10.health care for women 1


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10.health care for women 1

  1. 1. Health care for Women Disease of women’s reproductive organs
  2. 2. contents • • • • • • Health assessment for women Infectious disease of genitalia Sexual transmitted disease Endometrial problems Tumor of reproductive organs Menstrual disorders
  3. 3. Health assessment for women Papanicolaur test(Pap smear) Breast self examination(BSE)
  4. 4. Papanicolau test(Pap smear) • Regular pelvic examination and Pap smear are the best way to assess and detect condition in the reproductive system early • The Pap smear is a safe and in expensive tool for early detection of cervical cancer • Early diagnosis, the cure rate is almost 100% • Ps; Papanicolau test; DevelopedGreek Physician Dr. George Papanicolau in the 1940s
  5. 5. Screening schedule and guideline • 1st Pap smear; age 18/or first intercourse • 18-64yr; Yearly or every 3 yrs after consecutive yearly normal results • Age 65; Yearly, or 3yrs after two consecutive yearly normal results • Age 70: stop Pap test • Ps; U.S. preventive service task force guidelines
  6. 6. Classification of Pap smear • • • • • • • Dysplasia CIN SIL mild grade 1 low grade moderate grade 2 severe grade 3 high grade Carcinoma in situ CIN= cervical Intra epithelial neoplasia SIL= Squamous Intraepithelial lesion
  7. 7. Risk factors for cervical cancer • Exact etiology is Unknown • Sexual behavior and history; multiple partner, rape, early age sexual intercourse • HPV(Human papillomavirus) infection; HPV 16, 18, 45, 58 HPV 16 squamous cancer HPV 18 adenocarcinoma • Lower socioeconomic status • Cigarette smoking
  8. 8. Performing a pelvic exam and Pap smear • Purpose; to evaluate the condition of the internal female reproductive structure and to obtain specimen for cytologic screening • Equipment; - Examination glove, - Sheet or bath blanket for draping, - Specimen collection devices-cyto-brush and plastic spatula, - Label specimen container or slide and splay fixative - Complete lab request - Adequate light source
  9. 9. Implementation 1. Explain the procedure 2. Empty bladder to minimize discomfort and easy palpation internal organs 3. Wash hand 4. Have client position herself on the exam table-buttocks are just past the bottom edge of the table 5. Place sheet over the client for privacy 6. Ask relaxation technique
  10. 10. Implementation 7. Put on gloves 8. Warm the speculum with warm water to avoid chilling the clint 9. Using gloved hand, spread the labia, inspecting and palpating the area to check for abnomalities; throughout encourage the women take deep breaths to aid in relaxation
  11. 11. Implementation 10. Insert the warmed speculum in to the vagina and slowly open the blades to allow clear visualization of cervix; once in place, lock the blades
  12. 12. Implementation 11. Obtain samples for pap smear; use the cytoblush or sterile cotton tipped applicator and swab the endocervix, using one full circular motion 12. Use the plastic curved spatula to gently and firmly scrape the cervix os
  13. 13. Implementation 13. Immediately after collecting each specimen in the appropriately labeled container or slide and spray with a fixative 14. Unlock the blades of the speculum and remove it gently to reduce the risk for trauma too the client 15. Remove the glove from the nondominant hand and place on low abdomen; insert a lubricated gloved finger of the dominant hand in to vagina to perform the bimanual examination 16. Assist the client to sitting position and allow her to get dress
  14. 14. Result • If infection is suspected cause abnormal result treat the infection, repeat test • If infection is not reason  colposcopy, biopsy • Pap smear is most valuable, simple, easy and cost effective screening test for early detect of cancer • Barriers to gynecologic checkups and pap smear; fear, lack of information, cultural belief, social status, embarrassment, absence of symptom, lack of time and cost
  15. 15. Breast Heath • Purpose: preventing breast cancer • Key: risk factor screening, diagnostic testing • Risk factors: being a women, age, family history of breast cancer • Gene theory: Breast cance1(BRCA1) Breast cancer2(BRCA2) Ps; In 1994 discovered and found correlate with increase for breast, ovarian and other cancer
  16. 16. Breast Heath • Breast cancer is most common cancer in women. • Treatable cancers if detected early • 5 yr survival rate as - 99% no invasion - 90% for local invasion - 68% regional spread * Early detection is most important
  17. 17. Breast Cancer Screening Recommendation • Breast Self Examination: monthly at 20yr • Clinical Breast Examination: every 3 yrs from 20-40 yrs, yearly after 35 yrs if at risk, yearly after 40yrs • Mammography: 35 yrs if at risk every 1-2yrs from 40-50yrs, every year after 50
  18. 18. Breast Self Examination(BSL) 1. Observation in a mirror for any change in appearance of breast 2. To check their own breast by methodically palpating the breast tissue for change and lumps 3. The best time to examine the breast is few days after the menstrual period 4. BSE is most comfortable after the menstrual period because the breast are least tender
  19. 19. Breast Self Examination(BSL) • The following signs and symptoms require follow-up - Lump - Pain(breast cancer or may not painful) - Discharge - Skin change - Lymphadenopathy, with or without other symptoms - Any change the women finds as personal unusal
  20. 20. Breast Self Examination(BSL) • BSE early detection of potential malignancies continues to be single most important factor in successful treatment of breast cancer. • Nurse should encourage and educate women on performing BSE regardless of field of nursing.
  21. 21. Step in the Breast Self Examination(BSL)
  22. 22. Step in the Breast Self Examination(BSL)
  23. 23. Clinical Breast Examination • Clinical Breast Examination: - Experienced professionals may find changes that the women has missed. - To demonstrate and explain a through breast examination • Mammography
  24. 24. Steps in the clinical breast examination
  25. 25. Steps in the clinical breast examination