NUR 230 Chapter: Anatomy and Physiology 230_OB_Notes_Exam_1.docx

Chapter: Anatomy and Physiology • Objectives • Female Reproductive A & P • External Female Reproductive Organs – Vulva – Protects urethra and vaginal openings; highly sensitive to touch to increase females pleasure during intercourse. – Mons Pubis – Labia – Clitoris and Prepuce – Vestibule – Perineum • Internal Female Reproductive Organs o Vagina o Uterus o Cervix o Corpus o Fallopian tubes o Ovaries • Question: Is the following statement True or False? *The clitoris is considered an internal reproductive organ. • Answer: False; The clitoris is an external female reproductive organ. -Breasts = are external female reproductive organs because of breast feeding. - Accessory organs - specialized for milk secretion after pregnancy - Nipple • Areola • Lobes • Alveolar and lactiferous glands • Female Reproductive Cycle • Reproductive Cycle –Ovarian cycle –Follicular phase- Day 1 through ovulation usually day 10-14 –Ovulation- usually day 14 –Luteal phase- Day 15 through 28 • Endometrial Cycle –Proliferative phase –Secretory phase –Ischemic phase –Menstrual phase •Menstrual Cycle Hormones • Gonadotropin-releasing hormone- stimulates hormones •Follicle-stimulating hormone- develops around the egg to be released •Luteinizing hormone- box3.1 (stimulates follicle to produce estrogen) •Estrogen- once ovulation occurs estrogen decreases •Progesterone •Prostaglandins •Menstruation •Expulsion of inner uterine lining occurring monthly • Marks the beginning and end of each menstrual cycle • Menarche: establishment of menstruation in females (When you first have) • Menopause: naturally occurring cessation of regular menstrual cycles (Period stops) •Frequency variable: 21 to 36 days; average 28 days (Without being abnormal) •Question: A woman reports that her menstrual period occurs every 28 days. The nurse would determine that ovulation in this woman would occur at which time? a.Day 10 b.Day 14 c.Day 18 d.Day 22 • Answer: B; Day 14; For a 28-day cycle, ovulation occurs usually on day 14. REVIEW?•Menstrual Transition • Perimenopause- 2-8 years it can last and its before menopause even happens - Treats with hormone therapy… o Drawback- increases cardiovascular events o Advantage- prevents some cancer • Menopause- universal and irreversible part of aging. A woman no longer menstruates after a whole year • Alternative therapies- Instead of hormone therapy •Menopause and Impact on Body • Brain: hot flashes; sleep, mood, and memory problems • Heart: lower levels of HDL; increased risk of CVD • Bones: bone density loss; increased risk of osteoporosis • Breasts: duct and gland tissue replaced by fat • Genitourinary: vaginal dryness, stress incontinence, cystitis • GI: less Ca+ absorbed; increased fractures • Skin: skin dry, thin; collagen decreases • Nursing Assessment –Screening for osteoporosis, cardiovascular disease, and cancer risk –Lifestyle to plan strategies to prevent chronic conditions • Nursing Management –Health maintenance education; risk reduction –Lifestyle modifications –Stress management •Male Reproductive A & P • External Male Reproductive Organs –Penis- outlet for urine and sperm –Scrotum- Climate-control system for testes • Internal Male Reproductive Organs –Testes- Sperm production –The Ductal system- vas deference (sperm transport) –Accessory Glands • Question: Is the following statement True or False? The testes need a temperature that is warmer than body temperature for normal sperm development. • Answer: False.; The testes need to be slightly cooler than body temperature to allow normal sperm development. Chapter: Common Reproductive Issues •Menstrual Disorders - Amenorrhea (No Menstrual Flow) •Types: 1. Primary- Depends on cause; other than reproductive. Causes- Pregnant and never had a period, disorders, illness 2. Secondary- Hormone related issues Causes: had a period and stopped •Etiology: multiple causes Treatment: Hormone replacement, estrogen replacement therapy. •Therapeutic management: dependent on cause • Nursing assessment: history and physical examination; laboratory and Diagnostic testing (ultrasound, hormone levels, CT scan to rule out tumor) • Nursing management •Counseling •Education = inform what is going on • Question: Is the statement True or False? *Primary amenorrhea occurs in women who have previously menstruated regularly. • Answer: False.; Primary amenorrhea- is the absence of menses by age 14 with the absence of secondary sexual characteristics, or absence of menses by age 16 with normal development of secondary sex characteristics. Secondary amenorrhea- is the absence of menses for three cycles or 6 months in women who have previously menstruated. - Dysmenorrhea (Painful Menstrual Flow) •Types: 1. Primary- increased prostaglandin production by the endometrium in an ovulatory cycle highest in the first 2 days of menses. 2. Secondary- •Pelvic or uterine pathology (Endometriosis and IUD) •Endometriosis most common cause of secondary dysmenorrhea Adenomyosis- ingrowth of endometrium into uterine muscle. •Therapeutic management: pain relief, coping strategies ▪ Over- the- counter remedies to hormonal control • Nursing Assessment •Past medical history, sexual history, menstrual history; bimanual pelvic examination • Manifestations: pain, nausea, vomiting diarrhea, fatigue, fever, headache, dizziness; bloating, water retention, weight gain, muscle aches, food cravings, breast tenderness •Laboratory and diagnostic tests 1. Laparoscopy- two tiny incisions. 1st pole is the scope and the 2nd is another instrument. 2. Laparotomy- If find something big, typically incision open you up in abdominal cavity. • Nursing Management •Education (see Teaching Guidelines 4-3) heart, decrease caffeine and chocolate because it increases breast tenderness, •Comfort measures: heat, lifestyle changes • Administration of medications (NSAIDs, low-dose oral contraceptives) *Question: Is the statement True or False? *Endometriosis is the most common cause of secondary dysmenorrhea. •answer: True.; Secondary amenorrhea is most commonly due to endometriosis. • Dysfunctional Uterine Bleeding (abnormal uterine bleeding) -every woman experiences one or twice; associated with anovulatory cycles (not ovulating) •Similar to and may overlap with other uterine bleeding disorders: • Menorrhagia • Oligomenorrhea- no menstrual flow • Metrorrhagia- a lot • Menometrorrhagia •Polymenorrhea- many •Etiology: numerous causes •Therapeutic management