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Session 15: Ch 16 PowerPoint Presentation
1. Lecture Notes 16
Reproductive System
Diseases and Disorders
Classroom Activity to Accompany
Diseases of the Human Body
Fifth Edition
Carol D. Tamparo Marcia A. Lewis
3. Nobody will ever win the battle
of the sexes. There’s too much
fraternizing with the enemy.
—Henry A. Kissinger
3
4. Infertility
• Description
• Failure to become pregnant after 1 year of
regular unprotected intercourse, even after
one or more pregnancies
• Female fertility peaks at age 24 and
diminishes after age 30
• Male fertility peaks at age 25 and declines
after age 40
4
5. Infertility
• Etiology: female
• Hormonal problems
• Nutritional deficiencies
• Tumors
• Infections
• Anomalies of the reproductive system
5
6. Infertility
• Etiology: male
• Sperm deficiencies
• Congenital abnormalities
• Endocrine imbalances
• Surgical intervention
• Infection or chronic inflammation of the
testes, epididymis, vas deferens
6
7. Infertility
• Etiology: both sexes
• Advancing age
• Heavy alcohol use
• Drug abuse
• Obesity (especially in women)
• Radiation exposure
• Idiopathic in 10% of cases
7
8. Infertility
• Signs and symptoms
• Inability to conceive after 1 year of regular
unprotected intercourse
8
10. Infertility
• Diagnostic procedures: male
• Examination of ejaculate
• Complete history and physical exam
• CBC, blood hormone levels
• Sperm count
• Urine 17-ketosteroid
• Cystoscopy and catheterization of ejaculatory
ducts
• Vasography
• Seminal vesiculography
10
11. Infertility
• Treatment: female
• Salpingostomy
• Lysis of adhesions
• Removal of ovarian abnormalities
• Correction of endocrine imbalance
• Correction of cervicitis
• Hormone therapy
• Microsurgery
11
12. Infertility
• Treatment: male
• Surgical correction of any abnormality
• Correction of testicular hypofunction
• Surgical correction of hydrocele or varicocele
• Hormone therapy
12
13. Infertility
• Treatment
• Assisted reproductive therapy (ART)
• In vitro fertilization (IVF)
• Gamete fallopian transfer (GIFT)
• Zygote intrafallopian transfer (ZIFT)
• Tubal embryo transplant (TET)
13
14. Infertility
Complementary therapy
• Acupuncture, meditation, guided imagery
• Yoga
• Herbal therapy
Client communication
• Encourage weight loss
• Educate about how alcohol and cigarette smoking
decreases fertility
14
15. Infertility
• Prognosis
• 60% of couples who are treated achieve
pregnancy
• Some cases are untreatable
• Prevention
• Avoid causative factors
15
17. Common Signs and Symptoms of
Sexually Transmitted Diseases
• Dysuria, hematuria, urinary frequency,
incontinence, purulent discharge, burning, itching
on urination
• Pelvic or genital pain
• Any skin ulcerations, especially in genital areas
• Fever, malaise
• Dyspnea
17
18. Gonorrhea
• Description
• Contagious bacterial infection of epithelial
surfaces of the GU tract
• Most prevalent among teenagers and young
adults
GU = genitourinary.
18
19. Gonorrhea
• Etiology
• Bacteria (Neisseria gonorrhoeae) transmitted during
sexual intercourse or other intimate sexual contact
with infected partner
• Bacteria can grow in the mouth, throat, eyes, and
anus
• Infected mother can infect infant during vaginal
delivery
19
20. Gonorrhea
• Signs and symptoms
• Females: may be asymptomatic or present with
purulent, greenish-yellow discharge from cervix
• Itching, burning pain
• Males: purulent, urethral discharge; pain; urinary
frequency
• Newborns: gonorrheal ophthalmia neonatorum
20
21. Gonorrhea
• Diagnostic procedures
• Culture and sensitivity of discharge or urine
• Treatment
• Antibiotics; newer, potent antibiotics
• Culture after 1 to 2 weeks, 6 months
• Test for other STDs, also
STDs = sexually transmitted diseases.
