Care of mother and fetus during pregnancy: a. 40-week pregnancy b. Puerperium – 6 weeks following delivery 2. Initial Prenatal Visit a. Prevention and complications b. History and physical c. Pelvic measurements d. Laboratory tests – blood and urine tests (HCG, CBC, VDRL) Prenatal History a. Identify high risk b. Risk factors: disease, age, and OB history c. Gravida, Para: F.P.L.A. d. Potential serious problems Subsequent Prenatal visits Vital signs Measurement of fundus Tests and procedures
Eclampsia (toxemia) life threatening Gestational diabetes – usually disappears after pregnancy Hyperemesis gradiarum – excessive vomiting Placenta Previs – placenta may cover os Placenta abruptio – placenta separates from uterine lining
Pueryserium: usually 4 to 6 weeks Lochia Rubra Serosa Alba
GYN Cervical cancer Pap smear performed annually Other problems BSE Checks for abnormalities Medical Assistant teaches self-breast exam to patient
Colposcopy- exam of vagina and cervix with lighted instrument and magnifying lens, used for examination and biopsy; lithotomy position; unlubricated speculum; use acetic acid to help visualize (dissolves mucus) Cervical punch or cervical cone biopsy can be performed during colposcopy; punch uses cervical punch biopsy forceps, cone uses laser scalpel or electrosurgery Cryosurgery – freeze tissue to treat cervicitis and cervical erosion; tissue regenerates, may have discharge up to one month later Laparoscopy – use of lighted instrument to view inside pelvic cavity (dx. Endometriosis, ovarian cysts, tubal ligation/fugation). Can be done abdominally or vaginally D & C – dilate and scraping of cervix of endometrial tissue (abnormal uterine bleeding, incomplete abortion)
Testicular Cancer Most common type of male cancer; 20-35 years. Painless lump in testicle; history of undescended testicle or mumps predisposing factors; diagnosis by biopsy after palpation of mass. Surgery to remove testicle (orchidectomy) with radiation and chemo treatment. Self exam best preventive measure Prostatitis Inflammation of prostate; usually men over 50; prostate enlarges (burn w/ urination, pain in back, muscle aches, urinary frequency). Cause may be bacterial. UA, urine culture digital rectal exam used to diagnose; treatment:meds (penicillin/pain), force fluids Prostate Cancer 3 rd leading cause cancer death in men (lung & colon); Metastasis; symptoms: difficulty urinating, frequency urinating, inability to urinate; Check PSA (bllod), biopsy confirms. US or CAT scan used to check for metastasis; treatment: prostatectomy, hormonal therapy, radiation, chemotherapy, brachytherapy (seeds) Benign Prostatic Hypertrophy BPH common men +50; symptoms include urinary retention, diminished flow, difficulty starting flow, hesitancy & nocturia common; Probably caused by hormonal changes with aging; prostate enlarges to surround urethra; physician palpates during rectal exam, PSA, IVP, catheterization, US; Treatment : meds to relax prostate muscles, hormones, bladder relaxants. TURP of prostate common surgical tx.