Term
| assessment findings in older female |
|
Definition
amenorrhea
vasomotor instability
atrophy of vaginal mucosa
atrophy of urethrea
scanty body hair
increased facial hair
loss of elasticity and subcutaneous fat in skin and breasts
loss of bone
altered responses to sexual stimulation |
|
|
Term
|
Definition
|
|
Term
| what causes hotflashes and night sweats |
|
Definition
|
|
Term
| what causes vaginal dryness and dyspareunia |
|
Definition
| atrophy of vaginal mucosa |
|
|
Term
| what causes stress incontinence |
|
Definition
|
|
Term
|
Definition
| painful sexual intercourse |
|
|
Term
| what causes loss of bone in women |
|
Definition
|
|
Term
| t/f breast tissue is always changing in response to hormonal, nutritional, physical and/or environmental stimuli |
|
Definition
|
|
Term
| natural result of aging and hormonal changes in breast between ages 30-50 that causes swelling, tenderness and lumpiness, and pain |
|
Definition
| fibrocystic breast changes |
|
|
Term
| t/f fibrocystic breast changes are thicker and more lumpy the week before menses |
|
Definition
|
|
Term
| t/f caffeine contributes to fibrocystic breast changes |
|
Definition
|
|
Term
| how to diagnosis fibrocystic breast disease |
|
Definition
|
|
Term
| treatment for fibrocystic breast disease |
|
Definition
oral contraceptives
progesterone
synthetic androgen
tamoxifen
vitamin E
special diets
eliminate caffeine and chocolate
stop smoking
aspirin
mild analgesics
local heat/cold
there is no definitive treatment |
|
|
Term
| most common cancer in women |
|
Definition
|
|
Term
| 2nd cause of death in women |
|
Definition
|
|
Term
| 1st cause of death in women |
|
Definition
|
|
Term
| leading cause of death in African American women |
|
Definition
|
|
Term
| risk factors for breast cancer |
|
Definition
female, older than 50, family history
modifiable: no children after 30, estrogens and progesterone after menopause, alcohol, smoking, obesity, sedentary, etc. |
|
|
Term
| breast cancer gene identifiers |
|
Definition
|
|
Term
| t/f women with brca1/2 are believed to have a 50% chance of developing breast cancer before menopause and 85% chance before age 70 |
|
Definition
|
|
Term
| where do the majority of breast carcinomas occur |
|
Definition
ductal areas of breast
(Tail of Spence) |
|
|
Term
| breast cancer- noninvasive |
|
Definition
| proliferation of malignant cells in the ducts or lobules without invasion of surrounding tissue |
|
|
Term
|
Definition
| most are adenocarcinomas; arise in terminal section of ductal tissue; most common type is infiltrating ductal carcinoma (75%) prognosis poorer than other types |
|
|
Term
| manifestations of breast cancer |
|
Definition
non-tender lumpt
abnormal nipple discharge
rash around nipple
nipple retraction
dimpling of the skin
many with no S&S |
|
|
Term
| t/f many cases of breast cancer are found by the women themselves or by their partner |
|
Definition
|
|
Term
| breast cancer and metastasis |
|
Definition
to other sites through bloodstream or lymph system
half develop metastatic disease and die within 10 years
sites: bone, brain, lung, liver, skin, and lymph nodes |
|
|
Term
|
Definition
age 20-39 BSE- breast self exam and clinical every 3 years
age 40+ BSE every month, clinical BE annually, mammogram annually
woman at risk: discuss with doctor timing of diagnostic tests |
|
|
Term
| most useful diagnostic test for distinguishing between solid and cystic masses in the breast |
|
Definition
|
|
Term
| why is MRI/MRM less favorable in diagnosing breast cancer |
|
Definition
|
|
Term
|
Definition
fine needle biopsy
removes cells or fluid from lesion-stereotactic biopsy device |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| stereotactic device removes a core of tissue |
|
|
Term
|
Definition
radiation therapy:
