chapter 57 mangement of patient with female reproductive dirorder

Pataasin ang iyong marka sa homework at exams ngayon gamit ang Quizwiz!

Which statement is true regarding endometriosis?

It affects women of reproductive age.

A nurse is reviewing various treatment methods with a client diagnosed with a cystocele. Which of the following would the nurse describe as a nonsurgical method? Select all that apply.

Kegel exercises Pessary Colpexin sphere

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

Menorrhagia

Which of the following is an early symptom of vulvar cancer?

Pruritus with genital burning

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

Retroversion Explanation: In retroversion, the uterus turns posteriorly as a whole unit. In anteversion, the uterus tilts forward as a whole unit. In retroflexion, the fundus bends posteriorly. In anteflexion, the uterus bends anteriorly.

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

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

bleeding

Assessment of a client reveals evidence of a cystocele. The nurse interprets this as which of the following?

bulging of bladder

A patient had a pessary inserted for long-term treatment of a prolapsed uterus. As part of a teaching plan, the nurse would advise the patient to:

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

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.

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

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 woman in her late 30s has been having unusually heavy menstrual periods combined with occasional urine and stool leakage over the past few weeks. Upon further enquiry, she reveals that she also has postcoital pain and bleeding. To which diagnosis will the investigation most likely lead?

Cervical cancer

When a female client reports profuse purulent discharge, dysuria, and bleeding, the advance practice nurse is most likely to prescribe which medication to treat this condition?

Doxycycline for 1 week

A client who has cervical cancer is scheduled to undergo internal radiation. In teaching the client about the procedure, the nurse should tell the client that:

a bowel-cleansing procedure will precede radioactive implantation.

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 Explanation: Low-dose androgens are added to the hormone replacement regimen to restore an interest in sexual activity.

Which abnormality is not considered a structural abnormality?

pelvic inflammatory disease

Typical clinical manifestations of bacterial vaginosis (BV) include which of the following?

Malodorous, gray vaginal discharge

Which drug is the usual treatment for vulvar dystrophy?

Topical corticosteroids

A client who has been unable to conceive is intent on discovering the reason. The client has had very scanty, infrequent menses since their onset, and has a history of type 2 diabetes and acne. What could be the reason for this client's menstrual disorder?

polycystic ovarian syndrome Explanation: Polycystic ovarian syndrome, a condition characterized by a cluster of signs and symptoms that include amenorrhea and oligomenorrhea, affects women between 20 and 40 years of age. Polycystic ovarian syndrome is associated with multiple endocrine abnormalities such as overproduction and inefficient use of insulin and high testosterone levels. Women with this disorder tend to have problems including weight gain, excessive growth of body hair, acne, thinning hair or baldness, abnormal lipid levels, and hypertension.

Which is a risk factor for cervical cancer?

Exposure to the human papilloma virus (HPV)

Culture of client's vaginal discharge reveals Gardnerella vaginalis. Which of the following would the nurse expect to assess?

Fishy-smelling watery discharge

While caring for a client who is being treated for severe pelvic inflammatory disease (PID), the nurse insists on keeping the client in a semi-sitting position. The nurse advises this in order to:

facilitate pelvic drainage and minimize the upward extension of the infection. Explanation: While caring for a client hospitalized with PID, the nurse has to reduce the risk of the systemic spread of pathogenic microorganisms. The client must be advised to keep the upper body elevated; this facilitates pelvic drainage and minimizes the upward extension of infection.

Culture of client's vaginal discharge reveals Gardnerella vaginalis. Which of the following would the nurse expect to assess?

Fishy smelling watery discharge Explanation: Gardnerella vaginalis is associated with a gray white, watery, fishy smelling vaginal discharge. The discharge associated with a Candida infection is curdy white, thick, and strong. Discharge due to trichomonas vaginalis is yellow white, foamy, and foul.

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

While obtaining the history, a client reports that her mother was treated with diethylstilbestrol (DES) during her pregnancy. The nurse determines that this client is at risk for which of the following?

Cervical cancer

Which assessment finding will most likely influence the treatment regimen selected by a client with endometriosis?

Family planning Explanation: Selection of a more conservative option may be indicated to preserve the possibility for future childbearing. Pain, dysmenorrhea, and chocolate cysts are all symptoms associated with endometriosis and can influence decision for treatment.

