Female Sexuality

If a woman has PID and cannot stand up, what should a nurse not tell the patient?

"just stand up"

what are general questions that should be asked to every woman?

-do you have any allergies? -do you have any co-morbitities (diabetes, copd, osteoporosis)? -medications, including OTC drugs and herbs and supplements? -do you take any illegal substances or recreational drugs? -ask about preventative screenings? -any history of anemia? -ask about nutrition -any family members that have had breast cancer, cervical cancer? -had any genetic testing done? -5 P's: who are your partners and how many, sexual practices (why type of sex, vaginal, anal, oral), what kind of protection do you use? what is past history (sti, hpv, cancer), prevention of pregnancy? -any trouble voiding? -painful sex? -activity -sleep patterns -are you having any menopausal symptoms (insomnia, hot flashes, mood swings)? are you still having cycles? are you sexually active?

evista is mainly given to

-tiny females going through menopause that are very likely to develop osteoporosis -asian females and tiny caucasians?

TAH-BSO

-total abdominal hysterectomy/bilateral salpingo-oophorectomy -everything is taken out.

what size and length of needle would be given when administering 1.4 mL ceftriaxone via DG IM

21-23 gauge 1-1.5 inch needle

what age does a woman's estrogen peak?

40 years

Naproxen is aka

Aleve

diagnostic test for leiomyoma

CT

3 pituitary hormones produced

FSH, LH, prolactin (if pregnant)

drug therapy for endometriosis

NSAIDS, hormonal contraceptives, GnRH agonists,

what do the fallopian tubes do

Transport the egg from the ovary to the uterus

menopause is diagnosed when

a female does not have a period for a year

what is dysmenorrhea

abnormal pain during menstruation. affects half of the female population. primary: no pathology. secondary dysmenorrhea caused by underlying pelvic disease.

why does bleeding occur during the menstrual cycle?

an ovum is not fertilized and is discarded along with the built up endometrial tissue

examining the vulva includes?

assessing abscesses, blisters, warts, hair pattern

Leiomyomas are:

benign smooth muscle tumors of the uterus. also called fibroids? begin forming during child-bearing years.

when is calcium intake most important?

between 14-25 because that's when bones absorb it the most to release it throughout life later.

what complications can a drop in estrogen cause?

bone loss, vaginal dryness, urogenital atrophy, increased risk for microbes due to atrophy

what two supplements are important for postmenopausal women to prevent bone loss?

calcium and vitamin D -1500mg if not taking estrogen -1000mg if taking estrogen

what is secondary dysmenorrhea caused by?

caused by underlying pelvic disease

LH does what?

causes ovulation

what do females crave before their period?

chocolate (has natural endorphine) and caffeine

nonhormonal therapy for peri and postmenopause

cool environments, reduce alcohol and caffeine intake, relaxation techniques, vitamin E calcium and vitamin D, get adequate sleep and exercise

PMS (premenstrual syndrome)

disorder caused by hormonal changes. breast discomfort, edema (water retention) and bloating, binge eating and craving, headache (hormonal migraines), mood swings

two antibiotics used to treat PID

doxycycline and cefoxitin

endometriosis

endometrial backflows and grows outside of the uterus. causes dysmenorrhea, irregular bleeding, infertility

ovaries produce what two hormones

estrogen and progesterone

primary dysmenorrhea is caused by what?

excess prostaglandins that cause increased myometrial conractions, constrict endometrial blood vessels

Why are older females more susceptible to infections?

external organs droop and urethra gets closer to the anus and vagina

clinical manifestations of leiomyomas

extremely heavy menstruation, feeling bloated, frequent urge to void, constipation

fimbriae are what?

finger-like projections of the fallopian tubes that catch the egg

Midol

has a diuretic and helps with edema

calcium and magnesium

help make periods less painful

drug therapy for perimenopause and postmenopause

hormone replacement therapy, anti-depressants, SERMS, herbs

what is the menstrual cycle mediated by?

hormones

the decrease in estrogen and progesterone can lead to

increased risk for heart attack and stroke, bone loss, risk for osteoporosis

atrophy, alkalinity, and dryness of the genatalia place a woman at risk for?

infection

NSAIDs

inhibits inflammatory and prostaglandins

clinical manifestation of PCOS

irregular menstrual cycle, hirsutism (due to excessive hair growth), obesity, amenorrhea, increased glucose and hyperlipedemia

as a woman ages, what happens to her vaginal pH

it becomes more alkaline

seven dwarfs of menopause lol

itchy bitchy sweaty sleepy bloated forgetful and psycho

what drug can be given to a female with endometriosis that will put her in early menopause?