21
22. Gonorrhea
Complementary therapy
• Stimulate immune system by eliminating fatty
foods, sugar, white flour, salt, caffeine
• Vitamin, herbal supplements
Client communication
• Practice safer sex
• Take all medications
• Return for repeat cultures
22
23. Gonorrhea
• Prognosis
• Good with prompt treatment
• PID is complication among females
• Epididymitis is complication among males
PID = pelvic inflammatory disease.
23
24. Gonorrhea
• Prevention
• Use condoms, avoid multiple partners, trace
sexual partners of infected person
• Instill 1% silver nitrate solution in newborn’s
eyes
24
25. Genital Herpes
• Description
• Highly contagious viral infection of genitalia
• Recurs spontaneously
• Two stages
• Active with skin lesions
• Latent without symptoms
25
26. Genital Herpes
• Etiology
• HSV-1, HSV-2; latter most common genitally
• Transmitted through direct contact with
infected bodily secretions during sexual
intimacy
• Life-threatening form in infants during vaginal
birth
HSV = herpes simplex virus.
26
27. Genital Herpes
• Signs and Symptoms
• Multiple, shallow ulcerations, pustules, or
erythematous vesicles on genitals, mouth,
anus
• Erythema
• Vesicles rupture causing pain, itching
27
28. Genital Herpes
• Diagnostic procedures
• Physical exam shows lesions
• Scrapings, biopsy
• Blood test for antibodies
28
30. Genital Herpes
Complementary therapy
• Ice pack for erupted sores
• Cold compress or baking soda to soothe
• Topical cream
Client communication
• Take proper precautions; practice safer sex
• Alleviate embarrassment
30
31. Genital Herpes
• Prognosis
• No cure
• 80% with primary genital herpes have
recurrence within 12 months
• Associated with cervical cancer
31
32. Genital Herpes
• Prevention
• Avoid sexual intercourse and intimacy with
infected persons
• Use condoms
• C-section if mother is infected
32
33. Genital Herpes
• Herpes is characterized by multiple
erythematous
1. papules
2. pustules
3. vesicles
4. macules
33
34. Genital Human Papilloma (HPV)
Infection
• Description
• Most common STD
• Forty types of HPV that can infect the genital
areas
• Genital warts: circumscribed, elevated skin
lesions, usually seen on the external
genitalia or near the anus
34
35. Genital Human Papilloma (HPV)
Infection
• Etiology
• Spread by intimate sexual contact
• Pregnant women can pass the virus to the
fetus during childbirth
• Has an incubation of 1 to 6 months
35
36. Genital Human Papilloma (HPV)
Infection
• Signs and symptoms
• Most individuals are asymptomatic
• Warts can be solitary in form or in clusters
• In males warts at end of the penis or in perianal
area
• In females warts appear at vaginal entrance
• High-risk HPV can cause cervical cancer
36
37. Genital Human Papilloma (HPV)
Infection
• Diagnostic procedures
• Characteristic appearance and location
• Cervical cell changes can be found during a
Papanicolaou (Pap) smear
37
38. Genital Human Papilloma (HPV)
Infection
• Treatment
• No treatment
• A healthy immune system can deter HPV
• Warts can be removed by carbon dioxide
laser, cryosurgery, electrocautery,
debridement
• Cervical cancer is treatable if detected early
38
39. Genital Human Papilloma (HPV)
Infection
Complementary therapy
• Ointment of vitamin A and herbs may be applied
topically – wash hands after application
Client communication
• Recommend the use of condoms
• Encourage annual Pap smears
• Limit number of sexual partners
39
40. Genital Human Papilloma (HPV)
Infection
• Prognosis
• Low-risk HPV responds well to treatment
• Prognosis is variable for high-risk HPV or
cervical cancer
• Prevention
• HPV vaccine
• Annual Pap test
40
41. Trichomoniasis
• Description
• Protozoal infection of the vagina, urethra, or
prostate
• Common STD — 7.4 million new cases each
year
41
42. Chlamydial Infections
• Description
• Highly prevalent
• One of the most potentially damaging STDs in the United
States
• Etiology
• Chlamydia trachomatis through vaginal, oral, or anal sexual
contact with infected person
• Neonate exposed during delivery may develop conjunctivitis
42
43. Chlamydial Infections
• Signs and symptoms
• Silent STD; asymptomatic; transmission occurs
unknowingly
• Burning, itching in genitalia
• Mucopurulent vaginal discharge
• Discharge from penis
• Burning on urination
• Swollen scrotum
43
44. Chlamydial Infections
