CH 53 Caring for client with female reproductive system

What is the main cause of anemia in a client with active uterine leiomyoma?

menorrhagia Uterine leiomyomas or fibroids cause menorrhagia, which in turn causes anemia.

A client has been diagnosed with endometriosis. When planning this client's care, the nurse should prioritize what issue?

Acute pain related to misplaced endometrial tissue

A client undergoing treatment for vaginosis is also counseled about measures to prevent its recurrence. Which statement by the client best indicates effective counseling?

"I will avoid douching after my period." Vaginitis is a condition in which the vagina is inflamed. Frequent douching predisposes the client to vaginitis.

An elderly client, who can void only while standing and pushing upward on the vagina, is ordered a pessary. Which comment from the client indicates a need for further teaching about this device?

"I will remove and clean it every day." Pessaries should be removed, cleaned, and replaced periodically (at least every 2 months). If the client is unable to manage the pessary, then follow-up appointments should be made with the practitioner

During a routine sports physical examination, the nurse practitioner recommends HPV vaccination for an 11-year-old girl. Which statements by the client's mother demonstrates understanding of HPV vaccinations?

"I will track follow-up appointments in my smartphone so she receives all three injections."

A client is being treated for trichomoniasis. The client has received instructions about the prescribed drug therapy. The nurse determines that the client needs additional teaching when she states which of the following?

"My partner will not need any treatment." Trichomoniasis is treated with metronidazole. Both partners are treated and receive a one-time loading dose or smaller dose three times a day for a week. The client may experience a transient metallic taste when taking the drug. Client are strongly advised to abstain from alcohol when taking metronidazole because of a possible disulfiram-like reaction.

Which client has the highest risk of ovarian cancer?

45-year-old client who has never been pregnant

client is receiving the Gardasil vaccine. The nurse teaches that the client will receive three doses over how many months? Fill in the blank with a number.

6

A patient reports to the nurse that she has a sense of pelvic pressure and urinary problems such as incontinence, frequency, and urgency. The problem has gotten much worse since the birth of her third child. What does the nurse suspect the patient is experiencing?

A cystocele Cystocele is a downward displacement of the bladder toward the vaginal orifice

A 25-year-old woman has repeated vaginal infections. The symptoms suggest that the client has candidiasis caused by the yeastlike microorganism Candida albicans. After C. albicans is identified as the causative organism, the nurse would expect the physician to prescribe which treatment?

A nonprescription antifungal medication

A client states that PMS is significantly disrupting quality of life and that conservative management has failed to produce relief. What pharmacologic treatment may benefit this client?

A selective serotonin reuptake inhibitor (SSRI)

A client comes to the free clinic reporting a gray-white discharge that clings to the external vulva and vaginal walls. A nurse practitioner assesses the client and diagnoses Gardnerella vaginalis. What would be the most appropriate nursing action at this time?

Advise the client that this is an overgrowth of normal vaginal flora.

Which of the following would alert the nurse to a possible risk factor for developing cervical cancer?

Age at first coitus Risk factors for developing cervical cancer include an early age with first coitus, early childbearing, overweight status, and sexual intercourse with uncircumcised males.

A student nurse is caring for a client who has undergone a wide excision of the vulva. What action is contraindicated in the immediate postoperative period?

Ambulation to a chair

A client with diabetes and heart failure is taking an antibiotic, loop diuretic, corticosteroid, and an antipyretic medication. What medicines and/or conditions would likely increase the client's risk of developing the infection Candida albicans? Select all that apply.

Antibiotics Corticosteroid Diabetes

A client reports stress incontinence, pelvic pain, and a feeling like "something is dropping out of my vagina." The client is diagnosed as having a pelvic organ prolapse and the treatment plan includes using a pessary. Which instructions will the nurse include in client education?

Apply a sterile lubricant to the pessary before it is reinserted.

