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Adult Nursing II > Reproductive Conditions > Flashcards

Reproductive Conditions Flashcards

1
Q

Define: Pap smear

A

A sampling of cells from the cervix being examined for potential cancer

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2
Q

Define: Colposcopy

A

A visualization of the cervix

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3
Q

Define: Endometrial biopsy

A

A tissue sampling from the inner uterine lining

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4
Q

Define: Laparoscopy

A

A visualization of the pelvic organs

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5
Q

Define: D & C

A

A scraping of the inner uterine lining

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6
Q

What is the optimum time for a monthly breast exam?

A

At the end of each menstrual cycle (when breast tissue is holding the lease amount of fluid). Exams should be monthly beginning with adolescence. Early familiarization alerts the pt to any changes.

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7
Q

Why is an axilla exam part of a breast exam?

A

Lymph nodes under the arm connect with the breast. A lump in the axilla area may be a sign of abnormal growth in the breast. Examinations can reveal enlarged nodes.

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8
Q

What is the nursing responsibilities regarding a female pt for a pelvic exam?

A

Have the pt empty her bladder completely. Position her in dorsal lithotomy position, careful to provide privacy. Provide emotional support. Help the pt relax.

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9
Q

What instructions will you give a pt in preparation for a mammogram?

A

Remind the pt not to wear deodorant or talcum powder under her arms for the test. Explain that the discomfort will only last seconds.

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10
Q

What measures should be taken by a pt with fibrocystic disease? Why? Which is most important?

A

** Monthly self-breast exams. To detect any changes.** Try heat or cold packs for pain relief. Also can use mild anti-inflammatories. - Avoid caffeine. Caffeine is believed to cause overgrowth of tissue. - Wear a supportive bra. - Vitamin E supplements. In some pts, Vitamin E has helped to break down cystic tissue. - Regular physician follow-up and regular mammograms. To follow course of disease and detect changes.

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11
Q

Post-surgical teaching for a pt who has just had a modified radical mastectomy:

A

Arm elevation will assist in lymph drainage in the arm - advise pt to avoid carrying items in the affected arm or purse straps over the affected shoulder - No blood draws, blood pressure readings, or injections should be done on affected side - monitor injuries on affected side. Requires immediate attention. - swelling, bruising, and tingling should be reported to the physician at once. - Exercises for affected arm to aid in lessening of edema.

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12
Q

What would a sentinel node biopsy (done with breast surgeries) reveal?

A

Performed to see if there is evidence of spread of cancer cells by injecting dye into lymph system, dissecting out the first node that picks up the dye and seeing if it is positive for cancer cells.

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13
Q

How is cervical dysplasia treated?

A

A conization (surgical excision of cone-shaped section of abnormal tissue). Preserves child-bearing possibilities. Laser surgery, LEEP, cryosurgery to remove abnormal cells. Hysterectomy.

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14
Q

Explain the pathophysiology of endometriosis

A

Endometrial tissue abnormally implants itself on other pelvic structures. It continues to respond to monthly hormonal changes, resulting in bleeding outside of the uterus which leads to eventual scar tissue, formation of cysts and adhesions.

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15
Q

Define: amenorrhea

A

absence of menses

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16
Q

Define: menorrhagia and a possible cause

A

Menorrhea- excessively heavy menstrual flow during menses. May be caused by fibroids

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17
Q

Define: metrorrhagia

A

Bleeding between periods

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18
Q

Define: dysmenorrhea and 4 possible causes

A

Dysmenorrhea: Menstrual cramps. Possible causes: endometriosis, PID, PMS, or uterine displacement. Often the cause is unknown.

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19
Q

Menstrual bleeding after menopause can be a sign of…

A

Endometrial cancer

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20
Q

Describe symptoms of vaginitis caused by Candida albicans

A

vaginal itching, thick white vaginal discharge, vaginal pain

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21
Q

Describe nursing interventions for a pts vaginitis caused by Candida albicans

A

Eating yogurt with live cultures is encouraged. Clean, dry, loose-fitting underwear. Reduce sugar intake. Anti-fungal medications.

