Maternity & Pediatric Nursing Chapter 11

Breast Care
-Monthly breast self-exams(after 20yrs)
-Annual professional breast exam(Over 20yrs)
-Mammography as approprate(40yrs 1 or 2x yearly)

Vulvar self-examination
Women over 18yrs should be preformed a monthly examination of the external genitalia to identify lesions or masses that may indicate infection or malignancy

Pelvic Examination
Should be scheduled between menstration periods, and woman should not douche, or have intercourse 48 prior to the Pap test.

is the absence of menstration.
-Primary: failure to menstrate by age 16yrs, or by 14yrs if she has not developed secondary sex characteristics
-Secondary: cessation of menstration for least three cycles or 6mo in a woman who previously had an established pattern

is the uterine bleeding that is usually normal in amount but occurs at irregular intervals (35mL)

refers to the menstrual bleeding that is excessive amounts (greater than 80mL/month)

is pain that many women experience around ovulation, near the middle of their menstrual cycle

painful menses or “cramps” affects women, occurs soon after the onset of menses and are in spasmodic in nature

painful sexual intercourse

Factors that change the normal flora of the vagina, and predispose to vaginal infections
(antibiotics)-encourage yeast overgrowth
(Douching)-Changes in pH
(Sexual intercourse)-raises pH to 7 or higher 8 hr after coitus
(Uncontrolled diabetes mellitus)-increased glucose that promotes organism growth

Toxic Shock Syndrome
TSS- caused by strains staphylococcus aureus that produces toxins that cause shock, it is rare and potentially fatal disorder, s/s sudden spiking fever, flulike symptoms, hypotension, skin peeling form palms, and soles of feet

Pelvic Inflammatory Disease
(PID)- is a asymptomatic STI’s

Emergency Contraception
The “morning after pill” taken within 72hrs, and the repeat dose 12hrs later, Plan B

Permanent Contraception
(Sterilization)-vasectomy (male)
-Tube ligation (female)
-Hysteroscopic (female) closure of the fallopian tube within 3 months, for inflammation.

the inability to conceive when desired .

Factors Affecting Infertility (Male)
(Male factors)- abnormal sperm,abnormal erections, abnormal ejaculation,and abnormal seminal fluid.

Factors Affecting Infertility(Female)
(Female factors)- disorders of ovulation, abnormal fallopian tubes, abnormal Uterus Cervix or Ovaries, Hormone abnormalities

Other factors of infertility
-coital frequency, age, cigarette smoking, exercise, diet, weight, medical problems, and drugs/chemicals

Evaluation of Infertility
(male)- semen analysis
(female)-methods for predicting ovulation

Therapy for infertility
-Medications, surgical procedures, therapeutic insemination, surrogate parenting,and advanced reproductive techniques

Bypass Obsticles to Conception
(IVF)-In vitro fertilization, several ova are obtained and mixed with semen and returned 2 days later
(GIFT)-Gamete intrafallopian transfer, ova are obtained and mixed with sperm, and placed into the fallopian tubes fertilization and entry into the uterus occur normally
(TET)-Tubal embryo transfer, fertilization is outside the body and placed back in the fallopian tube

is the cessation of menstrual periods for more than 12 months because of changes in estrogen production. s/s changes in mentrual cycle, vasomotor instability (hot flashes), decreased moisture, and elasticity of the vagina

is also known as the perimenopausal period, which extends for 2 to 8 yrs before mentration ceases

Loss of bone mass, and calcium in the bone. related to lower estrogen levels

Pelvic Floor Dysfunction
occurs when the muscles, ligaments, and fascia that support the pelvic ograns are damaged or weakened two classafications:
(vaginal wall prolapse)-cystocele, anterior wall
-rectocele,posterior wall

when the anterior wall of the vagina becomes to weak to support the bladder that contains urine

when the posterior vaginal wall becomes weak and the women strains to defecate, feces are pushed against the weakened wall and not being directed towards the rectal sphincter for elimination

Uterine Prolapse
occurs when the ligaments that support the uterus and vagina are weakened, the uterus sags downward in the vagina

urinary incontinence
uncontrolled leakage of urine from the bladder

Stree incontinence
is leakage caused by sudden increase in intraabdominal pressure (sneezing or coughing)

Uterine Fibroids
(AKA leiomyomas) are benign growths of urine muscle cells, and very common

Ovarian Cysts
a follicular ovarian cyst may develop if the follicle fails to rupture its ovum during the menstrual cycle.

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