NURS 3120 Lecture Notes - Lecture 7: Benign Prostatic Hyperplasia, Trichomonas, Syphilis

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11 Mar 2017
School
Department
Course
Reproductive Health Assessment
Female Health History
Menstruation
Date of LMP
Regular or irregular cycle
Amenorrhea no menses
Menorrhagia heavy menses
Duration
Menopause
Age of onset
Problem-Based History: Problems with Menstruation
What problems are you experiencing?
o Noticed clotted blood during your periods
o When did this begin? Becoming worse?
o Menorrhagia: term for heavy menses
o Clotting indicated heavy flow or vaginal pooling
Cramps or other pains with period?
o Each month?
o What relieves discomfort?
o Do cramps or pain interfere with normal activities?
o Dysmenorrhea: term for painful or difficult menses, often associated with
hormonal imbalance
Do you ever have spotting between periods?
o Spotting between periods or midcycle bleeding may indicate hormonal
imbalance
o Other symptoms before menses?
With all periods or just occasionally?
Does it interfere with your routine activities?
Hormonal fluctuation associated with menstrual cycle may cause
premenstrual syndrome (PMS)
Asking how routine activities are affected by symptoms helps nurse gain
a better understanding of the significance of symptoms
When did menstrual periods slow or stop? Describe symptoms you are experiencing?
o Amenorrhea means absent menses
o Perimenopausal period for most women occurs between ages 42 and 58 years
o Common symptoms:
Hot flashes
Excessive sweating
Palpitations
Vaginal dryness
Painful intercourse
Changes in sexual desire
Mood swings
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Are you being treated for symptoms associated with menopause?
o Taking hormonal replacement?
o What, and how much?
o Have you noted any side effects?
o Hormone replacement therapy (HRT) may cause fluid retention, breast pain or
enlargement, and vaginal bleeding
o Link between cardiovascular disease and HRT has also been found
Birth control: as age, increases risk of complications (especially if smoking)
Common Issues Affecting Women
Preestrual “ydroe PM“
Endometriosis: when uterine tissue grows outside of the uterus
Leiomyomas (fibroids) uterine tumors can become quite large & multiply
Oaria ysts: groths ithi oaries, PCO“
Smooth and silky ovaries, facial hair
HPV infections
Cervical, ovarian & endometrial cancers
Ovarian cancer has highest mortality rate
Silent killer, quickly progresses to stage 3-4
Pregnancy History
Childbearing age: 15-44
Ever been pregnant
How many times
Number of births
H/O abortions, miscarriages, fetal loss
Gravida = # of pregnancies
Para = # of pregnancies that reached 20 weeks gestation
Female Examination
Position
Explain actions
Warm tools
Preparing for the Exam
Have patient empty bladder
Prepare room
Comfortable temperature in room
Supplies
Gown & sheet for patient
Have patient empty bladder before exam
Lithotomy position
Expose vulva only
Be able to see patient during exam
Help patient to relax
Explain what you will do and what they will feel
Performing a Female Exam
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Document Summary

Common issues affecting women: pre(cid:373)e(cid:374)strual y(cid:374)dro(cid:373)e (cid:862)pm (cid:863, endometriosis: when uterine tissue grows outside of the uterus, o(cid:448)aria(cid:374) (cid:272)ysts: gro(cid:449)ths (cid:449)ithi(cid:374) o(cid:448)aries, (cid:862)pco (cid:863) Leiomyomas (fibroids) uterine tumors can become quite large & multiply: smooth and silky ovaries, facial hair, hpv infections, cervical, ovarian & endometrial cancers, ovarian cancer has highest mortality rate, silent killer, quickly progresses to stage 3-4. Pregnancy history: childbearing age: 15-44, ever been pregnant. Para = # of pregnancies that reached 20 weeks gestation. Female examination: position, explain actions, warm tools. Preparing for the exam: have patient empty bladder, prepare room, comfortable temperature in room, supplies, gown & sheet for patient, have patient empty bladder before exam. Lithotomy position: expose vulva only, be able to see patient during exam, help patient to relax, explain what you will do and what they will feel. Inspect skin & hair over mons pubis & inguinal area for distribution patterns, lack of skin integrity.

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