maternity exam 3

How does an IUC work?

T-shaped device inserted into the uterus that releases copper, progesterone, or levonorgestrel

__% chance of recurrence occurs in the first 3 years of endometrial cancer.

85%

A nurse is caring for a female client who has a history of recurring vulvovaginal candidiasis. Which instruction should the nurse include in the teaching session with the client?

Wear white, 100% cotton underpants.

therapeutic management of endometrial cancer:

surgery (hysterectomy and salpingo-oophorectomy) adjunct therapy with radiation and chemo for advanced disease removal of tubes/ovaries

A client is receiving treatment for injuries sustained during a fight with a partner. The nurse observes that the partner visits the client daily in the hospital and appears very solicitous and contrite. When questioned, the client tries to convince the nurse that the partner always apologizes and brings gifts after a fight. Which information should the nurse provide this client?

"Although your partner seems sorry, often the person will repeat this behavior in the future."

A 42-year-old woman is scheduled for a mammogram. Which statement would the nurse include when teaching the woman about the procedure?

"Each breast will be firmly compressed between two plates."

A young client in the infertility clinic tells the nurse, "I just know it is my fault we cannot conceive." What would be the best response by the nurse?

"The problem can be with the man, woman, or both."

What causes candidiasis?

-*Fungus Candidas* -normal to digestive tract & vagina -usually harmless

PID testing

Based on exam, labs (blood/urine), check for STI's (chlamydia, gonorrhea, syphilis)

1. What is the word to describe the symptom of PID where the patient has cervical motion tenderness?

Chandelier's sign

cervical cap:

a contraceptive device that fits over the cervix by suction, thus blocking the passage of sperm into the uterus

HIV/Aids maternity issues:

can be passed on during pregnancy (C-section) can be spread through breast feeding

leading cause of death in women:

cardiovascular disease, a risk factor of menopause

vaginal cancer usually metastatic from:

cervix

STI's tested by blood/urine:

chlamydia gonorrhea hepatitis herpes HIV syphilis

two types of vulvar cancer:

classic simplex

danger signs of IUCs:

cramps, bleeding pelvic inflammatory disease infertility (up to 6-12 months) perforation of uterus

cervical cancer treatment:

cryotherapy (liquid nitro) cone biopsy or conization LEEP (heated wire) cold knife cone biopsy (surgical scalpel or laser) laser therapy hysterectomy radiation chemo

types of pelvic organ prolapse:

cystocele (posterior bladder) rectocele (rectum) enterocele (small intestines) uterine prolapse

A first year nursing student is learning how to differentiate between the two types of violence against women: intimate partner violence and sexual abuse. She learns that intimate partner violence includes:

dating, cohabitating, or marital relationships.

danger signs of combined oral contraceptives:

dizziness/nausea mood changes high BP blood clots heart attack/stroke

what happens to the integumentary system during menopause?

dry, thin skin and decreased collagen levels

HSV-2

herpes simplex virus type 2

key s/s of chlamydia:

mucopurulent discharge, no odor

maternal issues with HPV:

n/a :)

danger signs of emergency contraceptives:

nausea/vomiting abdominal pain fatigue headache risk of ectopic pregnancy

scabies s/s:

pruritic dermatitis lesions papule that reddens, erodes, and crusts FOUND ON WEBS of fingers and genitals

pubic lice s/s:

pruritus rash skin irritation from scratching visible evidence of lice or nits

The parent has been verbally abusive to the 6-year-old child and belittles the child routinely. In which type of maltreatment is the parent engaging?

psychological maltreatment

treatment of vaginal cancer:

radiation laser radical surgery if extensive

therapeutic management for ovarian cancer:

total abdominal hysterectomy bilateral salpingo-oophorectomy peritoneal biopsies omentectomy pelvic para-aortic lymph node sampling

A nurse is caring for a client who is being hospitalized for physical injuries. The client later confides to the nurse that the injuries are a result of a physical assault by the partner when drunk. The client feels degraded and ashamed but realizes that the partner was under the influence of alcohol. How should the nurse respond to this client?

