med surg test 3

medical management - endometriosis

Observe if symptoms are mild or absent Birth control pill may cause the misplaced tissue to slough off Androgen such as danazol may cause atrophy to edometrial tissue, depo-provera( injectible birth control) Leuprolide (monthly injections) Laparoscopic treatment involve laser destruction of tissue Hysterectomy with oophorectomy

3. A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms? a. Bactrim b. Levaquin c. Pyridium d. Septra

c. Pyridium

1. A patient comes to the clinic suspecting a possible UTI. What symptoms of a UTI would the nurse recognize from the assessment data gathered? a. Rebound tenderness at McBurney's point b. An output of 200mL with each voiding c. Cloudy urine d. Urine with a specific gravity of 1.005-1.022

c. cloudy urine

bladder cancer - nursing interventions

treatment depends on grade of tumor, stage Transurethral resection Simple cystectomy (remove bladder) Radical cystectomy

Doxycycline

treatment of various infections caused by unusual organisms (chlamydia)

nursing interventions with an IVP

Always have emergency equipment in case of allergies Allergy history Temporary warm flushed feeling on the face Monitor urine output Dye infusion drip

kidney stone: nursing management

Administer meds, encourage oral intake Encourage ambulation Monitor pain status, i&o and urinary ph

diet for PMS

Avoid caffeine, high fat foods, refined sugars, salf, etoh, nicotine, Diet includes whole grains, fruits, veggies, intake of water Vitamin B,E, calcium, mg and oil of evening primrose capsules

clinical manifestations for UTI

Burning feeling when urinating Frequent or intense urge to urinate Pain or pressure in lower back or abdomen Fever Nocturia

care of patient with BPH

Catheterize if patient cannot void Treat uti Aplpha adrenergic receptor blockers (relax smooth muscles) Hormonal manipulation (finasteride) Surgical Transurethral laser therapy Cryotherapy Balloon dilation

care of clients post cystectomy

Check for skin breakdown, hernia, check for blood in urine, check for blood clots, check for infections, same as most post care tbh Check stoma

clinical manifestations for pt with pyelonephritis

Chills Fever Leukocytocsis Bacteriuria Pyuria Low back/ flank pain N/V Headache Malaise Painful urination CVA tenderness Dysuria Frequency

Clinical manifestations for a patient with bladder cancer

Clincal triad in 10% of patients Visible painless hematuria Uti common complication Frequency and urgency Dysuria Change in voiding patterns

self exam: testicles

Do it monthly. After a warm shower. Examine them with both hands place index and middle fingers under testicle with thumb placed on top. Firmly but gently roll the testicle between your thumbs and fingers to feel any abnormalities

BPH/ CA of prostate labs

DRE(Digital rectal exam) PSA TRUS with biopsy Histological exam of tissue confirms diagnoses

Flomax

Decr urinary urgency, hesitancy, nocturia in BPH S/E: Dizziness, headache, orthostatic HTN Change position slowly, admin at bedtime, admin 30 min after same meal each day

prevention of STD/STI

Education should include high risk behaviors that can lead to infection Abstinence condoms

kidney stone diet

Encourage fluids avoid caffeine Eat less sodiym, lots of calcium Eat citrus, limit how much protein Low fat diet

endometriosis clinical manifestations

Excessive bleeding, bleeding between periods, painful bowel movements, painful coitus, dysmenorrhea (aching lower back, abd, vagina), depression, infertility

Care of a patient post TAH(Total abdominal hysterectomy)

Nursing management of a patient with PID(Pelvic inflammatory disease) IV antibiotics Bed rest Semi fowlers Heating pad to abdomen Cath or tampons avoided Vs q 4h Proper disposal of pads, bedpans, linens Hand washing Treat sexual partners

Gonorrhea

Local inflammation • Men • Burning with urination • Penile discharge • Painful swollen testicles

clinical manifestations of testicular cancer

Mass or lump in testicles Painless enlargement of testis (significant finding) Heaviness in scrotum, inguinal area or lower abdomen backache, abnormal pain, weight loss, general weakness

Care of pt with urinary diversion

Monitor urine volume Urine output below 30ml/h may indicate dehydration/obstruction Urethral stents not draining, carefully irrigate with 5 to 10ml sterile normal saline Hematuria normal 48 hrs post Inspect stoma

Care of a patient post mastectomy(include treatment for lymph edema, pain, exercises)