leuprolide (Trade: Lupron)

clinical manifestations of PID

lower abdominal pain (can't stand up straight because everything pulls), pain with intercourse, spotting after intercourse, discharge, fever and chills

physical assessment of the breasts include

make sure they are symmetrical, assessing for discharge

why may a female consider breasts important?

makes her feel more feminine, sexual arousal, feeding baby

How does eating red meats and exercising affect the menstrual cycle?

makes it less painful

first menstrual period

menarche

sex causes to what change in skin integrity

microabrasions

If a woman becomes pregnant but does not produce sufficient progesterone, what will happen?

miscarriage

as a woman ages, why is sex different?

more time and effort. less lubrication. decreased libido. estrogen drops.

how many eggs (oocytes) will a woman produce once she is of child-bearing age?

none. a female is born with all the eggs she will ever have

care for primary dysmenorrhea?

obtain health history, provide and educate about heating pads, relaxation and breathing/yoga, provide NSAIDs (4-600 every 8 h), oral contraceptives make hormones chill, exercise, education.

primary reproductive organ of females

ovaries (2)

PID

pelvic inflammatory disease

PCOS

polycystic ovarian syndrome

What does progesterone do?

prepares uterus for pregnancy, maintains the implanted egg

secondary sex characteristics develop in response to

presence of hormones

when assessing a client's reproductive genetalia, what should a nurse provide?

privacy

female reproductive functions

produce eggs secrete hormones protection of development of a fetus

what does estrogen do

proliferate egg, helps uterus adapt to house baby,

what causes menstrual cramps

prostaglandins

What is ceftriaxone's trade name and what is it always mixed with?

recephin, 1% lidocaine

what vaccine can pregnant women not have?

rubella

Care for PMS

rule out other causes and find out when the last period was and what the pattern is. signs and symptoms. focus on symptomatic care.

rugae in the vagina help

secretions, movement

Prevention of PID

seek treatment for STI's as soon as possible, cefoxitin (mefoxin) and doxycycline (vibramycin), no intercourse for 3 weeks, examine and treat partners, rest and fluids, reevaluate in 72 h, possible hospitalization.

SSRIs

selective serotonin reuptake inhibitors. keeps mood stable.

complications of PID

septic shock, peritonitis (infection leaks into peritoneum. hard to treat), ectopic pregnancies (due to inflammation of fallopian tubes), infertility, chronic pain (due to scar tissue)

What are considerations to make when asking about a client's sexual history?

some cultures will not talk about it if opposite sex

treatment for leiomyoma

start conservative because hysterectomy is most effective. consider how bad the symptoms are and if client wants to have a baby.

If a woman experiences PMS and takes ibuprofen what advice should a nurse give?

start taking it 2-3 days before cycle starts

FSH does what

stimulates the maturation of ovarian follicles in females.

long term hormone replacement therapy used to cause what?

stroke and heart attacks

examples of high complex carbs

sweet potatoes, whole wheat pasta

As females age, what happens to the external reproductive organs?

the external organs droop and "pull apart"

HRT (hormone replacement therapy) is decided between

the hcp and the client. do not encourage one way or another. is for women without a uterus. usually 4-5 years at the lowest effective dose.

what do serms provide?

the same benefits of estrogen

essentially, what is perimenopause?

the transition from regular periods to menopause

if scar tissue builds up in the fallopian tubes due to diseases, how does this affect fertility?

thinning of the tubes makes it not so easy for egg to move through

Why is a hysterectomy not sufficient enough for treating endometriosis?

tissue has already grown outside of the uterus and all of it can't be removed

what type of education is important to prevent PID

treat STIs ASAP, use protection like condoms

why is metformin good for PCOS

treats high glucose, hyperlipidemia, makes cycles very regular

etiology of PCOS

under 30, infertile

pathophysiology of PID

untreated cercivitis, chlamydia and gonorrhea

what is urogenital atrophy

urethra pulls back and vulva droops

types of diagnostics

urine tests hormone levels pap smear STD tests mammography: every year once youre 40 Ultrasound: if abdominal complaints CT: cancer MRI: cancer

clinical manifestations of perimenopause and menopause

vaginal dryness,

signs of sepsis

vomiting,

care for PCOS

weight management and exercise, metformin (used for diabetes but makes a woman's cycle very regular)