The document outlines various reproductive system disorders, focusing on assessment, clinical manifestations, diagnostic evaluation, and management of conditions such as dysmenorrhea, amenorrhea, vulvitis, cervical cancer, myomas, pelvic inflammatory disease, prostatitis, benign prostatic hyperplasia, and epididymitis. It emphasizes the importance of thorough medical history, physical examination, and various diagnostic tests, alongside treatment options ranging from medication to surgical interventions. Key nursing interventions and patient education are also highlighted to support effective management and coping strategies.

1. Reproductive System disorders
• Assessment of the reproductive system
• Pelvic Pain
• Characteristics: what is frequency, duration, severity,
location of pain? Was the onset sudden or gradual?
What aggravates and what relieves it?
• Associated factors: fever, nausea, vomiting, dizziness,
abnormal bleeding with it?
• History of STDs, obstetric trauma, or abdominal
surgery? Pregnancy history and history of ectopic
pregnancy?
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2. Physical Examination
• Physical examination for a patient with a
gynecologic disorder should focus on the
abdomen and genitalia.
• Palpate the lower abdomen for masses or
tenderness.
• Inspect the external genitalia for lesions,
discharge, or tissue bulging from the vagina.
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3. Menstrual Conditions
• DYSMENORRHEA
• Dysmenorrhea is painful menstruation; most
common of gynecologic dysfunctions.
• Primary Cause
• Increased prostaglandin production by the
endometrium.
• Secondary cause
• Endometriosis, pelvic infection, congenital
abnormality, uterine fibroids, ovarian cyst.
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4. Clinical Manifestations
• Pain may be caused by increased uterine
contractility and uterine hypoxia.
• Nausea, vomiting, diarrhea, headache, chills,
tiredness, nervousness, and lower backache may be
experienced.
• Diagnostic Evaluation
• Tests to rule out underlying lesion:
• Chlamydia and gonorrhea tests may show infection.
• Pelvic ultrasound may detect tumor, endometriosis,
cysts.
• Pregnancy test to rule out ectopic pregnancy.
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5. Management
• The following measures are for primary
dysmenorrhea
• Treatment of secondary dysmenorrhea is aimed at
underlying pathology.
• Local heat, to increase blood flow and decrease
spasms.
• Exercise, to suppress prostaglandin release.
• Nonsteroidal anti-inflammatory agents, such as
ibuprofen.
• Hormonal contraceptives to decrease contractility
and menstrual flow.
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6. AMENORRHEA
• Amenorrhea is absence of menstrual flow.
• Primary cause
• Menarche does not occur by age 16, or by age 14.
• Chromosomal disorders.
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7. Secondary causes
• Menstruation stops for 3 cycles or 6 months in a woman
in whom normal menstruation has been established.
• May be caused by normal pregnancy or lactation,
menopause, or ovarian cysts.
• Inadequate nutrition with decreased body fat stores is a
significant cause of amenorrhea in young women.
• Ovarian, adrenal, or pituitary tumor and thyroid disease
(hyperthyroidism) are hormonal causes.
• Hormonal contraceptives, may also induce amenorrhea.
• It may be a result of depression, or severe psychological
trauma.
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8. Diagnostic Evaluation
• Pregnancy test.
• Hormonal levels LH and FSH to detect ovarian
failure.
• Prolactin level (elevated) with pituitary tumor.
• Management
• Discontinue causative medications if desired.
• Nutritional or psychological counseling as indicated.
• Hormonal replacement therapy to regulate cycle.
• Treatment of tumor or other underlying cause.
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9. VULVITIS
• Vulvitis is inflammation of the vulva.
• Causes
• Trichomonas
• Bacteria
• Fungi.
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10. Clinical Manifestations
• Pruritus more acute at night.
• Reddened, edematous tissue, possible ulceration.
• Pain and burning sensation.
• Discharge, possibly profuse and purulent.
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11. CANDIDA ALBICANS
• A fungal infection caused by Candida albicans.
Predisposing factors include:
Steroid therapy
Obesity
Antibiotic therapy
Diabetes mellitus
Oral contraceptives
Frequent douching
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12. Signs and symptoms
• Vaginal discharge is thick and irritating
• White or yellow patchy, cheese like particles
adhere to vaginal walls.
• Itching is the most common complaint.
• May also experience burning, soreness,
frequency, and dysuria.
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13. Management
• Eradicate the fungus by applying antifungal
vaginal cream, or vaginal suppository for 3 or 7
nights as ordered.
• For severe or recurrent cases use systemic
antifungal.