The nurse is obtaining the history from a client who is suspected of having pelvic inflammatory disease (PID). Which client statement would help support the suspicion of PID?

"I was 15 years old when I first had sex." Explanation: Risk factors for PID include early age at first intercourse, mutliple sexual partners, frequent intercourse, intercourse without condoms, sex with a partner with a sexually transmitted infection, and a history of sexually transmitted infections or previous pelvic infections.

A client has just been diagnosed with endometriosis. Which of the following would be most appropriate to provide the client with support and guidance about treatment options? You Selected:

"It might help to include your partner in any of the discussions about options."

A 32-year-old client has been diagnosed with an ovarian cyst and asks the nurse, "Should I be worried about cancer?" Which response by the nurse would be most appropriate?

"Most cysts are benign in younger women, but it's good to have it checked out."

Malodorous, gray vaginal discharge Explanation: BV has a characteristic gray vaginal discharge with a "fishy" odor. Reference:

"My sexual partner will also need to be treated."

A client is being seen at the local community-based clinic where you practice nursing. Her healthcare provider has diagnosed the client with candidiasis and prescribed clotrimazole cream once daily for 7 days. You are providing education on how to administer the prescribed treatment. Which of the following techniques will the client use to administer this medication?

Administer cream at bedtime high into vaginal canal.

A client has been diagnosed with genital herpes. Knowing that education is an essential part of nursing care of the client with a genital herpes infection, the nurse plans to include which method(s) to minimize HIV transmission? Select all that apply.

Avoiding IV drug use Avoiding unprotected sexual intercourse Avoiding multiple sexual partners

A client has undergone a total abdominal hysterectomy and bilateral salpingo-oopherectomy as treatment for endometrial cancer. When providing postoperative care to this client the nurse would be alert for signs and symptoms of which of the following?

Bladder dysfunction

Which of the following is the preferred medication for bacterial vaginosis?

Metronidazole Explanation: The preferred medication for treatment of bacterial vaginosis is metronidazole 500 mg twice daily for seven days. Monistat, Gyne-Lotrimin, and Terazol are used in the management of candidiasis.

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) Explanation: Features of PCOS includes obesity, sleep apnea, and irregular menstrual periods.

A nurse who works in a gynecologist's office frequently cares for patients who are diagnosed with vulvovaginal candidiasis. The nurse should teach the patients how to manage and treat the most common symptom of:

Vulvar pruritus.

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 nurse is preparing a teaching plan for a client with a vulvovaginal infection. Which teaching would not be appropriate for the nurse to include?

Douche with a dilute vinegar solution twice a day.

Which is a risk factor for cervical cancer?

Exposure to HPV Explanation: Risk factors for cervical cancer include exposure to HPV, sex with uncircumcised males, overweight, and early childbearing.

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

FSH level determination Explanation: POF is diagnosed by determining the level of FSH in a sample of blood. A higher-than-normal level of FSH combined with the history of irregular menses or premature cessation of menstruation suggests POF.

A nurse is obtaining health history from a woman with suspected cervical cancer. Which of the following would the nurse identify as a possible risk factor?

History of chronic pelvic infections Explanation: Risk factors for cervical cancer include age younger than 20 years at first coitus, early childbearing, overweight status, and a history of chronic cervical or pelvic infections.

The nurse is providing education regarding sexually transmitted infections. Which statement regarding herpes virus 2 (herpes genitalis) is accurate?

In pregnant women with active herpes, babies delivered vaginally may become infected with the virus.

A nurse is preparing a presentation about cervical cancer for a local woman's group. Which of the following would the nurse include as a possible risk factor for the development of cervical cancer?

Infection with humanpapilloma virus (HPV)

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 patient is diagnosed with the most common type of uterine fibroid, an intramural fibroid. The nurse includes which information in teaching the patient about this type of fibroid?

It grows within the wall of the uterine muscle.

A client is in isolation after receiving an internal radioactive implant to treat cancer. Two hours later, the nurse discovers the implant in the bed linens. What should the nurse do first?

Leave the room and notify the radiation therapy department immediately.

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

Which of the following is the preferred medication for bacterial vaginosis?

Metronidazole

On a visit to the gynecologist, a client complains of urinary frequency, pelvic discomfort, and weight loss. After a complete physical examination, blood studies, and a pelvic examination with a Papanicolaou test, the physician diagnoses stage IV ovarian cancer. The nurse expects to prepare the client for which initial treatment?

