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Reproductive System

Reproductive System. Ch. 30-33. Female Reproductive Structures. Internal structure Ovaries Fallopian tubes Uterus Vagina. Ovaries. Location End of fallopian tubes Produce hormones Estrogen Progesterone Store Ovum. Fallopian tubes. Thin tubes Smooth muscle Lined with cilia

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Reproductive System

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  1. Reproductive System Ch. 30-33

  2. Female Reproductive Structures • Internal structure • Ovaries • Fallopian tubes • Uterus • Vagina

  3. Ovaries • Location • End of fallopian tubes • Produce hormones • Estrogen • Progesterone • Store • Ovum

  4. Fallopian tubes • Thin tubes • Smooth muscle • Lined with cilia • Fertilization occurs

  5. Uterus • AKA: womb • Location • Between • Bladder • Rectum • Function • Receive fertilized egg • Site for growth & development of the fetus

  6. Uterus • 3 parts • Fundus • Body • Cervix

  7. Uterus • 3 layers • Perimetrium • Outer layer • Myometrium • Middle layer • Endometrium • Innermost layer

  8. Endometrium • Responds to changes in • Estrogen • Progesterone • During the ovarian cycle • To prepare for implantation of the fertilized embryo

  9. Vagina • AKA: Birth canal • Fibromuscular tube • Between: • Bladder/urethra • Rectum • Function • Birth canal • Menstrual flow • Intercourse

  10. External Genitalia • Mons pubis • Pad of adipose tissue • Labia • Fold of tissue • Vestibule • Area between labia • Clitoris • Vaginal opening • Urethral opening

  11. Breast / Mammary glands • Supported by • Pectoral muscles • Richly supplied with • Nerves • Blood • Lymph nodes • Primary purpose • Nourishment

  12. Breast • Nipple • Areola • Mammary glands • Tail of Spence

  13. Endometrial changes during the menstrual cycle • Menstrual phase • Hemorrhages, sloughs and sheds • Proliferative phase • Repairs and thickens • Secretory phase • h vascularity • Prepares to support fertilized ovum

  14. Assessment of Female Reproductive System • Breast Exam • Size • Symmetry • Contour • Skin color • Lesions

  15. Assessment of Female Reproductive System - • Position • Lithotomy • Inspect • Palpate • Have client “bear down” • Bulging • Protrusion • Incontinence

  16. Mammography • X-ray of breast • Purpose: • Screen for breast CA

  17. Abdominal Laparoscopy • Visual examination of the abdomen using a fiberoptic tube. • abd. Filled with gas

  18. http://www.google.com/url?url=http://www.youtube.com/watch%3Fv%3DxECrwui9Lks&rct=j&sa=X&ctbm=vid&ei=-jm7TpHyGqOTiAKihrz_BA&sqi=2&ved=0CFEQuAIwAA&q=laparoscopic+hysterectomy&usg=AFQjCNHWtQoElG3corx6WIgqnaMeykfQjQ&cad=rjahttp://www.google.com/url?url=http://www.youtube.com/watch%3Fv%3DxECrwui9Lks&rct=j&sa=X&ctbm=vid&ei=-jm7TpHyGqOTiAKihrz_BA&sqi=2&ved=0CFEQuAIwAA&q=laparoscopic+hysterectomy&usg=AFQjCNHWtQoElG3corx6WIgqnaMeykfQjQ&cad=rja • http://www.google.com/url?url=http://www.youtube.com/watch%3Fv%3D7VfLv6gIMTA&rct=j&sa=X&ctbm=vid&ei=-jm7TpHyGqOTiAKihrz_BA&sqi=2&ved=0CIgBELgCMAg&q=laparoscopic+hysterectomy&usg=AFQjCNEnllO1PhW_sOIgCvEF4JkKe08_mw&cad=rja • http://www.google.com/url?url=http://www.youtube.com/watch%3Fv%3Dh-zuB2wsY5I&rct=j&sa=X&ctbm=vid&ei=-jm7TpHyGqOTiAKihrz_BA&sqi=2&ved=0CGYQuAIwAw&q=laparoscopic+hysterectomy&usg=AFQjCNEpuHV-R9FWz2gNhE_G6mSTAicSNg&cad=rja

  19. Nursing Care - Laparoscopy • Before • Informed consent • Reinforce teaching • Clarify questions • NOC before • douche • Antiseptic scrub • Empty bladder • Baseline vital signs

  20. Nursing Care - Laparoscopy • After • Monitor Vital signs • Report temp > 101oF • Apply perineal pad • Change q4 • Observe dressing • Drainage • Bleeding • Hematoma formation