• Diagnostic procedures
• Cytologic, serologic studies of bodily fluids
• Treatment
• Antibiotics for both partners
44
45. Chlamydial Infections
Complementary therapy
• Diet that eliminates sugar and includes probiotics
• Multivitamins
Client communication
• Refrain from sexual activity until treatment is
completed
• Take all medications
45
46. Chlamydial Infections
• Prognosis
• Good with early treatment
• If untreated, such complications as PID, infertility in
females; epididymitis in males; sterility in both
• Prevention
• Use condoms
• Contact tracing of intimate partners
46
48. Common Signs and Symptoms of
Reproductive System Diseases and
Disorders in Males
• Urinary complaints
• Frequency, urgency, incontinence, dysuria,
nocturia
• Pain in any reproductive organ or unusual
discharge
• Swelling or enlargement of any reproductive
organs
• Any sexual disorder or concern
48
49. Benign Prostatic Hyperplasia
• Description
• An enlarged prostate caused by growth
• Cells multiply and squeeze the urethra
• Cells grow into urethra and bladder outlet
• Common over age 50
• Significant if obstructs urinary outflow
• Etiology
• Due to metabolic, hormonal changes associated with aging
49
50. Benign Prostatic Hyperplasia
• Signs and symptoms
• Difficulty initiating urination or completely
emptying bladder
• Nocturia, urinary frequency
• Dribbling, weak stream
• Incontinence
50
51. Benign Prostatic Hyperplasia
• Diagnostic procedures
• Symptoms
• Digital rectal exam
• Blood test for PSA and PAP
• Completion of AUA Prostate Symptom Index
• Uroflowmetry
PSA = prostate-specific antigen; PAP = prostatic acid phosphatase; AUA = American Urological Association.
51
52. Benign Prostatic Hyperplasia
• Treatment
• “Watchful waiting”
• Alpha blocker medications
• Thermotherapy: microwave or radio
frequency
• Transurethral prostate resection (TURP)
52
53. Benign Prostatic Hyperplasia
Complementary therapy
• Avoid caffeine, tobacco, red pepper
• Herbal remedy from saw palmetto products
• Add soy and tomatoes to diet
Client communication
• Regular prostate exams
• Discuss sexuality, impotence concerns
53
54. Benign Prostatic Hyperplasia
• Prognosis
• Good with proper intervention; 80% to 90% surgical
success rate
• Complications include cystitis, dilation of ureters,
hydronephrosis
• Prevention
• None
• Regular prostate exams
54
55. Prostatitis
• Description
• Inflammation of the prostate gland
• May be acute or chronic
• Most common in males over age 50
• Routes of infection through urethra or blood
55
56. Epididymitis
• Description
• Inflammation due to infection
• Typically unilateral
• Most common infection of male reproductive
system
• Typically affects those ages 19 to 35
56
57. Epididymitis
• Etiology
• Result of prostatitis, UTI, TB, STDs
• Chlamydia trachomatis, Neisseria gonorrhoeae
most common agents
TB = tuberculosis.
57
58. Epididymitis
• Signs and symptoms
• Epididymis becomes enlarged, hard, tender, painful
• Scrotal, groin tenderness
• Fever, malaise
• “Waddle” walk
• Diagnostic procedures
• UA with culture and sensitivity
• Ultrasound
58
59. Epididymitis
• Treatment
• Antibiotics
• Antimicrobial therapy
• If STD is cause, treat partner(s)
59
60. Epididymitis
Complementary therapy
• Scrotal support, analgesic
• Scrotal elevation, cool compress to reduce
swelling, pain
Client communication
• Take all medication, analgesics
60
61. Epididymitis
• Prognosis
• Responds well to therapy
• Epididymis may be scarred
• Sterility is threat; orchitis is a complication
• Mumps vaccine for young males to prevent
orchitis
61
64. Prostatic Cancer
• Description
• Generally classified as adenocarcinoma
• Third leading cause of cancer deaths in
males
• Tends to metastasize
• Rare before age 50
64
65. Prostatic Cancer
• Etiology
• Family or race predisposition
• Exposure to environmental elements
• Coexisting STDs
• Endogenous hormonal influence
• Eating fat-containing animal products
65
66. Prostatic Cancer
• Signs and symptoms
• Asymptomatic or symptoms of urinary
obstruction
• Dysuria, difficulty voiding
• Urinary frequency, urinary retention
• Hematuria, bone pain
• Weight loss
66
67. Prostatic Cancer
• Diagnostic procedures
• Digital rectal exam
• Biopsy
• CT scan or ultrasonography
• PSA blood test
• AMACR genetic marker
AMACR = alpha-methylacyl-CoA racemase.
