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Women's Health
Terms and definitions related to the female reproductive system and STIs
107
Nursing
Undergraduate 3
04/25/2016

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Term
Fibrocystic Breast Disease
Definition
  • Common, benign
  • Most common in 30-50 year olds
  • S/S:
    • Pain, tenderness, swelling
  • Cyclical
    • More intense before menses and improves 1-2 days into menstrual cycle
Term
Treatment: Fibrocystic Breast Disease
Definition
  • Often subsides on its own after menopause
  • Decreased sodium and low dose diuretic in week prior to menses
  • Should do BSE one week after menses
Term
Fibroadenoma
Definition
  • Common, benign tumor
  • Solid, slowly enlarging mass
  • Most common in adolescence, decreases in size with age
Term
Risk Factors for Breast Cancer
Definition
  • Family or personal hx of breast, endometrium, ovary, or colon cancer; genetic factors
  • Older age
  • Pregnancy later in life (>30) or no pregnancies
  • Early menstruation or late menopause
  • Never breastfed a child
  • Postmenopausal obesity
  • Alcohol intake
Term
Physical Indicators of Breast Cancer
Definition
  • Left-skin dimpling
  • Right- peau d' orange
  • Lymph edema of arm
Term
Surgical Management: Breast Cancer
Definition
  • Excision of mass-- reduces risk for local recurrence
  • Dissection or removal of axillary lymph nodes
  • Sentinel lymph node biopsy
Term

