NSG 222 Family Nursing Exam 1 - Questions and Answers Dysmenorrhea Definition Dysmenorrhea refers to painful menstruation and is a common problem in
... [Show More] adolescence Primary Dysmenorrhea & Cause Primary dysmenorrhea refers to painful menstrual bleedings in the absence of any detectable underlying pathology. It is caused by increased prostaglandin production by the endometrium in an ovulatory cycle. This hormone causes contraction of the uterus, and levels tend to be higher in women with severe menstrual pain than women who experience mild or no menstrual pain. Dysmenorrhea is caused by an excess of prostaglandin production. These levels are highest during the first two days of menses, when symptoms peak Secondary Dysnmenorrhea & Cause Secondary dysmenorrhea is painful menstruation due to pelvic or uterine pathology. It may be caused by endometriosis, adenomyosis, fibroids, pelvic infection, an intrauterine system (IUS), cervical stenosis, or congenital uterine or vaginal abnormalities. Therapeutic Management of Infertility As noted earlier, the main causes of infertility are female-factor (e.g., anovulation, tubal damage, endometriosis, ovarian failure), male-factor (e.g., low or absent numbers of motile sperm in the ejaculate, erectile dysfunction), or unexplained. The test results are presented to the couple and different treatment options are suggested. The majority of infertility cases are treated with drugs or surgery. Treatment options include lifestyle changes, such as weight loss and smoking cessation; taking clomiphene to promote ovulation; hormone injections to promote ovulation; intrauterine insemination; and IVF. Various ovulation-enhancement drugs and timed intercourse might be used for the woman with ovulation problems . The woman should understand a drug's benefits and side effects before consenting to take it. Depending on the type of drug used and the dosage, some women may experience multiple pregnancies. If the woman's reproductive organs are damaged, surgery can be done to repair them Barrier Methods of Contraception Condom Cervical Cap Sponge Diaphragm Diaphragm Contraceptive Method The diaphragm is a soft latex dome surrounded by a metal spring. Used in conjunction with a spermicidal jelly or cream, it is inserted into the vagina to cover the cervix. The diaphragm may be inserted up to 2 hours before intercourse and must be left in place for at least 6 hours afterward. Diaphragms are available in a range of sizes and styles. The diaphragm is available only by prescription and must be professionally fitted by a health care provider. Cervical Cap Contraceptive Method The cervical cap is smaller than the diaphragm and covers only the cervix; it is held in place by suction. Caps are made from silicone or latex and are used with spermicide. The cap may be inserted up to 36 hours before intercourse and provides protection for 48 hours. The cap must be kept in the vagina for 6 hours after the final act of intercourse and should be replaced every year of use. Sponge Contraceptive Method The contraceptive sponge is a nonhormonal, nonprescription device that includes both a barrier and a spermicide. It is a soft concave device that prevents pregnancy by covering the cervix and releasing spermicide. Unlike the diaphragm, the sponge can be used for more than one coital act within 24 hours without the insertion of additional spermicide, and it does not require fitting or a prescription from a health care provider. To use the sponge, the woman first wets it with water, squeezes it until it is thoroughly wet and foamy, and then inserts it into the vagina with a finger, using a cord loop attachment. It can be inserted up to 24 hours before intercourse and should be left in place for at least 6 hours following intercourse. The sponge provides protection for up to 12 hours, but should not be left in for more than 30 hours after insertion to avoid the risk of TSS Medical Abortion Medical abortions are achieved through administration of medication either vaginally or orally. The administration of medication occurs in the clinic or doctor's office, may require more than one office visit, and costs between $500 and $800. Two Drugs used in Medical Abortion The most common regimen in the United States involves the use of two different medications, mifepristone and misoprostol. Mifepristone blocks progesterone, which is essential to the development of pregnancy. Misoprostol, taken 24 to 48 hours later, works to empty the uterus by causing cramping and bleeding. A follow-up visit is scheduled later to confirm the pregnancy was terminated via ultrasound or blood test SAVE Model S: Screen all of your clients for violence by asking: Within the last year have you been physically hurt by someone? Do you feel you are in control of your life? Within the last year, has anyone forced you to engage in sexual activities? Can you take about your abuse with me? How is your present relationship? A: Ask direct questions in a nonjudgmental way: Normalize the topic with women, make eye contact, stay calm, never blame the woman, do not dismiss anything she tells you, do not use formal technical language, and be direct. V: Validate the client by telling her believe her story, you do not blame her, it is brave of her to tell you, and there is help for her. E: Evaluate, Educate, and refer client by asking: what type of violence? Is she is danger right now? How is she feeling? Does she know that there are consequences to violence? Is she aware of her resources? Urge Incontinence: Definition, Symptoms, and Cause Urge Incontinence: Precipitous loss of urine preceded by a strong urge to void with increased bladder pressure and detrusor contraction. Urgency, frequency, nocturia, and large amount of urine loss. Causes: neurologic, idiopathic, or infectious Stress Incontinence: Definition, Symptoms, and Cause Stress Incontinence: Accidental leakage of urine that occurs with increased pressure on the bladder from coughing, sneezing, laughing, or physical excretion. Involuntary loss of a small amount of urine in response to physical activity that raises intra-abdominal pressure. Causes: Develops commonly in women in their 40s and 50s usually as a result of weakened muscles and ligaments in pelvis following child birth. Steps to Prevent Vaginitis Avoid douching to prevent altering the vaginal environment. Use condoms to avoid spreading the organism. Avoid tights, nylon underpants, and tight clothes. Wipe from front to back after using the toilet. Avoid powders, bubble baths, and perfumed vaginal sprays. Wear clean cotton underpants. Change out of wet bathing suits as soon as possible. Become familiar with the signs and symptoms of vaginitis. Choose to lead a healthy lifestyle. Common Symptoms of Menopause Hot flashes or flushes of the head and neck Dryness in the eyes and vagina Personality changes Anxiety and/or depression Loss of libido Decreased lubrication Weight gain and water retention Night sweats Atrophic changes—loss of elasticity of vaginal tissues Fatigue Irritability Poor self-esteem Insomnia [Show Less]