Exam 6- hiv/ cancer/ reproductive Flashcards
(226 cards)
1
Q
Hiv is retrovirus-
attacks what
specifically what
attacks what ability
A
attacks immune system-
specifically t cells
This attacks the ability to fight infections
2
Q
Risk factors HIV
what infections
what sex
multiple
what sex
what use
hx
what exposure
A
sti infections,
male to male sex,
multiple partners
Unprotected sex,
iv drug use,
hx of blood transfusion,
peri/breast milk exposure
3
Q
Hiv is present in
s
b
v s
b m
c
s
A
semen,
blood,
vaginal secretions,
breast milk,
csf,
saliva
4
Q
HIV is not present in
u
s
A
urine
stool
5
Q
what does being a retrovirus mean- carries information where
How does HIV work in the body? (patho)
A
carries information in rna
6
Q
when HIv enters body- affects what cells
once inside cell- does what
A
When it enters body- affects cells that are a T lymphocyte(CD4 antigen)
Once inside cell- Virus will shed its coat and convert from rna to DNA
7
Q
HIV does what with DNA
does what to host cell
A
DNA is then duplicated into host cell and duplicated during cell division
Kills host cell
8
Q
cannot detect HIV until what takes place
how long do you need to wait to detect
A
Cannot detect HIV until seroconversion has taken place- this is when the Body tries to make antibodies against HIV
Starts from 6 weeks to 6 months after initial exposure
9
Q
is hiv testing confidential
A
yes
10
Q
Acute/initial exposure stage-
wait how long for testing
is it still contagious
A
wait 6 weeks and up to 6 months for seroconversion-
you can still spread to others at all stages
11
Q
Primary/acute infection Early HIV s/s-
unexplained
n s
/
d
f
m
what like symptoms
unintentional
swollen
A
unexplained fever,
night sweats,
n/v, diarrhea,
fatigue,
malaise
, flu-like symptoms ,
unintentional Weight loss,
swollen lymph nodes
12
Q
Stage 2- asymptotic stage ”recovery/dormant stage”
what s/s
are they contagious
A
- no external symptoms/no s/s-
host is still contagious-
13
Q
Stage 3- symptomatic-
what is developed
s/s
f
m
what loss
what skin
r
A
aids is developed- end stage-
appearance of infections-
fever,
malaise,
wt loss,
dry skin,
rash
14
Q
Stage 3- symptomatic-
pt needs what
A
pt needs hospice, palliative care, comfort care, cannot go back
15
Q
ELISA test-Most widely used to diagnose HIV
what does it test for
does not detect what
HIV Labs and Diagnostics
A
Tests for the HIV antibodies,
does not detect active virus
16
Q
ELISA TEST
best used how long into exposure
HIV Labs and Diagnostics
A
99.5% or higher sensitivity when performed at least 13 weeks after infection
False negative is possible if prior to 13week exposure mark
17
Q
why also need an absolute CD4 lymphocyte count
monitors what-
HIV Labs and Diagnostics
A
monitors progress of disease and how treatment plan is working
18
Q
HIV rapid antibody Test4
what type of test
interpreted how
HIV Labs and Diagnostics
A
Rapid test in office, with strips that turn varied colors
Interpreted visually
19
Q
HIV Viral Load Tests
measures what
HIV Labs and Diagnostics
A
Measure amount of actively replicating HIV
20
Q
HIV Viral Load Tests
correlates to:
what progression
what response
HIV Labs and Diagnostics
A
Correlate to
disease progression
and response to AR medications
21
Q
CBC-Used to detect
a
L
t
L
HIV Labs and Diagnostics
A
anemia
Leukopenia
Thrombocytopenia
Lymphopenia
22
Q
may need what for potential HIV exposure
get what in females
A
May need to rule out other things, like getting tb test, mri
cultures for infections,
and get pap smears on females- cervical caner risk is increased
23
Q
HAART meds management in HIV
what stands for
what type of drugs
A
Highly
Active
Antiretroviral
Therapy
“ine” “vir” drugs
24
Q
med management -hiv
what is barrier for meds
why do they need strict compliance
need what plan
always do what
A
Medications are very expensive
Explain need for compliance with patients-can go into aids if miss an hour
need a missed dose plan
always have meds
25
goals of HAART meds
suppress
provide
reduce
increasing
Suppress the infection itself
Provide prophylaxis of opportunistic infections
Reduce HIV morbidity decreasing symptoms and prolonging life
Increasing quality of life
26
Nursing Interventions for HIV/AIDS
watch for increased risk of what
Increased risk of opportunistic infections
Bacterial
Viral
Fungal
27
Opportunistic Infections-Risk is predictable by the CD4 T-cell count
what is over 1000/mcl
what is below 500 mcl
what is below 200 mcl
Normal range is greater than 1000/mcL
When below 500/mcL immunodeficient is seen
When below 200 / mcL opportunistic infections and cancers are likely
28
examples of oppurtisitic infections
Pneumocystis Pneumonia
Tuberculosis-
Herpes Virus infections
Sinusitis
Parasitic infections
Candida Albicans
Pelvic inflammatory disease
29
what are precautions for HIV patients
Standard precautions unless they have an active disease process
30
when hiv positive mother is pregnant
what type of birth
no what
bloodless c section
no breastfeeding
31
airborne precautions
fit-tested N95
placing the patient in a negative pressure room,
and keeping the door closed.
