Copyright © 2014. F.A.

Davis Company
The learner will be able to
} Define key terms
} Identify factors that place a woman at risk for
adverse health conditions
} Discuss preventative screenings for women
across the life span
} Describe how lifestyle factors such as diet,
exercise, and cigarette smoking influence the
health of women
} Discuss the effect of obesity on women’s health
} Discuss the physical and emotional changes
related to perimenopause and menopause
} Health promotion is the process of enabling
people to increase control over, and to improve,
their health (WHO, 2010).

} The focus of nursing care is directed at

providing women with information and
resources that will enable them to increase
control over, and improve, their health.
} Leading causes of death in women in the US
◦ Heart disease—24.5%
◦ Cancer—21.7%
– (Breast #1, 13%, lung/bronchus, and colon/rectum)
◦ Stroke—6.5%
◦ Chronic lower respiratory disease—5.9%
◦ Alzheimer’s disease—4.6%
◦ Unintentional injuries—3.5%
◦ Diabetes—2.8%

◦ Why is Breast cancer so high, compared to other

countries? “E”
} Uncomfortable pressure, squeezing, fullness,
or pain in the center of the chest
} Pain or discomfort in one or both arms, back,
neck, jaw, stomach, and/or shoulder pain.
} Shortness of breath with or without chest
discomfort
} Nausea
} SOB
} Lightheadedness
} Sudden onset of
numbness or weakness
in the face, arm, and/or
leg, especially on one
side
} Sudden onset of trouble
seeing out of one or
both eyes
} Sudden onset of trouble
walking, dizziness, loss
of balance or
coordination
} Severe headache with
no known cause
The leading cause of death for females ages 15 to
24 is:
A. Homicide
B. Pneumonia
C. Septicemia
D. Unintentional injuries
} D
} Rationale: The leading cause of death among
wome age 15-24 regardless of race is
UNINTENTIONAL INJURIES
} Actions for reducing risks and promoting health
◦ Follow guidelines for routine screenings and
immunizations
– HPV vaccine (Gardasil): ages 9-26, 3-shot series (N, 1, 6 m)
– What cancer does HPV cause?
– Breast cancer screening: Teach Self Breast Exam
– When/Time woman should perform BSE?
– Mammograms every year, starting age 40
– Cervical cancer screening
– Starting age 21 (despite what you hear ), q3 years if last normal
– Colonoscopy
– Every 10 years, starting at age 50
– Blood glucose testing: based on DM risk factors (which are?)
– Eat a healthy diet: whatever that means
– Be physically active: x3-5/week for 30 min
– Maintain a healthy BMI <25
– Avoid cigarette smoking/Limit alcohol
– Prevent injury from accidents
– Prevent sexually transmitted illnesses
– How do we best do this?
Obesity places a woman at higher risk for:
} Coronary heart disease
} Type 2 diabetes

} Cancer: endometrial, cervical and breast

} Low back pain

} Knee osteoarthritis
} Abnormal menstrual cycle and sub-infertility
} High risk pregnancies: diabetes and hypertension

} Neonatal mortality/malformations
} Puberty
◦ Onset usually occurs between the ages of 8 and 13
◦ Triggered by the production of gonadotropin-
releasing hormone
◦ Secondary sex characteristics
◦ Menarche: initial menstrual period
– Occurs 2-2.5 years after puberty begins
◦ Menstrual cycle
} Physiology: decline in production of estrogen,
marks permanent cessation of menses.

} Treatment of symptoms and discomforts

– Lifestyle changes: Sleep, diet, exercise,
limit caffeine, alcohol, smoking
– Alternative medicine: herbs, acupuncture,
biofeedback, hypnosis, soy-> E
– Hormone replacement therapy (HRT)
– Which hormone do we replace?
– Higher risk:
– Breast CA, DVT, Stroke, CVD
} Irregular periods (longer/shorter…then cease)
} Hot flashes: Dress in layers, fans, avoid trigger
foods/drinks (coffee, ETOH)
} Night sweats: cotton, fan, cool shower before bed
} Sleep disturbances: room dark, quiet, cool,
routine (sleep later-sleep training)
} Vaginal dryness: water based lubricants, estrogen
} Mood changes and trouble focusing
} Also: decreased interest in sex, fatigue, hair loss,
incontinence, irregular heartbeat (palpitations)
Every woman experience MP differently*
} 1st stage: Peri-menopause
} Can last several years (1-5 years)
} Will have longer/shorter menses.
} S/S-may wants to treat sx (i.e., hot flashes)
} Still possible to become pregnant in this
stage
} NOT the cessation of menses
} 2nd stage: Menopause
} MP=NO Menses x12 months
} Dx retrospectively
} NO menses = NO pregnancy (?)
} Average age is 51 in U.S