Major surgery

On a visit to the gynecologist, a client complains of urinary frequency, pelvic discomfort, and weight loss. After a complete physical examination, blood studies, and a pelvic examination with a Papanicolaou test, the physician diagnoses stage IV ovarian cancer. The nurse expects to prepare the client for which initial treatment?

Major surgery Explanation: Ovarian cancer usually requires aggressive treatment — initially, surgery

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

Menorrhagia

The nurse is gathering data about a client's menstruation. The client reports that she has been experiencing some bleeding that occurs suddenly and without a regular pattern in between her normal menstrual periods. The nurse documents this finding as which of the following?

Metrorrhagia Explanation: Metrorrhagia is vaginal bleeding at a time other than a menstrual period. The amount of blood is not important; the fact that it occurs unexpectedly is significant. Oligomenorrhea is infrequent menses. Menorrhagia is excessive bleeding at the time of normal menstruation. Dysmenorrhea is painful menstruation.

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 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 Explanation: Dysmenorrhea is treated with mild non-narcotic analgesics and by treating the underlying cause if one is identified. Symptomatic relief is accomplished with NSAIDs, which reduce prostaglandins. Prostaglandins are biologic chemicals that exist in endometrial tissue, where they exert a stimulating effect on the uterus, producing cramping and pain

"Symptoms of endometriosis are increased during normal menstrual cycle." Correct response:

Pelvic inflammatory disease Cervical cancer

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 patient is diagnosed with stage 3 ovarian cancer. The nurse's best response would be to explain that the majority of women (75%) respond to treatment. The nurse should also explain that stage 3 ovarian cancer involves which of the following?

Peritoneal metastasis

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)

Following a radical vulvectomy, the nurse is preparing the client for discharge to home. Which care intervention would be considered the priority for this client?

Prevention of wound complications

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 female client comes to the clinic complianing of intense vulvar pruritus and irritation accompanied by a vaginal discharge. A specimen of the discharge is examined to determine the cause. Which of the following would the nurse interpret as indicative of candidiasis? You Selected:

Spores and hyphae

A client with vaginitis complains of itching and burning of the perineum. Which suggestion would be most appropriate to relieve the client's symptoms?

Take sitz baths frequently.

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 with HIV has recently completed a 7-day regimen of antibiotics. She reports vaginal itching and irritation. In addition, the client has a white, cheeselike vaginal discharge. Which condition is the client most likely experiencing?

Vulvovaginal candidiasis

A client reports loss of interest in sexual relations and discomfort during intercourse. Which is the best response by the nurse?

These are normal, manageable symptoms of menopause.

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.

Polycystic ovary syndrome (PCOS)

Trichomonas vaginalis

A nurse is reviewing a client's medical history. Which factor indicates the client is at risk for candidiasis?

Use of corticosteroids

Which of the following would be most important to determine when assessing a client being admitted for suspected toxic shock syndrome (TSS)?

Use of superabsorbent tampons Explanation: TSS is commonly associated with the use of superabsorbent tampons that are not changed frequently and internal contraceptives that remain in place longer than necessary. Assessing the use of oral contraceptives, psychological trauma, or menorrhagia is not required for diagnosing the cause of TSS.

The nurse is interviewing a postmenopausal client during an annual gynecologic exam. Which assessment finding presents the greatest concern in the care of this client?

Vaginal bleeding Explanation: Vaginal bleeding in a client after menopause is abnormal and a predominant symptom for vaginal cancers. The incidence of vaginal cancer is higher among woman infected with HPV and those who use a pessary but neglect to remove and clean it. Urinary stress incontinence is not a significant concern.

A client who had intracavity radiation treatment for cervical cancer 1 month earlier reports small amounts of vaginal bleeding. This finding most likely represents:

an expected effect of the radiation therapy.

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

Upon examination, the nurse practitioner notes a backward positioning of the client's uterus. How would the nurse document this finding?

retroversion

Culture of client's vaginal discharge reveals Gardnerella vaginalis. Which of the following would the nurse expect to assess?

Fishy smelling watery discharge

A 24-year-old client births a healthy female infant. Incidentally, the client was given diethylstilbestrol (DES) during her pregnancy. It is important that the nurse stresses frequent gynecological examinations of client's daughter when she reaches a certain age because of which concern?