32
contact precautions
gowns and gloves, and proper hand hygiene practices.
33
droplet precautions
face mask and distancing
34
neutropenic precautions
monitor what
wear what
no what x 2
stop who
always do what
monitor temperature
wear ppe
no fresh fruit and no flowers
no sick visitors
always do hand hygiene
35
Organ complications of HIV- affects
c
h
n
, cardio,
hepatic,
nephropathy
36
Kaposi Sarcoma- affects what are common places for lesions-
s
p
t
f
v o
Secondary Cancers-HIV
skin,
palate,
toes,
face,
visceral organs (gi,lymph,lungs)
starts as painless but get painful as disease progresses
37
Non-Hodgkin Lymphoma (most common)- s/s
h
changes
f
n s
Secondary Cancers-HIV
headache,
changes in loc,
fever,
night sweats
38
what invasive cancer
Secondary Cancers-HIV
Invasive Cervical Carcinoma-
39
AIDS- when what CD4
200/mcL -without opportunistic infections
40
S/s of Aids
general
f
f
n s
involuntary
what skin
d
o l
what risks
General malaise
Fever
Fatigue
Night Sweats
Involuntary weight loss
Skin dryness and rash
Diarrhea
Oral lesions
Opportunistic infections risk
Cancers r/t HIV
41
Nursing Interventions AIDS
what referral
what management
what prevention
Palliative/hospice referral support
Symptom management
Further infection prevention
42
Nursing Interventions AIDS
treatment of what
what support
what compliance
Treatment of cancers
Emotional/psychosocial support-Teach coping strategies
Medication administration and compliance
43
Nursing Interventions AIDS
reduce what behaviors
what diet
promote what
Reduce Risk Prone Behaviors-like reducing unprotected sex
Weight/nutrition support –high protien/low sugar
Promote Skin Integrity
44
cancer- malignant neoplasm -patho
normal cells do what
what is function of these cells
Normal cells that change into abnormal (cancer or malignant) cells due to exposure to carcinogen, genetic predisposition, functioning of immune system
that serve no useful purpose and are harmful to normal body tissues
45
malignant neoplasm consequences
destroys what
decreases what
spread to where
Destroys normal tissue,
decreasing function in that tissue or organ
spread into other areas to form another tumor
46
malignant neoplasm -cancer- s/s
Pain
Impaired immune & blood-producing function
Altered GI structure & function
Motor & sensory deficits
Decreased respiratory function
Infection
Hemorrhage
47
Cancer - Risk Factors
Genetics / Heredity
Age-70+
Gender
Poverty-access to healthcare, nutrition
Stress-high
Diet-sugar, processed foods
Occupation
Infection
Tobacco use / Alcohol use / other drug use
Obesity
Sun Exposure
48
Neoplasm- what is it
Cancer
new and abnormal tissue growth in the body (cancer)
49
Differentiation - definition
cancer
allows cells to special is certain tasks.
50
Hyperplasia Differentiation–
increase in what x2
is it reversible
increase in number and density of normal of cells-
reverasble
51
Metaplasia Differentiation–
change into what
change in normal pattern of differentiation cells
-change into types normally found in that part of body
52
Dysplasia Differentiation-
loss of what
cells look how
is it reversible
loss of dna control over differentiation –
cells are abnormal in size, shape and appearance-
reversable
53
Anaplasia Differentiation-
regression
loss
is it reversible
regression of cells into immature, undifferentiated cell types-
loss of useful function
- non reversible
54
: What are characteristics of malignant cells?