67
68. Prostatic Cancer
• Treatment
• Depends on tumor stage/grade
• Surgical removal
• Hormonal therapy, radiation, chemotherapy
• “Watchful waiting” for some older clients
68
69. Prostatic Cancer
Complementary therapy
• Genistein appears to inhibit growth of prostatic
cancer
• Cryoablation
Client communication
• Explain procedures, any possibility of impotence,
potential for cure
69
71. Testicular Cancer
• Description
• Malignant neoplasm of the testis
• Affects men under age 40
• Cryptorchidism may be predisposing factor
• Cure rate of nearly 90% if caught early
71
73. Common Signs and Symptoms of
Reproductive System Diseases and
Disorders in Females
• Pre-, postmenstrual complaints
(amenorrhea, dysmenorrhea, oligomenorrhea,
metrorrhagia; skin changes; psychological
reactions to hormonal changes)
• Lower abdominal or pelvic pain
• Any abnormal vaginal discharge or itching
73
74. Common Signs and Symptoms of
Reproductive System Diseases and
Disorders in Females
• Fever
• Dyspareunia or any sexual dysfunction
• Breast changes (unusual swelling, lumpiness,
mass formation, pain, nipple abnormalities)
• Bloating or fullness
74
75. Premenstrual Syndrome
• Description
• Distinct cluster of physical, psychological
symptoms; regularly recur 3 to 14 days
before menses; relieved by onset
• 30% to 40% experience mild to severe PMS
• More frequent in 30s and 40s
PMS = premenstrual syndrome.
75
78. Premenstrual Syndrome
• Diagnostic procedures
• Depends on timing of symptoms
• Keep journal for 3 months to document
• Blood levels of estrogen, progesterone
• History and physical examination
78
79. Premenstrual Syndrome
• Treatment
• Multivitamin with high folic acid, calcium, and vitamin D
• Reduce salt intake 2 weeks prior to menses
• Diuretics, analgesics
• Avoid coffee, nicotine, alcohol, simple sugars
• Proper diet, exercise, rest
79
80. Premenstrual Syndrome
Complementary therapy
• Daily exercise
• Relaxation programs
• Vitamin B6, vitamin E, calcium, magnesium, zinc
• Acupuncture
Client communication
• Encourage support from family, friends
80
82. Dysmenorrhea
• Description
• Pain associated with menstruation
• Primary: not associated with identifiable pelvic
disorder
• Secondary: there is underlying pelvic pathology or
disease
• More common in women with early onset of
menses
82
83. Ovarian Cysts and Tumors
• Description
• Cysts derived from ovarian follicles that do not open
to release ovum
• Occur from puberty to menopause
• True ovarian neoplasms may be benign (teratomas),
ovarian, or polycystic
• PCOS is a complex endocrine disorder in females in
reproductive years
PCOS = polycystic ovarian syndrome.