"Being drunk is not an excuse for physically assaulting an intimate partner."

A client with genital herpes asks the nurse about what to expect with the infection. Which response would be most appropriate?

"Even though you don't have symptoms, you could still spread the infection."

A nurse is conducting a health history on a male client. Which statement by the client related to the client's fertility would concern the nurse?

"I have a degree as a chemical engineer and work at the local plant."

A nurse is caring for a pregnant woman in her third trimester. The woman is HIV positive and voices concerns about passing the infection on to her baby. What is the nurse's best response?

"If you are taking antiretroviral medications and you don't breastfeed your baby, you greatly reduce the risk of perinatal transmission of the disease."

A nurse is working with a victim of violence. Which statement would be most appropriate to empower the victim to take action?

"You are a good person, and you deserve better than this."

A 49-year-old client who is in the perimenopausal phase of life reports to the nurse a loss of lubrication during intercourse, which she feels is hampering her sex life. Which response by the nurse is appropriate?

"You can manage the condition by using over-the-counter (OTC) moisturizers or lubricants."

1. A nurse is preparing an in-service program for a group of newly hired nurses about trends in care for pregnant women. When describing events of the past decade, the nurse would state that the average length of stay in the hospital for vaginal births is: 24 to 48 hrs or less 72 to 96 hrs or less 48 to 72 hrs or less 96 to 120 hrs or less

24 to 48 hrs or less

how long does the implant contraceptive last?

3 years; time release implant of levonorgestrel

what is the recommended age for a woman to start having mammogram screenings?

40 yo

average age of menopause:

51 years

What should a nurse consider when assessing older clients with a sexually transmitted infection (STI)?

Older adults can still be sexually active.

Lactational Amenorrhea Method (LAM):

A method of avoiding pregnancies based on the postpartum infertility that many women experience when they are breast-feeding.

What can the nurse educate a subfertile couple about to avoid the problem with lower sperm counts in the male partner?

Minimize actions that increase scrotal heat.

1. A nurse is caring for a client who has gonorrhea. Which of the following medications should the nurse anticipate the provider will prescribe? Ceftriaxone Fluconazole Metronidazole Zidovudine

Ceftriaxone

1. Which of the following is NOT a mechanical barrier method of contraception? Condom Diaphragm Cervical Ring Cervical Sponge

Cervical Ring

1. The nurse is presenting a class at a local community health center on violence during pregnancy. Which possible complication would the nurse include? Hypertension of pregnancy Chorioamnionitis Placenta Previa Post-term labor

Chorioamnionitis

1. The nurse is preparing a presentation for a local women's group about methods to reduce the risk of reproductive tract cancers. Which action should the nurse include? BP evaluation every 6 months Yearly Pap smears starting at age 40 Condom use with every sexual encounter Consumption of two to three glasses of red wine per day

Condom use with every sexual encounter

1. Which finding obtained during a client history would the nurse identify as increasing a client's risk for ovarian cancer? Multiple sexual partners Consumption of a high-fat diet Underweight Grand Multiparity

Consumption of a high-fat diet

1. The daughter of a woman who has been diagnosed with ovarian cancer asks the nurse about screening for this cancer. Which response by the nurse would be most appropriate? Currently there is no reliable screening test for Ovarian Cancer A Pap smear is almost always helpful in identifying this type of cancer There's a blood test for a marker, CA 125, that if elevated indicates cancer A genetic test for two genes, is positive, will identify ovarian cancer

Currently there is no reliable screening test for Ovarian Cancer

ovarian cancer s/s:

Early symptoms: (bloating, early satiety, fatigue, vague abdominal pain, urinary frequency, diarrhea, constipation, unexplained weight loss or gain) Late symptoms (anorexia, dyspepsia, ascites, palpable mass, pelvic pain, back pain)

Which action would the nurse include in a primary prevention program in the community to help reduce the incidence of HIV infection?