Loss of regulation of the rate of mitosis
Loss of specialization and differentiation
Loss of contact inhibition
Progressive acquisition of cancerous phenotype
Irreversibility
Altered cell structure
Simplified metabolic activities
Transplantability (metastasis)
Ability to promote their own survival
55
where is most common site of metastasis for sex cancers
what does that cause
sex cancers commonly metastasis to bone
bone pain is general complaint
56
what borders
how fast of growth
how easily can be removed
do they recur
Benign neoplasms-noncancerous
Local
Cohesive
Well-defined borders
Pushes other tissue out of the way
Slow growth
Encapsulated
Easily removed
Does not recur
57
malignant neoplasms
how fast of growth
I
goes where
does it recur
rapid growth
invasive
metastasizes to other sites
can recur
58
Physical and Psychological Effects of Cancer
disruption of what
what alteration
risk for what
Disruption of Function-like bowel
Hematologic Alteration
Risk for Infection
59
Physical and Psychological Effects of Cancer
risk of what
a
p syndromes
Risk of Hemorrhage
Anorexia (Cachexia Syndrome)-lose lots of weight
Paraneoplastic Syndromes
60
Physical and Psychological Effects of Cancer
what pain
what stress x2
Acute and Chronic Pain
Physical Stress
Psychological Stress
61
Cancer – Diagnostics
Cytologic Examination
Ongoing Imaging (X-ray, CT scan, MRI, ultrasonography, nuclear imaging, PET scan)
Direct Visualization (endoscopy, sigmoidoscopy, bronchoscopy)
62
cancer- diagnosis
why staging
what tests
what markers
Staging- sees if encapsulated or invading other tissues
Lab Tests
Tumor Markers
CEA (Carcinogenic embryonic antigen)
PSA (Prostate specific antigen)
CA 125-Ovarian Cancer
63
Surgical interventions
prophylactic surgery->
diagnostic surgery->
primary treatment->
Cancer – Treatment
Prophylactic surgery-removing breast before breast cancer
Diagnostic surgery- to diagnose
Primary treatment- remove tumor/tissue/ lymph nodes
64
what does in situ cancer mean
In situ- cancer that has stayed in placed it began and did not spread
65
cancer-
what drug for bladder cancer
what drug for leukemia/lymphoma
what drug for breast cancer
what drug for nausea/vomiting
bladder- cisplatin
l/l- vocsritine
breast- tamoxifen
ondansetron
66
Chemotherapy
involves use of what
disrupts what
how classified
Involves use of cytotoxic medications
Disrupts the cell cycle
Classified by effect of agent or by pharmacologic properties
67
Chemo-
suppresses what
causes what
Suppreses bone marrow,
causes thromyocyopenia,
low wbc,
low rbc counts
68
nursing care plan for anemic chemo pt
allow what
prevent what
allow lots of rest
prevent illness from occurring
69
nursing care for leukemia pt
what 2 precautions
nuetropenic
bleeding
70
bleeding precautions
avoid what
what toothbrush
e r
prevent what
what to do if bleeding
avoid straining
soft toothbrush
electric razors
prevent falls
if bleeding- apply direct pressure and put above head
71
Alkylating agents- how does it work
Chemotherapeutic Agents-
Cancer - Treatment
-damage dna to prevent cell replication-
72
Alkylating agents- side effects
what disruption
I
L
irreversible
Chemotherapeutic Agents-
Cancer - Treatment
bone marrow disruption/failure,
infertility,
leukemia,
irreversible kidney function
73
Antimetabolites- s/s
/
s
d
a
L
what toxicity x2
Chemotherapeutic Agents-
Cancer - Treatment
– n/v ,
stomatitis,
diahhra,
alopecia,
leukopenia,
liver and lung toxicity,
74
Antitumor antibiotics -
disrupt what
creates what
Chemotherapeutic Agents-
Cancer - Treatment
disrupt DNA replication and RNA transcription,
create free radicals:
75
Antitumor antibiotics - s/e
Chemotherapeutic Agents-
Cancer - Treatment
( s/e cardiac muscle damage,
76
Mitotic inhibitors: -prevent what
Chemotherapeutic Agents-
Cancer - Treatment
prevent cell division in the M phase (,)
77
Mitotic inhibitors s/e
what depression
