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Female reproductive system disorders have many
physiologic as well as psychosocial implications.
Any condition that affects the female
reproductive system can negatively influence a
woman’s self-perception and overall sense of
well-being. In many cultures, females hesitate to
seek for medical treatment for such conditions.
Moreover, female reproductive system disorders
may necessitate treatments like invasive
procedures that may be perceived as
embarrassing by many clients. Surgical
procedures may also alter reproductive
functions.
1. Pelvic Inflammatory Disease (PID)
An infectious process that may involve the
fallopian tubes, ovaries, pelvic peritoneum,
veins or uterine connective tissue.
Causes: Transmission of infection through sexual
intercourse.
Immunologic or renal disorders
Childbirth or abortion
Frequent vaginal douching
Multiple sex partners
Sexual contact with a partner with urethritis or
gonorrhea.
Signs and symptoms:
Abdominal and pelvic pain
Low back pain
Dyspareunia (painful sexual intercourse)
Menstrual irregularity
Causative Agents
Chlamydia Trachomatis
Clostridium Perfringes
Neisseria Gonorrheae
Potential Complications:
o Difficulty with ambulation resulting from
externally exposed portion of the uterus,
bladder or rectum.
Excess purulent discharge
Bleeding
Decubitus ulcer
8. Procidentia- inverted vagina due to
prolapsed uterus.
Collaborative management
o Hormones: topical estrogen, premarin
vaginal cream 2 times/week for 6 weeks,
then once a week.
Pessaries: devices wom in the vagina to
support the uterusfor women who ar poor
surgical risks.
Perineal exercises (Kegel’s exercise) to
improve pelvic tone.
Surgery
Retropubic cystourethropexy (to maintain
urinary continence)
Vaginal Hysterectomy
Anterior and posterior colporrhaphy
Colpocleisis (Le Fort’s Operation ) for elderly,
or high risk patients who are not sexually
active.
Psychosocial support
Nursing Diagnosis
Deficient knowledge related to lack of
information
Disturbed body image related to biophysical
changes.
Pain related to pressure of protruding uterus
Hormonal Disorders
Premenstrual Syndrome (PMS)
The cyclic recurrence, during the luteal
phase of the menstrual cycle, of a
combination of physical, psychologic, and
behavioral changes sufficient to interfere
with normal activities.
Increase in incidence and severity as
women near menopause.
Symptoms generally appear 7 to 10 days
before menses and decrease with onset of
menses.
Edema. Progesterone stimulates the
production of aldosterone which increases
sodium retention and edema formation.
Emotionality. The decrease in brain level of
monoamine oxidase that occurs as estrogen
production falls before menses probably
account for the feeling of depression.
Fluctuation of monoamine oxidase and
catecholamine levels in the brain may result to
irritability.
Decreased serotonin is also associated with
depression in humans.
Headache. Associated with vertigo and
migraine.
Other manifestations:
Breast tenderness and enlargement
Abdominal bloating
Food craving
Compulsive eating
Forgetfulness
Increase libido
Acne
Collaborative management for clients with
PMS:
Medications
Hydrochlorothiazide
Mefenamic acid
Naproxen
Medroxyprogesterone
Alprazolam (Xanax)
Leuprolide (Lupron)
Antidepressants (Elavil, Doxepine)
Vitamin B and E
Limit intake of salt, refined sugar, caffeine, animal
fats.
Relief of pain.
Adequate rest and sleep. Fatigue intensifies
symptoms.
Psychosocial support. Reassure symptoms are
temporary.
Nursing Diagnosis
Anxiety related to cyclical changes in health
status.
Ineffective coping related to inability to
conserve adaptive energies.
Menopause and Climacteric
Menopause is the physiological cessation of
menses.
Climacteric is the transitional period during
which reproductive function diminishes and
eventually ceases.
Menopause occurs between the ages of 48 and
55 average is 50 years.
Menopause occurs as a result of progressive
decline in ovarian secretion of estrogen.
Signs and symptoms
Subjective data
Hot flushes
Night sweats
Diaphoresis
Vertigo
Syncope
Numbness/ tingling/ pain in joints
Insomia
Chillysensation
Headache
Lack of appetite
Genitals
Decreased labial fat
Labia majora flattens
Labia minora disappers
Vagina becomes smaller with shallow fornices
with dry appearance.
Abdomen: abdominal fat deposition
Cardiovascular.Tachycardia, palpitations
Breast: reduction in size
Body hair: loss of pubic and axillary hair,
increase in facial hair and lip hair.
Behavioral changes: anxiety, decrease tolerance
level, body image changes.
Potential Complications: osteoporosis, coronary
heart diseases.
Collaborative management for clients with
dysmenorrhea:
Medications
Estrogen
a.Premarin (for hot flushes, prevention of
osteoporosis)
b. Transdermal estradiol (Estraderm)
Estrogen cream applied to vagina for
vaginitis
Progestins or progesterones
a. Provera (to prevent endomentrial CA)
Biophosphonates: Fosamax
Psychosocial support group/ classes
Nursing Diagnosis
Deficient knowledge related to lack of
information about self-care manegement.
Disturbed body image related to body
change.
Ineffective sexuality patterns related to
knowledge deficit about alternative response
to health-related topics.