The nurse is caring for a patient postoperatively who had a simple vulvectomy. What nursing interventions should be provided to this patient? Select all that apply

Cleansing the wound daily Offering a low-residue diet Positioning the patient with pillows

A client is postoperative day 1 following a vaginal hysterectomy. The nurse notes an increase in the client's abdominal girth and the client reports "bloating." What is the nurse's most appropriate action?

Apply warm compresses to the client's lower abdomen.

A client's current health reports are suggestive of a diagnosis of premenstrual dysphoric disorder (PMDD). Which should the nurse do first?

Assess the client for risk of suicide.

The nurse is planning health education for a client who has experienced a vaginal infection. What guidelines should the nurse include in this program regarding prevention?

Avoid commercial feminine hygiene products, such as sprays.

During consultations with the oncologist, a client with cervical cancer is informed that radioactive materials will be inserted in the area of the tumor. She has to undergo these sessions over a period of 3 weeks. Which method of cancer treatment is being described?

Brachytherapy

A 36-year-old client comes to the clinic reporting that premenstrual syndrome (PMS) is disrupting quality of life. What signs and symptoms are associated with this health problem? Select all that apply.

Breast tenderness Depression Fluid retention Headache

A nurse practitioner examines a patient suspected of having endometriosis. The nurse knows that although a definitive diagnosis could not be made without diagnostic treatment (transvaginal ultrasound), the most frequent symptom is:

Chronic pelvic pain.

Over the past 2 months, a client has been receiving treatment for multiple ear infections and tonsillitis. The client reports a curdy white vaginal discharge and burning with urination. What is the most likely cause of these symptoms?

Candida albicans

Which type of yeast infection is manifested by white, cheese-like discharge?

Candidiasis

While taking a health history on an Assigned Female at Birth (AFAB) client, the nurse ascertains the client has recently been treated with fluconazole. Which will the nurse educate the client about?

Candidiasis

A client who underwent an anterior colporrhaphy 6 hours ago has not voided. She reports some discomfort in her suprapubic area. Which of the following would the nurse expect to do?

Catheterize the client.

A client in their late 30s has been having unusually heavy menstrual periods combined with occasional urine and stool leakage over the past few weeks. Upon further inquiry, they also report post coital pain and bleeding. To which diagnosis will the investigation most likely lead?

Cervical cancer

Which of the following nursing interventions would a nurse be likely to employ for a client with premenstrual syndrome? Select all that apply.

Encourage the client to follow a regular schedule for meals. Explain how to maintain an accurate menstrual diary. Teach the client to reduce caffeine consumption.

Which of the following is the descent of the small intestine into the vaginal vault?

Enterocele

A client has just received a diagnosis of premature ovarian failure. How would this diagnosis be confirmed?

FSH level determination

A patient informs the nurse that she believes she has premenstrual syndrome and is having physical symptoms as well as moodiness. What physical symptoms does the nurse recognize are consistent with PMS? Select all that apply.

Fluid retention Low back pain Headache

The physician sees a 42-year-old woman for suspected fibroid tumors (myomas). In addition to pressure in the pelvic region, which sign or symptom is the client most likely to reveal during the nursing history?

Heavy menstrual bleeding

A young client presenting at the health clinic with fever and mucopurulent vaginal drainage is diagnosed with acute pelvic inflammatory disease (PID). Which long-term affect is of greatest concern in the care of this client?

Infertility

A client is ordered a vaginal cream for the treatment of a yeast infection. What teaching should the nurse include for inserting the vaginal medication?

Insert the medication into the vagina using an applicator.

A client who is Assigned Male at Birth (AMAB) presents to the clinic for an annual check-up. The nurse notices that the client wrote on a form that they identify as a woman and prefer the pronouns she/her. Which best practice(s) of gender diverse care should the nurse utilize? Select all that apply.

Introducing oneself using name and pronouns Entering the client's name, gender, and preferred pronouns in their health care record Remaining nonjudgmental while delivering care

"I will track follow-up appointments in my smartphone so she receives all three injections."

