LU 12 Common Disorders of Female Reproductive System

What are the common vaginal infections ?

• candidiasis

• trichomoniasis

What is candidiasis (vaginal thrush) and its sign and symptoms ?

• caused by yeast, Candida albicans that lead to changes to vaginal acidity

• s/s : extreme itching, soreness and redness in vaginal area, white clumpy vaginal discharge, painful intercourse

What are the management and treatment for candidiasis ?

• treatment : antifungal vaginal creams, oral treatment

• wipe genitalia from front to back and keep dry

• avoid tight fitting trousers/ underwear

• wear cotton underwear for better air circulation

What is trichomoniasis and its symptoms ?

• caused by protozoan parasite, Trichomonas vaginalis

• symptoms in women : thin, yellow green vaginal discharge with unpleasant fishy smell, painful urination

• symptoms in men : thin whitish discharge, painful urination

What are the treatment and management for trichomoniasis ?

• treatment : antibiotic (oral metronidazole)

• using condom during sexual intercourse during first 4-6th weeks after treatment

What are the nursing advice to prevent vaginal infections ?

• always wipe from front to back after going to the toilet

• wear cotton underwear

• wash underwear in hot water and double rinse

• change sanitary pads regulary

• avoid scented sanitary pads

• avoid tight fitting clothes

What is pelvic inflammatory disease (PID) and its risk factors ?

• an inflammatory condition of the pelvic cavity

• risk factors : i) early age of first intercourse ii) multiple sex partners iii) sex with a partner with an STD iv) history of STD

What are the causes of PID ?

• STD (chlamydia and gonorrhoea)

• acute or chronic infection of reproductive tract

• intrauterine device : higher risk of PID

Explain the pathophysiology of PID

• results from the ascending spread of microorganisms from the vagina and cervix to the upper genital tract

What are the clinical manifestation / s/s of PID ?

• lower abdominal pain (1st indication)

• pelvic pain and tenderness during examination

• purulent vaginal discharge

• dysuria

• fever, chill, nausea, vomiting

What are the complications of PID ?

• short term : peritonitis, pelvic abscess, sepsis

• long term : infertility, high risk of ectopic pregnancy

What are the medical and nursing management for PID ?

• medical : broad spectrum antibiotics (cefoxitin)

• nursing management : i) adequate rest, fluid and nourishing diet ii) note amount and characteristics of vaginal discharge iii) health education regarding safe sex

What are the risk factors for cervical cancer ?

• smoking

• weakened immune system

• early age of first sexual intercourse

• long term use of contraceptive pills

What are the sign and symptoms of cervical cancer ?

• bleeding that occurs between regular menstrual periods

• bleeding after sexual intercourse

• bleeding after going through menopause

• increased vaginal discharge

• foul smelling discharge

What are the general advice prior to sample collection HPV test / cytology ?

• avoid taking cervical cancer screening during normal menstruation

• avoid sexual intercourse 48 hours prior to procedure

• do not insert any form of medication or tampons into the vagina 48 hours prior to the procedure

What are the stages of cancer cervix ?

What are the treatment & management for cervix cancer ?

• surgical management : hysterectomy

• chemotherapy

• radiotherapy

What are the nursing management for cervix cancer ?

• HPV vaccination

• safe sex practices

• cervical cancer screening

• avoid multiple sexual partners

• delay first sexual intercourse

• no smoking

What are the tumour in ovarian cancer ?

• epithelial tumours (85-90%)

• germ cell tumours (15-20%)

• sex cord stromal tumours (5-10%)

What are the sign and symptoms of ovarian cancer ?

• pain

• abdominal swelling

• compressive symptoms such as indigestion, legs edema

• endocrine effects such as postmenopausal bleeding

What are the stages in FIGO staging ?

What are the treatment for ovarian cancer ?

• surgery (primary and conservative surgery)

• chemotherapy for stage 2-4

• radiotherapy

• palliative care (inform patient for pain relief)

What is endometrial carcinoma and its risk factors ?

• most common disease affecting uterus

• risk factors : obesity, nulliparity, menarche early age, late menopause, diabetes

What are the clinical presentation for endometrial cancer in

• post menopausal women

• premenopausal women

• post menopausal women : post menopausal bleeding, blood stained vaginal discharge, pelvic pain

• premenopausal women : inter menstrual bleeding, heavy and prolonged menses, pelvic pain

What are the management for endometrial cancer ?

• total abdominal hysterectomy and bilateral salpingoo-ophorectomy (TAHBSO)

• radiotherapy

What are the nursing role in women’s health ?

• health promotion

• illness prevention

• provide support and counseling

• encourage women to achieve healthy practices such as personal hygiene, diet and exercises