Module 16: Female Reproductive

Evaluate nursing responsibilities related to diagnostic testing for selected reproductive disorders.
Critically apply the nursing process to care for clients with cervical cancer undergoing surgery or radiation therapy.
Apply the nursing process to clients undergoing surgical procedures.
Develop a teaching plan for clients needing instructions on self-breast examination.
Describe diagnostic tests used to detect breast cancer and cervical cancer.
Use the nursing process as a framework for the care of clients with breast cancer.
Compare therapeutic usefulness of chemotherapy, surgery, and radiation in treating breast cancer.
Describe physical, psychosocial, and rehabilitative needs of clients who have had a mastectomy or hysterectomy.
Identify pharmacological therapies, including indications and common adverse reactions.

Main Functions of the Female Reproductive System:
1. Production of ova (egg cells)
2. Secretion of hormones
3. Protection and facilitation of fetal development during pregnancy
Pelvic Organs Include:
- Ovaries
- Fallopian tubes
- Vagina
- Uterus (located between the bladder and rectum; consists of fundus, body, cervix)
- External genitalia (vulva)
- Breasts
Pelvis Structure:
- Composed of four bones held together by ligaments.

Effects of Aging on the Female Reproductive System:
- Changes in sexual practices and response.
- Special attention needed due to societal attitudes toward the sexuality of older adults.
- Nursing role: Provide accurate, unbiased information; emphasize normality.
- Altered estrogen production during menopause leads to:
- Decreased circulating estrogen and other sex steroids.
- Atrophy of breasts and genitals.
- Reduced bone mass; increased atherosclerosis risk.

Key Areas of Assessment:
- Past health history, co-morbidities, medications, surgical treatments, genetic risks, lifestyle choices.
- Evaluate elimination patterns, activity-exercise patterns, and emotional health.
- May include symptoms like pelvic pain, dyspareunia (painful intercourse), and fatigue.

Breast Examination:
- Inspect and palpate for symmetry, size, shape, skin color, vascular patterns, and unusual lesions.
- Pay special attention to the axillary tail of Spence, a common area for malignancies.
Internal Pelvic Examination:
- Usually performed by healthcare professionals with specialized training using a speculum; includes obtaining Pap smears.

Types of Studies:
- Urine and Blood Studies: To detect ovarian function, syphilis, pregnancy, menstrual irregularities.
- Cultures and Tests: To identify infections such as Chlamydia, gonorrhea, etc.
- Radiologic Studies: Mammograms, ultrasounds of the breasts/pelvis for diagnosis.
- Invasive Procedures: Hysteroscopy, colposcopy, and pelvic laparoscopy.
- Fertility Assessments: Through hormonal testing and imaging.

Epidemiology:
- Second most common cancer in US women; significant mortality rates decreasing due to early detection.
- More common in women aged 60 or older; many have no identifiable risk factors.
Risk Factors Include:
- Family history, environmental factors, early menarche, late menopause, genetics, hormone therapy, age.
Screening Guidelines:
- Yearly mammograms starting at age 45, or earlier for high-risk women.

Commonly detected as: lump, thickening, mammography abnormalities.
If palpable: may find hard, irregular, nonmobile lumps with possible nipple discharge.

Treatment Plan Considerations:
- Prognostic factors, clinical stage, biological characteristics.
Staging of Cancer: TNM classification (Tumor size, lymph node involvement, metastasis).
Surgical Options: Mastectomy (total, modified radical, nipple-sparing), lumpectomy.
Therapies Include: Radiation, chemotherapy (often prior to surgery), hormone therapy, immunotherapy.

Goals include patient engagement in decision making, managing side effects, follow-up adherence.
Encourage lifestyle changes: maintain healthy weight, regular activity, limited alcohol use, smoking cessation.

High-risk factors, such as HPV infection, cervical changes, and lifestyle factors (smoking, multiple births).
Clinical Manifestations: Often asymptomatic initially, followed by abnormal discharge, vaginal bleeding.
Diagnostic Procedures: Co-testing (Pap smear and HPV), abnormally followed by colposcopy.

Risk Factors: Genetic predisposition, personal/family history, nulliparity.
Symptoms may be nonspecific: abdominal pain, bloating, or gastrointestinal symptoms.
Diagnostic Studies: Elevated CA-125 levels and imaging for masses.