m w
what disruption
p i
depression of DTR,
motor weakness,
cranial nerve disruptions,
paralytic ileus
78
Hormones (corticosteroids)-what alter
Chemotherapeutic Agents-
Cancer - Treatment
: alter cellular function and growth
79
Hormones- s/e
impaired
what glucose
what bp
o
Chemotherapeutic Agents-
Cancer - Treatment
Impaired healing,
hyperglycemia,
hypertension,
osteoporosis
80
Hormone antagonists:-how work
Chemotherapeutic Agents-
Cancer - Treatment
block hormone’s receptor site on tumor)
81
Hormone antagonists: s/e
secondary what
Chemotherapeutic Agents-
Cancer - Treatment
secondary sex characteristics-
hot flashes malaise, blood clots, wt gain
82
Tumor Lysis Syndrome- causes
what k
what uric acid
what phosphosrus
what calcium
Cancer - Complications
high K,
high uric acid,
high phosphorus,
low calcium
83
Tumor Lysis Syndrome- s/s
/
e
what fluid
what failure
t
a
s
Cancer - Complications
n/v,
edema,
fvo,
HF,
tetany,
arrythmias,
syncope
84
Tumor Lysis Syndrome- tx
Cancer - Complications
managing electrolyte imbalances
85
Hypercalcemia- from what
Cancer - Complications
from excessive parathyroid hormone secretion-
86
Hypercalcemia- s/s
f
p
c
diminished
complications of cancer
fatigue,
polyuria,
constipation,
diminished reflexes,
87
Hypercalcemia- tx x2
Cancer - Complications
biophosphates and diuretics
88
Sepsis- s/s
what volume
what temp
what bp
what hr
Cancer - Complications
hypovolemia, fever, hypotension, tachycardia
89
Sepsis- tx
Cancer - Complications
tx is antibiotics and pressers and fluid
90
Superior Vena Cava Syndrome-
why does it happen
Cancer complications
tumor pushes on SVC-
91
Superior Vena Cava Syndrome- s/s
p e
f e
what distress
cancer complication
periorbital edema,
facial edema,
respiratory distress //
92
Superior Vena Cava Syndrome-tx
what support
s
b
what if medical emergency
Cancer complications
respiratory support,
steroids,
bronchidailators,
trache if medical emergency
93
Alopecia or hair loss- teach what
Side Effects of Chemotherapy
teach emotional care
94
Nausea and vomiting
adminster what
monitor what
Side Effects of Chemotherapy
administer antiemetics/
monitor hydration/nutrient status
95
Mucositis- teach what
Side Effects of Chemotherapy
teaching oral care
96
Skin changes
what schedule
stay what
Side Effects of Chemotherapy
– turning schedule,
stay hydrated
97
anxiety/sleep disturbance - teach what
Side Effects of Chemotherapy
teach emotional care
98
Altered bowel elimination –
high what x3
Side Effects of Chemotherapy
high water, fiber and mobility
99
Decreased mobility –
passive
what to movement
Side Effects of Chemotherapy
passive rom
space out movement
100
Bone marrow suppression –
monitor what
what precautions
Side Effects of Chemotherapy
monitor wbcs, platletets, rbcs
bleeding/infection precautions
101
Thrombocytopenia
monitor what
what precautions
Side Effects of Chemotherapy
–monitor platelets-
bleeding precautions
102
What methods can chemo be given?
p
o
d
Preparation of chemotherapy agents
Port,
oral
direct into site
103
Preparation of chemotherapy agents
needs to wear what
HCP need to wear gloves, mask, gown when preparing, administering, and disposing chemo
104
Preparation of chemotherapy agents
HCP needs what
be careful w what
HCP need to be certified
Be careful with the patient’s body fluids- use ppe
105
Radiation Therapy
does what to tumor
Cancer - Treatment
- kills tumor or shrinks its size
106
External (tele-therapy)-
needs what
put what on burn
do not do what
wash how
Cancer - Treatment
needs marking-
put cold compress on burns,
do not rub skin
, wash with soap/water
107
Brachytherapy (internal):
how does it work
Cancer - Treatment
radioactive material is placed directly into tumor cavity-
108
Brachytherapy
needs what
no what
Cancer - Treatment
need private room,
no visitors longer then 10-30 mins
109
What are side effects of radiation therapy?
