Chapter 53: Caring for Clients with Disorders of the Female Reproductive System
Which is the earliest and the most common symptom of endometrial cancer?
bleeding
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."
The history of a female patient reveals the following: First coitus at age 16 years First pregnancy at age 28 years Sexual intercourse with circumcised partner Weight appropriate for height Which of the following would alert the nurse to a possible risk factor for developing cervical cancer?
Age at first coitus
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
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, cheeselike discharge?
Candidiasis
While taking a health history on a 20-year-old female client, the nurse learns that the client is taking miconazole. The nurse is justified in presuming that this client has what medical condition?
Candidiasis
A nurse practitioner is examining a client who presented at the free clinic with vulvar pruritus. For which assessment finding would the practitioner look that may indicate the client has an infection caused by Candida albicans?
Cottage cheese-like discharge
An adolescent patient comes to the clinic with complaints of "terrible pain" during menstruation. What should the nurse document this subjective data as?
Dysmenorrhea
Which of the following is the extrusion of the rectum into the posterior vagina?
Enterocele
When teaching clients about the risk factors of cervical cancer, what would the nurse identify as the most important risk factor?
Human papillomavirus (HPV)
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 nurse providing prenatal care to a pregnant woman is addressing measures to reduce her postpartum risk of cystocele, rectocele, and uterine prolapse. What action should the nurse recommend?
Performance of pelvic muscle exercises
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 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
Upon examination, the nurse practitioner notes a backward positioning of the client's uterus. How would the nurse document this finding?
Retroversion
A female client has just been diagnosed with condylomata acuminata (genital warts). What information is most appropriate for the nurse to tell this client?
The warts may require surgical removal or cryotherapy
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.
What is the main cause of anemia in a client with active uterine leiomyoma?
menorrhagia
Which drug is the most effective treatment for trichomoniasis?
Metronidazole
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
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 unprotected sexual intercourse • Avoiding multiple partners for sexual intercourse • Avoiding IV drug use
A middle-aged female client has been offered testing for HIV/AIDS upon admission to the hospital for an unrelated health problem. The nurse observes that the client is visibly surprised and embarrassed by this offer. How should the nurse best respond?
"This testing is offered to every adolescent and adult regardless of their lifestyle, appearance or history."
A client is postoperative day 1 following a vaginal hysterectomy. The nurse notes an increase in the client's abdominal girth and the client complains of "bloating." What is the nurse's most appropriate action?
Apply warm compresses to the client's lower abdomen.
A woman's current health complaints are suggestive of a diagnosis of premenstrual dysphoric disorder (PMDD). The nurse should first do which of the following?
Assess the client for risk of suicide.
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
A client, age 42, visits the gynecologist. After examining the client, the physician suspects cervical cancer. The nurse reviews the client's history for risk factors for this disease. Which history finding is a risk factor for cervical cancer?
Human papillomavirus infection at age 32
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 client has a routine Papanicolaou (Pap) test during a yearly gynecologic examination. The result reveals a class V finding. What should the nurse tell the client about this finding?
It calls for a biopsy as soon as possible.
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
In educating a patient with PMS about changing her dietary practices, what would the nurse recommend that she increase her intake of?
Magnesium
Which is the main cause of anemia in a client with active uterine leiomyoma?
Menorrhagia
Which of the following is a term used to describe excessive menstrual bleeding?
Menorrhagia
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
The nurse is caring for a client with a diagnosis of vulvar cancer who has returned from the PACU after undergoing a wide excision of the vulva. How should this client's analgesic regimen be best managed?
Scheduled analgesia should be administered around-the-clock to prevent pain.
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 client with heart failure is admitted to an acute care facility and is found to have a cystocele. When planning care for this client, the nurse is most likely to formulate which nursing diagnosis?
Stress urinary incontinence
The nurse is providing preoperative education for a client diagnosed with endometriosis. A hysterectomy has been scheduled. What education topic should the nurse be sure to include for this client?
The bladder must be emptied prior to surgery and a catheter may be placed during surgery.
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.
A 24-year-old client births a healthy female infant. This client was given diethylstilbestrol (DES) during her pregnancy. It is important that the nurse stresses frequent gynecologic examinations of the 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
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 female client tells the nurse that she thinks she has a vaginal infection because she has noted inflammation of her 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 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 of the following is the descent of the small intestine into the vaginal vault?
Uterine prolapse
A client is being discharged home after a hysterectomy. When providing discharge education for this client, the nurse has cautioned the client against sitting for long periods. This advice addresses the client's risk of what surgical complication?
Venous thromboembolism
Which term describes an opening between the bladder and the vagina?
Vesicovaginal fistula
A teenage girl is brought to the clinic by her mother. The mother explains to the nurse that her daughter has just started using tampons, but is not yet sexually active. The mother 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
Which client has the highest risk of ovarian cancer?
Which client has the highest risk of ovarian cancer?
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.