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- Harford Community College
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9/16/241 Chapter 4:
Special Issues of Women’s Healthcare and Reproduction
2 Learning Objectives:
• Describe health screening recommendations for women.
• Differentiate dysmenorrhea and premenstrual syndrome (PMS).
• Explain clinical manifestations, treatment, and nursing care for
endometriosis.
• Discuss risk factors for pelvis inflammation disease (PID).
• Explain causes and risk factors for pelvic support disorders.
• Compare and contrast methods of contraception.
• List possible causes and treatments of infertility problems.
• Identify major considerations for the peri- and postmenopausal
client.
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3 Health Screening for Women
Breast cancer screening
• Self-awareness of breast characteristics and yearly clinical
breast examinations are appropriate for women of all ages
• Women w/ average risk should start mammograms at age 45,
changed to every 2 years at age 55
• Women at higher risk due to family history or another reason
may begin earlier & more often
• Reinforce importance of mammography and BSE
• Avoid applying deodorant, powder, and lotions prior to
mammogram, can impact test results
4 Health Screening for Women
Breast self exam
• Self-scheduled, systematic approach to check breasts
• ACS now presents as optional; should know how breasts
normally look and feel
Pelvic exam and Pap test
• Initial Pap test at age 21, regardless of when first had sexual
intercourse, and then every 3 years from age 21 to 29 and every
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• Initial Pap test at age 21, regardless of when first had sexual
intercourse, and then every 3 years from age 21 to 29 and every
5 years after age 30 if HPV screening is done or every 3 years if
Pap test alone is done
• May also screen for HPV, HIV
5 Health Screening for Women
Vulvar self-examination
• Become familiar with own normal anatomy
• Inspect for lesions, growths, reddened areas, unusual discharge,
or changes in skin color
• Note any changes in sensation, such as itching or pain
• Report all changes to healthcare provider
6 Common Disorders of Women’s Reproductive Tract
Menstrual disturbances:
Amenorrhea: is absence of menstruation
• Primary: absence of menarche by 15 y.o.
• Secondary: absence of three menstrual cycles or 6 months in
woman who was previously menstruating
• Causes: pregnancy, endocrine issues, structural issues
Atypical uterine bleeding
• Menorrhagia: heavy or prolonged bleeding
• Metrorrhagia: normal menstrual bleeding at irregular intervals
between menstrual periods
• Breakthrough bleeding: metrorrhagia that occurs with
hormonal contraceptives
Dysmenorrhea: painful or difficult menses
• Primary: not associated with a disease process
• Secondary: secondary to pelvic condition such as
endometriosis or uterine fibroids
• Clinical manifestations: begins 6 mo to 2 yrs after menarche;
severe intermittent cramping, constant pain, nausea, diarrhea,
fatigue, headache
• Treatment: acetaminophen, NSAIDs, oral contraceptive agents
7 Common Disorders of Women’s Reproductive Tract
Menstrual disturbances
• Premenstrual syndrome (PMS): physiologic & emotional
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