NR 602 FINAL REVIEW WOMEN’S HEALTH STUDY TOPICS / NR602 FINAL REVIEW WOMEN’S HEALTH STUDY TOPICS:NEWEST-2022 |CHAMBERLAIN
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Course
NR 602 (NR602)
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Chamberlain College Of Nursing
NR 602 FINAL REVIEW WOMEN’S HEALTH STUDY TOPICS / NR602 FINAL REVIEW WOMEN’S HEALTH STUDY TOPICS:NEWEST-2022 |CHAMBERLAINNR 602 FINAL REVIEW WOMEN’S HEALTH STUDY TOPICS / NR602 FINAL REVIEW WOMEN’S HEALTH STUDY TOPICS:NEWEST-2022 |CHAMBERLAINNR 602 FINAL REVIEW WOMEN’S HEALTH STUDY TOPICS...
NR 602 FINAL REVIEW: WOMEN’S HEALTH STUDY TOPICS
39 - Benign Disorders of the Vulva and Vagina *Focus Topics in italics- Lichen
Sclerosus, Vulvar Lichen Simplex Chronicus, Lichen Planus, Herpes Genitalis,
Condyloma Acuminatum, Molluscum Contagiosum, Acrochordon Vaginitis, Candidiasis,
Bacterial Vaginosis, Trichomonas Vaginitis, Neisseria Gonorrhoeae, Chlamydia
Trachomatis, Conditions Mimicking Vaginitis - Cervicitis, Atrophic Vaginitis, Foreign
Bodies, Herpesvirus, Human Papispecallomavirus Infection
Anovulation: occur because of stress, age, endocrine disorders, uterine disorders, or
pregnancy
Abnormal/Dysfunctional Uterine Bleeding: common cause anovulation; results in variety of
irregular bleeding patterns; Abnormal bleeding patterns include metrorrhagia
(intermenstrual bleeding irregularly between periods), hypermenorrhea (excessive flow),
menorrhagia (increased amount and prolonged flow), menorrhea (prolonged flow), and
menometrorrhagia (prolonged flow with irregular bleeding and spotting between bleeding
episodes); • Abnormal uterine bleeding includes abnormal menstrual bleeding and bleeding
due to other causes such as pregnancy, systemic disease, or cancer.
In childbearing women, a complication of pregnancy must always be considered.
Exclusion of all possible pathologic causes of abnormal bleeding establishes the diagnosis
of dysfunctional uterine bleeding (nearly 60% of cases).
PATTERNS OF ABNORMAL UTERINE BLEEDING
The standard classification for patterns of abnormal bleeding recognizes 7 different patterns.
1. Menorrhagia (hypermenorrhea) is heavy or prolonged menstrual flow. The presence
of clots may not be abnormal but may signify excessive bleeding. “gushing” or
“open-faucet” bleeding is always abnormal. Submucous myomas, complications of
pregnancy, adenomyosis, iuds, endometrial hyperplasias, malignant tumors, and
dysfunctional bleeding are causes of menorrhagia.
2. Hypomenorrhea (cryptomenorrhea) is unusually light menstrual flow, sometimes
only spotting. An obstruction such as hymenal or cervical stenosis may be the cause.
Uterine synechiae (asherman's syndrome) can be causative and are diagnosed by a
hysterogram or hysteroscopy. Patients receiving oral contraceptives occasionally
complain of light flow and can be reassured that this is not significant.
3. Metrorrhagia (intermenstrual bleeding) is bleeding that occurs at any time between
menstrual periods. Ovulatory bleeding occurs midcycle as spotting and can be
documented with basal body temperatures. Endometrial polyps and endometrial and
NR602: Women’s Health Study Topics
, cervical carcinomas are pathologic causes. In recent years, exogenous estrogen
administration has become a common cause of this type of bleeding.
4. Polymenorrhea describes periods that occur too frequently. This usually is associated
with anovulation and rarely with a shortened luteal phase in the menstrual cycle.
5. Menometrorrhagia is bleeding that occurs at irregular intervals. The amount and
duration of bleeding also vary. Any condition that causes intermenstrual bleeding can
eventually lead to menometrorrhagia. Sudden onset of irregular bleeding episodes
may be an indication of malignant tumors or complications of pregnancy.