It grows within the wall of the uterine muscle.

In a discussion regarding fetal development, the nurse informs the client that as growth of the fetus increases, the amount of amniotic fluid increases. The client asks the nurse to explain the purpose of the amniotic fluid. Which response given by the nurse is most appropriate regarding the purpose of amniotic fluid?

It helps protect the fetus from external injury.

The nurse notes that a patient has a history of "fibroids" and is aware that this term refers to a benign tumor of the uterus. What is a more appropriate term for a fibroid?

Leiomyoma

The nurse is caring for a 63-year-old client with ovarian cancer. The client is to receive chemotherapy consisting of paclitaxel and carboplatin. For what adverse effect of this treatment should the nurse monitor the client?

Leukopenia

The nurse in the gynecology clinic is interviewing a patient who informs the nurse that her mother and aunt had carcinoma of the cervix. What does the nurse recognize are two chief symptoms of early carcinoma that the patient should be questioned about?

Leukorrhea and irregular vaginal bleeding or spotting

A recent colposcopy revealed precursor lesions for a client. A procedure was recommended to evaluate and remove any abnormal cells in the cervix. The client is most likely scheduled for what outpatient procedure?

Loop electrocautery excision procedure Loop electrocautery excision procedure (LEEP) is an outpatient procedure where a thin, wire loop laser is used to cut away a thin layer of cervical tissue and remove any abnormal cells.

In educating a patient with PMS about changing her dietary practices, what would the nurse recommend that she increase her intake of

Magnesium

A patient diagnosed with endometriosis asks for an explanation of the disease. What should the nurse explain to the patient?

Tissue from the lining of the uterus has implanted in areas outside the uterus.

Which of the following is a term used to describe excessive menstrual bleeding?

Menorrhagia Menorrhagia is excessive menstrual bleeding. Amenorrhea is the absence of menses. Dysmenorrhea is painful menses. Metrorrhagia is excessive and prolonged menstrual bleeding.

Which drug is the most effective treatment for trichomoniasis?

Metronidazole

A client has returned to the postsurgical unit after vulvar surgery. What intervention should the nurse prioritize during the initial postoperative period?

Monitoring the integrity of the surgical site

A client has a history of dysmenorrhea. During monthly menses, the client experiences incapacitating cramping and passes large clots. The client's primary care physician initiates conservative treatment. What interventions would the physician to recommend?

NSAIDs

A 16 year old client is diagnosed with a complete abruptio placenta. Which nursing action is most appropriate?

Obtain a written consent for an immediate C-section.

While caring for a client who is being treated for severe pelvic inflammatory disease (PID), which nursing action minimizes transmission of infection?

Performing hand hygiene when entering the room

A client is admitted to the health care center with abdominal pain, nausea, and vomiting. The client has a body mass index (BMI) of 30 and reports irregular menstrual cycles and feeling tired all the time. The nurse suspects the client's symptoms to indicate which condition?

Polycystic ovary syndrome (PCOS)

Which of the following should be a nurse's priority in considering causes for amenorrhea?

Pregnancy

A client diagnosed with cervical cancer will soon begin a round of radiation therapy. When planning the client's subsequent care, the nurse should prioritize actions with what goal?

Protecting the safety of the client, family, and staff

A 25-year-old client diagnosed with invasive cervical cancer expresses a desire to have children. What procedure might the care team offer as treatment?

Radical trachelectomy

Which position occurs when the uterus turns posteriorly as a whole unit?

Retroversion

A patient has had a pessary inserted for long-term treatment of a prolapsed uterus. As part of the teaching plan, what should the nurse advise the patient to do?

See her gynecologist to remove and clean the pessary at regular intervals.

A client who has been diagnosed with endometriosis has been provided with treatment options and is feeling anxious about making the right decision. Which suggestion would be the least effective in assisting the client with this process?

Stress that this is a serious condition and an immediate decision needs to be made.

