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Female reproductive disorders Flashcards

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1
Q

Benign Breast disorders:

A 
Breast pain
Cysts
Fibrocystic
Fibroadenomas 
Atypical ductal hyperplasia 
Lobular carcinoma in situ
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2
Q

What are the types of cysts?

A

Simple - require no intervention, can aspirate to relieve discomfort

Complicated - fluid inside, rarely malignant, aspirate to confirm it is complicated

Complex - wall is thick, solid, need biopsy to confirm it is benign

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3
Q

Fibrocystic breast disorder

A

Transient breast mass - typically r/t hormones

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4
Q

What are fibroadenomas (cause)

A

usually caused by cell abnormalities – causes a firm, round, movable nodule.

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5
Q

what is a risk atypical ductal hyperplasia

A

incidental finding, increases risk of cancer and

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6
Q

What is a risk with lobular carcinoma in situ

A

incidental finding, can indicate risk for cancer

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7
Q

Risk factors for breast cancer

A

Women, aging, inherited genetic mutation, family history, personal history, history of benign proliferative breast disease, history of high dose radiation to chest, hormonal factors, history of ovarian or endometrial cancer

obesity, alcohol consumption post-menopause, hormone replacement

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8
Q

Examples of screening and prevention of breast cancer

A 
Screening recommendations
Prevention strategies in the high-risk patient
- long term surveillance 
- chemoprevention
- prophylactic mastectomy
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9
Q

Clinical manifestations of breast cancer

A 
Dimpling
Nipple retraction
Skin ulceration
Nodule 
Hard/firm breast tissue
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10
Q

What are ways that breast biopsy can be obtained?

A 
Fine needle aspiration
Ultrasound guided 
Stereotactic breast biopsy
MRI guided biopsy
Surgical biopsy
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11
Q

Types of breast cancer

A

Ductal carcinoma in situ
Infiltrating ductal carcinoma
Infiltrating lobular carcinoma
Medullary carcinoma

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12
Q

Surgical management of breast cancer

A 
Lumpectomy
Simple mastectomy
Modified radical mastectomy
Radial mastectomy
Breast conversion therapy
Sentinel lymph node biopsy
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13
Q

What are complications of surgical management of breast cancer

A

Lymphedema
Hematoma and seroma formation
Infection

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14
Q

Breast cancer: reconstruction surgery

A

You can can reconstructive surgery for

  1. lumpectomy
  2. after mastectomy, this includes
    - tissue expander followed by permanent implant
    - tissue transfer procedures
    - nipple-alveolar reconstruction
    - prosthetics
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15
Q

Patient education - hand and arm care after axillary lymph node dissection (ALND)

A

Avoid blood pressures, injections, blood draws in the affected extremity
Sun screen (at least 15 spf)
Apply insect repellant to avoid insect bites
Wear gloves for gardening
Use cooking mitt for removing objects from oven
Avoid cutting with cuticles - push back instead
Avoid lifting >5-10 lb (increases pressure)
Avoid tight jewelry, clothing, bandages on arm
Avoid chemical hair removers
Observe area or 24 hours
If trauma or break in the skin occurs, wash area with soap and water and apply OTC abx ointment

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16
Q

Systemic therapy for breast cancer

A 
Radiation
Neoadjuvant
Adjuvant 
Biologic
Endocrine 
Chemo
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17
Q

What is neoadjuvant for systemic therapy of breast cancer

A

Give before surgery to help decrease tumor size

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18
Q

What is adjuvant for systemic therapy of breast cancer

A

Given with surgery to eradicate any residual tissues involved

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19
Q

What is biologic systemic therapy for breast cancer

A

looking at monoclonal antibodies to target specific protein to reduce the occurence rate of the tumor

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20
Q

What is endocrine systemic therapy for breast cancer

A

Estrogen is a hormone that is produced by ovaries that can increase breast cancer growth - so tamoxifen can be prescribed to work on blocking the effects of estrogen on the breast tissue

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21
Q

MANAGING the sfx of adjuvant hormonal therapy in breast cancer: hot flashes

A 
Wear breathable, layed clothing 
Avoid caffeine and spicy food
Perform breathing exercises 
Considered medications (medications, antidepressants)
Acupuncture
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22
Q

MANAGING the sfx of adjuvant hormonal therapy in breast cancer: vaginal dryness

A

Use vaginal moisturizers for everyday dryness

Apply vaginal lubrications during intercourse

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23
Q

MANAGING the sfx of adjuvant hormonal therapy in breast cancer: n/v

A

Bland diet

Try to take medication in evening

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24
Q

MANAGING the sfx of adjuvant hormonal therapy in breast cancer: Musculoskeletal symptoms

