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25)Female Reproductive System

25)Female Reproductive System - Female Reproductive System...

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Unformatted text preview: Female Reproductive System Female L Meneghini, RN, MSN, CEN Female Genitalia Female External Genitalia Mons Pubis Labia Majora Labia Minora Vestibule Urethral Meatus Skene’s Gland Vaginal Orifice Bartholins Gland Female Genitalia Female Internal Genitalia Vagina Cervix Uterus Ovaries Developmental Considerations Developmental Adolescents: At onset of puberty, estrogen stimulates cell At growth and secondary sex characteristics growth Menarche during latter half of puberty; irregular Menarche menses common in adolescence Pregnancy Signs on Exam Pregnancy 1) Cervical softening= Goodell’s sign at 4-6 1) weeks weeks 2) Vagina and cervix cyanosis=Chadwick’s 2) sign sign 3) Uterine Isthmus softens = Hegars sign Other changes in pregnancy: pH & pH hormonal changes increase risk of yeast infection in pregnancy; Mucus plug forms in cervix in Developmental Considerations: Menopause Developmental Age: usually 48 to 51 within wide possible age Age: range (35 to 60). Definition of menopause = cessation of menses for 12 full months; preceded by 1 to 2 yrs of irreg menses preceded Estrogen and progesterone production in Estrogen ovaries declines rapidly ovaries Physical changes after menopause: Uterus Physical decreases in size; mucosa thin & fragile; decreased vag secretions & pH changes = risk for vaginitis for Subjective Data Subjective Menstrual history: Menstrual Last menses: First day of LMP Last First menses: age at menarche How frequent? Duration: How many days bleeding? Usual amount: light, medium, heavy? Pain or cramps? (Dysmenorrhea) Subjective Data Subjective Obstetric history: Obstetric Gravida – number pregnancies Para – number of births Para Abortions – interrupted pregnancies including elective abortions and spontaneous miscarriages miscarriages Subjective Data Subjective Menopausal symptoms and related data: Menopausal Irregular menses, hot flashes, numbness, mood swings, vaginal dryness, using hormonal replacement therapy- if so, side effects? replacement Perceptions about menopause Subjective Data Subjective Self-Care Behaviors: Self-Care How often do you have a gynecologic exam? Last Pap Smear date and results DES baby? Diethystilbestrol (Taking of DES hormones by mother which may cause cervical or vaginal abnormalities in the offspring) or Subjective Data Subjective Urinary symptoms Burning painful urination (dysuria) Nocturia Nocturia Blood in urine (hematuria) Blood Color of urine Difficulty with urination Loss of urine with a sneeze, laugh, cough, Loss bearing down bearing Subjective Data Subjective Vaginal discharge Character or color (white, green, yellow, clear) When did it start ? Is it associated with itching, rash, odor, pain with Is intercourse? Partner having symptoms? intercourse? Medications- antibiotics? History of diabetes (increases glycogen content) Subjective Data Subjective Menstrual cycle now? Use of vaginal douche? Treated for discharge? Subjective Data Subjective Past history Any problems such as sores, lesions Abdominal pain Past history or surgeries Subjective Data Subjective Sexual health: Sexual Relationships: Partners (male and/or female); Relationships: number of partners (current and lifetime) number Age at first sexual activity Satisfaction with sexual relationships with your Satisfaction sexual response? sexual Satisfaction with ability to communicate with Satisfaction your partner(s)? your Subjective Data Subjective Contraceptive use: Contraceptive Do you use contraceptives? What type(s) Currently planning a pregnancy? Problems getting pregnant? STI’s: In past or recent exposure? how treated? Current symptoms? treated? STI risk reduction: Subjective Data Subjective Additional history for infants/children: Additional Problems urinating Problem with genital area such as rash, itching Problem discharge? discharge? Screen for sexual abuse Additional history for adolescents: Ask age appropriate questions about periods, Ask development, body change, sex, sexual behavior, protection, STD, sexual abuse behavior, Subjective Data Subjective Aging Adult: Vaginal bleeding after menopause ? Vaginal itching, discharge or dyspareunia (pain Vaginal with sexual intercourse)? with Feelings of pressure in genital area and/or loss Feelings of urine with cough, sneeze? of Current sexual relationship? Satisfaction? ...
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