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Nursing Care of a FamilyWhen a Child Has a

Reproductive Disorder Reporter:

Kathryne Miguel

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ALTE RE D R EP RODUC TIVE

DEVEL

OPME

NT

Amb iguous genitalia Hypospadias

Cryptochidism-

undecended testicle Congenital adrenocortical syndro m e Intersexed (her m aphrodite) person who has b oth

fe m ale and m ale genitalia. Pseudoher m aphrodites

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Hypospadias

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Cr yptochidism

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Precocious pu b erty Assess m ent Therapeutic m anage m ent

Delayed pu b erty

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REP RODUC TIVE DIS ORD E RS INMALES

B alanitis Phi m osis

Cryptorchidis m Hydrocele Varicocele

Testicular torsion Testicular cancer

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b alantitis

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phimolis pa r aphimolis

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Hydrocele

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Testicular torsion

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VA R ICOC ELE

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FEMALE REP RODUC TIVE DIS ORD E RS

Toxic shock syndro m e

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Toxic shock syndrome

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F e m ale Circu m cision Im perforate Hy m en

Vulvovaginitis PID

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Vulvovaginitis

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ME NST RU AL DIS ORD E RS

Am enorrhea Types: pri m ary or secondary Etiology: m ultiple causes Therapeutic m anage m ent: dependent on cause Nursing assess m ent: history and physical

exa m ination; la b oratory and diagnostic testing (ultrasound, hor m one levels, CT scan to rule outtu m or)

Nursing m anage m ent: counseling, education

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ME NST RU AL DIS ORD E RS (CON TD)

Dys m enorrhea Types: pri m ary or secondary Etiology

Increased prostaglandin production (pri m ary) Pelvic or uterine pathology (secondary) Endo m etriosis m ost co mm on cause of secondary

dys m enorrhea

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ME NST RU AL DIS ORD E RS (CON TD) Dys m enorrhea (contd)

Therapeutic m anage m ent: pain relief, coping strategies

Nursing A

ssessm

ent Past m edical history, sexual history, m enstrual history;b im anual pelvic exa m ination

Manifestations: pain, nausea, vo m iting diarrhea, fatigue,fever, headache, dizziness; b loating, water retention,weight gain, m uscle aches, food cravings, b reasttenderness

La b oratory and diagnostic tests

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ME NST RU AL DIS ORD E RS (CON TD)

Dys m enorrhea (contd)

Nursing Managem

ent Education (see Teaching Guidelines 4 -3 ) Com fort m easures: heat, lifestyle changes Ad m inistration of m edications (NS AIDs, low -dose oral

contraceptives)

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ME NST RU AL DIS ORD E RS (CON TD) Dysfunctional Uterine B leeding

Sim ilar to and m ay overlap with other uterine b leeding disorders:

Menorrhagia Oligo m enorrhea Metrorrhagia Meno m etrorrhagia Poly m enorrhea

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ME NST RU AL DIS ORD E RS (CON TD) Dysfunctional Uterine B leeding (contd)

Etiology: nu m erous causes Therapeutic m anage m ent

Medications: estrogens, progestins, oral contraceptives,NS AIDs, levonorgestrel -20 intrauterine syste m , iron salts

Surgery: D&C, endo m etrial a b lation, hysterecto m y

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ME NST RU AL DIS ORD E RS (CON TD)

Dysfunctional Uterine B leeding (contd) Nursing Assess m ent

History and physical exa m ination Clinical m anifestations: vaginal b leeding b etween

periods, irregular m enstrual cycles, infertility, m oodswings, hot flashes, vaginal tenderness, varia b lem enstrual flow, o b esity, acne, and dia b etes

Signs and sy m pto m s of ane m ia La b oratory and diagnostic tests

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MEN

STRU

ALD

ISORD

ER

S(CON

TD)

Dys m enorrhea (contd)

Nursing m

anagem

ent Education Medication m anage m ent F ollow -up (see Nursing Care Plan 4 -1 )

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ME NST RU AL DIS ORD E RS (CON TD)

Pre m enstrual Syndro m e Wide range of recurrent sy m pto m s More severe variant: Pre m enstrual dysphoric disorder

(PMDD) Etiology: unknown Therapeutic m anage m ent

Multidi m ensional approach

Vitam

in supplem

ents, diet changes, exercise, lifestyle,m edications

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ME NST RU AL DIS ORD E RS (CON TD)

Pre m enstrual Syndro m e (contd) Nursing Assess m ent: irrita b ility, tension, dysphoria ( m ost

pro m inent and consistent sy m pto m s) A: anxiety C: craving D: depression H: hydration O: other

ACOG criteria Mood disorders: m ain sy m pto m s of PMDD

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ME NST RU AL DIS ORD E RS (CON TD) Pre m enstrual syndro m e (contd)

Nursing m anage m ent Education Diet, exercise Medications (NS AIDs, spironolactone) Counseling, stress m anage m ent Comm unity resources and support

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ME NST RU AL DIS ORD E RS (CON TD)

Endo m etriosis

Etiology: risk factors; exact cause unknown Therapeutic m anage m ent

Surgery Medication therapy (see Ta b le 4 -2 )

Nursing Assess m ent: infertility and pain; nonspecific pelvictenderness; tender nodular m asses on uterosacralliga m ents, posterior uterus, or posterior cul -de -sac

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ME NST RU AL DIS ORD E RS (CON TD)

Endo m etriosis (contd)

Nursing m anage m ent Education Healthy lifestyle ha b its Support groups

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endometriosis

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B REAST DIS ORD E RS

Accessory Nipples B reast Hypertrophy

B reast Hypoplasia B reast Tenderness F at Necrosis

F ib rocystic B reast Disease F ib roadeno m a Mastitis

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A ccesso r ynipples

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hype r t r ophy

hypoplasia

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hermaprodite

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S exually transmitted infection

Candidiasis Tricho m oniasis B acterial vaginosis Chla m ydia tracho m atis infection Hu m an papillo m avirus Herpes genitalis Hepa B and C Gonorrhea Syphilis Group B streptococcal infection Hu m an i mm unodeficiency Virus (HIV)

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candidaisis

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chlamydia

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syphilis

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Human papillomavirus

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He r pes genitalis

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S exually t r ansmitted disease

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fib roadneoma

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endometriosis