83
84. Ovarian Cysts and Tumors
• Etiology
• Unknown
• Genetics, especially in PCOS
• Defects in ovary
• Hypothalamus–pituitary dysfunction
• Irregular menstrual cycles
84
85. Ovarian Cysts and Tumors
• Signs and symptoms
• Asymptomatic with small cysts
• Large cysts produce pelvic pain, lower-back
pain
• Dyspareunia
• Spasmodic abdominal pain
• Fever and vomiting
85
86. Ovarian Cysts and Tumors
• Diagnostic procedures
• Ultrasonography
• CT scan
• Blood tests for hormone levels
86
87. Ovarian Cysts and Tumors
• Treatment
• Cyst may disappear spontaneously
• Drug-induced ovulation therapy
• Surgical resection
• Oral contraceptives to regulate periods,
encourage ovulation
87
88. Ovarian Cysts and Tumors
• Ovarian cysts derive from the
1. fimbriae
2. epithelium
3. endometrium
4. follicles
88
89. Ovarian Cysts and Tumors
Complementary therapy
• Exercise, weight control
• Vegetarian diet with organic foods
• Avoid fried foods, coffee, tobacco, alcohol, sugar
Client communication
• Educate about disease process
• Offer support if infertility results
89
91. Endometriosis
• Description
• Growth of endometrial tissue in areas
outside the endometrium
• Responds to hormonal signals but no tissue
sloughing
• May lead to scarring of ectopic site
91
92. Endometriosis
• Etiology
• Unknown, perhaps familial
• Endometrial tissue gets into blood or lymph
• Dioxin exposure
92
93. Endometriosis
• Signs and symptoms
• Dysmenorrhea, profuse menses
• Pain in lower back, vagina
• Pain at ectopic site during menses
• Dyspareunia
• Dysuria
93
94. Endometriosis
• Diagnostic procedures
• History and physical examination
• Laparoscopy
• Palpation
• Staged from 1 (superficial to minor lesions)
to 4 (deep involvement, dense adhesions)
94
95. Endometriosis
• Treatment
• Depends on symptoms, desire to have child,
stage of disease
• Hormone therapy; pain medications
• Surgery
95
96. Endometriosis
Complementary therapy
• Increase essential fatty acids
• Reduce intake of meat, eggs, dairy products
Client communication
• Client support
96
97. Endometriosis
• Prognosis
• Varies with location of ectopic site, severity
of symptoms
• Infertility
• Prevention
• None
97
98. Pelvic Inflammatory Disease
• Description
• Acute or subacute infection of the uterus,
fallopian tubes, or ovaries
• May be recurrent or chronic
98
99. Pelvic Inflammatory Disease
• Etiology
• Infections from Neisseria gonorrhoeae or
Chlamydia trachomatis
• Infections following parturition
• Iatrogenic
99
100. Pelvic Inflammatory Disease
• Signs and symptoms
• Often asymptomatic, but damage occurs
• Symptoms include
• Sudden pelvic pain
• Purulent, foul-smelling discharge
• Fever
• Sexual dysfunction
• Metrorrhea
• Rebound pain
100
101. Pelvic Inflammatory Disease
• Diagnostic procedures
• Difficult to diagnose
• Smear of uterine secretions for culture
• ESR, WBC
• C-reactive protein (CRP) in the blood
• Ultrasonography
ESR = erythrocyte sedimentation rate; WBC = white blood cell.
101
103. Pelvic Inflammatory Disease
Complementary Therapy
• Abstinence during the infectious stage
• Acupuncture for pain
• Multivitamins and vitamin C
• Castor oil packs warmed and placed on the lower abdomen
Client Communication
• Remind client of the importance of taking all medication
• Educate about possible complications
103
104. Pelvic Inflammatory Disease
• Prognosis
• Good with early treatment
• Delayed treatment may result in formation of
scar tissue and adhesions
• Prevention
• Prompt treatment of an STD
104
105. Menopause
• Description
• Not a disease
• Cessation of menses, ovarian function due to
decrease in estrogen levels
105
106. Menopause
I used to have Saturday night
fever; now I have Saturday night
hot flashes.
—Maxine
106
107. Menopause
• Etiology
• Occurs between ages 45 and 55
• Surgically induced by oophorectomy
• Also induced by malnutrition, severe stress,
or disease with hormonal imbalance
107
108. Menopause
• Signs and symptoms
• Menstrual irregularities; flow decreases, then
ceases
• Occurs over months or years
• Night sweats, hot flashes
• Syncope
• Tachycardia
• Loss of skin elasticity
• Transient psychological symptoms
108
109. Menopause
• Diagnostic procedures
• History and physical examination
• Screening of blood serum levels of
estradiol, FSH, LH
FSH = follicle-stimulating hormone; LH = luteinizing hormone.
109
110. Menopause
• Treatment
• No treatment or some require HRT
• Antidepressants may lessen symptoms
HRT = hormone replacement therapy.
