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Diseases of the Reproductive Organ A presentation by Group 6 Azarcon,Raymond Paul Blances, Lorgie Dayao, Mildalene Faelangco, Joywiline Ferrer, Ma Gressia Pimentel, Roselyn
Female Reproductive Organ
ENDOMETRIOSIS
Endometriosis Video Presentation
Schematic Diagram (During menstrual period) Endometrial cells are stimulated by the ovarian hormones Some of the endometrial debris exits the uterus passing the fallopian tube attach to peritoneal surface invade tissues endometriosis
Assessment Findings ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Diagnostics ,[object Object],[object Object],[object Object],[object Object]
Nursing Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Medical Interventions ,[object Object],[object Object],[object Object],[object Object],[object Object]
Surgical Interventions >Conservative surgery > Hysterectomy  a total hysterectomy and the removal of both ovaries may be the best treatment. Hysterectomy alone is also effective, but removing the ovaries ensures that endometriosis will not return. Nursing Interventions PROMOTIVE Proper diet Daily exercise Monthly check-up Good lifestyle ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
OVARIAN CYSTS
It is any collection of fluid, surrounded by a very thin wall, within an ovary. Any ovarian follicle that is larger than about two centimeters is termed an ovarian cyst. An ovarian cyst can be as small as a pea, or larger than a cantaloupe. Ovarian Cyst
Types and Cause ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],>Dermoid cyst This cyst is similar to those present on skin tissue and can contain fat and occasionally bone, hair, and cartilage.  >Cystadenoma A cystadenoma is a type of benign tumor that develops from ovarian tissue.
Assessment ,[object Object],[object Object],[object Object],[object Object],Nursing diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnostics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laboratory Studies ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],Surgical Interventions ,[object Object],[object Object],[object Object],Medical Interventions
Promotive Eat proper diet Regular check up Regular exercise Preventive Regular pelvic examination Regular check up with the physician Rehabilitative Follow up check up Check for bleeding
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DYSMENORRHEAL
DYSMENORRHEAL   Dysmenorrhea  refers to the syndrome of painful menstruation..Dysmenorrhea is severe, frequent cramping during menstruation. Pain occurs in the lower abdomen but can spread to the lower back and thighs.  2 types: Primary dysmenorrhea.   Secondary dysmenorrhea .
Risk Factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Schematic Diagram During Menstrual Cycle Sloughing endometrial cells Release of Prostaglandins Strong myometrial contraction Constrict blood vessels (uterus) Ishemia and pain DYSMENORRHEA
Assessment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
>Oral contraceptives , which block monthly ovulation and may decrease menstrual flow, may also relieve symptoms.  >Nonsteroidal anti-inflammatory agents: These drugs are highly effective in treating dysmenorrhea, especially when they are started before the onset of menses and continued through day 2. >Acute pain  related to severe muscle spasms >Impaired comfort  related to pain >Ineffective role performance  related to severe discomfort >Risk for situational  low self-esteem  related to pain-> Impaired social interaction  related to severe discomfort- Medical Intervention Nsg. Diagnosis
Exams and Test ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Nursing Interventions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PRE-MENSTRUAL DYSPHORHIC DISORDER
Premenstrual Dysphoric  Disorder Premenstrual dysphoric disorder (PMDD)  is a diagnosis used to indicate serious premenstrual distress with associated deterioration in functioning. PMDD is characterized by depressed or labile mood, anxiety, irritability, anger, and other symptoms occurring exclusively during the 2 weeks preceding menses.
Assessment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Nursing Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Medical Interventions Nursing Diagnosis
Nursing Interventions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Nursing Interventions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
VAGINAL FISTULAS
Vaginal Fistula   A vaginal fistula is an abnormal passage that connects the vagina to other organs, such as the bladder or rectum, resulting in leakage of urine or feces into the vagina. Vaginal fistulas are classified into four types; treatment varies for each: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Schematic Diagram Ureterovaginal Fistula  Dissection around the infundibulopelvic ligament/ ligation of the uterine vessels The ureter may become injured Unexpected pelvic hemorrhage Ureteral injury Ureterovaginal fistula
Assessment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Exams and Tests ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Sigmoidovaginal fistula in a woman with a history of hysterectomy. Vaginogram shows a fistula involving the vaginal cuff (arrow). The vagina  (V) , sigmoid colon  (S) , and rectum  (R)  are highlighted by the contrast material.
