Project #92968 - Responses

WK11 Responses

 

Response # 1 To Deana Roper

 

Disorders of the Reproductive System

Vaginitis is defined as an infection of the vagina. Gardnerella vaginalis, Candida albicans, and Trichomoniasis are the three pathogens that account for 90% of the vaginitis cases (Kress, 2014). According to Huether & McCance (2012) the incidence of sexually transmitted vaginitis remains highest in women 15 to 24 years of age. Vaginitis develops as a result of vaginal pH being acidic and can be affected by detergents, douches, fabric softeners, soaps, spermicides, and vaginal sprays. The normal acidic environment of the vagina is 4.5 to 5.0 and is balanced by cervical secretions and the presence of normal flora (2012). Symptoms included burning, itching, and discharge. Normal vaginal discharge is clear, milky, or cloudy whereas and infection is likely when the discharge is copious, irritating, or has an offensive smell.  Diagnosis is based on a combination of patient history, physical examination and the collection of vaginal samples for pH measurement, whiff test, and microscopy (Kress, 2014). Treatment involves symptom relief, antimicrobial or antifungal medications and treating the women’s partner if the infection is sexually transmitted.

Endometriosis

Endometriosis is a gynecological condition characterized by the growth of endometrium-like tissues within and outside of the pelvic cavity (Pathophysiology and Immune Dysfunction in Endometriosis, 2015). Endometrial tissue is dependent on estrogen for growth and, therefore, responds to hormonal fluctuations of the menstrual cycle. According to a recent study Pathophysiology and Immune Dysfunction in Endometriosis (2015) almost 50% of adolescents with intractable dysmenorrhea or pelvic pain and 4% of women undergoing tubal ligation are diagnosed with endometriosis.  Although endometriosis can be asymptomatic, chronic pelvic pains that are aggravated during the period of menstruation, the inflammation may lead to fibrosis, scarring, and adhesions. According to Huether & McCance (2012) up to 25% to 40% of women with infertility have endometriosis. Diagnosis is based on the symptoms patients are experiencing and also a pelvic laparoscopy. Treatment is aimed at symptom relief, preventing progression of the disease, surgical interventions to remove the endometrial tissue, and medications to suppress ovulation.

Similarities versus Differences

Endometriosis is not considered an infection but can mimic some pelvic inflammatory diseases. The endometrial tissue can implant throughout the body but most commonly occur in the abdominal and pelvic cavities. Vaginitis is an infection that can be caused by sexually transmitted pathogens, bacterial vaginosis, and Candida albicans (Huether & McCance, 2012).

References

Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (Laureate custom ed.). St. Louis, MO: Mosby.

Kress, T. S. (2014). Achieving Accurate, Timely Vaginitis Diagnosis. Contemporary OB/GYN, 59(5), 33-36 4p.

Pathophysiology and Immune Dysfunction in Endometriosis. (2015). BioMed Research International, 20151-12 12p. doi:10.1155/2015/795976

 

 

 

Reesponse # 2 to Chelsea VanRooy

 

Main Discussion Post

            Reproductive disorders are wide ranging and can affect both men and women. The purpose of this discussion is to review two reproductive disorders. The age factor will be discussed as to how it affects the diagnosis and treatment of infertility and amenorrhea.

Male and Female Infertility

Infertility is clinically defined as the inability to conceive after a full year of unprotected intercourse (Heuther & McCance, 2012). Fertility issues can be caused by alterations in the reproductive organs of the male or female. In males, fertility issues can be caused by “diminished quality and production of sperm” (Heuther & McCance, 2012, p. 819). Causes for ineffective sperm production and quality can include infection, hormonal disturbances, immune problems, and environmental factors. Female fertility issue can arise through ovulatory, tubal and pelvic causes, as well as other hormonal imbalances (McPhee & Hammer, 2012). Ovulatory causes can include complete failure to ovulate or an inadequate supply of ovulatory products (McPhee & Hammer, 2012). Tubal and pelvic complications can cause failure of sperm and egg transport, failure of implementation, and inappropriate implantation sites (McPhee & Hammer, 2012).