Nursing Interventions: Post-op Care

Surgical Management of Breast Cancer

Definition
  • No BP measurement, injections, or blood draws in affected arm
  • Vital signs
  • Care of wound drainage
  • Comfort measures
  • Mobility, diet, and exercise of affected arm
  • Support and education
Term
Adjuvant Therapy: Breast Cancer
Definition
  • Treatment given after the primary or initial cancer treatment
  • Purpose:
    • Increases possibility of a cure
    • Decreases risk of cancer recurrence
Term
Examples of Adjuvant Therapy
Definition
  • Radiation therapy
  • Chemotherapy
  • Hormonal therapy
  • Stem cell transplantation
Term
Diagnostic and Screening for Breast Cancer
Definition
  • BSE (breast self-examination)
  • Clinical breast exam
  • Breast ultrasound
  • Mammography
  • Biopsy
  • Cytology
  • BRCA serum testing
Term
Client Teaching: Breast Cancer Screening
Definition
  • Monthly BSE
  • Annual clinical breast exam
  • Mammogram screening
    • Every 1-2 years starting at age 40
    • Annually starting at age 50
    • More frequent if high risk
  • Fine needle aspiration (confirms diagnosis)
Term
Gynecological Inflammatory/ Infectious Disorders
Definition
  • Pelvic inflammatory disease (PID)
  • Endometriosis
  • Vaginitis
  • Toxic shock syndrome (TSS)
Term
Gynecological Neoplasms
Definition
  • Cervical cancer
  • Endometrial cancer
  • Ovarian cancer
Term
Menstrual Disorders
Definition
  • Dysmenorrea
  • Amenorrea
  • Premenstrual syndrome
Term
Ovarian Disorders
Definition
  • Ovarian cysts
  • Polycystic ovarian syndrome (PCOS)
Term
Pelvic Inflammatory Disease (PID)
Definition
  • Inflammatory/ infectious process
  • Pathogenic invasion of the fallopian tubes, ovaries, or both as well as any vascular/ supporting structures w/in the pelvis (except the uterus)
  • Future infertility may develop (complications)
Term
Risk Factors for PID
Definition
  • Multiple sexual partners
  • Frequent intercourse
  • IUDs
  • Childbirth
Term
S/S of PID
Definition
  • Low-grade fever
  • Pelvic pain
  • Abdominal pain
  • "Bearing down" backache 
  • Foul-smelling vaginal discharge
  • Nausea
Term
Effects of PID
Definition
  • Irreversible scarring or strictures
  • Sterility
  • Ectopic pregnancies
Term
Endometriosis
Definition
Growth of endometrial tissue (normal lining of the uterus) outside of the uterus w/in the pelvic cavity
Most often in women >30 y.o. w/ familial hx
Term
Risk Factors: Endometriosis
Definition
  • Delayed fertility
  • Early menarche
  • Menstrual cycles <27 days
  • Menses >7 days
  • Family hx
  • Painful menstruation
Term
S/S of Endometriosis
Definition
  • Dysmenorrhea
  • Rectal pressure
  • Dyspareunia (painful sex)
  • Infertility
  • Dysfunctional uterine bleeding
Term
Diagnosing Endometriosis
Definition
  • Client hx
  • Pelvic ultrasound
  • Exploratory laproscopy
  • CBC
Term
Treatment: Endometriosis
Definition
  • NSAIDs
  • Contraceptives (OCPs, Depo Provera)
  • Danazol (causes masculinization)
  • Teaching
Term
Vaginitis
Definition
  • Infections caused by bacteria, protozoa, viruses, and yeasts
  • Common types:
    • Cnadidiasis, Chlamydia, etc.
Term
Prevention of Vaginitis
Definition
  • Wear cotton-crotch underwear
  • Avoid sitting in a wet bathing suit
  • Seek prompt medical attention @ 1st sign of infection
  • Eat an 8 oz container of yogurt w/ active cultures daily while taking antibiotics
Term
Toxic Shock Syndrome (TSS)
Definition
  • Most often associated w/ Staphylococcus aureus
  • Staph enters through the bloodstream
  • Associated with use of tampons 
Term
S/S of TSS
Definition
  • Fever
  • Vomiting
  • Diarrhea
  • Progressive hypotension
Term
Cervical Cancer
Definition
  • Most preventable gynecological cancer
  • Diagnosed by Pap smear
    • Dysplasia wil be seen on Pap smear (change in size and shape of cervical cells)
  • Most common cause is HPV (human papilloma virus)
  • Risk of death 2x higher in African Americans than Caucasians
Term
Risk Factors for Cervical Cancer
Definition
  • Young age at first coitus (<16 y.o.)
  • HIV infection
  • Hx of multiple partners
  • Hx of STI's
  • HPV infection
  • Hx of smoking
  • DES exposure
  • Family hx
Term
Human Papilloma Virus (HPV)
Definition
  • Virus that causes genital warts
  • Causes 90% of all cervical cancers
  • Subtypes 16 and 18 mostly to cause cancer
  • Can be prevented by Gardisil
Term
Gardisil
Definition
  • Protects against HPV subtypes 6, 11, 16, and 18
  • Recommended at 11-12 y.o. check up
  • Can be given b/w 9-26 years of age
  • Series of 3 vaccines over 6 months
  • Still need regular pap smears
Term
Guidelines for Pap Smears
Definition
  • 1st pap smear w/in 3 years of onset of sexual activity or by age 21
  • Subsequent pap smears annually until age 29 y.o.
  • At age 30 and after 3 normal smears in a row, may get pap smear every 2-3 years
  • At age 70 and after 3 norm. smears in a row and no abnormal smears in past 10 years, may stop
Term
What to do: Abnormal Pap Smear
Definition
  • HPV reflex testing
  • If HPV reflex is positive--> colopscopy done
Term
S/S of Cervical Cancer
Definition
  • May be asymptomatic (esp. preinvasive cancer)
  • Post-coital bleeding
  • Dyspareunia
  • Referred pain (thighs, upper legs, back)
  • Hematochezia (passing blood through the anus, esp. w/ stools)
  • Anemia, weight loss (metastasis)
Term
Endometrial Cancer
Definition
Alterations in the normal menstrual cycle and normal hormonal balance--> overgrowth in the lining of the uterus--> endometrial cancer
Term
Risk Factors: Endometrial Cancer
Definition
  • Greatest risk: postmenopausal women who have taken estrogen for >5 years
  • Late menopause (>50 y.o.)
  • Early menarche (<12 y.o.)
  • Infertility
  • Obesity and disease that cause obesity (like DM)
Term
S/S of Endometrial Cancer
Definition
  • Asymptomatic until relatively advanced
  • Unexplained vaginal bleeding (esp. after menopause)
  • Weight loss
  • Pelvic pain or mass
  • Lymph node enlargement, pleural effusion, abdominal masses, ascites (late stage)
Term
Treatment of Endometrial Cancer
Definition
  • Depends on stage of cancer and clients goals
  • D&C
  • Hysterectomy
  • Total abdominal hysterectomy w/ lymph node removal
  • Pelvic radiation or brachytherapy (local radiation)
  • Progestin therapy (to maintain fertility)
  • Chemotherapy
Term
Ovarian Cancer
Definition
  • AKA the silent killer
  • Incidence greatest in women b/w 45 and 65
  • Cancer begins in the cells of the ovary and a tumor grows
Term
Risk Factors for Ovarian Cancer
Definition
  • Nulliparity
  • Smoking
  • Alcohol
  • Infertility
  • High-fat diet
Term
S/S of Ovarian Cancer
Definition
  • Abdominal bloating/ feeling of fullness
  • Enlarged abdomen, waist of clothes tight
  • Pelvic discomfort or pain
  • Dyspareunia
  • Urinary symptoms (frequency, urgency)
  • Constipation, gas, bloating
  • Loss of appetite
  • Unexplained weight loss or gain
  • Loss of energy
  • Lower back pain
Term
The Menstrual Cycle
Definition
The monthly cycle of changes in the uterus and ovaries which occur in preparation for a potential pregnancy
Term
Menarche
Definition

