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THE UNIVERSITY OF RIO GRANDE Traditional and Online

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THE UNIVERSITY OF RIO GRANDE Traditional and Online Powered By Docstoc
					Reproductive System
 Amy McDonald MSN, RN
Female External Organs
Female Internal Organs
Female Reproductive Hormones
Male Reproductive System
Menstruation and Menopause
•   Menarche
•   Menses
•   Menopause
•   Climacteric
•   Biological changes with menopause
•   Artificial menopause
•   “hot flashes” – lack of estrogen, inc. other
    hormones, = surge & dilation of bld vessels
                        HRT
• Risks
• Benefits
• Contraindications
  –   Estrogen dependent cancer
  –   Undx abnormal vaginal bld
  –   DVT
  –   Liver disease
  –   Hx breast ca
  –   Heart disease
Male Menopause
Testosterone polypeptide structure
vs. HCG polypeptide structure
• Testosterone    • HCG
               Pap Smear

• No sexual intercourse for at least 24 hours
 before test
Colposcopy
Laparoscopy
Laparoscopy vs. Laparotomy
Hysteroscopy
Cervical Exam
Mammogram
Breast Biopsy
Needle Biopsy of Prostate
    Who’s at Risk?


•Just about all
of us
                 Syphilis

• Primary- chancre, painless, weeping
• Secondary- 6 wks to 6 mo. Flu-like sx
• Latency- shows on bld test? Maybe
• Tertiary- CNS involvement, balance, gait
• VDRL
• PCN
Syphilis
Syphilis
Syphilis
Syphilis
Secondary Syphilis
Congenital Syphilis
                    Gonorrhea
• “the clap”
• Urethral culture
• Gram stain (immediate but not as accurate,
    usually id’s bacteria causing clap
•   Tx with antibiotics
•   Women- can lead to infertility
•   Men- can lead to infertility (epididymitis)
•   Sexual partners need to be treated!!!
Herpes
• No cure
• #1 nsg dx ~ pain
             Genital Warts

• Strongly assoc. with dysplasia and cervical
  cancer
• May be “silent” for women
HPV
HPV
HPV
HPV
               Vaginitis

• What’s the number one nursing dx?
       Trichomonas Vaginalis

• Treat sexual partners
• No alcohol Flagyl (severe N/V, liver
 damage)
   Pelvic Inflammatory Disease

• Can cause sterility by scarring enough to
  permanently block fallopian tubes
• Lower abd pain
• Vaginal d/c
• Abnormal vaginal bld
• Dysuria
• Intrauterine devices contraindicated
    Intrauterine Devices (IUD)

• Progesterone thickens mucous of cervix
      Toxic Shock Syndrome

• Uncommon
• Assoc with use of tampons
• Wash hands before insertion of tampons
              Bartholinitis

• What is the function of the Bartholin
 glands?
          Uterine Fibroids

• Menorrhagia
More Fibroids
Uterine Prolapse
            Endometriosis

• Can result in infertility
• Danazol ~ side effects ~ hot flashes
Cystocele
Rectocele
Vaginal Fistula

• Leakage of urine, flatulence, or feces into
 vagina
Ectopic Pregnancy
Abdominal Pregnancy
Tubal Ligation
Tubal Ligation
           Hysterectomy

• When would an abdominal hysterectomy
 be needed?
                Orchitis

• Complication of mumps if not vaccinated
Hydrocele
Hydrocele
Hydrocele Transillumination
Orchitis Transillumination
“Don’t let it get this bad”
        Hydrocele
“Definitely don’t let it get this bad”
             Hydrocele
Varicocele
Varicocele
Testicular Torsion
Phimosis
Epididymitis
                  ED

• Men who take Viagra should NOT take
 Nitroglycerin~ can cause a sudden
 decrease in BP
                   BPH

• Enlargement of tissue of prostate causing
 compression on the urethra and thus
 urinary retention
TURP
Perineal
Suprapubic Catheter
            Prostatectomy

• Will have catheter at least one day
  regardless of type of surgery
• Avoid caffeine and spicy foods
              Vasectomy

• Is sperm production or transport
 disrupted?
Vasectomy
Fibroadenoma vs. Fibrocystic
       Breast Disease
           Breast Disorders

• Keep in mind that 90% of lumps are
  benign
• #1 nsg dx- anxiety r/t potential
  malignancy
         Oral Contraceptives

• Inhibits endometrial development
• Pros
  – 90-95% effective
  – Few serious short-term side effects
• Cons
  – Back up method needed if taken late
  – Ectopic pregnancies and ovarian cysts
         Side effects of BCP

• Estrogen- nausea, breast tenderness,
  headache
• Progesterone- acne, weight gain, oily skin
• Both- no menses, mood changes
                Teaching
• Antibiotics decrease effectiveness
• > 35, smoke, bld clots, breast endometrial
  cancer
• Missed pill = 1-2 pills immediately, backup
  7 days
• 3 pills missed- start over after menses,
  use backup
• Contact healthcare provider if ACHES
                 ACHES

• A- abdominal pain, problem with GB or
  liver
• C- chest pain, shortness of breath
• H- headaches
• E- eye problems
• S- severe leg pain
                 Ortho Evra

• Pros
  – Convenient
  – 99% effective
• Cons
  – Less effective > 198 lbs.
  – Risk of bld clot, heart attack, stroke
  – Exposure to 60% more estrogen
                   Nuvaring

• Pros
  – 99.7% effective
• Cons
  – Side effects same as pill, patch
• Contraindications
  – Vaginal irritation, ulceration
              Depo Provera

• Pros
  – 99.7% effective
• Cons
  – 4 lbs wt gain per year
  – High risk bone loss, contributing to
    osteoporosis
                     IUD

• Progestasert- good for one year
  – Not as effective as Mirena
• Mirena- good for 5 years
          IUD Pros and Cons

• Pros
  – 98-99% effective
  – Convenient
• Cons
  – Must have given birth
  – Incr. risk PID, uterine perforation, abnormal
    bleeding, ectopic pregnancy
      IUD Contraindications

• Pelvic disease
• Abnormal bleeding
• Abnormally shaped uterus
                 Paragard

• Pros
  – 99% effective
  – Convenient
  – No hormones used
• Cons
  – Longer, heavier periods
  – $450
                Diaphragm
• Pros
  – 80-94% effective
  – No hormones
  – May help with STDs and PID
• Cons
  – Custom fit
  – Interrupted relations
  – Incr. risk UTIs
Diaphragm
               Cervical Cap
• Pros
  – 84-91% effective (never given birth)
  – Good for 48 hours
• Cons
  – 68-74% effective (given birth)
  – Cervical ulcers
  – Fitted
  – Good manual dexterity
Cervical Cap
                        Sponge
• Pros
  –   OTC
  –   Good for 24 hrs
  –   Hormone free
  –   Inexpensive
• Cons
  – 84% effective with typical use
  – 91% effective with proper use
  – Can slip out of place during sex
Sponge
           Female Condom

• Helps protect against STDs
• OTC
• 79-95% more effective
• More sensation for male than regular
 condom
Female Condom
            Male Condom

• Helps protect against STDs
• 64-98% effective
              Spermicides

• Chemical action kills sperm
• OTC
• Good for one hour
• inexpensive
      Natural Family Planning

• 80% effective
• Calendar method
• Measure basal body temp
• Predictor tests for ovulation
    Non-Surgical Sterilization

• Essure Permanent Birth Control System
• Takes about 3 months
     Emergency Contraception

• “morning after pill”
• Controversial
• 75-89% effective
• Inhibits fertilization