Amenorrhea

            Primary amenorrhea, or lack of menstruation, is defined as failure to menstruate by the age of 14 (Heuther & McCance, 2012). Secondary amenorrhea is defined as a lack of menstruation for six months in women who have previously menstruated (Huether & McCance, 2012). Secondary amenorrhea can be caused by several factors including pregnancy, uterine dysfunction, decreased hormone secretion, polycystic ovarian syndrome, tumors, and menopause (Heuther & McCance, 2012). With uterine disorder, scarring and damage to the endometrium can lead to amenorrhea (McPhee & Hammer, 2012). This can occur after endometriosis and curettage to resolve abnormal bleeding (McPhee & Hammer, 2012). Ovarian dysfunction occurs when the ovaries fail to produce enough estrogen and progesterone needed to produce a menstrual cycle (McPhee & Hammer, 2012).

Age and the Diagnosis and Treatment of Infertility

            Diagnosis of infertility can include semen analysis and assessment of ovulation cycles (Heuther & McCance, 2012). If feasible, treatment for infertility should focus on correcting identified problems. There may be a need for in vitro fertilization (IVF) or other forms of assisted fertilization (Allen & Mounce, 2015). Age can play a role in the way advanced practice nurses should approach and treat their patients. Fertility issues are shown to be associated with a higher risk of depression and anxiety, social isolation, and divorce (Allen & Mounce, 2015). Many of these risks are inflated when the couple or individual trying to conceive is older. The combination of age, emotional stress and the stigma that follows infertility should be taken into account when treating these patients. Due to a hesitancy to self-disclose, nurses should be alert to the possibility of psychological stress (Allen & Mounce, 2015). Counseling and antidepressant and antianxiety medications may be necessary. Allen and Mounce (2015) stated that reproductive specialist should be consulted if a woman is over the age of 36.

Age and the Diagnosis and Treatment of Amenorrhea

Diagnosis of primary amenorrhea includes a history and physical, lab testing, nd imaging studies to check for anatomic abnormalities (Heuther & McCance, 2012). Diagnosis of secondary amenorrhea consists or ruling out pregnancy and thyroid issues (Heuther & McCance, 2012). Diagnostic assessment should also include testing for anatomical abnormalities and hormonal alterations (Heuther & McCance, 2012). Treatment of amenorrhea may include hormone replacement therapy and corrective surgical intervention (Heuther & McCance, 2012). Age plays a role in the diagnosis and treatment of amenorrhea. Primary amenorrhea is more often diagnosed at a younger age. Whereas secondary amenorrhea is diagnosed after a woman has had a history of menstruation (Heuther & McCance, 2012). Treatment is similar for both types of amenorrhea. Age should be taken into account when treating these individuals. For example, an advanced practice nurse wouldn’t approach a 13-year-old the same way they would a 30-year-old about their menstruation of lack thereof. Primary amenorrhea treatment may produce secondary sex characteristics (Heuther & McCance, 2012). Counseling may be needed for young girls receiving hormone replacement therapy.

Conclusion

            Reproductive disorders can cause a wide range of concerns for those involved. Fertility and amenorrhea can be sensitive topics. Treatment should be considerate of age and maturity level.

References

Allen, H. & Mounce, G. (2015). Managing infertility in primary care. Practice Nursing, 26(9), 440-443. Retrieved from http://www.practicenurse.co.uk/

Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (Laureate custom ed.). St. Louis, MO: Mosby.

McPhee, S. J., & Hammer, G. D. (2012). Pathophysiology of disease: An introduction to clinical medicine (Laureate Education, Inc., custom ed.). New York, NY: McGraw-Hill Medical.

 

 

Subject Medicine
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