To prevent the onset of vaginal carcinoma in the client's daughter

Which drug is the usual treatment for vulvar dystrophy?

Topical corticosteroids Explanation: Topical corticosteroids are the usual treatment for vulvar dystrophy. Antibiotics, antifungals, and progestins are not usual treatment for vulvar dystrophy.

A client is prescribed androgen therapy. Which of the following would the nurse explain as a possible adverse effect?

Weight gain Explanation: Androgen therapy causes recalcification of bone and the client has an increased appetite and gains weight. It may also cause fluid retention, increased libido, and symptoms of virilization.

Which group represents the fastest-growing segment of the population with AIDS?

Women Explanation: Women represent the fastest-growing segment of the population with AIDS.

Following a colposcopy, the confirmation of in situ carcinoma of the cervix has been determined. Which comment by the client indicates an appropriate understanding of the diagnosis?

"The cancer has not spread."

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." Explanation: 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.

A client who wishes to preserve childbearing asks the nurse to explain how taking oral contraceptives will work in the management of endometriosis. Which is the best response by the nurse?

"Symptoms of endometriosis are increased during normal menstrual cycle." Correct response:

A client reports loss of interest in sexual relations and discomfort during intercourse. Which is the best response by the nurse?

"These are normal, manageable symptoms of menopause." Explanation: Diminished libido and/or dyspareunia are common symptoms associated with perimenopause. Explaining that this can be a normal finding may help to alleviate worries for the client and provide hope for management of the symptoms.

Typical clinical manifestations of bacterial vaginosis (BV) include which of the following?

Malodorous, gray vaginal discharge Explanation: BV has a characteristic gray vaginal discharge with a "fishy" odor. Reference:

Which of the following is an early symptom of vulvar cancer?

Pruritus with genital burning Explanation: Pruritus and genital burning are the most frequent early symptoms of vulvar cancer, followed by a bloody discharge from the vagina.

When a female client reports a frothy, yellow-green vaginal discharge, the nurse suspects the client has a vaginal infection caused by which organism?

Trichomonas vaginalis

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." Explanation:

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 who wishes to preserve childbearing asks the nurse to explain how taking oral contraceptives will work in the management of endometriosis. Which is the best response by the nurse?

"Symptoms of endometriosis are increased during normal menstrual cycle." Explanation: The use of estrogen-progestin contraceptives keeps the client in a non bleeding phase of the menstrual cycle, therefore decreasing ectopic tissue from shedding and causing extra uterine bleeding. Blood that is trapped in the peritoneal cavity causes more pain as adhesions form. Endometriosis is cured by natural or surgical menopause but can be medically managed for periods of time with the use of oral contraceptives.

Which client has the highest risk of ovarian cancer?

45-year-old woman who has never been pregnant Explanation: The incidence of ovarian cancer increases in women who have never been pregnant, are older than age 40, are infertile, or have menstrual irregularities. Other risk factors include a family history of breast, bowel, or endometrial cancer. The risk of ovarian cancer is reduced in women who have taken hormonal contraceptives, have had multiple births, or have had a first child at a young age.

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

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

A client with challenging menopausal symptoms has discussed treatment options with the physician and now has some questions for the nurse. The client asks, "What are the potential risks of hormone replacement therapy?" What is the best answer?

All options are correct. Explanation: In using hormonal replacement therapy, the risks of breast cancer and the seriousness of future myocardial infarction and stroke may outweigh the potential benefit of alleviating symptoms associated with menopause. The Women's Health Initiative study revealed an increase in breast cancer, blood clots, stroke, and heart disease in postmenopausal women taking HRT.

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

Vesicovaginal fistula

The client is asking if there is a pill that can be ordered to control the symptoms of menopause. Which assessment finding is most important in determining nursing care in association with hormone replacement therapy?

Family history of breast cancer Explanation: The risk of endometrial or breast cancer in women prescribed HRT may outweigh the benefits of relieving symptoms of menopause and preventing kyphosis or hip fractures associated with osteoporosis.

A client has undergone a total abdominal hysterectomy and bilateral salpingo-oopherectomy as treatment for endometrial cancer. When providing postoperative care to this client the nurse would be alert for signs and symptoms of which of the following?

