Chapter 53

The nurse is educating a patient about decreasing the risk of developing deep vein thrombosis (DVT). What should the nurse be sure to include when discussing this with the patient?

Perform leg exercises Change position frequently Avoid pressure under the knees

A female patient is admitted to the nursing unit with dehydration related to frequent nausea and emesis. She was seen in the emergency department (ED) three weeks ago for a concussion and discharged home with instructions for physical and cognitive rest. Patient education and preparation should be done for which of the following tests?

Pregnancy test

When educating a group of teenagers about premenstrual syndrome (PMS), what information should the nurse include?

Premenstrual symptoms can be severe enough to impair interpersonal relationships. Premenstrual symptoms occur cyclically in the luteal phase just before menstruation.

Primary dysmenorrhea is most commonly caused by overproduction of which hormone?

Prostaglandin

A female patient reports severe back pain and abdominal cramping during her menstrual cycle, and the nurse educates the patient about taking nonsteroidal antiinflammatory drugs (NSAIDS) and using heat to relieve her discomfort. What explanation does the nurse give for how NSAIDs offer relief from this type of pain?

Prostaglandin production increases due to estrogen and progesterone.

A female patient is admitted to the fertility clinic newly diagnosed with polycystic ovarian syndrome (PCOS). Which nursing action should be the priority?

Provide emotional support for infertility.

The nurse is caring for a patient who has been sexually assaulted. What nursing actions are appropriate for this patient?

Refer to crisis center. Provide privacy and emotional support. Discuss the possibility of pregnancy and offer effective emergency contraceptive pills.

The nurse is giving discharge instructions to a woman that had an induced abortion. What should the nurse include in the education to avoid complications related to the procedure?

Report fever Report abnormal vaginal bleeding Report severe abdominal cramping Report any foul smelling discharge

The nurse is preparing to administer medication for a patient who is experiencing premenstrual dysphoric disorder (PMDD). Which medication will the nurse anticipate administering?

Sertraline

A patient with a subdural hematoma is being admitted to the unit from the emergency department (ED). The ED nurse reports that there is a suspicion of sexual abuse. Given this information, what is the most likely reason for a subdural hematoma?

Shoving that resulted in a fall

The nurse is performing an educational session for a group of women regarding cervical cancer. Which risk factors for cervical cancer should the nurse include in the presentation?

Smoking Chlamydia infection Low socioeconomic class

The nurse is providing education to a group of perimenopausal women. Which herbs or supplements would the nurse include in a discussion regarding effective alternative therapies for menopausal symptoms?

Soy, black cohosh

The nurse is assessing a patient with polycystic ovary syndrome who has excessive body hair. Which medication does the nurse anticipate to be most beneficial for the patient?

Spironolactone

A patient approaches the nurse expressing concerns about her impending menopause. What information should the nurse give to this patient to alleviate anxiety?

The age of menopause ranges from 44 to 55 years. Cigarette smoking may lead to early menopause.

A patient with newly diagnosed ovarian cancer states to the nurse, "I don't understand how the cancer spread so fast." What is the best response by the nurse?

The pelvic lymphatics and blood vessels are intermingled.

The nurse is caring for a patient with pelvic inflammatory disease. The nurse knows that positioning the patient into supine position with the head of the bed to 30 degrees is known to do what?

To promote drainage of the pelvic cavity

While caring for a patient with irritability, abdominal bloating, breast discomfort, and edema, the nurse administers spironolactone. What rationale does the nurse give to the patient for administration of the medication?

To reduce fluid retention

The nurse is educating an adolescent female about the use of tampons. Which condition will the nurse inform the patient can result from the prolonged use of superabsorbent tampons?

Toxic shock syndrome (TSS)

The nurse is providing care to a patient with frothy greenish and grey vaginal discharge. A pelvic examination reveals hemorrhagic spots on the cervix and vaginal walls. On the basis of these assessment data, which diagnosis does the nurse anticipate?

Trichomonas vaginitis infection

The nurse admits a female patient of childbearing age who reports severe abdominal pain, abnormal uterine bleeding, and constipation. For which diagnostic tests should the nurse anticipate preparing the patient?

Hysteroscopy Pelvic exam and ultrasound Complete blood count (CBC)

A patient with polycystic ovary syndrome (PCOS) is prescribed metformin. The patient seeks an explanation, as the drug is usually prescribed for diabetes. What explanation should the nurse provide to this patient?

It restores ovulation. It reduces plasma insulin. It improves hyperandrogenism.

A pregnant patient reports occasional spotting and severe pain in the abdomen. The ultrasonography reports reveal the absence of an intrauterine fetus and serum β-hCGof 1,500 mIU per mL. For which procedure that may prevent complications does the nurse prepare the patient?

Laparoscopy

Which condition is characterized as a benign, noncancerous, smooth muscle uterine tumor?

Leiomyoma

The normal physiologic cessation of menses associated with declining ovarian function is referred to as which condition?

Menopause

A patient with polycystic ovary syndrome (PCOS) is being treated to restore ovulation. What medication does the nurse administer to the patient?

Metformin

The nurse is caring for a patient who has an unruptured ectopic pregnancy located in the fallopian tube. What treatment option does the nurse anticipate administering?

Methotrexate

A patient has been diagnosed with a few small leiomyomas, and she has informed the health care provider that she would like to preserve her uterus. Regarding which procedure should the nurse prepare to educate the patient?

