1. The client can define normal menstruation.
    1. Menstruation is a woman’s monthly bleeding. Menstrual blood is partly blood and partly tissue from the inside or lining of the uterus. It flows from the uterus through the cervix and passes outside the body through the vagina.
    2. Menstruation is also called menses, menstrual period, or “period.”
    3. Puberty is the onset of sexual maturation. For females, this is when menstruation (menarche = first menstruation) begins.
    4. Menopause is the termination of female fertility (and menstruation).
    5. Menstrual cycle
      • Menses or bleeding usually starts around age 12.
      • It starts on the first day of bleeding.
      • Most periods of bleeding last 3 to 5 days.
      • The average cycle is 28 days but can range from 23 to 35 days.
  2. The client can list possible problems with menstruation and menses.
    1. Amenorrhea—lack of menstrual period. Causes of amenorrhea can be:
      • Pregnancy or breastfeeding, which are normal situations
      • Extreme weight loss caused by illness or eating disorders
      • Excessive exercising
      • Stress
      • Hormonal problems
    2. Dysmenorrhea—painful periods or severe cramps. Causes can be
      • Uterine fibroids
      • Endometriosis
      • Sometimes no cause that can be identified
    3. Abnormal bleeding such as
      • Very heavy bleeding
      • Unusually long periods (menorrhagia)
      • Dysfunctional uterine bleeding periods too close together or bleeding between periods
    4. Premenstrual syndrome—experience symptoms such as mood swings, tender breasts, swollen abdomen, food cravings, fatigue, irritability, and depression in days before monthly period
    5. Premenstrual dysphoric disorder—a more severe form of premenstrual syndrome
  3. The client can list reasons to consult a health care provider.
    1. If menstruation has not started by the age of 16 years
    2. If the period suddenly stopped
    3. If bleeding for more days than usual
    4. If bleeding is excessive
    5. Sudden sickness after using tampons (toxic shock syndrome teaching guide)
    6. If bleeding between periods (more than just drops)
    7. If having severe pain during period
  4. The client can list measure to prevent or manage menstrual problems.
    1. Take medication as ordered by a physician.
    2. Dietary suggestions include the following:
      1. Eat smaller, more frequent meals to reduce bloating and feelings of fullness.
      2. Limit salt and sodium.
      3. Choose foods high in complex carbohydrates (fruits, vegetables, and whole grains).
      4. Choose foods rich in calcium. If dairy products are not well tolerated, consider calcium supplements.
      5. Use multivitamin as suggested by a physician.
      6. Avoid caffeine and alcohol.
    3. Regular daily exercise will help with fatigue and depression.
    4. Reduce stress.
    5. Get plenty of sleep.
    6. Record symptoms and interventions to evaluate effectiveness.
    7. Discuss any herbal supplements or over-the-counter medications with a physician before use.

Resources

American College of Obstetricians and Gynecologists Resource Center800-762-2264 x192 (for publications requests only)www.acog.org

National Women’s Health Information Center800-994-9662

Centers for Disease Control and Preventionwww.cdc.gov/std/

References

Lutz, C., & Przytulski, K. (2001). Nutrition and diet therapy. Philadelphia: F. A. Davis Company.

Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott

Credits

Client Teaching Guides for Home Health Care, 2nd ed.

© 2008 Jones and Bartlett Publishers, Inc.

www.jbpub.com

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