Onset of menstruation (first period)

Average age = 12 years old

Term
Menopause
Definition

Permanent cessation of menstruation

End of reproductive years

Average age = 45-50 years old

Term
Menorrhagia
Definition
Excessive menstruation
Term
Amenorrhea
Definition

Absence of menstruation

Primary or secondary

Term
Metrorrhagia
Definition
Bleeding b/w menstrual periods
Term
Menometrorrhagia
Definition
Frequent and excessive menstrual periods
Term
Polymenorrhea
Definition

Menstrual periods <21 days in frequency

Short cycles

Term
Leukorrhea
Definition

White discharge

Don't confuse with lochia alba or candida infection !

Term
Dysmenorrhea
Definition

Uterine pain during menstruation

Menstrual cramps

More common in nulliparous women and in women not having sex

Term
Primary Amenorrhea
Definition

Absence of menstruation by age 17

Related to anatomical or genetic abnormalities

Term
Secondary Amenorrhea
Definition

When a woman w/ normal menstrual cycle stops getting her periods for >6 months

  • Result of:
    • Anatomic abnormalities, nutrition deficits, excessive exercise, emotional disturbances, endocrine dysfunction, med side effects, pregnancy, and lactation
Term
Premenstrual Syndrome (PMS)
Definition
  • Complex of symptoms:
    • Mood swings, fatigue, irritability, breast tenderness, food cravings, depression
  • Occurs 3-14 days before menstruation starts, alleviated by start of menstruation
  • Affects 25-40% of women w/ mild to moderate symptoms
Term
Risk Factors for PMS
Definition
  • Age >30
  • Depression
  • Stress
Term
Treatment of PMS
Definition
  • Pharmacological interventions
  • Diet 
  • Exercise
Term
Dysfunctional Uterine Bleeding
Definition
  • An abnormal amount of uterine bleeding
  • Occurs at various times during the month
  • Also describes excessively light or excessively heavy menses
Term
Ovarian Cysts
Definition

