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Genital Urinary System

Genital Urinary System. Female Reproductive System. Brunner and Suddarth’s Medical Surgical Nursing Text: Ch. 46-48. Behavioral Objectives:. Review the anatomy and physiology of the female GU systems Describe the physical assessment of the female GU systems

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Genital Urinary System

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  1. Genital Urinary System Female Reproductive System

  2. Brunner and Suddarth’s Medical Surgical Nursing Text: Ch. 46-48

  3. Behavioral Objectives: • Review the anatomy and physiology of the female GU systems • Describe the physical assessment of the female GU systems • Discuss the application of the nursing process as it relates to patients with disorders of the female GU system • Describe etiology, pathophysiology, clinical manifestations, nursing management and patient education for the following female GU disorders: • Vaginitis • Pelvic inflammatory disease (PID) • Endometriosis • Discuss incidence, prevention & tx of the pts with CA of the GU system • Discuss the nursing interventions in pre and post-operative care of patients undergoing the following surgeries • Hysterectomy • Mastectomy

  4. Anatomy Review: Breast • Female breast development • 10-16 yrs • Tail of Spence • Into axillary area • Cooper’s ligament • 12-20 lobes • Nipple • Areola

  5. Anatomy ReviewInternal Reproductive Structures Vagina • Mucus membrane • Posterior to bladder & urethra • Anterior to rectum • Anterior & posterior walls touch • Upper vagina surrounds cervix • Inferior uterus

  6. Anatomy ReviewInternal Reproductive Structures Uterus • Pear-shaped • Muscular • Size • ? • Variable • # pg

  7. Anatomy ReviewInternal Reproductive Structures • Location • Posterior to bladder • Ligaments

  8. Uterus • Two parts of the uterus • Cervix • Projects into the Vagina • Fundus • Body of the uterus • Endometrium: • Lining of the uterus

  9. Anatomy ReviewInternal Reproductive Structures Ovaries • Connected to uterus by the fallopian tubes • Contains • 1000’s of ova @ birth • Ova / Ovum • Egg cells (immature) • Ova – plural • Ovum - Singular

  10. Physiology Review Start Ovulation • Definition • Discharge of a mature ovum from the ovary

  11. Physiology Review Ovulation • Follicular Stage • Ovum enlarges cyst(graafian follicle) • Reaches the surface(of the ovary) • Ovum is discharged • Ovulation

  12. Physiology Review After Ovulations • Ovum • Fallopian tube • Uterus • IF is meets a spermatozoon • Union & conception • Location of fertilization?

  13. Physiology Review After ovulation • Ovum cyst  • Corpus luteum • Stays in the ovary • Produces progesterone • Prepares the uterus for the fertilized ovum

  14. The Menstrual Cycle • 2 system control menstruation process • Reproductive • Endocrine Hormones

  15. The Menstrual Cycle • Ovaries  • Estrogen • Progesterone

  16. The Menstrual Cycle Pituitary gland • FSH • Stim. Ovaries • to secrete estrogen • LH • Ovulation • Stim. Progesterone 

  17. The Menstrual Cycle • Cyclic pattern  • Changes in the endometrium and menstruation • 28 day cycle

  18. Menopausal Period • End of reproductive capacity • Age 45 – 52 yrs • Menstruation ceases • No periods for > 1 year

  19. Menopausal Period • Ovaries not active  • _?__ estrogen • i • Reproductive organs i size • No ova mature

  20. Physical assessment Health history • Menstrual hx • Menarche • Beginning of menstruation • Length • Amount • Cramps/pain ? • Hx of pregnancies

  21. Medication history • Hormone therapy • Hormonal contraceptives • Fertility treatment

  22. Assessment: History & Clinical Manifestations • Pain • Dysmenorrhea • Dyspareunia • Hx vaginal discharge • Odor • Itching • Hx urinary functions • Hx B&B control

  23. Assessment: History & Clinical Manifestations • Sexual history • History of sexual or physical abuse • History of surgery • History of chronic illness or disability • History of genetic disorders

  24. Physical Exam • Breast • Frequency: • Monthly

  25. Breast Exam – Assessment • Palpable masses • Skin changes • Pain • Swelling • Redness • Nipple changes • Self exam

  26. Abnormal breast findings • Erythema • Benign local infection or • Superficial neoplasm • Prominent venous pattern • h blood supply required by tumor • Edema & pitting • Neoplasm blocking the lymphatic drainage tubes

  27. Orange-peel appearance / Peau D’orange (edema) • Advanced breast cancer • Nipple inversion • If new  requires evaluation • Signs of dimpling, creasing, changes in contour

  28. Breast Cancer Mass - palpate • Single mass • One breast • Firm, hard, embedded in surrounding tissue • Non-tender

  29. Mammography • Duration • 15 minutes • Recommended frequency • Annually • > age 40

  30. Physical Assessment • Pelvic • Frequency • Annual • Initial • > age 18 • sexually active • breast • pelvic • Positioning • Supine lithotomy position

  31. Physical Assessment • Inspection • Inspects external genitilia • Speculum examination • Vaginal canal • Cervix

  32. Physical Assessment • Pap smear • Tissue sample of cervix • Purpose: • Dx Cervical Ca • No douche before visit

  33. Physical Assessment • Bimanual palpation • Cervical palpation • Uterine palpation

  34. Colposcopy • Portable microscope • Obtain sample

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