Female Reproductive And Breast Disorders
Displacement disorders:
- As we get older, we stretch out! This could be from weight or pregnancy
- Pts will complain of:
o Heaviness in the pelvic region
o Vaginal pain
o Pressure or bulging
o “Sitting on a ball” (uterus or bladder issue)
- There will be difficulty in urinating or be constipated depending on organ
displacement
Uterine Prolapse: downward displacement of the uterus into the vaginal canal
- Caused by: pregnancies probably
Cystocele: weakening between vagina and bladder are weakened. Bulging of anterior
vaginal wall when the client bears down.
- Causes urinary problems
o Cant empty correctly
o Urine sits and becomes stale
o Then bacteria grows
o Can cause urinary stasis (stoppage of urinating)
- Will do a pelvic exam or an x-ray to determine how severe it is
- Common prolapse disorder
Rectocele: weakening between the vagina and rectum. Bulging of posterior vaginal wall
when the client bears down.
- Causes GI problems (constipation)
- Can be found during the rectal exam
- Common prolapse disorder
Treatment for prolapse disorders:
- Teach women how to keep these muscles tight! (Kegel exercises)
o Stop mid pee then start again (stop and go)
o 10-20 times 3-4 times a day
- Pessary support is a device that holds organs in place (anterior or posterior)
o Take out and put in dentures cup before surgery
o It is removable! Its like a little disc.
o If they have a prolapsed organ look at their history
o Notify the provider if they have pain, discomfort, or discharge
- Surgery
o Mesh will be used
o Colporrhaphy is the surgery name
o Teaching post op:
o S/S of infection
o Avoid straining or defecations!
Stool softeners or laxatives
o Tightening or support pelvic muscles when sneezing or coughing
o Avoid heavy lifting
o No intercourse for 6 weeks
,Breast Cancer:
Epidemiology:
- 2nd most cause of cancer related deaths in women
- Early diagnosis for the best outcome
o Monthly breast exams 1 week after menses (period)
o Yearly mammogram after 40 y/o
- Greatest risk factor is age! Other include:
o High number of ovulatory cycles
o Starting period early or late menopause
o Lack of pregnancy or no live childbirths
o Genetic mutations
o American women are more at risk!
o Alcohol use
o Inactivity
o Use of hormones
Pathophysiology:
- Cells grow and divide abnormally and uncontrollably
o Can invade nearby tissues and spread to other areas through blood and
lymphatic system (lymph nodes in the arm is common)
- DCIS
o Ductal lesions occur and are limited to the lining of the milk ducts
- LCIS
o Lobular lesions occurring in the lobules where milk is produced
- Both DCIS and LCIS have an increased risk for developing invasive breast cancer
Clinical Manifestations:
- New mass or lump
o Hard, irregular, and PAINLESS
- Changes in breast shape or swelling
o Usually one or the other
- Skin changes
o Peeling, flaking, pitting, dimpling, or redness
o Can look like the outside of an orange
- Nipple changes
o Inverted nipple, thickening of tissue, or drainage
Medical management- Diagnosis:
- Mammography
- Ultrasonography
- MRI (magnetic resonance imaging)
- Biopsy for definitive diagnosis!
o Sentinel node biopsy is invasive is suspected
o Blue dye is injected to know which node
- Sage 0 (in-situ) it hasn’t gone anywhere!
- Stage 1-4 (invasive tumor of any size with direct extension to the chest wall or
skin with distant metastasis)
Medical management- Treatment:
, - Surgery
o Breast conservation (lumpectomy)
o Takes only the cancerous parts out along with some of the normal
surrounding tissue
o This plus radiation is common!
o Mastectomy
o Total breast removal
- Chemotherapy
- Radiation
- Antiestrogen therapy
o If breast cancer is related to hormones, they’ll try this and use
tamoxifen
o To decrease local occurrence
Long term complications:
- They remove lymph nodes (fluid filterer) so without them, you’ll devolve
edema maybe
o Fluids move slower through the lymphatic system
- Once a mastectomy is done, you DON’T:
o Do any blood pressures, iv sticks, or glucose checks, or anything like
that in that particular side
- Shoulder immobility
- Pain
- Lymphedema (lots of fluid build up and slow drainage of lymph
Nursing Management- Assessment and analysis:
- Assessment and care are dependent on point in time of diagnosis and
treatment
- Chemotherapy side effects:
o N/V
o Hair loss
o Dry and brittle skin/nails
o Taste aversions
o Increases WBC (Risk for infection) (good handwashing and avoid
crowds)
- Surgery lymph node removal complications:
o Swelling! (lymphedema)
- Radiation aide effects:
o Bleeding
o Infection
o Tiredness
o Emesis (vomiting)
o Skin changes
Nursing management- Nursing diagnosis
- Pain/discomfort r/t surgery or treatment
- Risk for infection r/t decreased wbc count (first priority)
- Altered nutrition less than body requirements r/t N/V and loss of appetite
Displacement disorders:
- As we get older, we stretch out! This could be from weight or pregnancy
- Pts will complain of:
o Heaviness in the pelvic region
o Vaginal pain
o Pressure or bulging
o “Sitting on a ball” (uterus or bladder issue)
- There will be difficulty in urinating or be constipated depending on organ
displacement
Uterine Prolapse: downward displacement of the uterus into the vaginal canal
- Caused by: pregnancies probably
Cystocele: weakening between vagina and bladder are weakened. Bulging of anterior
vaginal wall when the client bears down.
