NURSING > A-Level Question Paper > ADVANCED MED SURG 246 Reproductive Disorders Group (All)

ADVANCED MED SURG 246 Reproductive Disorders Group

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THE REPRODUCTIVE CYCLE - ● Menarche, beginning of menses, designates the first of menstrual cycle. ● Traditionally occur approx. 2 to 2 1⁄2 years after breast development ● Age range from 8-15 years old ● Average age of onset is 12 years ● If a girl had not started menstruation after 15 years/ longer than 3 years since breast development, a hcp should be consulted ● Length of menstrual cycle varies fm 24- 32 days, average cycle lasts 28 days ● Day 1 menstrual cycle = 1st day that blood flow (called the menstrual period) begins ● Flow lasts fm 1-8 days, average is 3-5 days ● Amt of flow ranges from 10-75mL, average is 35 mL per cycle ● Cleanliness is esp. Important during menstruation Disturbance of Menstruation Most common disturbances include the following: ● Amenorrhea: absence of menstrual flow ● Dysmenorrhea: painful menstruation ● Dysfunctional uterine bleeding (DUB): abnormal uterine bleeding ● Menorrhagia: bleeding that is excessive in amount and duration ● Metrorrhagia: bleeding b/w menstrual periods Amenorrhea (Absence of menstrual flow) ● Normal before puberty, after menopause, during pregnancy and sometimes during lactations ● Menstrual flow may also be absent or suppressed as result of hormonal abnormalities or surgical interventions such as hysterectomy (surgical removal of the uterus). Etiology and Pathophysiology: ● Amenorrhea is classified as primary when menarche not occurred by age 17-18 y.o ● Potential causes: congenital defects- imperforate hymen, blockages or narrowing of the cervix, missing uterus or vagina or vaginal septum. ● Secondary amenorrhea- menarche has occurred but flow has ceased for at least 6 months. ● Causes for secondary amenorrhea- freq. Vigorous exercise, low-body fat, anxiety or depression, pituitary tumors, hyperactive thyroid gland, PCOS, & medications ● Primary s/sx: absence of menstruation, wt gain/loss, hormonal imbalances- breast discharge, vaginal dryness, increased hair growth, changes in breast size and voice changes. Assessment: ● Early dx and prompt management = prevent more serious reproductive and genital problems ● Discussing presence and absence of menstruation should be included in health teaching provided to girls and parents ● Urged sexually active woman to see hcp asap if missed period ● Assess emotional or behavioral factors that may influence menstrual cycle ● Hx of medication, drugs used, menstrual periods

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