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22
Q

What factors can lead to a candida albicans (yeast) vaginitis?

A

Taking antibiotics, taking corticosteroids or immunosuppressants, HIV+, diabetes.

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23
Q

What precautions must a pt take when taking metronidazole/Flagyl?

A

No alcohol ingestion. Can cause severe vomiting. Take with food as can cause stomach distress.

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24
Q

Symptoms of PID

A

Low-grade fever, pelvic or abdominal pain, a “bearing down” backache, foul-smelling vaginal discharge, nausea and vomiting, dysmenorrheal, intense pain on pelvic exam.

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25
Q

Treatment plan for a pt with PID

A

Antibiotics, oral, or IV, depending on severity. Medicated vaginal suppositories. Bedrest in semi-Fowler’s position. No douching, tampons, or intercourse (pelvic rest). Pt teaching: safe sex practices, perineal hygiene.

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26
Q

Advantages (benefits) associated with estrogen replacement therapy (ERT) in the menopausal pt.

A

Decrease symptoms such as hot flashes, moodiness. Protects against osteoporosis. Relieves vaginal dryness.

27
Q

Disadvantages (risks) associated with estrogen replacement therapy (ERT) in the menopausal pt.

A

Increased risk of endometrial cancer. Fluid restriction. Increased risk of thrombus/clot formation and other CV events (HA, stroke). Continues to have monthly cycles.

28
Q

What instructions should be given to a pt regarding the management of menopause?

A

Exercise is the best way to decrease the potential for calcium loss from weight-bearing bones. Adequate daily intake of calcium and vitamin D rich foods or supplements. Teach pt to perform Kegel exercises to strengthen perineal muscle and aid in supporting pelvic organs. Empty bladder frequently. Monitor for abnormal bleeding. Advise use of lubricants in vaginal area.

29
Q

In general, what are the key nursing responsibilities for any post-operative patient.

A

Physiologically: Encourage deep breathing and coughing to keep airway clear. Use incentive spirometer. Observe for perfusion (vital signs, warmth, and color/pallor) and signs of infection. Have pt perform leg exercises to prevent the development of blood clots and check calves for signs of clots. As recovery time goes on, encourage ambulation activity. Observe surgical sites for bleeding. Monitor intake and output. Psychologically: Allay anxiety/ Provide emotional support. When no longer focused on physiological needs, can begin post-op teaching that is necessary.

30
Q

Consequences of rectovaginal fistula

A

anal itching, leakage of stool or gas from the vagina

31
Q

Consequences of vesicovaginal fistula

A

recurring UTIs, passage of urine from vagina (urinary incontinence)

32
Q

Describe the significance and pt education for PSA test.

A

(Prostate specific antigen): blood serum measurement of prostate protein that can be an indicator of prostate disease or cancer if elevated.

33
Q

Describe the significance and pt education for digital rectal exam

A

method of screening for prostate cancer. Annual for men over 40.

34
Q

Describe the significance and pt education for alpha-fetaprotein test

A

Tumor marker blood test: elevated in testicular cancer.

35
Q

What is the significance of benign prostatic hypertrophy (BPH)?

A

Enlargement of the prostate can lead to urinary outlet obstruction causing difficulty urinating, nocturia, recurrent UTIs, and even kidney damage. Also can eventually result in complete blockage and urinary retention (medical emergency).

36
Q

Describe typical symptoms collected when a patient is experiencing the gradual enlargement of the prostate gland.

A

Getting up frequently at night to empty bladder (nocturia), difficulty starting flow of urine, decreased force of stream, lengthening the amount of time it takes to empty bladder, not completely emptying the bladder with leads to UTIs.

37
Q

What are the nursing responsibilities in the post-op care of a TUR-P patient?