Educate clients on how to practice safe sex.

A client has recently been treated in the emergency department for trauma to the head as a result of intimate partner violence. The client expresses to the nurse the desire to go back home to the partner upon discharge. What is the best action for the nurse to take?

Ensure that the woman has the numbers for a 24-hour shelter and a social worker upon discharge, and advise her to carry it with her at all times

1. When obtaining the health history from a client, which factor would lead the nurse to suspect that the client has an increased risk for sexually transmitted infections (STIs)? Hive like rash for the past 2 days Five different sexual partners Wt gain of 5 lbs in one year Clear vaginal discharge

Five different sexual partners

A woman comes to the clinic to be screened for sexually transmitted infections (STI). Which factor places this client at high risk for an STI?

Five different sexual partners

1. The nurse would recommend the use of which supplement as a primary prevention strategy to prevent neural tube defects in the future offspring of pregnant women? Calcium Folic Acid Vitamin C Iron

Folic Acid

1. A woman is diagnosed with adenocarcinoma of the endometrium in situ. The nurse interprets this as indicating which information about the cancer? Spread to the uterine muscle wall Found on the endometrial surface Spread to the cervix Invaded the bladder

Found on the endometrial surface

vulvar cancer risk factors:

HPV multiple sex partners herpes

The sexual health nurse is presenting to a group of adolescents the government initiative that proposes to reduce the numbers of adolescents with sexually transmitted infections. What is the name of this initiative?

Healthy People 2020

A woman comes to the clinic for a routine check-up. After obtaining the client's history, the nurse identifies that the client is at increased risk for cervical cancer based on her history of exposure to which virus? Hepatitis Human Papillomavirus Cytomegalovirus Epstein-Barr virus

Human Papillomavirus

After teaching a woman with pelvic organ prolapse about dietary and lifestyle measures, which statement would indicate the need for additional teaching? If I wear a girdle it will help support the muscles in the area I should take up jogging to make sure I exercise enough I will try to drink at least 64 oz of fluid each day I need to increase the amount of fiber I eat every day

I should take up jogging to make sure I exercise enough

1. A nurse is assigned to care for an Asian American client. The nurse plans the care recognizing that which statement best explains an Asian American's view of illness? Illness is caused by supernatural forces Illness is a punishment for sins Illness may be caused by God's will or evil influences Illness is due to an imbalance between yin and yang

Illness is due to an imbalance between yin and yang

A young woman is seen in the emergency department with multiple bruises and two black eyes. She states that she tripped and fell down a flight of stairs and feels embarrassed. The nurse suspects intimate partner violence, but none is reported because the primary care provider states, "She is married to a prominent lawyer who is a good friend of mine, and I know he would never do this." What is wrong with this scenario?

It should be investigated as abusers come from all walks of life.

1. The nurse is teaching a client with polycystic ovarian syndrome (PCOS) who is receiving oral contraceptives as part of her treatment plan about the drug therapy and how it will help the client. The nurse determines that the teaching was successful when the client states which reason for the drug? It will help regulate my menstrual cycle It will help me ovulate My body will be able to use insulin better It will decrease my hair growth

It will help regulate my menstrual cycle

what is used for ovarian cancer diagnosis and staging:

Laparoscopy

gonorrhea s/s:

PID dysuria vaginal discharge dyspareunia endocervicitis arthritis ectopic pregnancy infertility

1. A nurse is working with a woman who is a victim of violence. Which intervention would be most important for this client? Providing for the client's safety Reassuring her she is not alone Documenting the abuse Educating about the cycle of violence

Providing for the client's safety

A client asks the nurse what she can do to help reduce her PMS symptoms. The nurse would recommend which action by the client?

Reduce or eliminate caffeine intake.

When health care professionals detect signs of elder mistreatment in clients, the law requires them to do what?

Report the treatment to the state authorities.

