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Women's Health Final Review NSG 6430; Questions & Answers 100% Verified

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  • NSG 6430

Women's Health Final Review NSG 6430; Questions & Answers 100% Verified Primary Amenorrhea Correct answer-Absence of menses: by age 15 years Often secondary to: dysfunction in the hypothalamus, pituitary, ovaries (HPO axis), uterus, or vagina DYSMENORRHEA Correct answer-Painful cramping: ass...

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  • August 8, 2024
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  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • NSG 6430
  • NSG 6430
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Women's Health Final Review NSG 6430;
Questions & Answers 100% Verified
Primary Amenorrhea Correct answer-Absence of menses: by age 15 years

Often secondary to: dysfunction in the hypothalamus, pituitary, ovaries (HPO

axis), uterus, or vagina




DYSMENORRHEA Correct answer-Painful cramping: associated with menstruation caused
by spasmodic uterine

contractions

Most common GYN problem: in adolescents & adult females

HISTORY: is KEY!!!

Primary versus Secondary




Primary Dysmenorrhea: Absence of pelvic pathology Correct answer-CAUSE: Excessive
Prostaglandins

ONSET: in adolescence

PAIN: starts 1-2 days prior to onset of menses or with menses, resolving over

12-72 hours

ASSOCIATED: with nausea, diarrhea, dizziness, fatigue, HA, back pain

IMPROVES: with NSAIDs, hormonal contraceptives, AGE & PARITY




Secondary Dysmenorrhea: Presence of Pelvic Pathology Correct answer-ONSET: Usually
after age 25 years

, Women's Health Final Review NSG 6430;
Questions & Answers 100% Verified
Abnormal uterine bleeding (AUB)

Variable SX: N, V, D, back pain

Dyspareunia: (esp. w/Endometriosis)

Symptoms: OFTEN worsen over time

Causes: Endometriosis, fibroids, infection/PID, adenomyosis, etc.




Dysmenorrhea Management Correct answer-Get a good history: (medical & menstrual)

Physical exam: to identify a cause

Pelvic exam: may defer if young, non-sexually active adolescents with mild

symptoms

Consider pelvic US: to look for adnexal masses, fibroids, other pelvic

pathology

If secondary, address underlying cause.




Dysmenorrhea Non-Pharm Management Correct answer-HEAT: to lower abdomen = Oral
Analgesics

EXERCISE: improves symptoms




Dysmenorrhea Pharm Management Correct answer-NSAIDs: 80-86% efficacy

o Start at onset of menses for x 1-2+ days

, Women's Health Final Review NSG 6430;
Questions & Answers 100% Verified
o If no relief, consider starting 1-2+ days before

Combination Hormonal Contraceptives (CHC)

Consider BOTH, if no relief with NSAIDs

Intrauterine Contraceptive (IUC): Hormonal

o Mirena or Skyla (smaller) with Levonorgestrel

If NO relief, consider SECONDARY CAUSE




ABNORMAL UTERINE BLEEDING (AUB) Correct answer-Comprehensive, focused history

Many causes: PALM-COEIN classification

Consider DIFFERENTIAL by AGE & HISTORY

Post-menopausal:

o Any bleeding beyond 12 months since LMP o Even "1 drop of blood" is concerning

o Must REFER to OBGYN to R/o cancer




Classification/Differential: PALM-COEIN Correct answer-Structural




P

Polyps:

> 30 years

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