atrophy and decreases in libido, potency, beard growth and muscle tone.
- menotropins (pergonal)
- stimulates testosterone production when injected IM
- adverse effects of menotropins (pergonal)
- nausea, vomiting, diarrhea, gynecomastia and fever
- addison's disease-
- deficit of cortisol and mineralocorticoid aldosterone, may experience inhibited sexual desire, erictile dysfuntion or diminished fertility
- inhibited sexual desire results from
- androgen deficiency
- erectile dysfunction caused by
- cause by psychoemotional problems, vascular insufficiency, neurologic disorders, androgen deficiency or resistance, or diseases of the penis
- ejaculatory dysfunction caused by
- result of drug therapy, androgen deficiency, or sympthetic degeneration, reduction of penile swelling (detumescence)
- Other uses of Levodopa (L-Dopa)
- effective in stimulating libido and treating erectile dysfunctions in non-Parkinson's clients
- SE of Viagra (Sildenafil citrate)
- flush, headache, dyspepsia, nasal congestion and diarrhea, other SE blurred vision, photosensitivity, changes in color perception, urinary tract symptoms,
- adenocarcinoma
- a malignant tumor with cells arranged in patterns similar to those of a gland
- drugs that cause sexual dysfunction
- anticholinergics, antidepressants, antihistamines, antihyperntensives, antipsychotics, sedatives and social drugs others-baclogen, steroids, ethionamide, digoxin, chemotherapeutic drugs, perhexiline
- drugs androgen replacment,delayed puberty, senile or postmenopausal ostioporosis
- testosteron (histerone, tesamone, testopel pellets, testosterone aqueous, testosterone powder
- drugs for carcinoma of the breast
- testosteron (histerone, tesamone, testopel pellets, testosterone aqueous, testosterone powder
- drugs androgen replacment,delayed puberty
- testosterone cypionate (Andro-Cyp, Andronate, depAndro, Depotest, Depo-Testosterone, Duratest, Testred cypionate, Virilon IM)
- Androgen deficiency, carcinoma of the breast drugs
- fluoxymesterone (Halotestin)
- Androgen dificiency drugs
- methyltestosterone (Android, Oreton Methyl, Testred Virilon)
- metronidazole (Flagyl)
- antiprotozoal and antibacterial agent- treats T Vaginalism bacterial vaginosis, endometritis, endomyometritis, tubo-ovarian abscess and postsurgical vaginal cuff infection
- Contraindications in Flagyl
- blood dyscrasias, breastfeeding (drug secreted in breast milk) impaired kidney or liver function, active CNS disease
- SE of Flagyl
- convulsive seizures, weakness, peripheral neuropathy insomnia, N/V, HA, Anorexia, diarrhea, Epigastric pain, abd cramping, constipation, metallic tase in mouth, dizziness, vertigo, uncoordination, ataxia, confusion, irritability, cystitis, dysuria, reversible neutropenia, thrombocytopenia, flattening T Wave on ECG, polyuria, incontinence, pelvic pressure, proliferatio of candida in the vagina and mouth, jnt pain, decreased libido, dryness in the mouth, vagina and vulva, dysparunia, depression
- vulvovaginal candidiasis
- moniliasis or yeast infection
- candida strains
- c glabrata, c tropicalis and c krusei
- ketoconazole effects on the liver
- hepatotoxicity
- trichomonas vaginalis
- a microscopic motile protozoan that thrives in alkaline environment
- effects of trichomoniasis in pregnant women
- may be at increased risk for premature rupture of membranes, preterm birth and low birth weight
- effects when taking metronidazole with alcohol
- Antabuse- abdominal pain, nausea, flushing or tremors
- sequelae
- a disease/disorder ie caused by a preceding disease/injury in the same individual
- friable cervix
- bleeds easily
- gonorrhea caused by bacterium
- Neisseria gonorrhoeae
- two STD's that occur together
- chlamydia and gonorrhea
- syphilis caused by spirochete
- treponema pallidum
- primary stage of syphilis
- painless chancre appears, symptoms include, fever, lossof weight and malaise > 4 weeks
- secondary period of syphilis
- skin eruption called condylomata lata, which resemble wartlike plaques-very infectious, appears on the vulva, other secondary Sx, acute arthritis, enlargement of the liver and spleen, nontender enlarged lymph nodes iritis, and a chronic sore throat /c hoarseness
- condylomata acuminata
- genetal warts
- organism most frequently identified with PID
- chlamydia trachomatis and Neisseria gonorrheoea
- ASB
- asymptomatic bacteriuria
- Causative pathogens of UTI
- staphylococcus saprophyticus, klebsiella, proteus, enterobacter and pseudomonas
- classic symptoms of cystitis
- acute dysuria, urgency and frequency, suprapubic and low back pain, occasional hematuria
- risks of pyelonephritis and pregnant women
- increased risk of preterm labor, preterm birth, development of ARDS and septicemia and in some instances intrauterine growth restriction, A
- Acute pyelenophritis sx
- high temperatures, sudden onset of chills
- what side is most affected in pregnant women in pyelenophritis
- the R side b/c the lrg bulk of intestines to the L pushes the uterus to the R putting pressure on the R ureter and kidney
- Diseases that may cause uterine bleeding
- thyroid dysfunction, coagulation disorders and cirrhosis, may result from trauma including accidental injury, sexual abuse or intercourse related trauma