LAGRIMAS, Kathleen Kay V.
MODULE 3: structural/functional and menstrual disorder
Disorder Signs and symptoms Diagnostics Management
Structural/functional disorder
cystocele Pelvic pressure cystourethrogram Medical Treatment:
Is a downward Fatigue
displacement of the Urinary incontinence, Pessary can be used to avoid
bladder toward the frequency and surgery. This device is inserted
vaginal orifice, urgency. into the vagina and positioned to
resulting from damage Back pain and pelvic keep an organ, such as bladder,
to the anterior vaginal pain may occur as uterus, or intestine, properly
support structures. well aligned when cystocele has
occurred.
Surgical Treatment:
anterior colporrhaphy is the
procedure to repair the anterior
vaginal wall.
Nursing Management:
Teach Kegel exercises, which
involve contracting or tightening
the vaginal muscles, are
prescribed to help strengthen
the weakened muscles. These
exercises are more effective in
the early stages of cystocele.
enterocele Vaginal discomfort intravenous Medical Treatment:
Is a protrusion of the Backache pyelogram (IVP) for
intestinal wall into the Abdominal pain cases of severe Pessary can be used to avoid
vagina. Diarrhea prolapse to rule out surgery. This device is inserted
Constipation hydronephrosis into the vagina and positioned to
Bowel obstruction keep an organ, such as bladder,
uterus, or intestine, properly
aligned.
Colpexin is another nonsurgical
device used to treat pelvic organ
prolapse.
Surgical Treatment:
Transvaginal Enterocele Repair
provides the best route of repair
and offers the greatest
likelihood of permanent
correction of the enterocele.
Nursing Management:
Teach Kegel exercises, which
involve contracting or tightening
the vaginal muscles, are
prescribed to help strengthen
the weakened muscles.
rectocele Rectal pressure rectovaginal Medical Treatment:
Is an upward pouching exam
of the rectum that Pessary can be used to avoid
pushes the posterior surgery. This device is inserted
wall of the vagina into the vagina and positioned to
forward. keep an organ, such as bladder,
uterus, or intestine, properly
aligned.
Colpexin is another nonsurgical
device used to treat pelvic organ
prolapse.
Surgical Treatment:
Posterior colporrhapy is a
surgery to repair a defect in
vaginal wall due to pelvic
prolapsed.
Nursing Management:
Teach Kegel exercises, which
involve contracting or tightening
the vaginal muscles, are
prescribed to help strengthen
the weakened muscles.
Uterine displacement Prolapse Medical Treatment:
In retroversion, the Backache
uterus tips backward Menstrual pain Pessaries may be the treatment
and also possibly Constipation of choice in elderly women or
sags downward. In those who are too ill to tolerate
Retroversion surgery
prolapse, the uterus
Most cases are
settles downward; symptomless.
sometimes the Surgical Treatment:
displacement is so
In post menopausal women, the
extreme that the
uterus may be removed
organ's narrow outer
(hysterectomy) or repaired by
end (cervix) juts out colpopexy.
from the vulva, and
may even drag down Colpocleisis, or vaginal closure,
with it part of the may be an option for women
rectum and bladder. who do not wish to have sexual
Prolapse is more intercourse or to bear children
common after the
"change of life"
(menopause) than and want to avoid hysterectomy.
before.
Nursing Management:
Advise to avoid lifting heavy
objects or standing more than
necessary while at work. She
should build up her general
health with balanced diet,
moderate exercise, and plenty of
rest.
Uterine deviation Medical Treatment:
Surgical Treatment:
Nursing Management:
Infertility Serum Medical Treatment:
Defined as a couple’s progesterone
inability to achieve level Gonadotropin treatment may
pregnancy after 1 year Ovulation index also be used if conception does
of unprotected HSG not occur.
intercourse. Laparoscopy
Analysis of semen Artificial insemination is the
(male) deposit of semen into the female
FSH and LH levels genital tract by artificial means.
(male)
In vitro fertilization is
accomplished by first stimulating
the ovary to produce multiple
eggs or ova, usually with
medications, because success
rates are greater with more than
one embryo. Sperm and eggs
are coincubated for up to 36
hours, and the embryos are
transferred about 48 hours after
retrieval. Implantation should
occur in 3 to 5 days.
Surgical Treatment:
Nursing Management:
Assisting in reducing stress in
the relationship, encouraging
cooperation, protecting privacy,
fostering understanding and
referring the couple to
appropriate resources when
necessary.
Smoking cessation
Advising couple to consider
adaption.
Endometriosis Dysmenorrheal Bimanual pelvic Medical Treatment:
A benign lesion or Dyspareunia examination,
lesion with cells similar Pelvic discomfort, fixed tender Palliative measures include use
to those lining the pain nodules are of medications, such as
uterus grow aberrantly Dyschezia (pain sometimes analgesic agents and
anywhere in the pelvic with bowel palpated
cavity outside the movements) Laparoscopic prostaglandin inhibitors, for
uterus. Infertility may examination pain.
occur because of
fibrosis and Hormonal therapy
adhesions
danazol (Danocrine)
Surgical Treatment:
laparoscopy may be used to
fulgurate (cut with high-
frequency current)
total hysterectomy is an option
Nursing Management:
health history and physical
examination
explaining the various diagnostic
procedure to alleviate the
patient’s anxiety
dispel myths and encourage
patient to seek care
Menstrual disorder
amenorrhea absent menstrual physical Medical management:
absence of menstrual periods examination
flow reduced menstrual vaginal treat underlying cause
is a symptom of period flow examination dopamine antagonist
variety of disorders pregnancy test Hormone replacement therapy
and dysfunctions serum prolactin Surgical management:
Treatment is directed toward
correcting any abnormalities.
Nursing management:
The nurse encourages the
patient to express her concerns
and anxiety about this problem
because the patient may feel
that she is different from her
peers.
Oligomenorrhea Short menstrual History Medical management:
A medical term that period Physical
refers to light or Infrequent examination cyclic progestin or oral
infrequent menstrual menstrual period contraceptives
periods Very light
menstrual period Nursing management:
The nurse encourages the
patient to express her concerns
and anxiety about this problem
because the patient may feel
that she is different from her
peers.
PMS Headache If symptoms Medical management:
Is a combination of Fatigue occur during the 5 Serotonin uptake inhibitors
bothersome Low back pain days prior to the GnRH agonist
symptoms, and Painful breasts onset of menses, Prostaglandin inhibitors
premenstrual disappear within 4 Oral contraceptive containing
Feeling of
dysphoric disorder. days of the onset drospirenone
abdominal of menses, and Vitamin B and E, magnesium
fullnes occur through
several cycles. Nursing management:
Advise regular exercise
Advise to avoid caffeine, high fat
foods, and refined sugars
menopause Irregular menses When ovulation Medical management:
Is the permanent Breast tenderness occurs less Hormone therapy
physiologic cessation Mood changes frequently, Alternative therapy for hot
of menses associated Hot or warm estrogen levels flushes
with declining ovarian flushes fluctuate, and Maintaining bone health
function Night sweats FSH levels Nutritional therapy
Fatigue increase in an
Sleep attempt to
disturbances stimulate Nursing management:
estrogen Nurse encourages women to
view menopause as a natural
change resulting in freedom
from symptoms related to
menses.