B
u
p
f
what changes
what complications
Cancer - Treatment
Burns,
ulcerations,
pneumonia,
fistulas,
skin changes
, gi complications
110
Biotherapy: use of what to enchance immune system
A
g f
v
no what
Cancer Treatment – Other Therapies
use of antibodies,
growth factors,
vaccines
no live vaccines
111
Photodynamic therapy (phototherapy, photo-radiation, photo-chemotherapy)
what is given first
drug activated how
Cancer Treatment – Other Therapies
IV dose of a photosensitizing compound (Photo-frin) given first
Drug activated by laser treatment
112
what transplantations x2
Cancer Treatment – Other Therapies
Bone marrow
and peripheral blood stem cell transplantations
113
Complementary therapies-
n
d
v
m
Cancer Treatment – Other Therapies
nutrition,
diet,
vitramins,
meditation
114
Bone Marrow Transplantation (BMT)
tx what
used following what
Tx of some forms of leukemia-
used following chemo/radiation
115
Bone Marrow Transplantation (BMT)
allogenic
autogenous
Allogenic- donated from healthy donor
Autogenous- from yourself pre chemo/radiation
116
Bone Marrow Transplantation (BMT)
how long is recovery
what is the bad things about it
Recovery is 6months to 1 year
Very expensive
117
Peripheral Blood Stem Cell Transplantations (PBSCT)
removing what
when returning them
Cancer – Treatment
Removing stem cells from peripheral blood through apheresis
and returning cells to patient after chemotherapy
118
Peripheral Blood Stem Cell Transplantations (PBSCT)
compared to bone marrow therapy:
fewer that
shorter what
decreased what
Cancer – Treatment
Fewer side effects,
shorter hospitalization,
and decreased cost compared to BMT
119
Bone marrow transplant and stem cell- can cause what
what happened
occurs when
can cause graft vs host disease
Immune cells of donated bone marrow identify body as foreign invader
occurs days to weeks following bmt
120
Graft vs host- T lymphocytes in donates marrow attack liver, gi, skin
Causing
r
d
what bleeding
what damage
rashes,
diahhrea,
gi bleeding,
liver damage
121
Actinic Keratoses-
from what
what is tx- f/c
Skin Cancer
from the sun
- tx is ryosurgery (freezing) or with 5-fluorouracil (5-FU) cream and remove before sun makes It worse
122
(Nonmelanoma) Basal Cell ->Carcinoma;
most common, least aggressive
examples
Skin Cancer
Nodular
Superficial
Pigmented
Morpheaform
Keratotic
123
Basal cell carcinoma
tx-before/after
Skin Cancer
Tx Is preventative tx- sunscreen, limit sun exposure
after-surgery or freeze to get off
124
Basal cell carcinoma - if left untreated
Skin Cancer
can destroy body parts
125
Squamous Cell Carcinoma (nonmelanoma)
manifestations
worse looking skin lesions-
scaly red patches, open sores, rough, thickened or wart-like skin, or raised growths with a central depression
126
Squamous Cell Carcinoma (nonmelanoma)
locations
how to remove
on areas that are exposed to the sun, like forehead, ear, nose, back of hand
remove with surgical
127
Melanoma (deadliest form of skin cancer)
what needs to be checked out immediately
what very quickly
Any sings of asymmetrical or irregular borders needs to be checked out immediately
Metastasizes very quickly
128
risk for melanoma
white skin
blue eyeds
blond hair
129
Melanoma (deadliest form of skin cancer)
tx
s
i
r
b
Tx with surgery/
immunotherapy/ (interferons, interleukins)
radiation therapy/
biologic therapy(antibodies, growth factors, vaccines)
130
Multiple Myeloma (bone cancer) what kind of cancer
White blood cell cancer of plasma cells
131
Multiple Myeloma (bone cancer) Patho
what happen uncontrollably
spreads how
: plasma cells multiple uncontrollably into tissues-
spreads via blood stream to other organs
132
Multiple Myeloma (bone cancer)-Manifestations:
f
easily
what pain
f
what bp
increased what
what calcium
what fluid
what glucose
fatigue,
easy bruising,
bone pain,
fractures,
hypertension,
increased infection,
hypercalcemia,
fluid imbalance
high glucose
133
Multiple Myeloma (bone cancer) Dx with
xray, biopsy, protein, serum calcium, bun, uric acid, urine samples
134
Multiple Myeloma (bone cancer)-Treatment
this is what
what is palliative care
control what
what for high calcium
- terminal,
palliative care is radiation,
control pain/ symptoms
calcitonin
135