A woman in active labor is crying out in pain. She states that she has seen her spiritual healer, and has decided to refuse pain medication. Which action by the nurse is most appropriate in this situation?

Respect the woman's choice of no medication and assist with nonpharmacologic pain relief options.

1. When describing an episode, the victim reports that she attempted to calm her partner down to keep things from escalating. The nurse interprets this behavior as reflecting which phase of the cycle of violence? Battering Honeymoon Tension-building Reconciliation

Tension-building

A nurse has performed disease prevention teaching with a female client who has genital herpes. Which client behavior indicates that the teaching has been successful?

The client washes her hands before and after touching lesions.

During a presentation on sexually transmitted infections (STIs), a participant asks the nurse why STIs occur more often in women. What would the nurse address as a possible reason?

The woman's moist vaginal environment is highly conducive to microbial growth.

A pregnant client with multiple bruises comes to the clinic for treatment. She appears withdrawn and quiet when the nurse approaches her. Her husband accompanies her to the exam room and begins to answer all the questions the nurse asks her. There is minimal eye contact from the client to the nurse. What is the nurse's analysis of this situation?

There may be intimate partner violence.

1. A woman is scheduled for diagnostic testing to evaluate for endometrial cancer. The nurse would expect to prepare the woman for which procedure? CA-125 testing Transvaginal ultrasound Pap smear Mammography

Transvaginal ultrasound

The nurse at a fertility clinic determines the risk factors for clients using oral contraceptives. Which client would be at highest risk for heart attack or stroke related to use of these contraceptives?

a 38-year-old woman who smokes

Essure:

a method of tubal sterilization that blocks the oviducts by use of metal coils

amenorrhea (the final stage in menopause)

absence of menstruation

behavioral contraceptive methods:

abstinence fertility awareness-based methods withdrawal (pulling out) lactational amenorrhea method (LAM)

HIV/Aids s/s:

acute seroconversion: flu-like sensation, fever, pharyngitis, rash, myalgia (3-12 months) asymptomatic: virus replicates, runs down immune system, CD4 T-cell count lowers AIDS: CD4 <200

risk factors for vaginal cancer:

advanced age vaginal trauma genital warts chronic vaginal discharge smoking

A client with trichomoniasis is to receive metronidazole. What should the nurse instruct the client to avoid while taking this drug?

alcohol

chemo and (possibly) radiation is recommended for what stage of ovarian cancer?

all of them

danger signs for diaphragm:

allergy to latex/rubber/polyurethane or spermicide toxic shock syndrome may become dislodged in female superior position

danger signs to female condom:

allergy to polyutrethane

danger signs of implant (contraception)

anemia if bleeding is heavy

s/s of CAD:

angina breathlessness chronic fatigue dizziness edema of hands/feet fluttering of heat gastric upset heavy pain in back/shoulders

vulvar cancer screening:

annual vulva exams biopsy of suspicious lesions (on labia majora)

movable and stationary lumps:

movable: less likely to be cancerous stationary (hard): more suspicious

warning signs of reproductive cancer:

blood in stool unusual vaginal discharge/chronic vulvar itching persistent abdominal bloating or constipation irregular bleeding persistent low backache not related to standing elevated or discolored vulvar lesions bleeding after menopause pain/bleeding after intercourse

screening and diagnosis for endometrial cancer:

no specific screening test not routine endometrial biopsy as procedure of choice; ultrasound usually diagnosed early

patient education on vulvar cancer:

no tight underwear no perfumes or dyes in vulvar region barrier methods no multiple partners

risk factors for reproductive cancer:

early menarche late menopause STI hormonal agents infertility family history lifestyle/behaviors

types of PID:

endometritis (uterine lining) parametritis (connective tissue adjacent to uterus) salpingitis (Fallopian tubes) peritonitis (serous membrane that lines part of the abdominal cavity and viscera)

nurses 3 responsibilities with informed consent:

ensure consent form is completed with signatures from client/parent/legal guardian serving as a witness to the signature process determine whether the client or parents or legal guardians understand what they are signing by asking them pertinent questions

treatment of scabies and pubic lice:

eradication of infestation with meds, removing nits, and preventing spread by managing environment

