Académique Documents
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Peyton Brown
Leiomyomas or myomas
Pelvic Discomfort
Pelvic Pain
Bladder Problems
Rectal Pressure
Dyspareunia
Fibroids Cont
Ultrasound
Saline Hysterosonography
Hysteroscopy
IUD-bleeding
Myomectomy
Hysterectomy
Clinical Signs/Symptoms
Begins after menarche
Infertility
Irregular menstrual periods
Oligomenorrhea
Obesity
Hirsutism
Acne
Acanthosis nigricans
Skin tags
Alopecia
How is it treated?
No cure for PCOS
PCOS tends to be treated based on the symptoms that the patient presents
Infertility
First line treatment for ovulation induction: anti-estrogen clomiphene citrate (CC)
Improves secretion of gonadotropins
Exogenous gonadotropins: for whom CC treatment has failed
Oligomenorrhea
Combination of oral contraceptives: suppress the secretion of pituitary luteinizing
hormone and ovarian androgen; increases sex hormone-binding globulin
Hirsuitism
Spironolactone: diuretic, aldosterone antagonist, ovarian and adrenal
steroidogenesis inhibitor
Primary
No Menses by age 14 and
no secondary sex
characteristics OR
No menses by age 16 with
secondary sex
characteristics
Primary
Possible Causes?
Body build, minimal fat
Hereditary, family history of delay
Pituitary function, lack of LH or FSH
Congenital absence of Vagina
Management
Treat the underlying condition
Provide emotional support
Secondary
No menses for 6
months in a woman
who normally has a
menstrual cycle
Secondary
Possible causes?
Pregnancy
Lack of ovarian production
Polycystic ovarian syndrome
Nutritional or endocrine disturbances
Uncontrolled diabetes
Heavy athletic activity
Emotional distress
Management
Treat underlying condition
Explain Cause
Diagnosis
Take a sample from site of infection (nose, vagina or skin)
Blood sample
Blood tests to monitor kidney or liver function and to rule
out other causes.
Treatment
Start IV fluids and antibiotics
Remove tampon, contraceptive or wound packing and
clean the wound
Can be fatal, curable if recognized and treated early
Nursing Actions
The patient will usually be in the hospital for a few days
Monitor blood pressure and breathing
Signs of organ damage
Monitor wound for infection
Dysuria
Frequency
Urgency
Dehydration (secondary to increased
urinary output)
Bacteriuria
Suprapubic discomfort
Can lead to pyelonephritis
Pyelonephritis
Chills
Flank pain
CVA tenderness
Pyuria
Hematuria
Fever
Nausea
Vomiting
Proteinuria
Urosepsis
Diagnosis
Physical Examination
CVA tenderness
Examine urine
Temperature
Pelvic examination
Testing
Urinalysis
Urine dipstick
Urine culture
Pyelonephritis >10000 CFUs
Cystitis > 1000 CFUs
CT scan
Ultrasonography
Treatment
Pyelonephritis
Cystitis
Diagnosis
Clinical Breast Exam
manual examination of breast tissue and
lymph nodes in neck and underarm area
if changes found- will have another exam after
menstrual period.
If not related to menstrual period:
Mammogram-x-ray for abnormal thickening or
bump
Ultrasound- distinguish between solid masses
and cysts
Breast Biopsy- test of breast tissue
Treatment
If no symptoms- no treatment!
If severe pain:
over the counter of prescription pain
medication
large cysts:
fine needle aspiration: draining cyst to remove
discomfort
Surgical excision: if cyst does not resolve
following aspiration
Oral contraceptive may decrease fibrocystic
breast changes
References:
The American College of Obstetricians and Gynecologists. (2015). Dysmenorrhea: Painful periods frequently asked questions. Retrieved April 26, 2015,
from http://www.acog.org/-/media/For-Patients/faq046.pdf?dmc=1&ts=20150426T1943557270
Barclift, S. (2014). Premenstrual syndrome (PMS) factsheet. Retrieved April 24, 2015, from Womenshealth.gov website:
http://womenshealth.gov/publications/our-publications/fact-sheet/premenstrual-syndrome.html
Dewailly, D., Lujan, M. E., Carmina, E., Cedars, M. I., Laven, J., Norman, R. J., & Escobar-Morreale, H. F. (2014). Definition and significance of polycystic ovarian morphology: a task force
report from the Androgen Excess and Polycystic Ovary Syndrome Society. Human Reproduction Update, 20(3), 334-352. doi:10.1093/humupd/dmt061
Disease and conditions: Fibrocystic breasts. (2013). Retrieved from: http://www.mayoclinic.org/diseases-conditions/fibrocystic-breasts/basics/treatment/con-20034681
Hirsch, L. (2014, June 1). Toxic Shock Syndrome. Retrieved April 25, 2015, from http://kidshealth.org/parent/infections/bacterial_viral/toxic_shock.html#
Madnani, N., Khan, K., Chauhan, P., & Parmar, G. (2013). Polycystic ovarian syndrome. Indian Journal Of Dermatology, Venereology & Leprology, 79(3), 310-321.
doi:10.4103/0378-6323.110759
Moroni, R., Vieira, C., Ferriani, R., Candido-Dos-Reis, F., & Brito, L. (2014). Pharmacological treatment of uterine fibroids. Annals of Medical and Health Sciences Research, 4(Suppl 3), S18592. doi:10.4103/2141-9248.141955
Patel, A., Malik, M., Britten, J., Cox, J., & Catherino, W. H. (2014). Alternative therapies in management of leiomyomas. Fertility and Sterility, 102(3), 649-655.
doi:10.1016/j.fertnstert.2014.07.008