A client recently diagnosed with premenstrual syndrome (PMS) meets with the nurse to discuss lifestyle changes that will aid in relieving symptoms. Which intervention(s) should the nurse suggest during the discussion? Select all that apply.

Take a vitamin E supplement. Eliminate alcohol prior to menstruation. Consume complex carbohydrates and foods high in calcium.

A client comes to the clinic reporting a tender, inflamed vulva. Testing does not reveal the presence of any known causative microorganism. What aspect of this client's current health status may account for the client's symptoms of vulvitis?

The client has type 1 diabetes. ulvitis, an inflammation of the vulva, may occur because of other disorders, such as diabetes, dermatologic problems, or poor hygiene.

A 34-year-old client has been diagnosed with endometriosis. What topic should the nurse emphasize during health education?

The importance of reporting a possible pregnancy as soon as it occurs

A client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client?

This condition puts them at a higher risk for cervical cancer; therefore, they should have a Papanicolaou (Pap) smear annually.

The nurse is caring for a client who has been diagnosed with genital herpes. When preparing a teaching plan for this client, what general guidelines should be taught?

Thorough handwashing is essential.

A client has herpes simplex 2 viral infection (HSV-2). The nurse recognizes that which of the following should be included in teaching the client?

Treatment is aimed at relieving symptoms

A client tells the nurse that they think they have a vaginal infection because the client has noted inflammation of the vulva and the presence of a frothy, yellow-green discharge. The nurse recognizes that the clinical manifestations described are typical of what vaginal infection?

Trichomonas vaginalis

A patient has been diagnosed with a vaginal infection and received a prescription for metronidazole (Flagyl). The nurse knows that this is the recommended treatment for a vaginal infection caused by what organism?

Trichomonas vaginalis

A patient is diagnosed with Bartholinitis. What organism does the nurse recognize the patient is most likely infected with?

Trichomonas vaginalis

A nurse is using a diagram to educate a client with a pelvic organ prolapse. Which condition would the client have based on the illustration?

Uterine prolapse

Which term describes an opening between the bladder and the vagina?

Vesicovaginal fistula

A teenage girl is brought to the clinic by a parent. The parent explains to the nurse that the daughter has just started using tampons, but is not yet sexually active. The parent states, "I am very concerned because my daughter is having a lot of stabbing pain and burning." Assessment reveals no signs of infection, so the nurse should suspect what health problem?

Vulvodynia

What interventions for the relief of pain and discomfort can the nurse educate the patient with a vulvovaginal infection about using? Select all that apply.

Warm perineal irrigations Sitz baths Cornstarch for chafed inner thighs

A client has been diagnosed with polycystic ovary syndrome (PCOS). The nurse should encourage what health promotion activity to address the client's hormone imbalance and infertility?

Weight loss

Over the past 2 months, a client has been receiving treatment for multiple ear infections and tonsillitis. The client reports vaginal discharge and itching. What is likely the cause of the client's vaginitis?

antibiotics When antibiotics are taken for a long time or repeated courses of antibiotic therapy are necessary, an overgrowth of yeast-like fungi that usually exists in small numbers in the vagina can occur, resulting in vaginitis. Antibiotics or frequent douching eliminate the bacilli that promote an acidic vaginal environment, which can lead to vaginitis.

Which is the earliest and the most common symptom of endometrial cancer?

bleeding

A client is experiencing symptoms associated with menopause. What is a likely recommendation to increase the client's interest in sexual activity?

low-dose androgens

Which abnormality is not considered a structural abnormality?

pelvic inflammatory disease

During the health history, a client informs the nurse that the client's mother was prescribed DES early in her pregnancy for the client. The nurse must stress the need for frequent gynecological examinations for this client in order to:

prevent the onset of cervical cancer.

A nurse is advising a client who has just had her first menses on how to use a tampon. Instructions include using the least absorbent tampon and changing tampons frequently, at least every 4 to 6 hours. Which condition is the nurse most likely trying to prevent?

toxic shock syndrome