Chapter 19 Flashcards
(87 cards)
1
Q
3 main types of hysterectomy
A
- partial
- total
- radical
(4th is hysterectomy with bilateral salpingo-oophorectomy)
2
Q
radical hysterectomy
A
removal of
- uterus
- cervix
- fallopian tubes
- ovaries
- upper portion of the vagina
- lymph nodes
3
Q
partial hysterectomy
A
removal of
- uterus
*cervix left in place
4
Q
total hysterectomy
A
removal of
- uterus
- cervix
5
Q
hysterectomy post op care
A
- monitor:
-VS
-blood loss
-LOC
-lung sounds - use anti-embolism stockings
- pain relief and assist w/ ambulation (standing)
6
Q
polycystic ovary syndrome (PCOS)
A
cysts on the ovaries
- endocrine disorder
- genetic component
7
Q
women with polycystic ovary syndrome (PCOS) are at risk for:
A
- Type 2 DM
- cardiovascular disease
- HTN
- cancer
- hyperlipidemia
- pregnancy/birth complications
- sleep apnea
8
Q
cystocele
A
- anterior prolapse
- wall btwn vagina and bladder weakens (prolapsed bladder)
- bulging mass in the anterior wall of the vagina
9
Q
rectocele
A
- posterior prolapse
- wall btwn vagina and rectum weakens (prolapsed rectum)
- bulging mass in the posterior vaginal wall
10
Q
s/sx of polycystic ovary syndrome (PCOS)
A
- infertility
- menstrual disorders
- hirsutism (excess hair on mouth/chin)
- ovarian cysts
- obesity
- pelvic pain
- male pattern baldness
11
Q
endometriosis
A
chronic inflammatory disease in which the presence and growth of endometrial tissue is found outside the uterine cavity
12
Q
endometriosis s/sx
A
- LBP
- pelvic pressure
- dyspareunia (genital pain)
- infertility
- premenstrual spotting and menorrhagia (heavy/prolonged bleeding)
- diarrhea, pain with defecation, and constipation usually present when there are lesions of the bowel
- bloody urine and dysuria usually present when there are lesions on the bladder
- fixed retroverted uterus
- enlarged and tender ovaries
13
Q
dyspareunia
A
genital pain before, during or after intercourse
14
Q
sexually transmitted infections are primarily transmitted
A
transmitted through sex
15
Q
top 3 reported STIs
A
- chlamydia
- gonorrhea
- syphilis
16
Q
what population has the highest reporting of STIs
A
adolescent females
17
Q
how can someone reduce the risk of an STI?
A
- know your partner:
-communicate with partner about STI
-have regular pelvic exams, pap smears, HPV tests - be in a monogamous relationship
- be with partner that has been screened and know to be negative
- use condoms or dental dams (correctly)
18
Q
vaginitis
A
inflammation of the vagina
19
Q
common types of vaginitis
A
- candida vaginitis (yeast infection)
- bacterial vaginosis
- trichomoniasis
20
Q
candida vaginitis: what is it/causes it
A
aka yeast infection
*fungus lives on the surface of the body and grows when the vagina ecosystem is disturbed:
- hormone changes
- corticosteroids
- antibiotics
21
Q
bacterial vaginosis
A
occurs when normal vaginal flora is disrupted
22
Q
trichomoniasis
A
aka trichomonas vaginalis (STI)
*inflammation of the vagina and/or vulva
23
Q
chlamydia
A
- transmitted through digital-vaginal/vulva contact
- most common bacterial STI in the US
- most women are asymptomatic
24
Q
gonorrhea: prenatal complications
A
premature rupture
- miscarriage
- preterm labor
25
syphilis
single painless ulcer (chancre) in the genital area, mouth, or point of contact
- transmitted through oral-anal contact
- shows up 10-90 days after contact
- lasts 4-6 weeks
- usually resolves w/out treatment (Penicillin G if needed)
26
condylomas are also called
genital warts
27
genital warts
- painless warty growth in the vagina or on the vulva, perineum, or anal areas
28
s/sx of yeast infection
- itching
- white cheesy discharge
- pain with sex
- burning with urination
29
treatment of yeast infection
- fluconazole
- clotrimazole
- miconazole
30
s/sx of bacterial vaginosis
- fishy smelling vaginal odor
- milky discharge that is thin, white or gray in color
31
treatment of bacterial vaginosis
- metronidazole
- clindamycin
- tinidazole
32
management of trichomoniasis
- metronidazole
- partner needs to be tested and treated
- condoms used to prevent future infections
33
how is trichomoniasis confirmed?
