Female Reproductive Disorders Flashcards
list the risk factors, clinical signs, and treatment for cervical cancer.
risk factors
early age at first intercourse, multiple sexual partners, smoking, hx of STIs.
list the risk factors, clinical signs, and treatment for cervical cancer.
clinical signs
clinical signs
women present with abnormal vaginal bleeding, spotting and discharge.
bleeding can occur anytime but most frequently reported after intercourse.
with more advanced disease: pelvic or back pain that radiates down the leg, hematuria, fistulas, or evidence of metastatic disease to supraclavicular or inguinal lymph node areas.
list the risk factors, clinical signs, and treatment for cervical cancer.
treatment.
early stage disease: removal of the lesion, biopsy can be curative.
invasive cancer is treated with radiation therapy, surgery, or both.
surgery: trachelectomy–women with early stage cancer desiring fertility, radical hysterectomy (uterus, cervix, parametria, upper portion of the vagina)
state recommendations for the vaccine gardasil
approved for girls and boys between 9-26 years of age to precent HPV 6 and HPV 11 genital warts.
The vaccine targets the two strains of HPV (16 and 18) responsible for 70% of cervical cancer, and the two most common benign strains (6 and 11) which account for 90% of genital warts.
give prior to them becoming sexually active.
describe the clinical signs and treatment of endometrial and ovarian cancer
clinical signs: ovarian
abdominal or pelvic pain, increased abdominal size/bloating, difficulty eating or feeling full after ingesting food. clinically evident ascites is seen in approximately one fourth of women with malignant ovarian tumors and is associated with a worse prognosis.
treatment: ovarian
surgery–removal of the uterus, fallopian tubes, ovaries, omentum.
woman with very early cancer who wish to be pregnant may have only the affected ovary removed.
recommendations for tx vary depending on the stage of the disease.
explain risk factors associated with breast cancer
sex, increasing age, personal or family history of breast cancer, history of benign breast disease, and hormonal influences that promote breast maturation and may increase the chances of cell mutation, late menopause, no term pregnancies or first child after thirty years of age.
modifiable: obesity, inactivity, and alcohol intake greater than one drink per day
describe the clinical signs associated with breast cancer
a mass, a puckering, nipple retraction, or unusual discharge.
what is the significance of a sentinel lymph node biopsy?
Sentinel node biopsy is a surgical procedure used to determine whether cancer has spread beyond a primary tumor into your lymphatic system.
So basically determining if it’s metastasized into your lymphatic system
explain treatment options for breast cancer, including surgery, and Tamoxifen
surgery: total or partial mastectomy
Tamoxifen
gold standard
approved for treating established disease and for primary prevention in women at high risk.
MOA: metabolites block ERs on breast cancer cells and thereby prevent receptor activation by estradiol, the principal endogenous estrogen. Estrogen actus on tumor cells to stimulate growth and proliferation. In the absence of estrogen, the rate of tumor cell proliferation declines and tumors regress in size.
ae’s: hot flashes, fluid retention, vaginal discharge, nausea, vomiting, menstrual irregularities.
small risk of DVT, PE, and stroke.
for the antiestrogen Anastrozole MOA therapeutic uses ae's nursing implications
MOA: deprives breast cancer cells of estrogen, growth is stopped
therapeutic uses: POSTmenopausal women with early or advanced ER positive breast cancer.
ae’s: musculoskeletal pain, asthenia, headache, and menopausal symptoms (GI disturbances, hot flashes, vaginal dryness).
other: anorexia, vomiting, diarrhea, constipation, dyspnea, peripheral edema, vaginal hemorrhage, hypertension
nursing implications: can give mild dose of analgesic to help with the pain, high dose vitamin D and adequate intake of calcium to reduce bone loss. Women at high risk for bone loss should take a bisphosphonate (Zoledronate or Denosumab)
for the aromatase inhibitor Trastuzumab MOA therapeutic uses ae's nursing implications
MOA: binds with HER2 and inhibits cell proliferation and promotes antibody dependent cell death
therapeutic uses: alone in women who failed to respond to prior chemotherapy, in combination with paclitaxel as first line therapy, and for adjuvant treatment as part of a regimen containing doxorubicin, cyclophosphamide, and paclitaxel.
ae’s: cardiotoxicity, manifesting as ventricular dysfunction and CHF. Flu like syndrome as a first dose response, will diminish the more infusions they have.
nursing implications: bc of cardiotoxicity, should be used with caution in women with pre-existing heart disease. NO CONCURRENT use with doxorubicin and other anthracyclines.
SAFETY ALERT SAFETY ALERT SAFETY ALERT
can cause potential fatal hypersensitivity reactions, infusion reactions, and pulmonary events.
symptoms include urticaria, bronchospasm, angioedema, hyPOtension, dyspnea, wheezing, pleural effusion, pulmonary edema, and hypoxia requiring oxygen.
Most severe reactions develop in association with the first dose, either during the infusion or by 12 hours after. STOP the infusion if symptoms start during it.