Pain control, observation of infection and bleeding Taking a warm shower before excercises may help loosen stiff muscles and provide comfort Wall hand climbing, rope turning, rod or broomstick lifting, pulley tugging For lymph edema be in semi fowlers with arm elevated to aid gravity in removing fluid ROM exercises

care of pt post TURP/prostatectomy

Potential for bleeding, urinary incontinence VS q 2 hours initially then q 4 Monitor for pallor and rising pulse Stool softeneres to prevent straining Administer antibiotics and pain meds as prescribed Check tubing for patency Check hemorrhage Monitor incision Three way foley for TURP

Syphillis

Primary: occurs 2-3 weeks after initial inoculation with the organism • Painless lesion called a chancre at site of infection occurs. • Untreated lesions resolves within 2 months

nursing care for pt with UTI

Promote fluid intake Adm antibiotic Encourage to void every 2-4 hours Encourage shower Avoid indwelling Cath

care of CBI post surgery

Prostatectomy patients connected to CBI w sterile NS to prevent clots Drainage begins pink and increases in color as time goes by

nursing interventions associated with preventing UTI

Shower rather than bathe Clean front to back Drink liberal amounts of fluids daily Avoid coffee, tea, alcohol Void every 2-3 hours Take meds as prescribed Acidify the urine

purpose of self exams of testes and breast

To find the mass in time If you have cancer, better your possibilities of survival

4. The nurse is educating a patient with urolithiasis about preventative measures to avoid another occurrence. What should the patient be encouraged to do? a. Increase fluid intake so that the patient can excrete 2,500 to 4,000 mL every day, which will help prevent additional stone formation. b. Participate in strenuous exercises so that the tone of smooth muscle in the urinary tract can be strengthened to help propel calculi. c. Add calcium supplements to the diet to replace losses to renal calculi. d. Limit voiding to every 6 to 8 hours so that increased volume can increase hydrostatic pressure, which will help push stones along the urinary system.

a. Increase fluid intake so that the patient can excrete 2,500 to 4,000 mL every day, which will help prevent additional stone formation

6. The nurse is caring for a patient with dementia in the long-term care facility when the patient has a change in cognitive function. What should the nurse suspect this patient may be experiencing? a. A UTI b. A stroke c. An aneurysm d. Fecal impaction

a. UTI

Bactrim

antibiotic

Cipro

antibiotic: treatment of skin infections

5. The nurse is providing an education program for the nursing assistants in a long-term care facility in order to decrease the number of UTIs in the female population. What interventions should the nurse introduce in the program? (Select all that apply.) a. For those patients who are incontinent, insert indwelling catheters. b. Perform hand hygiene prior to patient care. c. Assist the patients with frequent toileting. d. Provide careful perineal care. e. Encourage patients to wear briefs.

b. Perform hand hygiene prior to patient care. c. Assist the patients with frequent toileting. d. Provide careful perineal care.

2. A patient has been diagnosed with a UTI and is prescribed an antibiotic. What first-line fluoroquinolone antibacterial agent for UTIs has been found to be significantly effective? a. Bactrim b. Cipro c. Macrodantin d. Septra

b. cipro

Pyriduim

diminishes urinary tract discomfort Turns urine bright orange

self exam: breast

done monthly after menses 5-7 days after menstration has begun Using the pads of your fingers, move around your entire breast in a circular pattern moving from the outside to the center, checking the entire breast and armpit area. Check both breasts each month feeling for any lump, thickening, or hardened knot. Notice any changes and get lumps evaluated by your healthcare provider.

over flow

from the pressure of urine in the bladder

stress

involuntary loss of urine as a result of sneezing, coughing or changing positions

urge

involuntary loss of urine associated with strong urge to void

herpes

itching, pain, swelling, blister • Women- labia primary site • Men - glans penis, foreskin, penile shaft affected • Flu-like symptoms • Swollen lymph nodes in groin, malaise, headache, myalgia, dysuria

reflex

leakage with reflex stimulation

Chlamydia

same as with Gonorrhea • PID, chronic pain, infertility in women, • Men: urethritis asymptomatic, but can transmit to women

Early signs of breast cancer

Ø Nipple discharge Ø Micro calcifications in mammography

late signs of breast cancer

•Lump in breast, nontender, irregular borders, may be fixed • Retractions /dimpling • Inversion of nipple • Inflammatory signs • Edema (type peau d'orange)Abnormal discharge • Nipple retraction • Dimpling • Peau d' orange • Swelling or enlargement • Increased firmness • Appearance of a reddened area or dry flaky area • More pain • Asymmetry and elevation of affected breast • Can spread to nearby lymph nodes, axillary but can include subpectoral and clavicular nodes • Other sites: lungs, liver, bone and brain