Nursing Assessment: Reproductive System

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Nursing Assessment Reproductive System

• NURS 1228
• Spring 2003
• By Nina Green, RN, Instructor

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Male Reproductive System

• External Structures
• Penis
• Scrotum

• Internal Structures
• Prostate gland
• Seminal vesicles
• Cowpers glands
• Testes
• Epididymis
• Spermatic cord

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Male Reproductive
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Female Reproductive System

• Breasts
• Pelvic Organs
• Ovaries
• Fallopian tubes
• Uterus
• Vagina

• External Genitalia
• Mons pubis
• Labia majora
• Labia minora
• Clitoris
• Urethra
• Vaginal orifice
• Bartholhins glands

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Female Reproductive Organs
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Hormone regulation
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Menstrual cycle

• Menarche
• Menstrual cycle
• Three phases
• The proliferative or follicular phase
• The secretory or luteal phase,
• The menstrual or ischemic phase.

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Menopause

• Premenopausal
• Perimenopausal
• Postmenopausal
• Dyspareunia
• Amenorrhea
• Menorrhagia
• Metorrhagia

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Phases of Sexual Response

• Male Sexual Response
• Excitement phase
• Plateau phase
• Resolution phase

• Female Sexual Response
• Excitement phase
• Plateau phase
• Resolution phase

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Effects of aging on Reproductive System (Male)

• Decrease in size of penis
• Fewer sustained erections
• Decreased testosterone
• Prostate enlargement
• Some breast enlargement

• Increased stimulation needed for erection
• Decreased need to ejaculate
• Decreased ability to attain an erection
• Possible decreased response to sexual stimuli

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Effects of aging on Reproductive System (Female)

• Decreased size, shape, and tone of breasts
• Decrease in size of vulva, clitoris, labia and
  amount of pubic hair
• Decrease muscle tone, moisture, depth and width
  of vagina

• Decrease in muscle tone of urethra
• Decrease in size and thickness of uterus
• Decreased ovarian function and size
• Decreased vaginal lubrication and sexual response

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Assessement of Reproductive System

• Problems in other areas of life are often
  interrelated with problems and stresses within
  the reproductive system.
• Reproduction and sexual issues are considered
  extremely personal and private.
• The nurse must develop trust to elicit this
  information.

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Common childhood illnesses that affect
reproductive function

• Mumps
• Rubella

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Chronic diseases that affect the Reproductive
System

• Diabetes Mellitus
• Cardiovascular disease
• Anemia
• CVA
• Post MI
• Endocrine disorders
• Kidney and urinary tract problems

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Medications Assessment

• Diuretics
• Psychotropic drugs
• Antihypertensives
• Contraceptives or hormones
• Alcohol
• Barbiturates and amphetamines
• Marijuana and street drugs

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Surgery Assessment

• Men
• Herniorrhaphy
• Orchiectomy
• Prostatectomy
• Repair of testicular torsion
• Varicocelectomy
• Vasectomy

• Women
• Cryosurgery
• D C
• Hysterectomy
• Oophorectomy
• Repair of cystocele
• Repair of rectocele
• Salpingectomy
• Tubal sterilization

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Functional health Patterns

• Health perception-health management pattern
• Immunization for rubella?
• Attempting to become pregnant?
• Examine breasts? How?
• Last mammogram? Pap smear? Rectal exam? Results?
• Chronic illness? Vaginal discharge? Safe sex?
• Protect self from unwanted pregnancy, STDs? How?

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Functional Health Patterns

• Nutritional-Metabolic
• Anemic?
• Enough calcium in diet?
• Eat calcium rich foods? Calcium supplement?
• Average daily caloric intake?
• How do you feel about weight? Want to be thinner
  or heavier?
• Diet?

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Functional Health Patterns

• Elimination
• Problems urinating?
• Problems with bowels?
• Bladder infection? When? How often?
• Anything make it better?
• Laxatives? Vomit after eating?

• Activity-Exercise
• Activities done each day?
• Dress yourself? Feed yourself? Walk without
  help?

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Functional Health Patterns

• Cognitive-Perceptual
• Problems with balance?
• Pain in private parts?
• Pain during sexual activity or intercourse?
• Forgetful?

• Self-perception-Self-Concept
• Problem in reproductive system affecting feelings
  about themselves as a man/woman?
• Has problem affected sex life? How?

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Functional Health Patterns

• Role-Relationship
• Effect reproductive problem/pregnancy had on
  work, family, and or social life?
• Role related problems in family?

• Sexuality-Reproductive
• Satisfied with sexual activity as you now do it?
• Recent changes in sexual practices?
• Problem with reproductive system affect sexual
  expression or practice?

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Functional Health Patterns

• Coping-Stress Tolerance
• Stress in life right now?
• How do you handle your health problems?
• Who do you go to for support? Does it help?

• Value-Belief
• Beliefs about health problems?
• Medical treatment contradict personal beliefs?
• Home remedies?
• Homeopath, naturopath, or chiropractor?

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Diagnostic tests

• Urine studies
• Pregnancy testing
• Hormone studies
• FSH assay

• Blood Studies
• Prolactin assay
• Serum hCG assay
• Serum androstnedione and testosterone levels
• Serum progesterone
• Serum estradiol
• Serum FSH

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Diagnostic studies

• Syphilis studies
• Nontreponemal serologic tests
• Treponemal test

• Miscellaneous studies
• Dark-field microscopy
• Wet mounts
• Cultures
• Gram stain

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Diagnostic studies

• Cytologic Studies
• Pap smear
• Nipple discharge test

• Radiologic Studies
• Soft tissue mammography
• Contrast mammography
• ultrasound

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Diagnostic Studies

• Invasive procedures
• Breast biopsy
• Hysterosalpingogram
• Colposcopy
• Conization
• Loop electrosurgical excision (LEETZ LEEP)

• Operative Procedures
• Culdotomy, culdoscopy, and culdocentesis
• Laparoscopy
• D C

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Diagnostic Studies

• Fertility Studies
• Semen analysis
• Basal body temperature assessment
• Huhner test or Sims-Huhner
• Endometrial biopsy
• Hysterosalpingogram
• Serum progesterone