following surgery if lymph is involved, chest wall, or tumor > 5 cm
radiation is used to shrink the tumor prior to surger; most commonly used with lumpectomy for early stage
surgery: mastectomy, lumpectomy, reconstruction |
|
|
Term
|
Definition
| entire breast, underlying chest muscles, and lymph nodes under arms removed |
|
|
Term
| modified radical mastectomy |
|
Definition
| breast tissue and lymph nodes under arm removed |
|
|
Term
|
Definition
|
|
Term
|
Definition
| tumore and margin; axillary node dissection |
|
|
Term
| pharmacology for breast cancer |
|
Definition
horomone therapy
tamoxifen- anti-estrogen drug that inhibits tumor growth
chemo- to shrink and destroy cancer cells |
|
|
Term
| nursing care for breast cancer |
|
Definition
anxiety
anticipatory grieving
risk for body image disturbance
decisional conflict
risk for infection
pain
self-esteem
sleep pattern disturbance |
|
|
Term
|
Definition
| anti-estrogen drug must widely prescribed for breast cancer that inhibits tumor growth |
|
|
Term
|
Definition
|
|
Term
|
Definition
| vascular solid tumor attached by stem |
|
|
Term
|
Definition
|
|
Term
| where can polyps and cysts occur |
|
Definition
| vulva, cervix, endometrium, ovary |
|
|
Term
|
Definition
most common in vulva
caused by infection or obstruction |
|
|
Term
|
Definition
most common benign cervical lesion
over age 40
possibly develops from endocervial hyperplasia
at vaginal end of cervix |
|
|
Term
| endometrial cysts and polyps |
|
Definition
caused by endometrial overgrowth and often filled with old blood
(chocolate cysts)
polyps are intrauterine overgrowths |
|
|
Term
| ovarian cysts (polycystic ovary syndrome) |
|
Definition
numerous follicular cysts
manifestations
complications |
|
|
Term
| Lab and DX for cysts/polyps |
|
Definition
WBC
LH level
pregnancy test
laparoscopy
C&S tests
ultrasound
xray |
|
|
Term
| pharmacology for cysts/polyps |
|
Definition
antibiotics
regulation of ovarian hormones with OC |
|
|
Term
|
Definition
cervical polyp removed with speculum and clamp
endometrial polyp removed with a transcervical approach
bartholins cysts with I&D and drainage device
ovarian cysts with cystectomy or oophorectomy |
|
|
Term
| manifestations of cysts/polyps |
|
Definition
pain
anxiety
sexual dysfunction
altered patterns of urinary elimination
constipation
ineffective individual coping |
|
|
Term
| teaching for cysts/polyps |
|
Definition
importance of follow-ups
prevent thrombophlebitis during post-op time
signs of infection
excessive bleeding |
|
|
Term
|
Definition
wide range of recurrent symptoms that occur 3-14 days before mensturation and relieved with onset of menses
common in ages 30-40 |
|
|
Term
| t/f premenstrual syndrome thought to be related to imbalance between estrogen and progesterone as well as increased levels of aldosterone and prolactin |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
irritability
tension
dysphoria |
|
|
Term
|
Definition
state of feeling unwell or unhappy
difficult to bear |
|
|
Term
|
Definition
decrease stress
exercise
balanced diet
decrease caffeine
stop smoking
limit alcohol
support group
vitamin and mineral supplements:
Vitamin e
calcium
magnesium
medications:
NSAIDs
OCs
antidepressants
anxiolytics
diuretics |
|
|
Term
|
Definition
| not a pathologic process but a physiologic response to hormonal changes |
|
|
Term
| dysfunctional uterine bleeding |
|
Definition
vaginal bleeding
usually painless but abnormal in amount, duration, or timing.
increases with age |
|
|
Term
| most frequently reported health care problem |
|
Definition
|
|
Term
| leading cause of hysterectomy |
|
Definition
|
|
Term
| possible causes of dysfunctional uterine bleeding |
|
Definition
stress
weight changes
OC and IUD
hormonal imbalance
PCOS
steroid therapy
hypothyroidism
etc.
