1. Medical-Surgical Nursing: Concepts & Practice
3rd edition
Chapter 38
Care of Women with Reproductive Disorders
Copyright © 2017, Elsevier Inc. All rights reserved.

2. Female Reproductive System
Female reproductive organs—internal, external structures, and accessory organs
Female reproductive cycle
Ovarian cycle
Menstrual cycle

3. Female Reproductive System (Cont.)
Fetal development
Sexual maturation
Menopause
Effects of aging

4. Female Reproductive System (Cont.)
Menstruation and normal menstrual bleeding
Normal vaginal discharge
Breasts
Contraception and fertility

5. Contraception and Fertility
Contraceptive options
Emergency contraception
Legal and ethical considerations: the “morning-after” pill
Infertility
Primary infertility
Secondary infertility
Menopause

6. Proper Application of a Condom
See Figure 38-2 on p. 886.
Modified from Leifer G: Introduction to maternity and pediatric nursing, ed. 5, Philadelphia, 2007, Saunders.

7. Proper Application of a Diaphragm
See Figure 38-2 on p. 886.
Modified from Leifer G: Introduction to maternity and pediatric nursing, ed. 5, Philadelphia, 2007, Saunders.

8. Contributing Factors to Infertility in Women
Problems with ovulation
An abnormality in the pathway between the cervix and fallopian tube
An abnormality in the endometrium of the uterus, or malformation of the uterus
Tumors in the reproductive tract
Vaginal or cervical environment that is inhospitable to sperm motility or viability

9. Causes of Repeated Pregnancy Loss
An abnormality in fetal chromosomes that result in spontaneous abortion
Abnormalities of the cervix or uterus
Disorders of the endocrine or immune system
Infections
Environmental factors, such as toxic agents

10. Infertility Emotional impact of infertility
Patient teaching and communication
Herbal products and fertility
Assisted reproduction

11. Some Assisted Reproductive Therapies
In vitro fertilization (IVF-ET)
Zygote intrafallopian transfer (ZIFT)
Therapeutic donor insemination (TDI)
Intracytoplasmic sperm injection
Surrogate mother
See Box 38-2 on p. 892.

12. Health Risks of Menopause
Osteoporosis
Fosamax
Coronary heart disease
Treatment options during menopause
Hormone therapy
Bioidentical hormones
Alternative therapies
Diet, exercise, and support groups

13. Activities that Increase the Risk of Osteoporosis
Inadequate lifetime intake of calcium and vitamin D
Smoking
Excess alcohol intake
Excess caffeine, cola, or soft drink intake
See Box 38-3 on p. 893.

14. Health Screening and Assessments
Primary prevention decreases the probability of becoming ill.
Secondary prevention focuses on early detection of specific at-risk diseases and early treatment like annual mammograms.
Tertiary prevention minimizes the impact of an already-diagnosed condition.

15. Health Screening and Assessments (Cont.)
Breast self-examination
Vulvar self-examination
Diagnostic tests
Pelvic examination and Papanicolaou (Pap) smear
Older adult considerations for screening
Nursing management

16. Menstrual Dysfunctions
Premenstrual syndrome
Premenstrual dysphoric disorder
Dysmenorrhea
Primary dysmenorrhea
Secondary dysmenorrhea

17. Pelvic Relaxation Syndrome
Cystocele, rectocele, and enterocele
Etiology and pathophysiology
Signs and symptoms
Diagnosis
Treatment
Nursing management

18. Treatment of Pelvic Relaxation Syndrome
Nonsurgical management
Kegel exercises
Lifestyle changes
Pessary
Biofeedback and transcutaneous electrical nerve stimulation (TENS)
Surgical management

19. Disorders of the Female Reproductive System
Polycystic ovarian syndrome
Dysfunctional uterine bleeding
Oligomenorrhea
Amenorrhea
Metrorrhagia
Menorrhagia
Abnormal uterine bleeding

20. Leiomyoma
Medical management
Uterine artery embolization
Myomectomy

21. Endometriosis
Endometrial tissue is found outside the uterus, particularly on the ovaries, in the rectovaginal septum, and in the pelvis and abdomen.
Continuous hormonal contraceptive therapy

22. Inflammations of the Lower Genital Tract
Etiology and pathophysiology
Signs, symptoms, and diagnosis
Treatment
Nursing management

23. Toxic Shock Syndrome
Risk factors include the prolonged use of high-absorbency tampons, cervical caps, or diaphragms.
Symptoms
Sudden spiking fever, flu-like symptoms, hypotension, generalized rash resembling a sunburn, and peeling skin on the palms or soles
Treatment

24. Cancer of the Female Reproductive Tract
Vulvar cancer
Cancer of the cervix
Cancer of the uterus
Cancer of the ovary

25. Warning Signs of Ovarian Cancer
Abdominal pain
Feeling full quickly when eating
Feeling a frequent or urgent need to urinate
Increased abdominal girth

26. Benign Disorders of the Breast
Fibroadenoma
Fibrocystic breast changes (FBCs)
CAM therapy for FBCs
Intraductal papilloma

27. Breast Cancer Etiology and pathophysiology
Signs, symptoms, and diagnosis
Prevention
Treatment
Surgery
Radiation therapy

28. Breast Reconstructive Surgery
Reduction mammoplasty
Augmentation mammoplasty
Reconstructive mammoplasty
Nursing management
Preoperative care
Postoperative care
Collaborative care
Home and community care

29. Lymphedema Do not assess blood pressure in the affected arm.
Do not give injections or do venipuncture in the affected arm.
Provide meticulous skin care.
Teach the patient to wear gloves in the kitchen and when gardening to prevent skin irritation or injury.

30. Lymphedema (Cont.) Teach the patient to avoid heavy lifting.
Wear a compression garment during strenuous activities.
Elevate and exercise the arm daily.

31. Risk Factors for Breast Cancer
Family history of relative with breast cancer
Early menarche, late menopause
Late first pregnancy or no children
Abnormal cells in previous breast biopsy
Obesity
Environmental exposure to hormone-modulating chemicals, polycyclic aromatic hydrocarbons
Inherited BRCA1 or BRCA2 gene
See Box 38-5 on p. 909.

32. Stages of Breast Cancer
Stage I
Stage II
Stage III
Stage IIIA
Stage IIIB
Stage IIIC
Stage IV
See Table 38-6 on p. 909.

33. Comparisons of Bacterial Vaginosis and Yeast Infection
Primary causative organism(s)
Onset
Odor
Itching
Discharge
Sexually transmitted
Vulvar signs
Vaginal signs
Treatment
See Table 38-5 on p. 906.

34. Nursing Management of a Woman with a Reproductive Disorder
Care of a patient after a hysterectomy
Care of a patient after breast lumpectomy
See Nursing Care Plan 38-1 on pp
See Nursing Care Plan 38-2 on p. 912.