A

Maintain the continuous bladder irrigation which reduces clot formation that could interfere with urinary drainage. Observe urine; bright red for more than a few hours could indicate hemorrhage. I & O. If patient complains of urgency or feeling the need to void, check patency of catheter first. Alleviate bladder spasms with medication.

38
Q

Why is continuous irrigation used post-op in the TUR-P patient?

A

To prevent and reduce formation which can interfere with urinary drainage.

39
Q

What is the treatment and nursing interventions for a pt with epididymitis or orchitis?

A

Bedrest. Scrotal support. Ice compress. Administration of antibiotics, if appropriate.

40
Q

What risk does a cryptorchidism pt face?

A

Higher incidence of testicular cancer.

41
Q

Explain the post-op teaching for a pt who has undergone a vasectomy

A

Rest for 2-4 hours after surgery with ice packs up to four hours postoperatively. Avoid strenuous activity or exercise for one week. Use a barrier method of birth control until specimens show no sperm (up to 6 weeks).

42
Q

What data is important to collect in an exam for a pt with suspected STI?

A

Pts sexual orientation and number of sexual contacts in past 6 months. Any prior treatment for STIs. Symptoms and history. Results of diagnostic tests and exams. Important to maintain a relaxed, non-judgmental attitude.

43
Q

STIs that can be transmitted to a newborn’s eyes

A

Chlamydia, Gonorrhea

44
Q

STI that should not be catheterized

A

Gonorrhea

45
Q

STI that spreads with direct mucous membrane contact

A

Gonorrhea

46
Q

“Silent STD”; many asymptomatic

A

Chlamydia

47
Q

STI with no cure available

A

Herpes Genitalis

48
Q

STI that is clean, painless ulcer formation

A

Syphilis

49
Q

STI that burns on urination

A

Gonorrhea, and sometimes Chlamydia

50
Q

acyclovir/Zovirax treats which STI

A

Herpes Genitalis

51
Q

penicillin G/Bicillin treats which STI

A

Syphilis

52
Q

ceftriaxone/Rocephin treats which STI

A

Gonorrhea, Chlamydia

53
Q

metronidazole/Flagyl treats which STI

A

Trichomoniasis

54
Q

What is the risk associated with Human Papillomavirus (HPV) in women?

A

Incidence of HPV infection is linked to the development of cervical cancer. It is even higher in women who smoke. Those with HPV need to have Pap smears regularly due to this cancer risk.

55
Q

What is the pharmacology recommendation for treating Gonorrhea?

A

PCN-resistant strains exist. Treat as if all are resistant. Usually one dose ceftriazone/Rocephin sufficient/ One time infected dose preferable in those who might not complete oral course.

56
Q

What is the pharmacology recommendation for treating Syphilis?

A

Penicillin (IM) sill the drug of choice.

57
Q

Describe the nursing interventions during a recurrence of Herpes Genitalis.

A

No cure; symptomatic treatment only. Keep perineal area clean and dry. Cotton underwear, loose clothing. Hand washing after toileting or handling area of lesions.

58
Q

Describe the medications used for Herpes Genitalis recurrences.

A

acyclovir/Zovirax can sometimes speed up healing or course of outbreak but does not cure it.

59
Q

Why can syphilis escape undetected, particularly in women?

A

A clean painless non-weeping ulcer is signs of syphilis but may form on the internal genitalia where it is not observed.

60
Q

Describe the symptoms of Gonorrhea

A

Urethritis, pus-like discharge from urethra, discomfort and burning on urination. Often no symptoms in women.

61
Q

Describe the symptoms of Syphilis

A

Painless, clean sores with no discharge, achiness, fatigue, fevers

62
Q

Describe the symptoms of Herpes

A

Painful vesicles that ooze and crust over several days to weeks.

63
Q

Describe the symptoms of Chlamydia

A

Often no symptoms. Could have urethritis.

64
Q

Describe the symptoms of HPV

A

Painless, papular growths in anus, genital areas for men and women.

Adult Nursing II (5 decks)

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