Myomectomy

The diagnostic reports of a patient who has infertility problems indicate the presence of tubal obstruction due to the growth of endometrial tissue. Which medication would be most beneficial for the patient?

Nafarelin Leuprolide

A patient reports back pain after a hysterectomy, and the nurse observes that urine output is less than 30 mL/hr. What is the priority intervention provided by the nurse?

Notifying the primary health care provider

The nurse is caring for a patient who has polycystic ovary syndrome (PCOS). When preparing to teach this patient, the nurse should know that which classic manifestation is associated with the severity of symptoms, including infertility?

Obesity

A nurse is educating a patient on abnormal uterine bleeding. The nurse should encourage the patient to report which symptoms to her healthcare provider?

Passing clots Excessive bleeding Unusually long duration of menstrual cycles

The nurse is caring for a postoperative ovarian cancer patient the day after she had a tumor debulking. The patient is crying and refusing to allow her husband of 25 years to visit. What is the most likely reason for the patient's refusal to allow her husband to visit?

Perceived perception of the husband's feelings about this type of surgery

A patient has undergone induced abortion. The nurse is evaluating the patient after teaching about necessary interventions to avoid complications. Which statement made by the patient indicates effective learning?

"I should avoid intercourse for two weeks."

A nurse is educating a patient with a diagnosis of menopause who is not receiving hormone replacement therapy about strategies to prevent or reduce the risk of osteoporosis. Which patient statement is most important for the nurse to determine that the education is understood?

"I should have an intake of at least 1,500 mg of calcium every day."

A patient with premenstrual syndrome (PMS) states, "My PMS symptoms get so bad sometimes. I feel like my boyfriend thinks it is all in my head." What is the most therapeutic response from the nurse?

"PMS symptoms are physiological. Let's talk about different ways you can manage your symptoms."

The nurse is educating a patient regarding the risk factors for ovarian cancer after the patient states that she is concerned because her sister died with the disease. What is the best response by the nurse?

"Some forms of hormonal therapy may be a risk factor."

What instruction does the nurse give to the patient with cystocele who undergoes an anterior colporrhaphy to ensure effective treatment after surgery?

"You should eat a low-residue diet." "You should take a stool softener every night." "You should avoid intercourse until the follow up visit."

A patient has a vesicovaginal fistula and undergoes colporrhaphy to prevent further complications. What instruction should the nurse provide to the patient after the procedure?

"You should ensure that a catheter is in place for 10 days."

A patient is diagnosed with a cervical polyp. What information should the nurse give this patient?

A malignant change may occur. Polyps may be excised or cauterized on an outpatient basis.

A patient is admitted to the hospital with severe pain due to a tuboovarian abscess caused by pelvic inflammatory disease (PID). Which nursing interventions are appropriate for the patient?

Administer IV fluids. Give a sitz bath to the patient. Administer analgesics to relieve pain.

The nurse is caring for a patient that underwent colporrhaphy. Which nursing intervention would provide the most comfort to this patient?

Apply ice locally in the area of swelling. Provide sitz bath regularly to the patient. Ask the patient to perform perineal care twice daily.

A patient reports radiating lower abdominal pain associated with nausea, diarrhea, and fatigue even on the fourth day of menstruation. Which is the best nursing intervention for this patient?

Apply warm compresses to the lower abdomen and back.

A patient has a history of familial sexual abuse and was the victim of a sexual assault three weeks prior. This week, the patient misses an appointment. Which of the following is the priority nursing intervention?

Call the patient expediently to assess why they missed the appointment.

A patient is diagnosed with a vesicovaginal fistula and is to be discharged. What instructions should the nurse give to this patient?

Change perineal pads frequently. Cleanse the perineum every four hours.

The nurse is preparing a nutritional plan for a postmenopausal woman. What does the nurse include in the patient's dietary plan?

Daily intake of vitamin E Adequate intake of calcium Adequate intake of sunflower seeds

The nurse is educating a female patient who is experiencing menopausal symptoms about conditions at which the patient will now be at a greater risk. For which conditions will the nurse monitor this patient?

Depression Osteoporosis Bladder infections Coronary artery disease

The nurse finds that a patient reporting infertility has polycystic ovary syndrome (PCOS) that has been left untreated. About which complications does the nurse anticipate educating the patient?

Diabetes mellitus Cardiovascular disease

Which is the biggest risk factor for endometrial cancer?

Estrogen exposure

A patient with cervical cancer asks the nurse about various treatment modalities. What information should the nurse provide to this patient?

External radiotherapy or internal radiotherapy or both Management depends on stage of the tumor, patient's age, and general state of health Surgical procedures include hysterectomy and radical hysterectomy (involving adjacent structures)

A woman is scheduled for an induced abortion on her 40th day of gestation. What instructions should the nurse give to the patient about the procedure?

Fever and foul-smelling drainage postprocedure may indicate complications. Abnormal vaginal bleeding and severe abdominal cramping need to be reported to the health care provider. Intercourse and vaginal insertions should be avoided until postprocedure reexamination, which needs to be in two weeks.

Recurrent vaginitis may be classified as severe when a patient experiences more than how many episodes per year?

Four

Along with the Papanicolaou (Pap) test, which test is used to screen for cervical cancer?

Human papillomavirus (HPV) test