microscopic evaluation
34
what is a clear sign of trichomoniasis?
copious amounts of green discharge
35
why do we put erythromycin in the baby's eyes after birth?
to prevent newborn blindness from contraction of gonorrhea through their eyes
36
s/sx of gonorrhea
- silent, sometimes burning on urination
- backache
- pain during sexual intercourse
37
name the infection: copious amounts of green discharge
trichomoniasis
38
name the infection: fishy odor
bacterial vaginosis
39
name the infection: mucopurulent cervical discharge
chlamydia
40
name the infection: white cheesy discharge
candidiasis (yeast infection)
41
name the infection: silent- or burning on urination
gonorrhea
42
UTI
infection of the urinary system
- bladder, urethra, ureters, kidneys
43
why are UTIs more common in women?
- shorter urethra in close proximity to the vagina and anus: closer proximity to bacteria that does not belong in the urinary tract system (most common UTIs are cystitis and urethritis)
- more common in older women because of suppressed immune system, weakened bladder muscles (incomplete emptying), decreased estrogen (alters normal vaginal flora- E. coli)
44
s/sx of UTI
- dysuria
- frequency
- feeling of bladder fullness
- tenderness
- cloudy, foul-smelling urine
- LBP
- low-grade fever
45
treatment of UTI
antibiotics
- ciprofloxin
- nitrofurantoin macrocrystals
- bactrim
46
nursing actions for patient with UTI
- drink 2-4 quarts of fluid daily
- void q2-4 hours
- empty bladder pre and post intercourse
- wipe front to back
- wear cotton
- avoid tight fitting clothing
- avoid caffeine and ETOH
- patient teaching: s/sx of UTI
47
organs are supported by __ , ___ , and ____
muscles, ligaments, and fascia
48
pelvic organ prolapse
weakened structures (muscles, ligaments, fascia) lead to organ prolapse
49
common disorders associated with pelvic organ prolapse
- cystocele
- rectocele
50
risk factors for prolapse organs
- large babies
- vaginal deliveries
- assisted deliveries- forceps or vacuum
- poor repairs of episiotomy or lacerations
- obesity
- low levels of estrogen (menopause)
51
uterine prolapse
the uterus descends out of the vagina
52
s/sx of uterine prolapse
- uterine protrusion
- LBP
- heaviness in the pelvis region
- sensation uterus is falling out
53
treatment of uterine prolapse
- pessary
- surgery
54
what happens as a result of (s/sx) of cystocele
- stress incontinence
- bladder infections
- fullness/pressure in vaginal area
55
what happens as a result of (s/sx) of rectocele
- constipation
- irritation of vaginal mucosa
56
nursing actions for cystocele and rectocele
- teach kegel exercises
- prevent constipation to prevent straining
- avoid heavy lifting
- discuss weight loss strategies
57
urinary incontinence
loss of bladder control
- stress incontinence
- sudden urge
58
what is female stress incontinence?
