Reproductive Disorders NC3
Terms
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- Menstrual cycle is divided into 2 cycles- what are they?
- ovarian cycle and the endomerial(uterine)cycle
- Ovarian cycle
- Is divided into follicular phase, the ovulatory phase and the luteal phase
- Follicular phase
- estrogen dominate when the follicle matures
- ovulatory phase
- follicle ruptures from the ovary on approximately the 14th day before onset of the next cycle
- lutreal phase
- progesterone is dominant as theuterus prepares for implantation
- Endometrial cycle
- Divided into the proliferative, secretory and ischemic phases
- Proliferative
- proliferation of endometrium dominant
- secretory
- progesterone dominant pahse cause endometrial glands to continue to grow and become dense preparatory to implantation
- ischemic
- occurs only if fertilization does not occur. Corpus luteum regresses, progesterone and estrogen production decreases. Endometrium degenerates, capillaries rupture and endometrium sloughs off
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Male hormones
hypothalamus released gonadotropin-releasing hormone, influencing the anterior pituitary gland to release FSH and LH - x
- FSH
- releases androgen-binding protein (ABP)
- LH
- releases testosterone
- ABP
- binds with testosterone to promote spermatogenesis
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Male sexual response
phases - excitement phase, plateau, orgasm, resolution, male climacteric
- excitement phase
- rapid erection due to vasocongestion, elevation of the scrotal sac. Testes increase in size
- Plateau phase
- thichening of penis, testes continue to increase in size. Nipple erection and sex flush. Orgasm is the climax of the plateau phase
- orgasm
- expulsive contractions of the length of the urethra to ejaculate semen containing sperm out of the urethra
- resolution phase(final phase)
- rapid loss of vasocongestion with the decrease in penis size. Testes descend back into the scrotum
- Male Climacteric
- physiologic changes occur in older men. Men may need more direct genital stimulation during excitement phase and has decreased testicular elevation
- hysterectomy
- removal of uterus with or w/o removal of the ovaries(oophorectomy)
- HRT- hormone replacement therapy
- Used to decrease symptoms that women may experience due to menopause. Symptoms such as insomnia, hot flashes, mood swings, and lack of concentration. HRT may protect against osteoporisis and cardiovascular disease
- atrophic vaginitis
- physiologic changes associated with decreasing amounts of estrogen as women age. Thinning of vaginal tissue, painful intercourse, itching, burning or irritation. pH becomes slightly alkaline increasing susceptibility to infxn
- endometriosis
- growth of the endometrial tissue outside the uterus. S/S include lower backache, painful intercourse etc
- PID pelvic inflammatory disease
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pathogenic invasion of the fallopian tubes, ovaries or both. May be gonococcus, streptococcus and staphylococcus and other infxn that are ascending in nature. Risk factors include multiple sexual partners, frequent intercourse, IUDs and childbirth.
S/S low grade fever, pelvic and abdominal pain, foul-smelling vaginal dischange - TSS toxic shoch syndrome
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staphylococcus aureus enters the bloodstream. Relationship between TSS and tampon usage.
S/S temp > 102, vomiting, diarrhea and progressive hypotension - Fibroid tumors (leiomyoma)
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benign tumors that grow in or on the uterus.
S/S excessive heavy menstrual flow, pelvic pressure, dysmenorrhea, abdominal enlargement and constipation - dysmenorrhea
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painful menstruation. Common in nulliparous women, not having intercourse.
S/S uterine cramping, irritation and contractions - Amonorrhea
- absence of menstruation. Primary is absence of menstruation by age 17.(anatomical or genetic abnormalities such as Turner syndrome) Secondary is absence after 6 months of regular periods or 12 months or irregular periods. (anatomic abnormalities, nutritional deficits, excessive exercise, decreased body fat, endocrine dysfunction, emotional disturbances, medication side effects, pregnancy and lactation)
- fibrocystic breast disease (FBD)
- chronic cystic mastitis. Single or multiple fluid-filled cysts. Vitamin E supplements and elimination of caffeine are recommended
- Benign Prostatic hypertrophy (BPH)
- progressive adenomatous enlargement of prostate gland that occurs because of aging. Urinary outlet obstruction, decreased force of urine stream, urinary frequency and nocturia
- breast cancer
- second major cause of ca death among women
- cervical ca
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most preventable gynecological ca. Abnormal Pap smear.
Most common sign is abnormal bleeding - prostate ca
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second leading cause of ca deaths in men.
DX- test include PSA(prostate specific antigen)transrectal ultrasonic exam, and prostatic biopsy
S/S weak urinary stream, increased urinary frequency - cystocele
- support between the vagina and bladder is weakened
- urethrocele
- downward displacement of the urethra into the vagina
- rectocele
- weakening between the vagina and rectum
- fistula
- abnormal opening between internalorgans or between an organ and the exterior body
- vesicovaginal fistulas
- between vagina and bladder that causes urine to leak into the vagina
- rectovaginal fistulas
- rectum and vagina and cause flatus and feces to enter vagina. Both fistulas cause excoriation and irritaiton and may lead to severe infxn. some fistuls spontaneously heal, others require surgical excision
- Benign Prostate Hypertrophy (BPH)
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progressive adnomatous enlargement of the prostate gland, common in aging. Urinary outlet obstruction with hesitancy, decreased force of urine stream, urinary frequency and nocturia
TX- may include alpha-beta blockers that are usually used to treat hypertension - penile implants
- treat impotence. Surgical implantation of semi-rigid implant that is flexible or with a hydraulic pump located in the scrotum or end
- pessary
- small molded plastic apparatus fits in the vagina behind the pubic bone and in front of the rectum to provide support for the uterus. Cleaning required once every one to two weeks. Complications include vaginal necrosis or ulceration
- scrotal supports
- support the scrotum to relieve swelling or decrease discomfort of inflammation post operatively
- TURP-transurethral resection of the prostate
- includes bladder irrigation to reduce clot formation that could interfere with urinary drainage. Continuous irrigation with a three-way Foley catheter for at least 24 hrs. Irrigant should be subtracted from total output to assess urinary output. Absorption of irrigation fluid may result in water intoxication manifested with mental status changes, agitation, confusion and even convulsions
- hysterectomy- post op
- assessment of dressing for signs of bleeding during the first 8 hrs. Assess for urinary retention due to temporary bladder atony. Client should also be assessed for development of thrombophlebitis
- dilation and curettage
- curet of endometrial lining to assess abnormal bleeding patterns, evaluate the uterus or cytological evaluation of the endometrial lining
- anterior-posterior colporrhaphy
- suturing of the vagina to correct a cystocele(anterior) or rectocele(posterior). Perinial care at least 2x a day and after urination/defecation. Ice packs, sitz baths and heat lamps enhance healing process. No heavy lifting or prolonged standing, walking or sitting and avoidance of intercourse
- hydrocelectomy
- surgical drainage of a hydrocele. Hydrocele is a nontender, fluid filled mass resulting from interference of lymphatic drainage of the scrotum. The swelling surrounds the testes. Monitor for adequate voiding patterns and give comfort measures.
- orchiopexy
- surgical suturing of an undescended testicle in the scrotum. Monitor for swelling,pain, infxn, and voiding patterns