May contain fluid and tissue

Occur spontaneously or as a result of hyperstimulation of the ovaries

Term
Risk Factors for Ovarian Cysts
Definition
  • Any ovulating female
  • Excessive amounts of luteinizing hormone (endogenous or exogenous)
  • Hx of STIs
Term
S/S of Ovarian Cysts
Definition
  • Abdominal pain (unilateral or bilateral)
  • Fullness or bloating
  • Amenorrhea
  • May be asymptomatic
Term
Diagnosis of Ovarian Cysts
Definition
  • Physical exam
  • Client hx
  • Pelvic ultrasound
  • Exploratory laparotomy
Term
Treatment of Ovarian Cysts
Definition
  • OCP's
  • Analgesics
  • Antibiotics
  • Surgery
Term
S/S of Polycystic Ovary Syndrome (PCOS)
Definition
  • Enlarged cystic ovaries
  • Amennorrhea
  • Oligomenorrhea
  • Obesity
  • Acne/ oily skin
  • Hirsuitism
  • Hyperlipidemia
  • Infertility
Term
Incidence and Risk Factors for PCOS
Definition
  • Risk:
    • Obesity and hyperandrogenism
  • Affects 6-10% of women
  • Increased risk of breast and enometrial cancer
  • Possible increased risk of CVD
Term
Treatment of PCOS
Definition
  • Education and emotional support
  • Initial treatment:
    • Weight loss of at least 10% (if overweight)
    • Other treatments to follow
Term
Menopause (aka climacteric)
Definition
  • Cessation of menstruation & end of natural reproductive ability
  • Decreased ovarian functioning--> decreased estrogen adn progesterone--> menopause
  • Average age = 50 years
  • Treatment:
    • Pharmacological intervention, diet, and exercise
Term
S/S of Menopause
Definition
  • Absence of menses for 1 full year
  • Depression, nervousness, insomnia
  • Hot flashes
  • Decreased fertility
  • Vaginal changes (increased pH)
  • Changes in fat distribution and appearance
  • FSH > 30 mIu/m
  • Skin dryness, hair thinning, decreased breast fullness, shrinkage of ovaries, uterus, cervix, and vagina
Term
Cystocele
Definition
Downward displacement of the bladder into the anterior vaginal wall
Term
Urethrocele
Definition
Downward displacement of the urethra into the vagina
Term
Rectocele
Definition
Anterior displacement of the rectum into the posterior vaginal wall
Term
Prolapsed Uterus
Definition
Downward displacement of the uterus into the vagina
Term
Risk Factors for Structural Disorders
Definition
  • Multiparity
  • 3rd or 4th degree lacerations w/ childbirth
  • Weakening of pelvic muscles (w/ age)
Term
Uterine Prolapse
Definition
Dropping of the uterus into the vaginal vault caused by weakened pelvic musculature
Term
Treatment of Uterine Prolapse
Definition
  • Pessaries
  • Surgery
    • Colporrhaply (AP repair) 
    • Marshall-Marchetti-Krantz
  • Estrogen for post menopausal women (restores elasticity to tissues)
  • Teaching
Term
Infertility: Diagnostic Tests
Definition
  • Endometrial biopsy (detect tissue responses during both phases of menstrual cycle)
  • Endocrine imbalance testing
  • Laparoscopy (discover endometriosis, adhesions, or scar tissue)
Term
Infertility
Definition

The inability to conceive
Possibly related to anatomic or endocrine problems

Primary or secondary

Term
Primary Infertility
Definition
A woman who has never been pregnant
Term
Secondary Infertility
Definition
A woman who has been pregnant in the past
Term
Risk Factors for Infertility
Definition
  • Increased age
  • Disease (cancer, etc.)
  • Congenital deformities
  • Drugs/ smoking
  • Sperm mobility
  • Abnormal erections
  • Abnormalities of seminal fluid
Term
Evaluating Infertility
Definition
  • Semen analysis (usually 1st test in men)
  • Endometrial biopsy
  • Postcoital test
  • Basal body temp (chart entire cycle)
Term
Endometrial Biopsy
Definition

Done during luteal or secretory phase of menstrual cycle

Evaluation of infertility

Term
Postcoital Test
Definition

Looks for normal motile sperm in cervical mucous

Evaluation of infertility

Term
Female Evaluation of Infertility
Definition
  • Ovulation predictor kit
  • Ultrasound
  • Hysterosalpingogram
  • Hysteroscopy
Term
Contraception Methods
Definition
  • Natural/ rhythm method
  • Barrier methods
  • Oral contraceptives
  • Norplant
  • Depo-Provera
  • Intrauterine Device (IUD)
  • Sterilization (tubal ligation, vasectomy)
Term
Norplant
Definition