- Causes urinary problems
o Cant empty correctly
o Urine sits and becomes stale
o Then bacteria grows
o Can cause urinary stasis (stoppage of urinating)
- Will do a pelvic exam or an x-ray to determine how severe it is
- Common prolapse disorder
Rectocele: weakening between the vagina and rectum. Bulging of posterior vaginal wall
when the client bears down.
- Causes GI problems (constipation)
- Can be found during the rectal exam
- Common prolapse disorder
Treatment for prolapse disorders:
- Teach women how to keep these muscles tight! (Kegel exercises)
o Stop mid pee then start again (stop and go)
o 10-20 times 3-4 times a day
- Pessary support is a device that holds organs in place (anterior or posterior)
o Take out and put in dentures cup before surgery
o It is removable! Its like a little disc.
o If they have a prolapsed organ look at their history
o Notify the provider if they have pain, discomfort, or discharge
- Surgery
o Mesh will be used
o Colporrhaphy is the surgery name
o Teaching post op:
o S/S of infection
o Avoid straining or defecations!
Stool softeners or laxatives
o Tightening or support pelvic muscles when sneezing or coughing
o Avoid heavy lifting
o No intercourse for 6 weeks
,Breast Cancer:
Epidemiology:
- 2nd most cause of cancer related deaths in women
- Early diagnosis for the best outcome
o Monthly breast exams 1 week after menses (period)
o Yearly mammogram after 40 y/o
- Greatest risk factor is age! Other include:
o High number of ovulatory cycles
o Starting period early or late menopause
o Lack of pregnancy or no live childbirths
o Genetic mutations
o American women are more at risk!
o Alcohol use
o Inactivity
o Use of hormones
Pathophysiology:
- Cells grow and divide abnormally and uncontrollably
o Can invade nearby tissues and spread to other areas through blood and
lymphatic system (lymph nodes in the arm is common)
- DCIS
o Ductal lesions occur and are limited to the lining of the milk ducts
- LCIS
o Lobular lesions occurring in the lobules where milk is produced
- Both DCIS and LCIS have an increased risk for developing invasive breast cancer
Clinical Manifestations:
- New mass or lump
o Hard, irregular, and PAINLESS
- Changes in breast shape or swelling
o Usually one or the other
- Skin changes
o Peeling, flaking, pitting, dimpling, or redness
o Can look like the outside of an orange
- Nipple changes
o Inverted nipple, thickening of tissue, or drainage
Medical management- Diagnosis:
- Mammography
- Ultrasonography
- MRI (magnetic resonance imaging)
- Biopsy for definitive diagnosis!
o Sentinel node biopsy is invasive is suspected
o Blue dye is injected to know which node
- Sage 0 (in-situ) it hasn’t gone anywhere!
- Stage 1-4 (invasive tumor of any size with direct extension to the chest wall or
skin with distant metastasis)
Medical management- Treatment:
, - Surgery
o Breast conservation (lumpectomy)
o Takes only the cancerous parts out along with some of the normal
surrounding tissue
o This plus radiation is common!
o Mastectomy
o Total breast removal
- Chemotherapy
- Radiation
- Antiestrogen therapy
o If breast cancer is related to hormones, they’ll try this and use
tamoxifen
o To decrease local occurrence
Long term complications:
- They remove lymph nodes (fluid filterer) so without them, you’ll devolve
edema maybe
o Fluids move slower through the lymphatic system
- Once a mastectomy is done, you DON’T:
o Do any blood pressures, iv sticks, or glucose checks, or anything like
that in that particular side
- Shoulder immobility
- Pain
- Lymphedema (lots of fluid build up and slow drainage of lymph
Nursing Management- Assessment and analysis:
- Assessment and care are dependent on point in time of diagnosis and
treatment
- Chemotherapy side effects:
o N/V
o Hair loss
o Dry and brittle skin/nails
o Taste aversions
o Increases WBC (Risk for infection) (good handwashing and avoid
crowds)
- Surgery lymph node removal complications:
o Swelling! (lymphedema)
- Radiation aide effects:
o Bleeding
o Infection
o Tiredness
o Emesis (vomiting)
o Skin changes
Nursing management- Nursing diagnosis
- Pain/discomfort r/t surgery or treatment
- Risk for infection r/t decreased wbc count (first priority)
- Altered nutrition less than body requirements r/t N/V and loss of appetite