110
112. Menopause
• Prognosis
• Good; recognize mood swings
• Postmenopausal women may suffer bone
loss and cholesterol changes
• Prevention
• None
112
113. Menopause
• Menopause can be surgically induced
by
1. oophorectomy
2. oophorotomy
3. salpingectomy
4. hysterectomy
113
114. Ovarian Cancer
• Description
• Sixth most common cancer among females
• Risk decreases by 60% for women who take
oral contraceptives for longer than 5 years
• “Silent killer”
114
115. Ovarian Cancer
• Etiology
• Exact cause is unknown
• Contributing factors
• Familial tendency
• HRT with only estrogen
• Obesity
• Use of androgens to treat endometriosis
• Increased risk for women who carry BRCA1,
BRCA2, BNC2, or HNPCC genes
HNPCC = hereditary nonpolyposis colorectal cancer.
115
116. Ovarian Cancer
• Signs and symptoms
• Urinary urgency
• Pelvic pain
• Abdominal pressure
• Fullness and bloating
• Persistent indigestion or nausea
• Change in bowel habits
116
117. Ovarian Cancer
• Signs and symptoms (cont.)
• Loss of appetite
• Increased abdominal girth
• Dyspareunia
• Lack of energy
• Low back pain
• Changes in menstruation
117
118. Ovarian Cancer
• Diagnostic procedures
• Clinical evaluation
• Complete history and physical
• Transvaginal sonography
• Abdominal ultrasound
• CT scan
• Test for HE4 biomarker
• Test for protein CA125
118
119. Ovarian Cancer
• Treatment
• Dependent on grading and staging
• Surgery to remove tumor
• Chemotherapy
• Immunotherapy
• Drug Avastin
119
120. Ovarian Cancer
Complementary therapy
• Controlled amino acid therapy
• Green tea and ginger capsules for nausea
• Acupuncture, meditation, and aroma therapy
Client communication
• Educate clients about staging, typing of cancer, and
subsequent treatment plans
• Encourage reporting of treatment side effects
120
121. Ovarian Cancer
• Prognosis
• Dependent upon type and stage of cancer when diagnosed
• Early detection has a 95% 5-year survival rate
• If progressed, survival rate is less than 35%
• Prevention
• Yearly pelvic exam
• Genetic testing
• Factors that reduce risk are oral contraceptives, breast feeding
after pregnancy, tubal ligation or hysterectomy
121
122. Fibrocystic Breasts
• Description
• Palpable lumps, cysts that fluctuate in size
with menses
• Fluid-filled round or oval cysts, fibrosis, and
hyperplasia of the cells lining the milk ducts
• Ages 30 to 55
122
124. Fibrocystic Breasts
• Signs and symptoms
• Most frequent in upper, outer quadrant of
breast
• Widespread lumpiness or localized mass
• Pain, tenderness, feeling of fullness before
menses
• Fluctuating size
• Nonbloody nipple discharge (rare)
124
125. Fibrocystic Breasts
• Diagnostic procedures
• Monthly breast self-exam
• Mammogram
• Ultrasound
• Biopsy for suspicious area
125
126. Fibrocystic Breasts
• Treatment
• Severe pain or large cysts may require
• Needle aspiration
• Analgesics
• Supportive bra to alleviate pain
• Restricting caffeine and salt
126
127. Fibrocystic Breasts
Complementary therapy
• Evening primrose oil, 1 capsule 3 times a day
• Removal of caffeine
Client communication
• Teach breast self-exam to determine “normal”
from “abnormal” lumps
127
128. Fibrocystic Breasts
• Prognosis
• Good
• Exacerbations may continue until
menopause
• Prevention
• Monthly breast self-exams
• Regular mammography
• Reduce caffeine in diet
128
129. Carcinoma of the Breast
• Description
• Variety of malignant neoplasms of the breast
• Usually begins in milk-producing glands
• Most common site of cancer in females
129
130. Carcinoma of the Breast
• Etiology
• Unknown
• Hereditary
• Higher in women with biopsy-confirmed
atypical hyperplasia, a long menstrual
history, obesity after menopause, smoking
• High-fat diet; little or no exercise
130
131. Carcinoma of the Breast
• Signs and symptoms
• Abnormality on mammogram
• Breast changes such as lump, thickening,
dimpling, swelling, skin irritation, distortion
• Nipple discharge
• Pain, tenderness
131
132. Carcinoma of the Breast
• Diagnostic procedures
• Monthly breast self-exam
• Mammogram
• Ultrasound, CT, and MRI
• Biopsy
• Staging, typing
MRI = magnetic resonance imaging.