When teaching a group of postmenopausal women about hot flashes and night sweats, the nurse would address which primary cause?

estrogen deficiency

key s/s of pubic lice:

extreme pruritus

maternity issues with chlamydia:

eye infections (conjunctivitis) pneumonia low birth weight/preterm PROM still birth

what is the feeling of pelvic organ prolapse?

feeling of dragging, lump in vagina, something is "coming down"

Key S/S of bacterial vaginosis:

fish odor

The nurse would recommend the use of which supplement as a primary prevention strategy to prevent neural tube defects in the future offspring of pregnant women?

folic acid

HPV:

genital warts

key s/s of HPV:

genital warts

key s/s of gonorrhea:

greenish-yellow, foul odor

endometritis:

inflammation of the inner lining of the uterus

A young client has just been told by her primary care provider that she has a problem with ovulation. Which treatment would the nurse expect the care provider to prescribe for this client?

hormones

A woman comes to the clinic for a routine check up. After obtaining the client's history, the nurse identifies that the client is at increased risk for cervical cancer based on her history of exposure to which virus?

human papillomavirus

danger signs of depo-provera injection (hormonal contraception):

if depression is a problem, this method may increase risks

chorioamnionitis

inflammation of the fetal membranes

s/s of candidiasis:

itching/rash cottage cheese like discharge dyspareunia external dysuria

vulvar cancer treatment:

laser surgery cryosurgery electrosurgical incision radical vulvectomy

danger signs of male condom:

latex allergy

what happens to the GI system during menopause?

less absorption of calcium from food, increasing risk of fractures

danger signs of patch:

less effective in women weighing more than 200 lbs

what happens to the cardiovascular system during menopause?

lower levels of HDL and increased risk of CVD

what might be some medical considerations when choosing contraceptives?

medical history family history OB/GYN history # of sexual partners physical examination/vitals diagnostic testing current STI status

HSV-2 cause:

oral secretions; can be spread to genitals through poor handwashing of infected person or oral/genital contact

female cancers:

ovarian endometrial cervical vaginal vulvar breast

most ovarian cancer cells originate in:

ovarian epithelium also originates from fimbriated distal end of Fallopian tube; ovary gets only involved at later stage

vulvar cancer s/s:

persistent vulvar itching dyspareunia ulcers vulvar swelling vulvar bleeding urinary problems

cystocele:

posterior bladder wall protrudes through anterior vaginal wall

simplex vulvar cancer associated with:

postmenopausal women chronic irritation not as common

A client who is a rape survivor has appeared to cope very well. However, at a routine visit several months later, the client describes nightmares and flashbacks. The nurse would suspect which condition?

posttraumatic stress disorder

lowering risk factors for ovarian cancer:

pregnancy/breast feeding (before 30 yo) oral contraceptives (3+ years) avoid talc/hygiene spray on genitals review risks related to BRCA 1/2 healthy lifestyle

PROM:

premature rupture of membranes

what might be some personal considerations when deciding on method of contraception?

religious beliefs sexual pleasure what is patient currently using cost/insurance partner influence stable, monogamous relationship? personal touching family planning

The nurse was teaching a college student how to properly take the prescribed combination oral contraceptive (COC). The nurse determines the session is successful when the client correctly chooses which instruction to follow when taking the COC?

same time of day, each day

HIV/Aids cuase:

sexual activity blood born used needles mother/baby in pregnancy

chlamydia cause:

sexual activity and childbirth

gonorrhea cause:

sexual activity and childbirth

HPV cause:

sexual activity with infected person

syphilis cause:

sexual contact with infected person

enterocele:

small intestine bulges through posterior vaginal wall (common in straining)