condition in which females fail to control their urination in certain situations
59
treatment of urinary incontinence
- bladder training
- schedule trips
- limit caffeine and alcohol
- weight loss
- kegel exercises
- pessary or vaginal insert
- surgery
60
breast disorders
fibrocystic disease
breast cancer
61
fibrocystic disease
- benign cysts and fibrous tissue develop in the breast
62
how common is fibrocystic disease
50%
63
management/teaching for patient with fibrocystic disease
- supportive bra
- avoid caffeine, smoking and alcohol
- apply heat to breasts
- OTC pain meds (NSAIDs, acetaminophen)
- oral contraceptives
64
how is fibrocystic disease diagnosed
mammogram
65
s/sx of fibrocystic disease
- cyclic bilateral pain (usually in upper outer quadrants of breasts)
- increased engorgement and density
- increased nodularity
- fluctuation in size of the cystic areas
66
breast cancer risk factors
- increased age (most invasive form found in 55+)
- defects in the genes BRACA1 & BRACA2
- family hx (2/10 dx)
- dense breasts
- personal hx of breast cancer in at least 1 breast
- exposure to head or chest radiation
- obesity
- early periods, late menopause or hormone treatment
- smoking
- excess alcohol use
67
breast cancer treatment
- depends on stage
- surgery
-lumpectomy
-partial/segmental mastectomy
-simple mastectomy
-modified radical mastectomy
- radiation
- chemotherapy
- hormone therapy
- targeted treatment (trastuzumab)
68
breast cancer is diagnosed
(** in this order)
- mammogram
- ultrasound
- MRI
- breast biopsy
69
after a woman has a mastectomy she may choose to do ____, which is done ____ (timing)
breast reconstruction surgery
- done at same time as mastectomy
70
gynecological cancer (locations)
- cervix
- uterus
- ovaries
- fallopian tubes
- vagina
- vulva
71
cervical cancer: primary cause
HPV
72
cervical cancer is diagnosed via
pap smear
73
growth rate of cervical cancer
typically, slow growing
74
risk factors for cervical cancer
- HPV
- sex before 16
- smoking cigarettes
- STIs
- multiple sex partners
- birth control more than 5 years
- birth to 3 or more children
75
s/sx of cervical cancer
- watery, pink/brown bloody or foul smelling discharge
- abnormal bleeding btwn periods
- dyspareunia
- weight loss/gain
- fatigue
- pelvic or back pain
76
intimate partner violences (IPV) includes
- physical violence
- sexual violence
- stalking
- psychological aggression
77
who can IPV be committed by?
- current partner
- former partner
78
risk factors for IPV
- low self esteem
- low academic achievement
- adolescent or young adult
- alcohol or drug abuse
- having low friends
- marital conflict
- partner dominance and control in relationship
79
characteristics of abusers
- extreme jealousy
- possessiveness
- controlling behaviors
- blaming partner for bad things
- demeaning partner
- controlling what the partner wears
80
critical signs of IPV
- repeated nonspecific complaints
- overuse of healthcare system
- hesitancy, embarrassment, or evasiveness in detailing hx of injury
- time lag btwn injury and seeking care
- untreated serious injuries
- overly solicitous partner who stays close
- head, neck, face, and areas covered by 1-piece bathing suit (bruises/cuts/harm)
- during pregnancy- injuries to abdomen or breasts
- bruises in various stages of healing
81
nursing actions if you suspect your patient experiences IPV
- universal screening
- routine assessment
- documentation of abuse
82
common questions to ask your patient if you suspect (IPV)
- has your partner ever hit you?
- do arguments with your partner result in you feeling bad about yourself?
- do you every feel frightened about what your partner says or does?
- do you feel safe in your current relationship?
83
licensed HCP are legislatively mandated reporters of ____
- suspected abuse, neglect or exploitation of certain groups of people
84
s/sx of UTI in older women
**differ from normal s/sx
- confusion/delirium
- agitation
- hallucinations
- poor motor skills/dizziness
- falling
- fever- needs immediate treatment, serious infection
85
most common bacterial STI in the US & leading cause of infertility and ectopic pregnancies
chlamydia
86
type of hysterectomy used to treat some cases of reproductive cancer
radical hysterectomy
87
type of hysterectomy that leaves the cervix in place
partial hysterectomy