Trichomoniasis
what discharge
what tx
Sexually Transmitted Infections
greenish, white discharge
Tx: metronidazole
136
Chlamydia
what discharge
what tx
Sexually Transmitted Infections
yellowish discharge
Tx: Azithromycin or doxycycline
137
Gonorrhea
what similar to
what tx
Sexually Transmitted Infections
similar to Chlamydia
Tx: Ceftriaxone IM and azithromycin
138
Herpes genitalis
what s/s
what tx
Sexually Transmitted Infections
blisters
Tx: no cure, can take antivirals to prevent outbreaks
139
Syphilis
what s/s
what tx
Sexually Transmitted Infections
chancre-painless genital ulcer
Tx: penicillin , if not treated early can be deadly and deadly to fetus
140
Venereal Wart (HPV)
what s/s
tx- l/c/a
sexually Transmitted Infections
Condylomas acuminatum,-small genital warts
Tx: laser warts off, cryotherapy, acid
141
Pelvic Inflammatory Disease
what builds up
from what x2
scar tissue that builds up
from chlamydia or gonorrhea
142
Pelvic Inflammatory Disease
Signs and Symptoms:
what pain
what w active sti
positive what
Pelvic Pain
Discharge with active STI
Positive Chandelier sign-
143
Positive Chandelier sign-
Pelvic Inflammatory Disease
Manuel pelvic exam that causes pelvis to be thrusted up towards sky because pain is so difficult
144
Pelvic Inflammatory Disease Prevention
what methods
limit what
if have it, get what->
- barrier methods,
limit sex partners,
if have pid-> get annual pap smears
145
Pelvic Inflammatory Disease tx
a
routine what
antibiotics
routine pelvic exam
146
Polycystic Ovarian syndrome definition
what disorder
excess what
what may form
endocrine disorder characterized by
excess of androgens-
cysts may form in ovaries
147
Polycystic Ovarian syndrome-Signs and Symptoms-
a
o
a
what bp
s a
I
what resistance
amenorrhea,
obesity,
acne,
hypertension,
sleep apnea,
infertility,
insulin resistance
148
amenorrhea-
what is it
still doing what
can they get pregnant
no period
still ovulating
can get pregnant
149
Polycystic Ovarian syndrome-Treatment
relief
lose what
/
may need what-risk for what
- relief of symptoms-
lose weight(metformin),
diet/exercise,
may need fertility meds-risk for clots-clomiphene
150
Endometriosis-Definition
what cells
found where
-endometrial cells normally found in uterus travel back into fallopian tubes and bowel/bladder
151
EndometriosisSigns and Symptoms-
chronic what
d
chronic pelvic pain,
dysmenorrhea,
152
EndometriosisTreatment
Medical
controlling what
what pills
- controlling s/s,
birth control pills- oral contraceptives, goserelin, depo-provera,danazol, aramotose
153
EndometriosisSurgical-
dnc, laparoscopy, lyses of adhesions, maybe hysterectomy
154
Cervical Cancer- what is it
Progressive disorder from normal cells premalignant cells (dysplasia) cancer in situ (CIS)
155
Cervical CancerRisk factors:
multiple what
what sti
what ethnicity
multiple sex partners,
sti (HPV),
hispanics and African Americans
156
Cervical Cancer-S/Sx:
bleeding when
postmenopausal bleeding, bleeding after intercourse
157
cervical cancer health promotion
what test
control what
what alternatives
what vaccine
Pap Test
Control risk factors
Safe sex alternatives
Gardasil vaccine against cervical cancer and other diseases caused by certain types of the human papillomavirus (HPV
158
Cervical Cancer Diagnosis
p s
c
c b
L
: Pap smear,
colposcopy
, cervical biopsy,
Leep (dx and Tx), excision
159
Cervical Cancer Treatment: depends on stage of Ca
r/c
Radiation, chemotherapy
160
Cervical Cancer Surgical treatment:
electrosurgical excision (LEEP),
laser therapy,
cryosurgery conization,
hysterectomy,
pelvic exenteration
161
Colposcopy
: A procedure in which a gynecologist uses a lighted magnifying instrument which is called a colposcope to examine the tissues of the vagina and the cervix
162
Endometrial Cancer (cancer of uterus) Numerous risk factors-
prolonged what
early what
late what
hormonal what
no what
prolonged estrogen ,
early onset periods,
late menopause,
hormonal replacement tx
no kids,
163
Endometrial Cancer (cancer of uterus)S/Sx:
abnormal what
pelvic what
bleeding when
low what
abnormal painless vaginal bleeding (menorrhagia/ postmenopausal bleeding),
pelvic cramping
, bleeding after intercourse,
low abdominal pressure.
