1. Chapter 91 Female Reproductive Disorders

2. Gynecology Gynecology Focuses on the female reproductive system
Gynecologists
Obstetrician-gynecologists (OB/GYN)

3. Pelvic Examination To visualize the cervix, vagina, and perineum
Cervical biopsy
Cauterization, removal, or coagulation of a portion of the cervix using electricity or laser

4. Laboratory Tests Pap (Papanicolaou) test or Pap smear Cervical cancer
Tests for endometrial cancer
Blood tests

5. Question Is the following statement true or false?
Women who have had a hysterectomy and who still have a cervix are not at risk for cervical cancer and do not need to have Pap tests.

6. Answer
False
All women with a cervix are at risk for cervical cancer, even women who have had a hysterectomy but who still have a cervix are at risk for cervical cancer and need to have Pap tests. Some women have a higher than normal chance of contracting cervical cancer and require regular screening.
Pap tests should be done between a woman’s menstrual periods, as tests are less accurate when a woman is menstruating.

7. Breast Examination Mammography Breast ultrasound Breast biopsy
Aspiration
Needle biopsy
Excisional biopsy
Incisional biopsy

8. Other Diagnostic Tests
Abdominal or pelvic ultrasonography
X-ray examinations
Laparoscopy
Culdoscopy
Colposcopy
Cervical biopsy
Conization (cone biopsy)
Cerclage

9. Question Is the following statement true or false?
Following a laparoscopy, a client may feel severe pain under a clavicle.

10. Answer
True
Following a laparoscopy, severe pain, such as “shoulder strap pain,” may be felt as pain under a clavicle.
This type of referred pain may result from either gas instilled during the procedure, which is temporarily trapped under the diaphragm, or from blood accumulating under the diaphragm.

11. Common Surgical Treatments
Dilation and curettage (D&C)
Hysterectomy and pelvic exenteration
Vaginal hysterectomy
Abdominal hysterectomy
Cosmetic breast surgery
Augmentation mammoplasty
Reduction mammoplasty
Mastectomy

12. Nursing Process Data collection Planning and implementation
Teaching feminine hygiene and breast self- examination
Providing perineal care and sitz baths
Performing a douche or vaginal irrigation
Inserting a vaginal suppository
Evaluation

13. Disorders Related to the Menstrual Cycle
Amenorrhea
Menorrhagia, metrorrhagia
Dysmenorrhea
Extreme irregularity
Premenstrual syndrome (PMS)
Premenstrual dysphoric disorder (PMDD)
Toxic shock syndrome
Discomforts of menopause
Induced menopause

14. Structural Disorders Vaginal fistula
Ureterovaginal, vesicovaginal, rectovaginal
Cystocele
Rectocele
Prolapsed uterus
Dyspareunia
Abnormal flexion of the uterus

15. Inflammatory Disorders
Vulvitis
Vaginitis
Atrophic (senile) vaginitis
Cervicitis
Endometriosis
Pelvic inflammatory disease (PID)
Vulvodynia

16. Question Is the following statement true or false?
If a pregnant woman contracts trichomoniasis, treatment is postponed until after she has delivered her baby.

17. Answer
False
If a pregnant woman contracts trichomoniasis, treatment is necessary, although it can be postponed until the second or third trimester because of the unknown effects of the drug on the developing fetus.
Untreated trichomoniasis can lead to a fragile cervix that will be unable to maintain pregnancy or withstand delivery.

18. Trauma Battering, automobile accidents, or falls Rape
Vaginal, cervical, or anal bruising or tearing
Tampon impaction
STIs
Injuries are diagnosed and treated symptomatically.

19. Neoplasms Tumors of the ovary Benign ovarian tumors
Malignant ovarian tumors
Tumors of the uterus
Benign uterine tumors
Cancer of the fundus or endometrium

20. Neoplasms (cont’d) Cancer of the cervix Signs and symptoms
Staging of cervical cancer
Treatment
Cervical cancer in the pregnant woman
Caring for the woman undergoing a hysterectomy
Preoperative considerations
Postoperative nursing considerations

21. Neoplasms (cont’d) Risk factors for developing cervical cancer
Infection with human papillomavirus (HPV)
Sexual activity at a young age, frequent sexual activity, multiple sex partners
Presence of genital warts (condyloma) or herpes virus II
Maternal history of cancer, especially cervical cancer
Maternal use of diethylstilbestrol (DES) during pregnancy with this daughter

22. Breast Neoplasms Benign neoplasms Chronic cystic mastitis
Breast cancer

23. Breast Neoplasms (cont’d)
Risk factors for breast cancer
Menarche prior to age 12, late menopause, long or irregular menstrual cycles, or women older than 40
Family history of breast cancer, fibrocystic breast disease, cancer of the other breast, endometrial or ovarian cancer
Radiation exposure, previous breast surgery, or estrogen replacement therapy >8 years

24. Breast Neoplasms (cont’d)
Risk factors for breast cancer (cont’d)
Women who have never had a baby, had their first baby after age 30, have not breastfed, or on antihypertensive therapy
Diet high in fat, obesity, alcohol, or tobacco use

25. Question Is the following statement true or false?
A nurse should encourage female clients to get a regular mammogram as well as conduct breast self- examinations.

26. Answer
True
According to research, some breast cancers may exist for as long as 6 years before they are detected by palpation.
Thus, regular mammography, in conjunction with breast self-examination and annual clinical breast examination by a healthcare provider, are recommended for every woman older than 40 years.

27. End of Presentation