Female reproductive disorders
leiomyomas a.k.a. uterine fibroids are three times more common in ________ women
black
What are common late signs of cervical cancer
pain, leg edema, urinary and rectal problems, and weight loss.
To assess for anemia for your female client, you review the H&H values. You would look for a hemoglobin less than ____ to support a diagnosis of anemia.
12
When preparing discharge instructions for client after an abdominal hysterectomy, the nurse should FIRST 1. Have the client watch an educational video 2. Assess the client's available social supports. 3. Call the social worker to evaluate the client 4. Read the discharge instructions to the client
2. Assess the client's available social supports. Assessing social supports is a key aspect of discharge planning
Your client will have an abdominal hysterectomy tomorrow. Which of the following is the MOST IMPORTANT for the nurse to teach the client prior to admission to the hospital? 1. What to wear to the hospital 2. What she can eat and drink before admission 3. The type of pain meds that will be prescribed post-op. 4. The amount of activity she can engage in after surgery.
2. What she can eat and drink before admission. It is a priority for the client to know she can't eat or drink for 8 hours before admission. This is because a client who consumes food and fluid before receiving a general anesthetic is at RISK FOR ASPIRATION.
On the 2nd postop day after an abdominal hysterectomy, the client develops a temp of 100.4. The nurse's FIRST action should be to 1. Increase the number of wound changes to minimize infection 2. Obtain a culture and sensitivity study of the urine to determine the source of infection 3. Ensure the client takes at least 10 deep breaths every hours 4. Change the site of the client's IV fluid catheter to reduce the risk of infection
3. Ensure the client takes at least 10 deep breaths every hours Elevated temp on 2nd postop day is suggestive of a respiratory tract infection. These most often occur during the first 48 hours after surgery.
Which treatment is appropriate for a client with cervical polyps who has been treated with cryosurgery? 1. Daily douche 2. Oral antibiotics 3. Intravaginal antibiotic cream 4. Use of tampons for 72 hours
3. Intravaginal antibiotic cream is commonly used to aid healing and prevent infection. Oral antibiotics are used for clients with acute cervicitis or perimetritis. Douching and tampon use should be avoided for 2 weeks.
What nursing intervention would most likely relieve postoperative gas pains after an abdominal hysterectomy? 1. Offering the client a hot beverage 2. Providing extra warmth 3. Applying a snugly fitting abdominal binder 4. Helping a client walk.
4. Helping a client walk. Gas is more easily expelled with exercise. The anesthesia, analgesics, and immobility alter normal peristalsis and exercise will help stimulate peristalsis.
What should you do if your patient with leiomyomas develops severe anemia from excessive bleeding?
Administer iron and blood transfusions as ordered.
What test(s) would support a diagnosis of leiomyomas?
Blood studies indicating anemia; D&C or a submucosal hysterosalpingography that detects submucosal leiomyomas; or a Laparoscopy that shows subserous leiomyomas on the uterine surface
T or F Taking estrogen alone decreases the risk for endometrial cancer in women who still have an intact uterus
False...using estrogen alone without progesterone increases the risk. Taking.oral contraceptives for at least a year that contain both estrogen and progesterone decrease the risk
With menopause, _____ and ____ levels increase dramatically.
Follicle-stimulating hormone (FSH) and luteinizing hormone (LH)
It is important for a client undergoing an abdominal hysterectomy to understand that the surgery will result in ___________.
INFERTILITY. Removal of the uterus means she can no longer bear children or have menstrual periods.
A postmenopausal woman is taking the drug tamoxifen for breast cancer. Is she at an increased or decreased risk for endometrial cancer
Increased...tamoxifen increases the risk in postmenopausal women
leiomyomas are classified three ways, according to location. What are those locations?
Intramural (within the uterine wall) Submucosal (protruding into the endometrial cavity) subserosal (protruding from the serosal surface of the uterus. In all three cases the uterine cavity may become larger increasing the endometrial surface area and causing increased uterine bleeding.
What are some discharge instructions to provide to a client who just had a D&C?
Strenous work and sexual intercourse should be avoided for two weeks to allow healing and decrease the risk for infection. Tampons and tub baths should be avoided for 1 week. Resume activity gradually.
What is the treatment of choice for patients diagnosed with leiomyomas who still wish to have children?
Surgical removal
T or F Exercise decreases the risk for endometrial cancer
True
T or F: If a pregnant woman has a leiomyomatous uterus that is no larger than a 6 month normal uterus by the 16th week, surgery is usually unnecessary and the pregnancy outcome is favorable
True
T or F: Later stages of pregnancy increase tumor size and hGH levels?
True
T or F: he early stages of cervical cancer are usually asymptomatic?
True
T or F: increased parity (having more children) and duration of lactation decrease the risk for endometrial cancer
True
What is the MOST IMPORTANT information for a nurse to give a client to decrease the risk of toxic shock syndrome
Use pads, not tampons, overnight. This is because when tampons are left in place for more than 8 hours (such as overnight), it provided a good environment for the growth of bacteria.
What should you teach the patient with leiomyomas to report
abnormal bleeding or pelvic pain immediately
what is the classic symptom of endometriosis
acquired dysmenorrhea (characterized by pain in the lower abdomen, vagina, posterior pelvis, and back that lasts for 2-3 days and occurs 5-7 days before menses)
Which disorder is characterized by pain in the lower abdomen, vagina, posterior pelvis, and back that lasts for 2-3 days and occurs 5-7 days before menses?
endometriosis
condition that results in benign, ectopic tissue appearing outside of the lining of the uterine cavity . The tissue can appear anywhere in the body.
endometriosis
With menopause, ______ ______ occur in about 80% of women. Many times they occur at night disrupting sleep patterns.
hot flashes
leiomyomas that twist or grow large enough to cause intestinal obstruction require a _________
hysterectomy
what is the primary complication of endometriosis
infertility
Why is douching not typically recommended?
it removes natural mucus and changes the balance of normal vaginal flora
this is the most common benign tumor in women
leiomyomas a.k.a. uterine fibroids (only 0.1% become malignant)
What is usually the 1st noticeable symptom in a client with cervical cancer
light bleeding or serosanguineous discharge
A client who will be having a vaginal examination should be placed in what preferred position?
lithotomy. This position offers the best visualization
A ___________ ______ is needed after a hysterosalpingography because the contrast medium may leak from the vagina for several hours and stain the clothing.
perineal pad
What is likely to occur if a pregnant woman has a leiomyomatous uterus the size of a 5-6 month normal uterus by the 9th week of pregnancy?
spontaneous abortion (especially with a cervical leiomyoma)
What is the cardinal sign of uterine leiomyomas?
submucosal hypermenorrhea
what causes leiomyomas?
the exact cause is unknown but excessive levels of estrogen and hGH (human growth hormone) as well as progesterone have been implicated as regulators of leiomyoma growth.
What is the cause of toxic shock syndrome
A toxin produced by Staphylococcus aureus bacteria
A woman with uterine fibroids and dysmenorrhea is at risk for what type of anemia?
Iron deficiency
T or F: Uterine leiomyomas usually shrink or disappear after menopause
True (estrogen production decreases after menopause)