164
Endometrial Cancer (cancer of uterus) Advanced s/s
what abdominal
p e
a
presentation of what
: abdominal mass,
pleural effusion,
ascites,
presentation of bowel obstruction
165
Endometrial Cancer Diagnosis
d
e b
t u
dilation and curettage (D & C),
endometrial biopsy,
transvaginal ultrasound
166
Endometrial Cancer Treatment
what therapy
r
c
&
what if stage 2 or greater
: Hormone therapy,
radiation,
chemotherapy
, TAH & bilateral salpingo-oopharectomy,
radical hysterectomy for stage 2 or greater
167
Endometrial CancerHealth Promotion:
p e
report what
pelvic exam,
report unexpected bleeding/spotting
168
Ovarian Cancer- what is it
90% are epithelial tumors,
most common is serous adenocarcinoma (fast growing & spreading)
169
Ovarian Cancer Risk factor
genetics,
170
Ovarian Cancer s/s
abdominal what
b
losing
c
f
abdominal discomfort,
bloating,
losing wt,
constipation,
fatigue
171
Ovarian Cancer Complications- metastasis to where
b
b
l
l
bone,
brain,
liver,
lymph
172
Ovarian Cancer Diagnosis
: palpation of abdominal mass, ultrasound, CT, MRI, PET scan, laparotomy, biopsy, CA-125
173
Ovarian Cancer Treatment
s
along with what
possible
: Surgery (TAH with BSO)
along with chemotherapy (remissive, not curative)
& possible radiation (external/intracavity implant)
174
TAH w BSO- risk for hypovolemic shock
do what counts
monitor what
check what
this surgery is what
do pad counts
monitor labs
check bandages
this surgery is very very painful
175
Cancer of Vulva Risk factors:
what std
what type of herpes
what age
d
hx of what
STDs (HPV),
Herpes simplex type 2,
advanced age,
DM,
hx of leukoplakia
176
Cancer of Vulva S/Sx:
a-
what discovered on examination
p
asymptomatic,
white macular patches to red painful sores discovered on examination,
pruritis (itching)
177
Cancer of Vulva Diagnosis:
e
c
b e
I
c
c/m
excisional biopsy of lesion,
CXR,
barium enema
, IVP,
cystoscopy,
CT, MRI
178
Cancer of Vulva Treatment
l s
c
e
v
: laser surgery
, cryosurgery,
electrocautery,
vulvectomy (in advanced disease) simple vs. radical (high risk for infection)
179
Fibrocystic breast changes-Benign breast disease
s/s
Benign Breast Disorders
Round, fluid-filled, freely movable cysts form in connective tissue
180
Fibrocystic breast changes
Shrink w/
p
L
m
Benign Breast Disorders
pregnancy
/ lactation /
menopause
181
Fibrocystic breast changes -Teaching
decrease what
increase what
have a good what
keep track of what
dont do what
Benign Breast Disorders
: decrease caffeine intake,
increase water intake,
good diet
, keep track of size,
don’t hesitate to call
182
Gynecomastia- what is it
growth where
Benign condition of breast enlargement in men
Abnormal growth of the glandular tissue (including mammary ducts & ductal stroma)
183
Gynecomastia-
usually what
if uni- evaluate for what
Usually bilateral after adolescence
(if unilateral, evaluate for cancer)
184
Gynecomastia- if men notice what(p/t/n d
could indicate what
If men notice pain/ tenderness, nipple draining-
come in because it could be breast cancer
185
Breast cancer- Most common site of metastasis is to
b
b
L
L
L
bone tissue
, brain,
lung,
liver,
skin
lymph nodes
186
Breast CA Risk/Prevalence
Age and gender
Family history-first gen
Genetic risk factors: BRCA1, BRCA2
Dense breast tissue
Personal history of breast cancer
Previous chest irradiation
Menstrual history
Lifestyle related factors –obesity/smoking
187
Breast CA Manifestation
Solitary, unilateral, solid, hard, irregular, poorly delineated, non-mobile, painless lumps
188
Breast CA Manifestations-
Most Ca in females are found where x2
in upper outer quadrant
tail of Spence – axilla ( armpit) area
189
Breast CA other potential Manifestations
d
p do
c
abnormal what
n r
Dimpling,
Peau d’orange,
cellulitis,
abnormal nipple discharge,
nipple retraction
190
Breast CA Diagnosis
c b e
m
p n b
b b
Clinical breast exam,
mammography
Percutaneous needle biopsy
Breast biopsy
191
Breast CA Interventions-Specific to each patient, their specific goals and outcome
what if early
what if it has metastasis
Early detection would be aimed at Cure
Metastasis: aimed at Improving quality of life and prolonging life
192
Breast CA Interventions- meds
what hormone therapy
what b
what inhibitor
r/c
hormone therapy- tamoxifen
bisosophaenate
aramtoase inhibitor
radiation/ chemo
193
what is always done
what just removes lump
what are masectomy/partial
what if enough skin
Breast Cancer Surgical interventions
Biopsy-always done
Lumpectomy- remove luml
Partial mastectomy-partial removal of bresat