can be r/t
dysmenorrhea
menorrhagia
metrorrhagia
amenorrhea |
|
|
Term
| hormonal imbalance that leads to endometrial hyperplasia |
|
Definition
| decreased progesterone and increased estrogen |
|
|
Term
| t/f estrogen promotes proliferation but needs progesterone to maintain sloughing |
|
Definition
|
|
Term
|
Definition
| endometrial layer is permanently destroyed |
|
|
Term
|
Definition
removal of uterus
with or without ovaries
abdominal or vaginal approach |
|
|
Term
|
Definition
painful menstruation;
50% of women |
|
|
Term
| primary cause of dysmenorrhea |
|
Definition
increase prostaglandin production by endometrium- worst in first 2 days
patho: excessive prostaglandins stimulate uterine muscle fibers to contract
mild to severe cramps
uterine ischemia
pain
psychologic factors contribute
childbirth decreases signs |
|
|
Term
| secondary cause of dysmenorrhea |
|
Definition
related to identified pelvic or uterine pathology (30-40 years old)
patho: underlying organic conditions that involve scarring or injury to reproductive tract |
|
|
Term
| pharmacology for dysmenorrhea |
|
Definition
nsaids
COX-2 inhibitors
hormonal contraceptives
decrease salt, sugar, caffeine, and alcohol, fluids
increase: protein, calcium, magnesium, vitamin b6
exercise, weight loss, relaxation |
|
|
Term
|
Definition
| absence of menses during reproductive years |
|
|
Term
|
Definition
absence by 14, w/ absence of development of secondary sex characteristic OR absence by 16 w/ normal development
etiology: extreme weight gain/loss; congenital; stress from major event; increased exercise; eating disorder; PCOS; Cushing's disease; hypothyroidism; chronic illness; etc. |
|
|
Term
|
Definition
absence for 3 cycles or 6 months were regular
etiology: pregnancy; lactation; stress; certain tumors; depression; rapid weight change; early menopause; etc. |
|
|
Term
| primary treatment amenorrhea |
|
Definition
| correct underlying disorders |
|
|
Term
| secondary treatment amenorrhea |
|
Definition
cyclic progesterone
bromocriptine
GnRH
thyroid hormone replacement therapy |
|
|
Term
|
Definition
climacteric
permanent cessation of menses
period of time when reproductive function gradually ceases
normal physiologic process
accompanied by unpleasant S&S
35-58 years old (average age 50)
begins with a decline in production of estrogen |
|
|
Term
|
Definition
as ovarian function decreases production of estradiol (E2) decreases and is ultimately replaced by estrone- produced in small amounts and has 1/10 activity of estradiol
with decreased ovary function, progesterone is also decreased |
|
|
Term
|
Definition
| decreased estrogen affects brain, breasts, cardiovascular, skeletal, GU, GI, integumentary, body shape |
|
|
Term
| t/f hormone replacement therapy appears to lower the risk of coronary artery disease, lower the risk of osteoporosis but increases the risk of breast cancer |
|
Definition
|
|
Term
| most common types ofpelvic organ prolapse |
|
Definition
cystocele
rectocele
uterine prolapse |
|
|
Term
|
Definition
| prolapse into vaginal canal |
|
|
Term
|
Definition
| cervix descends into vaginal introitus |
|
|
Term
| procidentia (third-degree) prolapse |
|
Definition
| cervix below vaginal introitus |
|
|
Term
| causes of pelvic organ prolapse |
|
Definition
| erect posture, aging and decreased estrogen, childbirth, surgery, pelvic radiation, increased abdominal pressure, weakened muscles, unrepaired lacerations, rapid deliveries, multiple pregnancies, aging process |
|
|
Term
|
Definition
anterior colporrhaphy
shortens the pelvic muscles
support for bladder |
|
|
Term
|
Definition
posterior colporrhaphy
shortens the pelvic muscles
support for the bladder |
|
|
Term
|
Definition
repositioned and muscles shortened to provide support
hysterectomy |
|
|
Term
|
Definition
leiomyomas
solid pedunculated benign tumors
any age but 50% in women over 30 years old
most common indication for hysterectomy
often asymptomatic; symptoms due to crowding
predisposing factors:
age, genetics, African americans, nulliparity, obesity |
|
|
Term
|
Definition
| the state of not bearing offspring |
|
|
Term
| manifestations of leiomyomas |
|
Definition
pelvic pain
low back pain
bloating
infertility
dysmenorrhea
dysparenunia |
|
|
Term
|
Definition
an abnormal opening or passage between two organs or spaces that are normally separated or an abnormal passage to the outside of the body (vesicovaginal; rectobaginal)
