High Acuity Quiz Week 3

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. Candidiasis is a fungal or yeast infection caused by strains of Candida. Miconazole (Monistat) is an antifungal medication used in the treatment of candidiasis. This agent is inserted into the vagina with an applicator at bedtime and may be applied to the vulvar area for pruritus. HPV, bacterial vaginosis, and TSS are not treated by Monistat.

The nurse is assessing a 53-year-old woman who has been experiencing dysmenorrhea. What questions should the nurse include in an assessment of the client's menstrual history? Select all that apply.

"Do you experience cramps or pain during your cycle?" "How long is your typical cycle?" "Do you ever experience bleeding after intercourse?" Menstrual history addresses such factors as the length of cycles, duration and amount of flow, presence of cramps or pain, and bleeding between periods or after intercourse. Family members' menarche and prior STIs are not likely to affect the client's current cycles.

A client states that PMS is significantly disrupting her 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). Pharmacologic remedies for PMS include selective serotonin reuptake inhibitors. MAOIs are not used for this purpose. Calcium channel blockers and opioids would not lead to symptom relief.

The nurse is utilizing the PLISSIT model of sexual health assessment during an interaction with a new client. According to this model, the nurse should begin with what action?

Asking the client's permission to discuss sexuality. The PLISSIT model of sexual assessment begins with permission and subsequently includes limited information, specific suggestions, and intensive therapy.

The nurse is teaching a client preventative measures regarding vaginal infections. The nurse should include which of the following as an important risk factor?

Frequent douching. Risk factors associated with vulvovaginal infections include pregnancy, premenarche, low estrogen levels, and frequent douching. Caucasians are not more susceptible.

The nurse is working with a couple who have been unable to conceive despite more than 2 years of trying to get pregnant. The couple has just learned that in vitro fertilization (IVF) was unsuccessful and they are both tearful. What nursing diagnosis is most likely to apply to this couple?

Hopelessness related to failed IVF. Although further assessment is undoubtedly necessary, it is likely that the couple will be experiencing hopelessness at the news that a potentially promising intervention has failed. Acute confusion denotes a cognitive deficit, not a sense of despair. Sadness at this news is not necessarily suggestive of impaired coping. Moral distress is unlikely because this is not a situation involving morality.

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. The intestinal tract and the bladder need to be empty before the client is taken to the OR to prevent contamination and injury to the bladder or intestinal tract. The client is informed that her periods are now over, but she may have a slightly bloody discharge for a few days. The client is instructed to avoid straining, lifting, or driving until her surgeon permits her to resume these activities. The client's hormonal balance is upset, which usually occurs in reproductive system disturbances. The client may experience depression and heightened emotional sensitivity to people and situations.

The school nurse is presenting a class on female reproductive health. The nurse should describe what aspect of Pap smears?

The test can detect early evidence of cervical cancer. The test should be performed when the client is not menstruating. Douching washes away cellular material. The test detects cervical cancer, and false-negative Pap smear results occur mostly from sampling errors or improper technique. For most women, a Pap smear should be done annually.

A 48-year-old woman presenting for care is seeking information about hormone therapy (HT) for the treatment of her perimenopausal symptoms. The client's need for relief from hot flashes and other symptoms will be weighed carefully against the increased risks of what complications of HT? Select all that apply.

Venous thromboembolism Breast cancer Cardiovascular disease Although HT decreases hot flashes and reduces the risk of osteoporotic fractures as well as colorectal cancer, studies have shown that it increases the risk of breast cancer, heart attack, stroke, and blood clots. There is no significant risk of anaphylaxis.

A 51-year-old woman has come to the OB/GYN clinic for her annual physical. She tells the nurse that she has been experiencing severe hot flashes, but that she is reluctant to begin hormone therapy (HT). What potential solution should the nurse discuss with the client?

Vitamin supplements - calcium and vit. d. For some women, vitamins B6 and E have proven beneficial for the treatment of hot flashes. Sodium restriction, vegan diet, and massage have not been noted to relieve this symptom of perimenopause.