WOMEN’S HEALTH CARE

1. WOMEN’S HEALTH CARE By. Lutfatul Latifah

2. Nurses have an important role in primary and preventive care of women as it relates to routine assessments, screening procedure & management of specific health concern

3. HEALTH MAINTENANCE

4. HEALTH HISTORY • Personal history (demographic, state of health, height, weight, allergies, exercize pattern etc) • Menstrual history (age of menarche, regularity, menstrual discomfort, age of menopause) • Obstetric history (gravida, para, length of gestation, labor experience, medical intervantion) • Sexual history (sexual activity, method of contraception, previous STD, knowledge/practice to prevent STD) • Family history (cardiovascular problem, cancer, osteoporosis) • Pshychosocial history (marital status, employment, occupation, education)

5. Physical Examination • Vital signs • Weight • Height • Head to toe examination

6. Screening Procedure • Breast self examination (BSE) • Clinical breast examination (CBE) • Mammography • Vulvar Self Examination • Pelvic Examination • The pap test • Rectal examination

7. BSE • Perform monthly by all women > 20 years • Approximatelly 1 week after the onset of menses • Most breast cancers are discover by the women herself

8. CBE • Perform by a health care prefessional • every 3 years age 20-39 & yearly for > 40 • More frequent in higher risk condition

9. Mammography • Used to screen for cancer or assist in the diagnosis of a palpable mass in the breast • The primary screening tools that can detect breast lumps long before they are large enough to be palpated • Recommends yearly for women 40 years & older, or younger age for women with suspicious growth in the breast

10. Vulvar Self Examination • Monthly by all women > 2o years, or younger than 18 years who are sexually active

11. Pelvic Examination • External organ • Speculum examination • Bimanual examination

12. The PAP Test • To detect precancerous or cancerous cells that may be shed by the cervix

13. Rectal Examination • The anus is inspected for hemorrhoids, inflammation, & lesion • Fecal occult blood testing (FOBT) : screening measure for colorectal cancer

14. COMMON WOMEN’S HEALTH PROBLEMS

15. Breast Disorder

16. Benign Breast Disorder • Fibrocystic breast changes (common during menstrual cycle) • Fibroadenoma (common benign tumor) • Ductal estacia (dilation of the collecting ducts, usually occur as women approaches menopause) • Intraductal papilloma (develops most often just before or during menopause)

17. Mallignant Tumors of the Breast • The primary women’s health problems in the world (incidence 1 in 8 (USA), men : < 1% • The second cancer problem after cervix cancer in Indonesia ( incidence 20%)

18. Cardiovascular Disease Disorder of the heart (Myocardial infarction, etc) Disorder of the vessel (coronary artery disease, hypertention, stroke)

19. Menstrual Cycle Disorder Amenorrhea Abnormal uterine bleeding Pain associated with the menstrual cycle (Dysmenore) Endometriosis Premenstrual syndrome

20. Endometriosis • Endometrial tissue is present outside the uterus • Incidence : 10% • Associated with secondary dysmenorrhea, chronic pelvic pain, & infertility

21. Pelvic Floor Dysfunction Vaginal wall prolapse Uterine prolapse

22. Vaginal Wall Prolapse • Cystocele • Enterocele • Rectocele

23. Uterine Prolapse • The cardinal ligaments which support the uterus & vagina streched during pregnancy & do not return to normal after childbirth • Kegel exercises strengthen the pubococcygeus muscle which surrounds the urethra, vagina & rectum & provide s support for the pelvic floor

24. Disorder of The Reproductive Tract Benign disorder Malignant disorder

25. Benign Disorder • Cervical polyps • Uterine leiomyomas (fibroids) • Ovarian Cyst

26. Uterine Leiomyomas (fibroids) • The most common gynecologic tumors • Develop from smooth muscle cells & are estrogen dependent • Grow rapidly during childbearing year & atrophy during menopause • Usually no symptoms, but increase uterine size, pelvic pain, or excessive menstrual bleeding; additional symptoms: feeling pelvic pressure, bloating & urinary frequency • Treatment depends on multiple factors : size, number, location, symptoms & future childbearing desire

27. Ovarian Cyst • Follicular, ovarian follicle fails to rupture during ovulation a follicular cyst ; asymptomatic & usually regress during the next menstrual cycle • Luteal, the corpus luteum become cystic & fail to regress a lutein cyst; cause pain & delay in next menstrual cycle

28. Malignant Disorder • Cervical Cancer • Endometrial Cancer • Ovarian Cancer

29. Infectious Disorder of The Reproductive Tract Candidiasis Sexually Transmitted Diseases Pelvic Inflamatory Disease

30. Sexually Transmitted Diseases • Trichomoniasis • Bacterial Vaginosis • Chlamydial Infection • Gonorrhea • Syphilis • Herpes Genital • Human Papillomavirus • AIDS

31. Pelvic Inflamatory Disease • Infection of the upper genital tract that may cause chronic pelvic pain. • The primary source of infection are C. Trachomatis & N. Gonorrheae. G. Vaginalis also may be found in PID • These organism invade the endocervical canal & cause cervicitis, bacteria ascend & infect the endometrium, fallopian tubes & pelvic cavity. • Some PID is asymptomatic or mild symptoms; some experience pelvic pain, fever, purulent vaginal discharge, nausea, anorexia & irregular vaginal bleeding

32. ANY QUETIONS ?

33. Thank you !