NCM 109 (Unit 5): Nsg Care of Patients with Specific Disturbances in Reproduction and Sexuality

Reproductive and Sexual Disturbances in Infants

• phimosis

• hypospadias

• epispadias & exstrophy complex

• cryptorchidism

• hydrocele

Reproductive and Sexual Disturbances in Adolescents

• Varicocele

Reproductive and Sexual Disturbances in Adult Women

• breast cancer

• fibrocystic breast

• Fibroadenoma of the Breast

• Dysmenorrhea

• Imperforated Hymen

• Premenstrual Syndrome

• Menopausal Syndrome

Reproductive and Sexual Disturbance in Adult Men

Benign Prostatic Hyperplasia

Phimosis

• The inability to retract the foreskin from the glans of the penis

• Can occur naturally or be a result of scarring

• A tight foreskin is common in baby boys who aren’t circumcised, but usually stops being a problem by the age of 3

3 yrs old

Age or period when a tight foreskin common in baby boys who aren’t circumcised usually stops being a problem

Balanitis

• inflammation of the phimotic foreskin or;

• inflammation of the glands or head of the penis due to infection or other causes

• Can be uncomfortable and sometimes painful, but it is not usually serious

• can be relieved with topical medication

N/C of Phimosis

● Proper hygiene

● Do not forcibly retract the skin or else other problems might occur such as Paraphimosis

Paraphimosis

• a urologic emergency in which the retracted foreskin of an uncircumcised male can’t return to its normal anatomical position

• Can result in gangrene and amputation of the glans penis

TTT of phimosis

• Steroid cream

• Circumcision

Hypospadias

• Abnormal ventral placement of the urethral opening on the underside of the penis instead of the tip

• This is common and doesn’t cause difficulty caring for this infant

• Surgery usually restores the appearance of the child’s penis.

S/sx of hypospadias

Chordee

Downward curvature of the penis

Exstrophy

Referred as ‘turned inside out’

Epispadias

All boys with bladder exstrophy also has this disorder and occurs on its own

Orchiopexy

• done at 6-24 mos. of life

• Surgical procedure in which the undescended testicle is moved down to its proper place in the scrotum

Types of hydrocele

Communicating hydrocele

Non-communicating hydrocele

Varicocelectomy

Surgical procedure that removes the enlarged veins and it is done to restore proper blood flow to the reproductive organ

TTT of breast cancer

• lumpectomy

• mastectomy

• chemotherapy

• radiation therapy

Estrogen

Etiology of fibrocystic breast

Diagnostic tests for fibrocystic breasts

• Clinical and Self Breast Exam

• Mammogram

• UTZ

Types of fibroadenoma

• complex fibroadenoma

• juvenile fibroadenoma

• giant fibroadenoma

Cryoablation

A minimally invasive procedure;

Treatment of cancer by killing cancer cells with extreme cold

Primary dysmenorrhea

• due to prostaglandin release

• 8-48 hours from the start of the first day of menstruation

Secondary dysmenorrhea

• due to pathologic condition

• Dull pain that radiates to buttocks and thighs

N/C of hypospadias

Anticholinergic (Oxybutynin)

Used to treat Bladder spasm for patient with hypospadias

Med for hypospadias

TTT of hypospadias

Bladder exstrophy:

Epispadias in boys

Epispadias in Girls

N/C of epispadias and exstrophy complex

TTT of epispadias & exstrophy complex

Cryptorchidism

S/sx of Cryptorchidism

TTT of Cryptorchidism

N/C of Cryptorchidism

N/C of Cryptorchidism

Hydrocele

Communicating Hydrocele

No communicating Hydrocele

TTT & N/C of hydrocele

Varicocele

S/sx of Varicocele

● Wormlike mass above the testes

● Decreased testes

● Decreased dihydrotestosterone

● Rarely causes pain, but pain may vary from sharp to dull

○ Increased pain when standing or physical exertion

over long periods

○ Pain worsens over the course of the day

○ Relieves when the person lies down on his back

○ Causes impairment in fertility

Common cause of Varicocele

TTT of Varicocele

Breast cancer

S/sx of breast cancer

Lumpectomy

Mastectomy

Chemotherapy

Radiation Therapy

N/C of breast cancer

Fibrocystic breast

S/sx Fibrocystic breast

TTT Fibrocystic breast

fibroadenoma of breast

S/sx of fibroadenoma of breast

Complex fibroadenomas

Juvenile fibroadenomas

Giant fibroadenomas

Phyllodes tumor

TTT of fibroadenoma of breast

N/C of fibroadenomas

Dysmenorrhea

Primary Dysmenorrhea

Secondary Dysmenorrhea

Risk Factors of Dysmenorrhea

N/C Dysmenorrhea

Hymen

Imperforate hymen

S/sx Imperforate hymen

TTT & N/C of Imperforate hymen

Physical s/sx of PMS

Emotional and behavioral s/sx of PMS

S/Sx of Premenstrual Dysphoric Disorder (PMDD)

Premenstrual Dysphoric Disorder (PMDD)

small number of women with premenstrual syndrome have disabling symptoms. This form of PMS is called cause significant physical and behavioral symptoms that interfere with daily living

Menopausal syndrome

Etiology Menopausal syndrome

S/sx of Premenopausal

S/sx of Premenopausal

Complications of menopausal syndrome

TTT of menopausal syndromeu

Gabapentin

Med for hot flashes

Vitamin D and calcium

Supplements that prevent osteoporosis

BENIGN PROSTATIC HYPERPLASIA

S/sx of benign prostatic hyperplasia

Risk factors of benign prostatic hyperplasia

● Aging (60 y.o and above)

● Family history of BPH

● Diabetes and heart disease (due to the use of beta blockers)

● Obesity