6 small progestin-filled pellets inserted under the skin of the upper arm

Form of contraception

Term
Depo-Provera
Definition

Form of contraception

Injected every 12 weeks

Term
Factors Affecting Contraceptive Effectiveness
Definition
  • Frequency of intercourse
  • Motivation to prevent pregnancy
  • Understanding use of the method chosen
  • Adherence to method
  • Provision of short/ long term protection
  • Likelihood of pregnancy for the individual woman
  • Consistent use of method
Term
Barrier Methods of Contraception
Definition
  • Spermicides
  • Condoms
  • Diaphragm
  • Cervical cap
  • Contraceptive sponge
Term
Hormonal Methods of Contraception
Definition
  • Combined estrogen-progestin contraceptives
  • Progestin-only contraception
  • Emergency contraeption (Plan B)
  • IUD
  • Sterilization
Term
Genital Warts (Condylomata Acuminata)
Definition
  • Caused by HPV
  • Transmitted via genital contact or vaginal delivery
  • Incubation period 2-3 months
  • Occur on vagina, cervix, penis, scrotum, anus, and perineal areas
  • Use condoms !!
Term
S/S of Genital Warts
Definition
  • Often asymptomatic
  • Visible genital warts
  • Pre-cancerous changes in cervix, vulva, anus, or penis
Term
Assessment of Genital Warts
Definition
  • Visual inspection
  • Abnormal pap tests
  • Blood test
Term
Treatment of Genital Warts
Definition
  • No cure !
  • Topical creams
  • Cryosurgery/ freezing (liquid nitrogen)
  • Electric or laser cauterization (burning the warts)
  • Surgery
Term
Gonorrhea
Definition
  • Caused by Neisseria gonorrhoeae 
  • Grows and multiplies easily in the cervix, uterus, fallopian tubes, urethra, throat, eyes, and anus
  • Transmitted via contact w/ penis, vagina, mouth, blood, body fluids, or vaginal delivery of baby
  • Incubation period 3-10 days
Term
S/S of Gonorrhea in Men
Definition
  • May be asymptomatic
  • Burning w/ urination
  • White, yellow, or green discharge from penis
  • Painful or swollen testicles
Term
S/S of Gonorrhea in Women
Definition
  • Painful or burning sensation w/ urination
  • Increased vaginal discharge
  • Vaginal bleeding b/w periods
Term
Assessment for Gonorrhea
Definition
  • Inspect for discharge
  • Obtain specimen of the discharge for testing from parts of body likely to be infected (cervix, urethra, rectum, or throat)
Term
Treatment of Gonorrhea
Definition

Antibiotics (rocephin, cipro, floxin)

No sex until all meds completed

Term
Chlamydia
Definition
  • Caused by Chlamydia trachomatis
  • Incubation period = 1-3 weeks to months
  • Modes of transmission:
    • Vaginal, anal, oral, bodily fluids, vaginal delivery
Term
S/S of Chlamydia
Definition
  • Women:
    • Often asymptomatic
    • Vaginal discharge
  • Men:
    • Urethritis
    • Discharge from penis
Term
Assessment and Treatment of Chlamydia
Definition
  • Assessment:
    • Culture cells from cervix, urethra, or both
  • Treatment:
    • Antibiotics (azithromycin/ doxycycline)
Term
Complications of Chlamydia
Definition
  • Women:
    • PID--> ectopic pregnancy and infertility
    • Salpingitis (inflammed fallopian tubes)
  • Men:
    • Epididymitis
    • Prostatitis
    • Infertility
Term
Trichomoniasis
Definition
  • Protozoal infection of the vagina
  • S/S:
    • Copious, malodorous yellow/green discharge
    • Itching/ burning
Term
Bacterial Vaginosis
Definition
  • Most common cause of vaginal discharge
  • S/S:
    • Thin, watery, gray/white discharge
    • Fishy odor
Term
Candidiasis
Definition
  • Yeast infection
  • Risk factors:
    • Meds-- antibiotics, immunosuppressants, corticosteroids
    • DM
    • Pregnancy
    • Obesity
    • High sugar diets
Term
Group B Strep
Definition
  • Present in 9-23% of healthy women
  • Positive GBS = poor pregnancy outcomes
    • Give antibiotics once in labor/ ROM
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