complication of childbirth, gynecologic or urologic surgery, radiation therapy |
|
|
Term
| diagnosis for vaginal fistula |
|
Definition
| use dye to identify fistula |
|
|
Term
| t/f small fistulas heal spontaneously |
|
Definition
|
|
Term
| t/f large fistulas repaired with surgery AFTER inflammation resolved |
|
Definition
|
|
Term
|
Definition
most common gynecologic cancer in US
uncommon before age 40 |
|
|
Term
| most common symptom of endometrial cancer |
|
Definition
|
|
Term
| risk factors of endometrial cancer |
|
Definition
early menarche
late menopause
history of infertility
failure to ovulate
nulliparity
extended use of tamoxifen
obesity
diabetes
high-fat diet
etc. |
|
|
Term
| path of endometrial cancer |
|
Definition
adenocarcinomas
slow growing
slow to metastasize
endometrial hyperplasia is a precursor
presents with abnormal uterine bleeding
painless
lymph node enargement
pleural effusion
ascites |
|
|
Term
|
Definition
low mortality and incidence rate with pap test
most treatable cancer if detected early
patho: abnormal changes in cellular lining or surface of cervix
primary factor is HPV
risk factors: early 1st intercourse, low socioeconomic status, promiscuous male partners, unprotected sex, family history, sex w/ uncircumsized male, smoking, HIV, OC (oral contraceptives) etc. |
|
|
Term
| first symptoms of cervical cancer |
|
Definition
| abnormal vaginal bleeding |
|
|
Term
| diagnosing cervical cancer |
|
Definition
| pap smear, colposcopy and biopsy, MRI/CT of pelvis, abdomen, or bones |
|
|
Term
| pharmacology for cervical cancer |
|
Definition
chemo for tumors unresponsive to other therapy
radiation- treats invasive cervical cancer
surgery- laser surgery wit h colposcopy; cryosurgery; conization; hysterectomy; pelvic or anterior exenteration |
|
|
Term
|
Definition
most lethal of the gynecologic cancers
2nd most common gynecologic cancer
55-75 years old
white women
mortality rate increased with African americans
often asymptomatic
70-80% of tumors benign
the remaining tumors have already metastasized when diagnosed- they have poor prognosis
cause unknown
risk factors: family history, age, late 1st pregnancy, nulliparity, previous breast cancer diagnosis, long-tern HRT, use of products with talc, BRCA-1&2
patho: 90% epithelial tumors, germ cell tumors, or gonadal tumors; 5 types of ovarian cancers exist; can spread by peritoneal fluid through out the pelvis and through the lymphatic and circulatory systems |
|
|
Term
| new pharmacology med for ovarian cancer |
|
Definition
|
|
Term
|
Definition
multiple, small usually benign implantations of endometrial tissue develeop outside of uterine cavity
risk factors
age, nulliparity, family history, short cycle, long flow
patho: unclear cause
manifestations:
no single diagnostic symptom
dysmenorrhea
pelvic pain
premenstrual dyspareunia |
|
|
Term
|
Definition
60+ years old
4th most common gynecologic cancer
may be r/t std's
risk factors: HPV, HSV2, age, diabetes, leukoplakia
prognosis depends on degree of invasion, health status of pt, chronic diseases, and ability to take treatments
5 year survival if diagnosed early
most are arachnoid or squamous carcinomas
primary site usually labia majora
pruritis most common symptom |
|
|
Term
| pelvic inflammatory disease |
|
Definition
umbrella term used to describe infection of the pelvic organs (uterine tubes, ovaries, cervix, uterus, and peritoneum)
caused by infectious agents
results in scarring and obstruction of tubes
risk factors: IUD, STDs, multiple sex partners, PID, etc
prognosis: depends on number of episodes, promt treatment, modification of risk behaviors, prevention
patho: organisms enter vaginal and travel to uterus during intercourse or other sexual activities; can gain access during childbirth, abortion, surgery; then spreads to uterine tubes, obstructing them with scarring. can also enter lymph system |
|
|
Term
|
Definition
high fever
vaginal discharge
severe lower abdominal pain
nausea
malaise
dysuria
infertility
increased risk of ectopic pregnancy
abscess
dyspareunia
dysmenorrhea |
|
|
Term
|
Definition
antibiotic therapy- tetracycline, penicillin, quinolones, cephalosporins
analgesics
IV fluids |
|
|
Term
|
Definition
rare
acute
caused by staphylococcus aureus
r/t tampon use
high mortality rate
patho: access to vascular system through open blood vessels; organism produces toxins that cause problems. manifestations |
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|