Mastectomy – remove breast
Breast reconstruction- if enough skin on wall
194
Lymphedema
accumulation of what
caused by what
Breast Cancer Surgical complication
-- accumulation of fluid in soft tissues of the arm
caused by removal of lymph channels
195
prevention of lymphedema
no n
no b
no I
no c
no needles,
no blood draws,
no iv,
no compression(BP)
196
Breast CA Surgical Post-op Care
avoid what
Avoid using affected arm for B/P, injections, or drawing blood
197
Breast CA Surgical Post-op Care
what is routine post op
focus on maintaining what
Routine post - op vital signs, check dressing for bleeding,
Focus on maintaining physiologic stability and comfort
198
Breast CA Surgical Post-op Care
what to drain
post what
what positioning
Drainage tubes (Jackson-Pratt drain)
Post mastectomy exercises
Positioning- don’t lay on arm
199
Breast CA Health Promotion- early detection is key to srivval- how to early detect
m
b s e
c b e
Mammography
Breast self exam (BSE)
Clinical breast exam (CBE)
200
how to do self breast exam
how to do testicualr self exam
arm on head- use other hand to move circles
in shower- check one at a time for any lumps
201
Hydrocele - common
what is it
do you tx
Benign Scrotal Mass
Fluid filled mass in scrotum
Don’t tend to do anything unless painful
202
Hydrocele - common
Transillumination does what
Benign Scrotal Mass
to differentiate from solid mass and hydrocele
203
Spermatocele
what is it
due to what
Benign Scrotal Mass
-mobile painless mass
due to leakage of sperm, trauma or sti
204
Varicocele
abnormal what
can lead to what
Benign Scrotal Mass
- abnormal dilation of prismatic cord-
can lead to infertility
205
Testicular Cancer risk factors
c
waht age
f h
cancer where
Cryptorchidism-undescented testicle
age (20-54),
family history,
cancer of the other testicle
206
Testicular Cancer-Germ cell tumors come from what
what age
- come from sperm producing cells,
age 15-35 years
207
Testicular Cancer-Non-Germ cell tumors- do not usually do what
-usually do not metastasize
208
Testicular Cancer- non germ cell
interstitial cell tumors- may cause what
-may cause early puberty
209
Testicular Cancer-non germ cell
Androblastoma- may cause what
2-may cause gynecomastia
210
Testicular CA Manifestations
slight
what abdominal
feeling of what
Slight enlargement of 1 testicle with some discomfort
Abdominal ache
Feeling of heaviness in scrotum
211
Testicular CA metastasis Manifestations
edema where
b p
sytmptoms x2
include LE edema,
back pain,
respiratory symptoms,
GI symptoms
212
Testicular CA Interventions
c
r o
other
r
Chemotherapy
Radical orchiectomy
Radical/modified retroperitoneal lymph node dissection
Radiation
213
Testicular CA Interventions
may need what
can have what
May need sperm donation before had due to risk of infertility
Can have reconstruction
214
Prostate Cancer- where does it metastasis to
L
b
bones where
s
L s
lymph nodes,
bone marrow,
bones of pelvis,
sacrum
lumbar spine
215
Prostate CA Manifestations GU
d
f
reduction of what
n
h
abnormal
: dysuria,
frequency,
reduction of stream,
nocturia,
hematuria,
abnormal finding on exam
216
Prostate CA Manifestations MSK
what pain
migratory
b pain
: bone or joint pain,
migratory bone pain,
back pain
217
Prostate CA Manifestations Neuro
what pain
weakness where
what dysfunction
muscle
: nerve pain,
BLE weakness,
bowel/bladder dysfunction,
muscle spasms
218
Prostate CA Manifestations Systemic
w l
f
: weight loss,
fatigue
219
Prostate CA Manifestations Complications
m
a
Impaired what
- metastasis,
anemia,
impaired immune function
220
Prostate CA dx
what test
what is definitive
DRE and PSA test
Biopsy (Definitive
221
prostate cancer after diagnosis
c
m
what scan
ct
mri
bone scan
222
what increases risk for prostate cancer
diet high in
f
what vitamin
what ethnicity
fat
\
vitamin a
african American
223
Prostate CA /Treatment
w w
m
c
r
watchful waiting
medications
radiation
chemo
224
Prostate CA surgical Treatment
simple
radiacal
Simple prostatectomy-TURP
Radical prostatectomy-removal of prostate, capsule, seminal vesicles
225
post turp-
when stop bladder irrigation
why do you need strict I/o
monitor for what-(h / I/ bs})
when it is a watermelon colored
strict I/o to prevent turn syndrome- severe hyponatramia and can lead to seizures/coma/ death
monitor for infection, hemorrhage, bladder spasm
226
picc line manamgent
what technique
change what
use what method for medicaitions
always do what
sterile technique
changing dressing
use SASH method for medications
always clamp ports