Diagnostic Procedures Vesicovaginal, Ureterovaginal and Urethrovaginal Fistulas  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Cont.
Complications ,[object Object],[object Object],[object Object],[object Object],[object Object]
v ,[object Object],[object Object],[object Object],[object Object],Local repair methods  - Transanal advancement flap repair -Transvaginal inversion repair - Bioprosthetic repair Medical Interventions Nursing Diagnosis
Nursing Interventions  Promotive - encourage women to have prenatal check ups - encourge pregnany women to deliver in hospitals or clinics Preventive -educational programs about the causes of the diseases for  rural areas Curative   - may need to give medicine or wound care to heal the tissue before  surgery to client as prescribed by the physician.  Rehabilitative - Patients are seen 2 weeks after discharge for evaluation of  wounds and bowel habits. -Offer sips of clear liquids to patient on the first postoperative day. - Early ambulation is beneficial for the patient -instruct patient to refrain from sexual activity or any physical activity  more strenuous than a slow walk for 3 weeks.
UTERINE PROLAPSED
  Uterine prolapsed means your uterus has descended from its position in the pelvis farther down into your vagina.  Uterine Prolapsed
Schematic Diagram Menopause, multiparity, child birth trauma, chomic straining Decrease in circulating estrogen Lose of elasticity and ability to support of supporting structure of the pelvic floor Relaxation and Prolapsed of urogenital organs
Pathophysiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Assessment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Assessment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnostics Preoperative - Ensure the patient's bladder and bowel are empty before surgery -obtain informed consent Intraoperative -insert catheter Postoperative - prevent bladder distension -removed catheter as ordered by the physician and as soon as client is ambulatory -monitor bleeding Instruct and teach the patient to: -keep bladder empty by voiding every 2 hours to avoid placing pressure along the suture line - avoid any exercise or heavy lifting -refrain from intercourse for 6 weeks after her discharge from the hospital. - avoid causes of increased intra-abdominal pressure, such as constipation, weight lifting, and cigarette smoking, for at least 3 months.
Complications ,[object Object],[object Object],[object Object]
Nursing Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pelvic exercises and pessaries are the current mainstays of nonsurgical management of patients with UP. - Gellhorn pessaries is most often used for patients with significant UP and a large introital diameter who have not obtained relief with other pessaries - Hysterectomy - performed by way of incisions through the vaginal wall into the pelvic cavity and supportive structure. The uterus is removed from its supporting brood, round, and uterosacral ligaments. The supprting ligaments are then attached to the vaginal cuff to maintain vaginal length. -The 3 common vaginal procedures to suspend the prolapsed vaginal apex are sacrospinous ligament fixation, modified McCall culdoplasty, and iliococcygeus fascia suspension. Medical Interventions Nursing Diagnosis
Nursing Care ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Promotive -educational programs about the causes of the diseases for rural areas Rehabilitative - teach patient how to insert, clean, and remove the pessary herself - If the woman is obese, attaining and maintaining optimal weight is recommended. Teach to avoid heavy lifting or straining. - Measures to treat and prevent chronic cough, such as smoking cessation, are also recommended.
RECTAL PROLAPSED
  Rectal prolapsed occurs when part or all of the wall of the rectum slides out of place, sometimes sticking out of the anus. There are three types  of rectal prolapsed: ,[object Object],[object Object],[object Object],[object Object],[object Object],Rectal Prolapsed
Assessment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Exams and Tests   -A  Defecogram  (a test that evaluates bowel control) may help distinguish between a mucosal prolapsed and a complete prolapsed. -It is confirmed by  Sigmoidoscopy  (inspection of the colon with a viewing instrument called a endoscope)  - Barium Enema
Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Nursing Diagnosis ,[object Object],[object Object],[object Object]
Medication ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Docusate
Surgery   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],Prevention Rehabilitative
IMPERFORATED HYMEN
[object Object],Imperforated Hymen
Schematic Diagram Obstruction of the vaginal tract (at the level of introitus) Prenatal, perinatal, adolescent period Intrapment of vaginal and uterine secretions Becomes evident when the distensible membranes bulges in the vagina between the labia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Assessment Additional Testing Prior to surgery, computed tomography (CT) scanning was performed to further delineate pelvic anatomy. Hematocolpos and hematometra were noted ,[object Object],[object Object],[object Object],Pelvic examination revealed normal labia, but a large bulging imperforate hymen was seen upon their separation
Nursing Diagnosis >Amenorrhoea  >Haematometra >Dyspareunia >Hydrometrocolpos >Haematocolpos
Surgical Intervention Hymenectomy A Hymenectomy (hymenotomy) surgical removal or opening of the hymen.  Preoperative . Preoperative pelvic and abdominal ultrasound to view the kidneys and urinary tract as many patients with hematocolpos have pelvic adhesions which could lead to ureteric obstruction and hence subsequent renal failure. Postoperative Ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed for the cramping. Topical lidocaine jelly is recommended for the vaginal orifice.