A

Take NSAIDS

Warm baths

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25
MANAGING the sfx of adjuvant hormonal therapy in breast cancer: risk of endometrial cancer
Report any irregular bleeding
26
MANAGING the sfx of adjuvant hormonal therapy in breast cancer: Risk for thromoembolic events
Report and redness, swelling, or tenderness in the lower extremities or any unexplained SOB
27
MANAGING the sfx of adjuvant hormonal therapy in breast cancer: risk for osteoporosis or fractures
Undergo a baseline bone density scan Perform regular weight bearing exercises Take calcium supplements with vitamin D Take biphosphonates (alendronate) or calcium as prescribed
28
What are examples of reproductive disorders
Amenorrhea Dysmenorrhea Abnormal uterine bleeding PMS
29
What are the types of amenorrhea
Primary - not getting period until after age of 16; usually caused by some type of endocrine disorder Secondary - already est. a regular cycle then it goes away (i.e., eating disorder)
30
What are the types of dysmenorrhea
Primary: occurs at onset of period Secondary: well after menstrual cycle; usually caused by some type of organic or structural cause (i.e., fibroids)
31
What are symptoms you will experience during ovulation
``` Tender breasts Increased sex drive Spotting mucus discharge Lower abdominal pain increased body temperature ```
32
when does PMS occur
week before period
33
Bacterial vaginosis: risk factors
``` New or multiple sex partners douching increase in sexual activity retained foreign body in body (tampon, condom) co-existing STI ```
34
Bacterial vaginosis: manifestations
Malodorous vaginal discharge, greyish or white in color | Odor more noticable after intercourse or menses
35
Bacterial vaginosis: medical/nursing management
Metronizole
36
What is the primary cause of vulvovaginal candidiasis
Candidia
37
vulvovaginal candidiasis risk factors
antibiotics, corticosteroids, pregnancy, increased sexual partners, sex toys, sexual partner who is not circumcised, diabetes
38
vulvovaginal candidiasis s/s
Dysuria, redness, inflammation, itching, dysmenorria, pain with intercourse, thick-white curd-like discharge
39
vulvovaginal candidiasis medical and nursing management
Monostat, fluconizole education on proper hygiene
40
Female prolapse: Cystocele
The herniation of the bladder into the anterior vagina
41
Female prolapse: Rectorcele
The extrusion of the rectum into the posterior vagina
42
Female prolapse: Enterocele
The descent of the small intestine into the vaginal vault
43
Female prolapse: uterine prolapse
Downward descent of the uterus into the vagina
44
Female prolapse: vault prolapse
Top of the vagina prolapses after a hysterectomy
45
What can help with female prolapses?
Regular exercise, reconstructive surgery, kegels
46
Female structural disorders: fistula
abnormal opening between 2 organs - usually between vagina and rectum biggest issue -- incontinence and infection
47
What are signs and symptoms of a fistula
urinary or fecal incontinence
48
What is medical management of fistulas
sitz bath changing perineal pads good hygiene reconstructive surgery
49
What are examples of benign disorders of the female reproductive system?
Cysts Fibroids Endometriosis
50
What are functional (simple) cysts
rupture or hemorrage occassionally causing pain | - typically treated with NSAIDS
51
What are nonfunctional cysts
developed as result of sloughed-off endometrial tissue and form a cystic mass on the ovaries
52
fibroids - risk factors
african american | over weight
53
Fibroids - s/s
usually asymptomatic unless it impacts other organs, then you will see - irregular bleeding - dysmenorrhea - pelvic pain - potentially infertility
54
What is medical management of fibroids
hysterectomy fibroid removal NO ASPIRIN -- increase risk for bleeding
55
What is endometriosis
progressive, benign disorder impacting women in childbearing years
56
What is cause of endometriosis
chronic inflammation | formation of adhesions
57
Endometriosis
``` Chronic pelvic pain lower back pain dysmenorrhea dysuria dyskensia (pain w defacation) ```
58
Endometrosis
NSAIDS and surgical intervention | hysterectomy
59
What are malignant conditions of the female reproductive tract
Cervical malignancies Uterine malignancies Ovarian malignancies Vulva malignancies -- best screening tool is pap smear
60
What are risk factors for malignant conditions of female reproductive tract
``` Intercourse with uncircumcised men early age of intercourse multiple sex partners STI Cig smoking exposure to HPV ```
61
Cervical cancer tx
radiation
62
uterine cancer tx
removal of fallopian tubes and ovaries or full hysterectomy radiation chemo
63
ovarian cancer s/s
``` bloating changes in bowel/bladder habits irregular bleeding UTI weight gain gerd ```
64
vulva cancer r/t what
HPV
65
Vulva cancer s/s
itching, burning
66
What are the types of hysterectomy
Total abdominal hysterectomy (TAH) | Total vaginal hysterectomy
67
Total abdominal hysterectomy (TAH) teaching
no driving for 4-5 weeks avoid heavy lifting, pushing, pulling vaginal bleeding for 1 week
68
Total vaginal hysterectomy (TVH) - what to know about it
``` less blood loss quicker recovery short hospital stays fewer infections less pain than abominal approach, which required incisions through abdominal muscles ```
69
Hysterectomy - nursing management for surgical patient
``` pain DVT, PE wound infection UTI Return of bowel/bladder functions Lungs - incentive spirometer early ambulation discharge planning ```
70
Trangender community - health disparities and nursing management
care for them how they want to be cared for - be respectfull hormone therapy - think about the physical and emotional changes they experience --> high risk for SI
71
Rectovaginal fistula
abnormal openings that occur between the vagina and the rectum, allowing fecal material and flatulence to leak into the vagina, causing fecal incontinence

NURSING 3 (16 decks)

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