  21. Nursing Care - Laparoscopy • May occur • Shoulder pain • Gas through vagina • Hiccups • Keep IV until PO resumed • Provide discharge instructions

  22. Nursing Care - Laparoscopy • When to notify MD • Bleeding • Intense abd pain • Fever • fluid leakage • Malaise • Difficulty breathing

  23. Colposcopy • Examine • Vagina • Cervix • Brightly lighted microscope

  24. Colposcopy • http://www.google.com/url?url=http://medicalvideos.eu/video/c6f9bd5d256af06/Getting-a-Colposcopy-Exam&rct=j&sa=X&ctbm=vid&ei=9Oy6TrvZFoLTiALE-oC4DA&ved=0CFwQuAIwATgK&q=colposcopy&usg=AFQjCNEu7hbpErmFG94yVa9SKIoXouI6Eg&cad=rja

  25. Small Group Questions • A patient is going to have a colposcopy. What teaching would you do before the procedure? • What would you note in a breast exam as being abnormal and worthy of further investigation? • Identify the anatomical structures that an ovum travels through and then exits the body (and their functions) • What is the endometrium and how is it different than other tissue of the body? • What would you teach your client following a laparoscopic procedure?

  26. Endometriosis • -osis • Abnormal condition • Endometri/0 • Inner lining of the uterus • Endometrial tissue is found outside the uterus

  27. Endometriosis • Ectopic locations • Pelvic organs • Diaphram

  28. Endometriosis • Ectopic tissue respond to ovarian cycle • Inflammation • Cysts • Scarring • Adhesions

  29. S&S: Endometriosis • Just before / during menses • Dysmenorrhea • Backache • Cramps • Dysuria • Infertility

  30. Dx: Endometriosis • Laparoscopy

  31. Rx: Endometriosis • Pain • Mild analgesics • NSAIDS • Suppress ovarian function • Oral contraceptives • Pg

  32. Pelvic Inflammatory Disease (PID) • Infection of the pelvic organs • Fallopian tubes • Ovaries • Uterus • Cervix

  33. Cause by infection • Gonorrhea • Chlamydia • Major cause of female infertility

  34. Pathophysiology • Organism travels up vagina  • spreads

  35. S&S: PID • High fever • Vaginal discharge • Severe lower abd pain • Nausea • Malaise • Dysuria

  36. Rx: PID • Antibiotics • Analgesics • Treat the partner too!

  37. Small Group Questions • Describe the pathophysiology of endometriosis? • What are the S&S of endometriosis? • What are the complications of endometriosis? • What is the pathophysiology of PID? • What is the primary cause of PID? • What is the usual treatment option for PID?

  38. S&S: Breast Cancer • Small hard painless lumps or masses • Change in size/shape of breast • Dimpling • Rash, discharge, flaking • Location • Upper outer quadrant

  39. Breast cancer is the 2nd leading cause of cancer deaths in women, what is the leading cause of cancer deaths in women? • Cervical • Ovarian • Stomach • Lung • Uterine

  40. Breast Exam • Emphasize the importance of continuing regular breast exams after menopause because the risk for breast cancer increases with age.

  41. Mastectomy • Before surgery • Preoperative care • Reinforce teaching • Allow access to support persons • Offer emotional support

  42. Mastectomy • After surgery • Routine post-op care • Reinforce teaching

  43. Mastectomy • Teaching • Empty the drain and replace dressing daily • Return for drain removal in 2-4 days per order • Take analgesics before pain becomes severe per order • Report excessive bleeding

  44. Mastectomy • Numbness & tingling in axillary are common • Arm / shoulder exercises per MD order • Drive • within 7-10 days • Return to work • 4-6 weeks • Don’t lift with arm on operated side

  45. NrsDx MastectomyGrieving • Listen attentively • Spend time • Explain feelings are normal • Enlist support

  46. Nrs. Dx. MastectomyRisk for infection • Assess dressing, incisions • Enc well balanced diet • Teach incision care • Report S&S of infection • avoid deodorant • skin care

  47. Nrs. Dx. MastectomyRisk for Injury • Use nonsurgical side • Elevate arm on a pillow • Enc. ROM • Teach protective measures

  48. Nrs. Dx. MastectomyRisk for Disturbed Body Image • Enc. Verbalization • Explain • Include partner • Provide resources • Enc. to look at the incision • Reassure

  49. Cervical Cancer • Common • Most r/t • Human papillomavirus (HSP) • STD/STI

  50. Cervical Cancer is highly treatable if found in the early stages. What is the best way to detect cervical cancer? • Signs and symptoms • MRI • CT-Scan • Pap smear • Palpation (via a self physical exam)

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