Bladder dysfunction Explanation: After a total abdominal hysterectomy and bilateral salpingo-oopherectomy, the client is at risk for several complications, especially bladder dysfunction because the surgical site is close to the bladder. Leukopenia and neurotoxicity are adverse effects of chemotherapy agents such as paclitaxel and carboplatin used to treat ovarian cancer. Deep vein thrombosis, not clotting deficiencies are a potential complication after this type of surgery.

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 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.

Culture of client's vaginal discharge reveals Gardnerella vaginalis. Which of the following would the nurse expect to assess?

Fishy-smelling watery discharge Explanation: Gardnerella vaginalis is associated with a gray-white, watery, fishy smelling vaginal discharge

The nurse is providing education regarding sexually transmitted diseases. Which statement regarding herpes virus 2 (herpes genitalis) is accurate?

In pregnant women with active herpes, babies delivered vaginally may become infected with the virus.

A patient is taking oral danazol (Danocrine), 800 mg/day, for 9 months for the treatment of endometriosis. How does the nurse describe this medication to the patient?

It is an antigonadotropin that decreases pituitary and ovarian stimulations.

The nurse reports to work an evening shift on the postsurgical unit. Based on the information received before beginning the shift, which client does the nurse need to see first?

June, 2 days after abdominal surgery, reports chest discomfort. June's vital signs are temperature, 99.4°F, pulse 98, respirations 12, and blood pressure 140/86.

A woman comes to the emergency department reporting vaginal discharge and pelvic pain that increases with urination. The client also reports nausea and vomiting, headache, and anorexia. A pelvic examination reveals cervical motion tenderness. The client is diagnosed with acute pelvic inflammatory disease (PID) and is admitted. Which of the following would be most appropriate to include in this client's plan of care?

Maintaining bedrest in the semi-Fowler's position Explanation: The hospitalized client with pelvic inflammatory disease (PID) is maintained on bed rest and is placed in the semi-Fowler's position to facilitate dependent drainage. Heat may be applied to the abdomen to provide comfort and pain relief

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

Menorrhagia Explanation: 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

The nurse is reviewing the medical record of a client diagnosed with uterine cancer. Which of the following, if noted, would the nurse identify as a risk factor?

Nulliparity

Most cervical cancers, if not detected and treated, spread to which area

Regional pelvic lymph nodes

Most cervical cancers, if not detected and treated, spread to which area?

Regional pelvic lymph nodes

A perimenopausal woman informs the nurse that she is having irregular vaginal bleeding. What should the nurse encourage the patient to do?

See her gynecologist as soon as possible

A patient has a diagnosis of stage III ovarian cancer and wants to know what organs are involved. What information should be provided to the patient?

The cancer involves metastases outside the pelvis. Explanation: Stage III ovarian cancer involves one or both ovaries, and one or both of the following are present: (1) cancer has spread beyond the pelvis to the lining of the abdomen; (2) cancer has spread to lymph nodes. Stage I ovarian cancer is contained within the ovary (or ovaries). Stage II ovarian cancer is in one or both ovaries and has involved other organs (i.e., uterus, fallopian tubes, bladder, the sigmoid colon, or the rectum) within the pelvis. Stage IV involves distant metastasis to the liver, lungs, or other organs outside the peritoneal cavity.

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 Explanation: Clients with endometriosis need to report pregnancies as soon as possible so that relevant treatment can be provided.

A patient who is diagnosed as having endometriosis asks for an explanation of the disease. What is the nurse's best response?

Tissue similar to the lining of the uterus has implanted in areas outside the uterus.

A patient is receiving chemotherapy with paclitaxel as treatment for ovarian cancer. The patient arrives at the facility for laboratory testing prior to her next dose of chemotherapy. The results are as follows:Hemoglobin: 12.9 gm/dLWhite blood cell count: 2,200 /cu mmPlatelets: 250,000 /cu mmRed blood cell count: 4,400,00/cu mmWhich result would be a cause for concern?

White blood cell count Explanation: The patient's white blood cell count is low, revealing leukopenia and placing the patient at an increased risk for infection. The other results are within normal parameters and would not be a cause for concern.

A client who had intracavity radiation treatment for cervical cancer 1 month earlier reports small amounts of vaginal bleeding. This finding most likely represents

an expected effect of the radiation therapy.


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