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)