} 3rd stage: Post-menopause

} Refers to the time after menopause
} Osteoporosis is loss of bone mass that occurs
when more bone is absorbed than new body
mass is laid down.
} Osteoclast > Osteoblast activity
} Loss of bone mass greatest after age 65
} S/S: Back pain, loss of height, stooped posture,
Bone fractures
} Diagnosis:
◦ DEXA scan T score > -2.5
 } Woman with
osteoporosis who
suffer a vertebral or
hip fracture, have a
50% chance of dying
within 1 year.

} Prevent Fx
} Give Rx

DEXA scan measures

Mortality Statistic
density
} Risk factors: ◦ Low levels of Calcium
} 80% of Americans Dx’d and Vit D
are women ◦ Excessive Alcohol
◦ Caucasian/Asian women consumption
◦ Thin, small boned ◦ Decreased estrogen
women levels (E High in >BMI)
◦ Family Hx of ◦ Long term use of
osteoporosis steroids (?)
◦ Hx of smoking ◦ Eating disorders such as
anorexia
◦ Weight loss surgery
} Risk reduction: Maintain healthy diet high in
calcium (1,500 mg) and vitamin D
◦ Engage in weight-bearing exercise (jogging, dancing,
weigh-lifting 3-4 times a week)
◦ Avoid smoking
◦ Limit Alcohol

} Therapy: Bisphosphonates (x1/month Boniva)

◦ Decreases bone re-absorption
◦ High GI irritation (esophagus)-Needs Education on Rx
◦ Empty stomach in A.M w/full glass of water (ONLY H2O)
◦ Taken in sitting position, remain upright for 30 min*
} Barriers to quality health care: societal stigma,
discrimination, denial of civil rights
◦ Lack of health insurance, fear of negative rxn by PCP,
lack of education regarding lesbian health issues

} Healthy People 2020: Need for more research to

document, understand, and address factors to
contribute to health disparities in LGBT
community
} Health issues (Higher Risk)
◦ Cancer: Higher risk for breast, cervical,
endometrial, ovarian due to lifestyle and less
likely to follow recommendations for routine
screenings (more likely obese and a smoker)
◦ Obesity: higher risk for heart disease and cancer
◦ Polycystic Ovarian syndrome: higher risk
◦ STI
◦ Tobacco, alcohol, and substance abuse
◦ Domestic violence: less than heterosexual
women but need screening
} Ages 12-19: Time of physical, cognitive,
and psychosocial development
} At risk for :
◦ Unintentional injuries
◦ Eating disorders
◦ STDs (highest rates) and Pregnancies
◦ Issues with self esteem (bullied)
◦ Menstrual disorders
◦ Acne
} During a well women’s clinic visit, a 55-year-
old woman who is perimenopausal shares that
she is having difficulty sleeping. She also
shares with you that she is experiencing five to
six hot flashes per day and two to three
episodes of night sweats each night.
} Based on this information, describe the
teaching plan for this woman.
An 80-year-old woman has a sudden onset
of numbness in her right arm. She is feeling
dizzy and is having difficulty seeing out of
her left eye. These are signs of a(n)
____________.
A. Heart attack
B. Stroke
C. Aneurism
D. Brain tumor
An 80-year-old woman has a sudden onset of
numbness in her right arm. She is feeling dizzy
and is having difficulty seeing out of her left eye.
These are signs of a(n) ____________.
A. Heart attack
B. Stroke
C. Aneurism
D. Brain tumor
A woman is taking Actonel for prevention of
osteoporosis. To decrease the risk of esophageal ulcers,
the nurse instructs the woman to
A. Remain standing or sitting upright for 30 minutes
after taking medication.
B. Take the medication immediately after eating.
C. Take the medication with an antacid.
D. Lay on her right side for 30 minutes after taking the
medication.
A woman is taking Actonel for prevention of
osteoporosis. To decrease the risk of esophageal
ulcers, the nurse instructs the woman to
A. Remain standing or sitting upright for 30
minutes after taking medication.
B. Take the medication immediately after eating.
C. Take the medication with an antacid.
D. Lay on her right side for 30 minutes after taking
the medication.