132
133. Carcinoma of the Breast
• Treatment
• Depends on stage, type
• Surgery: lumpectomy or mastectomy
• Radiation, chemotherapy
• Hormone therapy
133
134. Carcinoma of the Breast
Complementary therapy
• Enhance immune system
• Acupuncture, massage, Reiki, tai chi, yoga
Client communication
• Educate about all types of treatment
• Refer to support system
134
135. Carcinoma of the Breast
• Prognosis
• In early stages, prognosis is good, especially
without metastasis
• Prevention
• Breast self-exam, regular mammography
135
136. Common Symptoms of Diseases
and Disorders of Pregnancy and
Delivery
• Abdominal pain, tenderness, cramping
• Unusual discharge, pink or brown in color,
or clotted
• Hypertension, rapid weight gain, edema
• Malaise
136
137. Spontaneous Abortion
• Description
• Also called miscarriage
• Expulsion of the fetus before the 20th week of
pregnancy
• Incidence is higher in first pregnancy
• Risk higher in women over age 35
137
138. Ectopic Pregnancy
• Description
• Fertilized ovum implants, grows somewhere
other than uterine cavity
• Usually within one fallopian tube
138
139. Ectopic Pregnancy
• Etiology
• Scarring, inflammation of fallopian tubes as
result of infection
• Congenital tube malformation
• Endometriosis, PID, tumors
139
140. Ectopic Pregnancy
• Signs and symptoms
• Signs of early pregnancy
• Abdominal pain, tenderness
• Slight vaginal bleeding
• If tube ruptures, severe abdominal pain,
intra-abdominal bleeding
140
141. Ectopic Pregnancy
• Diagnostic procedures
• Pelvic exam
• History and physical examination
• Serum pregnancy test
• Ultrasound
• Laparoscopy, exploratory laparotomy
141
143. Ectopic Pregnancy
Complementary therapy
• None
Client communication
• Support during diagnosis, treatment
phases
143
144. Ectopic Pregnancy
• Prognosis
• With rupture, complications can be life-
threatening: hemorrhage, shock, peritonitis
• Prevention
• Prompt treatment of any GU infection
144
145. Pregnancy-Induced
Hypertension
• Description
• PIH disorder develops during third trimester
• Occurs more frequently in primigravidae, ages 12 to
18 or older than age 35 with multiple births
• Preeclampsia is the nonconvulsive form
• Eclampsia is the convulsive form with coma
145
149. Pregnancy-Induced
Hypertension
• Treatment
• Preeclampsia: prevent eclampsia, deliver
normal baby, rest, antihypertensives
• Eclampsia: hospitalized with intensive care
• Goal is to manage delivery until 32 to 34
weeks into pregnancy; then cesarean
delivery
149
150. Pregnancy-Induced
Hypertension
Complementary therapy
• None
Client communication
• Stress importance of rest during preeclampsia
• Support during labor, delivery
150
151. Pregnancy-Induced
Hypertension
• Prognosis
• Good with preeclampsia
• In eclampsia, maternal mortality rate is 15%
• Prevention
• Adequate nutrition
• Good prenatal care
• Control of blood pressure during pregnancy
151
153. Placenta Previa
• Description
• Placenta is implanted abnormally low in the
uterus so that it covers all or part of the
cervical os
• Placenta may prematurely separate from the
uterus causing maternal hemorrhage and
interrupting oxygen flow to the fetus
153
154. Credits
Publisher: Margaret Biblis
Acquisitions Editor: Andy McPhee
Developmental Editor: Yvonne Gillam, Julie Munden
Backgrounds: Joseph John Clark, Jr.
Production Manager: Sam Rondinelli
Manager of Electronic Product Development: Kirk Pedrick
Electronic Publishing: Frank Musick
The publisher is not responsible for errors of omission or for consequences from application of information in this presentation,
and makes no warranty, expressed or implied, in regard to its content. Any practice described in this presentation should be
applied by the reader in accordance with professional standards of care used with regard to the unique circumstances that may
apply in each situation.
154