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14. TRICHOMONAS VAGINALIS
• A condition produced by a protozoan (pear-shaped and
motile) that thrives in an alkaline environment.
• It is sexually transmitted disease.
• Signs and symptoms
• Malodorous discharge; may be frothy and yellow-green in
color.
• May have pruritus, and spotting.
• May also have vulvar edema, dysuria, and hyperemia
secondary to irritation of discharge.
• Destroy infective protozoa by taking metronidazole
(orally), usually single dose of 2
• Prevent re infection by treating male.
• Avoid alcohol during treatment.
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15. CANCER OF THE CERVIX
• Cancer of the cervix is a common gynecologic
malignancy.
• Most common between ages 35 and 55.
• Cause: Unknown
• Predisposing factor
• Early sexual activity, multiple sexual partners,
and history of STDs, especially HPV, are major
risk factors
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16. Clinical Manifestations
• Early disease is usually asymptomatic.
• Initial symptoms include postcoital bleeding,
irregular vaginal bleeding or spotting between
periods or after menopause, and malodorous
discharge.
• As disease progresses, bleeding becomes more
constant and is accompanied by pain that
radiates to buttocks and legs.
• Weight loss, anemia, and fever signal advanced
disease.
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17. Diagnostic Evaluation
• Pap smear-routine screening measure.
• Management
• Hysterectomy
• Radiotherapy(for localized early stage)
• Chemotherapy, used for advanced disease; or for
metastatic disease.
• Complications
• Spread to bladder and rectum; metastasis to
lungs, bones, and liver.
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18. Nursing Assessment
• Obtain history of Pap tests, sexual activity, past STDs.
• Obtain history of symptoms.
• Assess understanding of disease and responses, such
as guilt, fear, denial, anxiety.
• Nursing Diagnoses
• Anxiety related to cancer and treatment
• Disturbed Body Image related to surgical treatment
• Goal
• Relieving Anxiety
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19. Nursing Intervention
• Assist patient to seek information on stage of cancer,
treatment options.
• Goal
• Enhancing Body Image
• Nursing Intervention
• Provide emotional support during treatment.
• Encourage patient to take pride in appearance by
dressing, putting on makeup as able.
• Encourage activity and socialization when patient
able.
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20. • Explain the importance of lifelong follow-up,
regardless of treatments, to determine the
response to treatment and detect spread of
cancer.
• Expected Outcomes
• Reports decreased anxiety, increased decision-
making ability
• Reports continued interest in appearance
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21. MYOMAS OF THE UTERUS
• Myomas (fibroids) are benign tumors of the
uterine myometrium (smooth muscle).
• Develop in women ages 25 to 50.
• Cause: unknown.
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22. Clinical Manifestations
• Small myomas do not cause symptoms.
• First indication may be palpable mass.
• Irregular bleeding usually menorrhagia.
• Pain comes from pressure on adjacent organs
possible heavy feeling in pelvis.
• Secondary symptoms include fatigue because of
anemia, urinary disturbances, and constipation
• Diagnostic Evaluation
• Ultrasound to identify size and location of
myomas.
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23. Management
• Myomectomy may be done for small tumor.
• Hysterectomy for large or numerous tumors.
• Gonadotropin-releasing hormone antagonist
(Lupron) therapy to create hypoestrogenic
environment and to try to shrink tumors.
• Complications
• Infertility
• Habitual abortion
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24. PELVIC INFLAMMATORY DISEASE
(PID)
• PID is an infection that may involve the fallopian
tubes, ovaries, uterus, or peritoneum.
• Cause
• Causative agents include N. gonorrhoeae,
anaerobes, gram-negative bacteria, and
streptococci.
• Cervical infection ascends through the
endometrium, into the fallopian tubes, and
possibly into the peritoneal cavity.
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25. Predisposing factors:
• Multiple sexual partners
• Use of IUCDs
• Criminal abortion
• Clinical Manifestations
• Pelvic pain most common presenting symptoms.
• Fever
• Cervical discharge mucopurulent.
• Cervical motion tenderness.
• Irregular bleeding.
• GI symptoms nausea, vomiting, acute abdomen.
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26. Diagnostic Evaluation
• Culture to identify organisms.
• Laparoscopy provides direct visualization of the
fallopian tubes.
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27. Management
• Antibiotics combinations of tetracyclines, penicillins,
and cephalosporins, orally or parenterally depending
on the patient's condition.
• Clindamycin 900 mg I.V. every 8 hours plus
gentamicin 2 mg/kg of body weight I.V. or I.M. as
loading dose.