Medical Interventions Medical Therapy After initial presentation and suspected diagnosis of an obstructive anomaly, the use of continually-administered oral contraceptive pills to suppress menses allows symptomatic relief and essential time needed to obtain further diagnostic studies. In addition, the use of nonsteroidal anti-inflammatories can provide pain relief.
Nursing Interventions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TOXIC SHOCK SYNDROME
Toxic shock syndrome (TSS) is a rare, often life-threatening illness that develops suddenly after an infection and can rapidly affect several different organ systems, including the lungs, kidneys, and liver.  Toxic shock syndrome commonly causes a red strawberry tongue. This woman with toxic shock syndrome developed a flat, red, sunburn-like-rash. This rash causes the skin to peel 1-2 weeks after the illness. What is toxic shock syndrome?
Schematic Diagram Presence of Strep/Stap Produces Endotoxins Binding of MNC II with T cell receptors Polyclonal T cell activation Cytokine storm- related to the immune system Multi system disease (Lungs, Liver and Kidney)
Assessment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Cont.
Exams and Tests ,[object Object],[object Object],[object Object]
Medical intervention ,[object Object],[object Object],[object Object],[object Object],[object Object],Cont.
Surgical Interventions ,[object Object],[object Object],[object Object]
Nursing Diagnosis and Interventions Nursing Diagnosis Anxiety Fluid volume deficit Fatigue Hyperthermia Nursing Interventions Monitor signs of dehydration Increase fluid intake
 

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REPRODUCTIVE DISORDERS OF FISHER, FILAMER

  • 1. Diseases of the Reproductive Organ A presentation by Group 6 Azarcon,Raymond Paul Blances, Lorgie Dayao, Mildalene Faelangco, Joywiline Ferrer, Ma Gressia Pimentel, Roselyn
  • 5. Schematic Diagram (During menstrual period) Endometrial cells are stimulated by the ovarian hormones Some of the endometrial debris exits the uterus passing the fallopian tube attach to peritoneal surface invade tissues endometriosis
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  • 11. It is any collection of fluid, surrounded by a very thin wall, within an ovary. Any ovarian follicle that is larger than about two centimeters is termed an ovarian cyst. An ovarian cyst can be as small as a pea, or larger than a cantaloupe. Ovarian Cyst
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  • 17. Promotive Eat proper diet Regular check up Regular exercise Preventive Regular pelvic examination Regular check up with the physician Rehabilitative Follow up check up Check for bleeding
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  • 20. DYSMENORRHEAL Dysmenorrhea refers to the syndrome of painful menstruation..Dysmenorrhea is severe, frequent cramping during menstruation. Pain occurs in the lower abdomen but can spread to the lower back and thighs. 2 types: Primary dysmenorrhea. Secondary dysmenorrhea .
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  • 22. Schematic Diagram During Menstrual Cycle Sloughing endometrial cells Release of Prostaglandins Strong myometrial contraction Constrict blood vessels (uterus) Ishemia and pain DYSMENORRHEA
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  • 24. >Oral contraceptives , which block monthly ovulation and may decrease menstrual flow, may also relieve symptoms. >Nonsteroidal anti-inflammatory agents: These drugs are highly effective in treating dysmenorrhea, especially when they are started before the onset of menses and continued through day 2. >Acute pain related to severe muscle spasms >Impaired comfort related to pain >Ineffective role performance  related to severe discomfort >Risk for situational  low self-esteem related to pain-> Impaired social interaction related to severe discomfort- Medical Intervention Nsg. Diagnosis
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  • 28. Premenstrual Dysphoric Disorder Premenstrual dysphoric disorder (PMDD) is a diagnosis used to indicate serious premenstrual distress with associated deterioration in functioning. PMDD is characterized by depressed or labile mood, anxiety, irritability, anger, and other symptoms occurring exclusively during the 2 weeks preceding menses.