6. Oligomenorrhea describes menstrual periods that occur more than 35 days apart.
Amenorrhea is diagnosed if no menstrual period occurs for more than 6 months.
Bleeding usually is decreased in amount and associated with anovulation, either from
endocrine causes (eg, pregnancy, pituitary-hypothalamic causes, menopause) or
systemic causes (eg, excessive weight loss). Estrogen-secreting tumors produce
oligomenorrhea prior to other patterns of abnormal bleeding.
7. Contact bleeding (postcoital bleeding) is self-explanatory but must be considered a
sign of cervical cancer until proved otherwise. Other causes of contact bleeding are
much more common, including cervical eversion, cervical polyps, cervical or vaginal
infection (eg, trichomonas), or atrophic vaginitis. A negative cytologic smear does
not rule out invasive cervical cancer, and colposcopy, biopsy, or both may be
necessary.
Eval: Detailed history, physical examination, cytologic examination, pelvic ultrasound,
and blood tests are the first steps in the evaluation of abnormal uterine bleeding. The
main aim of the blood tests is to exclude a systemic disease, pregnancy, or a
trophoblastic disease.
All Menstrual Cycle Phases: All menstrual cycle phases:
M ENSTRUAL CYCLE AVG 28 DAYS
Throughout the female reproductive system, estrogens and progesterone control growth and
differentiation of epithelial cells and associated connective tissue. before birth, these cells
NR602: Women’s Health Study Topics
, are influenced by circulating maternal estrogen and progesterone that reach the fetus
through the placenta. After menopause, diminished synthesis of these hormones results in a
general involution of tissues in the reproductive tract.
Viable endometrial cells frequently undergo menstrual reflux into or through the uterine
tubes.
this can lead to endometriosis, a disorder with pelvic pain due to endometrial tissue
growing on the ovaries, oviducts, or elsewhere. Under the influence of estrogen and
progesterone, the ectopic tissue grows and degenerates monthly but cannot be removed
effectively from the body. endometriosis, the pain usually begins 1–2 weeks before the
menses, reaches a peak 1–2 days before, and is relieved at the onset of flow or shortly
thereafter. Severe pain during sexual intercourse or findings of adnexal tenderness or mass
or cul-de-sac nodularity, particularly in the premenstrual interval, help to confirm the
diagnosis
From puberty until menopause at about age 45-50, pituitary gonadotropins produce cyclic
changes in ovarian hormone levels, which cause the endometrium to undergo cyclic
modifications during the menstrual cycle. Proliferative, secretory, and premenstrual
phases in the uterus.
Premenstrual Syndrome: Symptoms include mood symptoms (irritability, mood swings,
depression, anxiety), physical symptoms (bloating, breast tenderness, insomnia, fatigue, hot
flushes, appetite changes), and cognitive changes (confusion and poor concentration).
Symptoms must occur in the second half of the menstrual cycle (luteal phase).
There must be a symptom-free period of at least 7 days in the first half of the cycle.
Symptoms must occur in at least 2 consecutive cycles.
Symptoms must be severe enough to require medical advice or treatment.
No objective screening or diagnostic tests for pms and pmdd, specific, well localized, and
recurrent.. Mastodynia specifically refers to a cyclical occurrence of severe breast pain,
usually in the luteal phase of the menstrual cycle, and it may be the primary symptom of
this syndrome in some. It has been shown to be related to high gonadotropin levels.
Estrogen stimulates the ductal elements, whereas progesterone stimulates the stroma. An
augmented response to prolactin has also been suggested. limiting caffeine, alcohol,
tobacco, and chocolate intake, and eating small, frequent meals high in complex
carbohydrates---Hormonal interventions have been shown to be effective. Use of selected
oral contraceptives and transdermal estradiol patch has been suggested because they
suppress ovulation; Ibuprofen tx
Cervical Cancer: the uspstf recommends screening for cervical cancer in women age 21 to
65 years with cytology (pap smear) every 3 years or, for women age 30 to 65 years who
NR602: Women’s Health Study Topics
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