• followed by 1.5 mg/kg every 8 hours as
maintenance dosage.
• Ceftriaxone 250 mg I.M. once per day plus
doxycycline 100 mg orally twice per day for 14 days.
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28. Complications
• Sepsis.
• Infertility because of adhesions to fallopian tubes
and ovaries.
• Ectopic pregnancy caused by inability of
fertilized egg to pass stricture.
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29. MALE REPRODUCTIVE
DISORDER
• PROSTATITIS
• Prostatitis is an inflammation of the prostate
gland
• Cause
• Bacteria, fungi, mycoplasma
• Microorganisms are usually carried to the
prostate from the urethra.
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30. Clinical Manifestations
• Perineal discomfort
• Burning
• urgency
• Frequency, and pain with or after ejaculation.
• Acute bacterial prostatitis may produce sudden
fever and chills and perineal, rectal, or low back
pain.
• Urinary symptoms, such as dysuria, frequency,
urgency, and nocturia (urination during the
night), may occur.
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31. Complications:
• swelling of the prostate gland
• Urinary retention.
• Epididymitis
• Bacteremia
• Pyelonephritis.
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32. Diagnostic Findings
• Urinalysis after prostate examination commonly
reveals many white blood cells.
• Medical Management
• The goal of therapy for acute bacterial prostatitis
is to avoid the complications of abscess
formation and septicemia.
• A broad spectrum antibiotic agent is
administered for 10 to 14 days.
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33. Nursing Management
• Nursing management includes:
• Administration of prescribed antibiotics and
prescribed analgesic agents.
• Sitz baths (to relieve pain and spasm)
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34. Benign prostatic hyperplasia
• In many patients older than 50 years, the
prostate gland enlarges Extending upward into
the bladder and obstructing the outflow of urine.
• This condition is known as benign prostatic
hyperplasia (BPH).
• Cause
• Evidence suggests that hormones initiate
hyperplasia
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35. Clinical Manifestations
• Examination reveals a prostate gland that is
large, and nontender.
• The hypertrophied lobes may obstruct the
vesical neck or prostatic urethra, causing
incomplete emptying of the bladder and urinary
retention.
• Generalized symptoms may also be noted,
including fatigue, anorexia, nausea, vomiting, and
epigastric discomfort..
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36. • The obstructive and irritative symptoms
includes: increased frequency of urination,
nocturia, urgency, hesitancy in starting urination,
• A decrease in the volume and force of the urinary
stream, interruption of the urinary stream,
dribbling (urine dribbles out after urination)
• A sensation that the bladder has not been
completely emptied, acute urinary retention ,
and recurrent urinary tract infections
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37. Medical Management
• If the patient is admitted on an emergency basis
because he cannot void, he is immediately
catheterized.
• Prostatectomy to remove the hyperplastic
prostatic tissue is frequently performed.
• Rest
• elevation of the scrotum
• Ice packs to reduce scrotal edema
• Antibiotics, analgesic agents, and anti-
inflammatory medications are recommended.
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38. EPIDIDYMITIS
• Epididymitis is an infection of the epididymis
that usually descends from an infected prostate
or urinary tract.
• It may also develop as a complication of
gonorrhea.
• Cause
• Chlamydia trachomatis. The infection passes
upward through the urethra and the ejaculatory
duct and then along the vas deferens to the
epididymis.
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39. Signs and symptoms
• The patient complains of unilateral pain and
soreness in the inguinal canal along the course of
the vas deferens and then develops pain and
swelling in the scrotum and the groin.
• The epididymis becomes swollen and extremely
painful; the patient’s temperature is elevated.
• The urine may contain pus (pyuria) and bacteria
(bacteriuria), and the patient may experience
chills and fever.
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40. Medical Management
• If the patient is seen within the first 24 hours after
onset of pain, the spermatic cord may be infiltrated
with a local anesthetic agent to relieve pain.
• If the epididymitis is from a chlamydial infection, the
patient and his sexual partner must be treated with
antibiotics.
• The patient is observed for abscess formation as
well. If no
• An epididymectomy (excision of the epididymis from
the testis) may be performed for patients with
recurrent, epididymitis or for those with chronic,
painful conditions.
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41. Complication
• infertility
• REDUCING ANXIETY
• Nursing Intervention
• When appropriate, the patient is encouraged to
discuss anxieties and fear associated with the
diagnosis, therapy, or prognosis.
• By individualizing teaching efforts, factual
information applied to specific needs may offer
reassurance.
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42. END
•THANKS FOR
YOUR
ATTENTION
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