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  • 36. Schematic Diagram Ureterovaginal Fistula Dissection around the infundibulopelvic ligament/ ligation of the uterine vessels The ureter may become injured Unexpected pelvic hemorrhage Ureteral injury Ureterovaginal fistula
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  • 42. Nursing Interventions Promotive - encourage women to have prenatal check ups - encourge pregnany women to deliver in hospitals or clinics Preventive -educational programs about the causes of the diseases for rural areas Curative - may need to give medicine or wound care to heal the tissue before surgery to client as prescribed by the physician. Rehabilitative - Patients are seen 2 weeks after discharge for evaluation of wounds and bowel habits. -Offer sips of clear liquids to patient on the first postoperative day. - Early ambulation is beneficial for the patient -instruct patient to refrain from sexual activity or any physical activity more strenuous than a slow walk for 3 weeks.
  • 44. Uterine prolapsed means your uterus has descended from its position in the pelvis farther down into your vagina. Uterine Prolapsed
  • 45. Schematic Diagram Menopause, multiparity, child birth trauma, chomic straining Decrease in circulating estrogen Lose of elasticity and ability to support of supporting structure of the pelvic floor Relaxation and Prolapsed of urogenital organs
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  • 49. Diagnostics Preoperative - Ensure the patient's bladder and bowel are empty before surgery -obtain informed consent Intraoperative -insert catheter Postoperative - prevent bladder distension -removed catheter as ordered by the physician and as soon as client is ambulatory -monitor bleeding Instruct and teach the patient to: -keep bladder empty by voiding every 2 hours to avoid placing pressure along the suture line - avoid any exercise or heavy lifting -refrain from intercourse for 6 weeks after her discharge from the hospital. - avoid causes of increased intra-abdominal pressure, such as constipation, weight lifting, and cigarette smoking, for at least 3 months.
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  • 52. Pelvic exercises and pessaries are the current mainstays of nonsurgical management of patients with UP. - Gellhorn pessaries is most often used for patients with significant UP and a large introital diameter who have not obtained relief with other pessaries - Hysterectomy - performed by way of incisions through the vaginal wall into the pelvic cavity and supportive structure. The uterus is removed from its supporting brood, round, and uterosacral ligaments. The supprting ligaments are then attached to the vaginal cuff to maintain vaginal length. -The 3 common vaginal procedures to suspend the prolapsed vaginal apex are sacrospinous ligament fixation, modified McCall culdoplasty, and iliococcygeus fascia suspension. Medical Interventions Nursing Diagnosis
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  • 57. Exams and Tests -A Defecogram (a test that evaluates bowel control) may help distinguish between a mucosal prolapsed and a complete prolapsed. -It is confirmed by Sigmoidoscopy (inspection of the colon with a viewing instrument called a endoscope) - Barium Enema
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  • 67. Nursing Diagnosis >Amenorrhoea >Haematometra >Dyspareunia >Hydrometrocolpos >Haematocolpos
  • 68. Surgical Intervention Hymenectomy A Hymenectomy (hymenotomy) surgical removal or opening of the hymen. Preoperative . Preoperative pelvic and abdominal ultrasound to view the kidneys and urinary tract as many patients with hematocolpos have pelvic adhesions which could lead to ureteric obstruction and hence subsequent renal failure. Postoperative Ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed for the cramping. Topical lidocaine jelly is recommended for the vaginal orifice.
  • 69. Medical Interventions Medical Therapy After initial presentation and suspected diagnosis of an obstructive anomaly, the use of continually-administered oral contraceptive pills to suppress menses allows symptomatic relief and essential time needed to obtain further diagnostic studies. In addition, the use of nonsteroidal anti-inflammatories can provide pain relief.
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  • 72. Toxic shock syndrome (TSS) is a rare, often life-threatening illness that develops suddenly after an infection and can rapidly affect several different organ systems, including the lungs, kidneys, and liver. Toxic shock syndrome commonly causes a red strawberry tongue. This woman with toxic shock syndrome developed a flat, red, sunburn-like-rash. This rash causes the skin to peel 1-2 weeks after the illness. What is toxic shock syndrome?
  • 73. Schematic Diagram Presence of Strep/Stap Produces Endotoxins Binding of MNC II with T cell receptors Polyclonal T cell activation Cytokine storm- related to the immune system Multi system disease (Lungs, Liver and Kidney)
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  • 78. Nursing Diagnosis and Interventions Nursing Diagnosis Anxiety Fluid volume deficit Fatigue Hyperthermia Nursing Interventions Monitor signs of dehydration Increase fluid intake
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