Hepatitis B:

transmitted through saliva, blood serum, semen, menstrual blood, and vaginal secretions. incubation period is from 6 weeks to 6 months highest STI mortality rate (aside from HIV/Aids)

A female client is interested in knowing what the most effective procedure for permanent sterilization in women is. The nurse should mention which procedure to the client?

tubal ligation

permanent contraception methods:

tubal ligation or essure (women) vasectomy (men)

hepatitis prevention:

vaccination for both A and B

least common reproductive cancer:

vaginal cancer

classic vulvar cancer associated with:

younger women (30-40) HPV smoking most common

The nurse is providing care to a pregnant woman who speaks a different language from that of the nurse. When communicating with this client, the nurse demonstrates best practice by which action?

arranging for an interpreter to be present during any communication

1. The nurse determines that a woman has implemented prescribed therapy for her fibrocystic breast disease when the client reports that she has eliminated which from her lifestyle? Caffeine Cigarettes Dairy products Sweets

caffeine

An 18-year-old female client who is sexually active asks the nurse for information on barrier contraceptives. Which contraceptive should the nurse say is a mechanical barrier contraceptive?

cervical cap

key s/s of syphilis:

chancre

key s/s of pelvic inflammatory disease:

chandelier's sign

barrier methods of contraception:

condom (men/women) diaphragm cervical cap sponge

After discussing various methods of contraception with a client and her partner, the nurse determines that the teaching was successful when they identify which contraceptive method as providing protection against sexually transmitted infections (STIs)?

condoms

contraception methods that protect against STI's:

condoms abstinence

key s/s of candidiasis:

cottage cheese like discharge

hormonal contraception:

oral injectable transdermal patch vaginal ring implantable intrauterine emergency (plan b)

1. To assist the woman in regaining control of the urinary sphincter after bladder surgery, the nurse should teach the client to perform which action? Perform Kegel exercises daily Void every hour while awake Limit the intake of fluid Take a laxative every night

perform kegel exercises daily

1. A nurse is reading a journal article about care of the woman with pelvic organ prolapse. The nurse would expect to find information related to which disorder? Select all that apply. Rectocele Fecal incontinence Cystocele Urinary incontinence Enterocele

rectocele cystocele enterocele

key s/s for trichomoniasis:

yellow-green, frothy discharge

A client who has been seen in the clinic multiple times for counseling recently admitted to being a victim of intimate partner violence over a period of five years. Today the client states, "My partner has been so sweet to me the last six days that I think this time he has really changed. He even brought me flowers yesterday and said he loves me." How should the nurse respond to this?

"Over a period of time the honeymoon phase ends and abuse becomes accelerated and thus more dangerous."

While obtaining a health history from a male adolescent during a well checkup, the nurse assesses his sexual behavior and risk for sexually transmitted infections. Based on the information, the nurse plans to teach the adolescent about using a condom. What statement would the nurse include in the teaching plan?

"Put the condom on before engaging in any genital contact."

The nurse suspects a client is a victim of intimate partner violence. When the nurse asks the client if a partner abuses her, the client responds, "Oh no, he doesn't hit me." How will the nurse respond?

"There are many types of abuse beyond physical abuse."

A client with genital herpes simplex infection asks the nurse, "Will I ever be cured of this infection?" Which response by the nurse would be most appropriate?

"There is no cure, but drug therapy helps to reduce symptoms and recurrences."

A client tells the nurse that she is getting divorced and wants to be sure that her soon-to-be ex-husband cannot have access to her medical information. Which response would be the most accurate for the nurse to give the client?

"You have the right to say who can access your health records and who cannot."

1. A nurse is conducting a class for a local woman's group about recommendations for a Pap smear. One of the participants asks, "At what age should a woman have her first Pap smear?" The nurse responds by stating that a woman should have her first Pap smear at which age? 18 21 25 28

21

there are no early signs for breast cancer. the first is usually __a__. The later signs include: b

A: lump felt on breast nontender, fixed and hard with irregular borders B: continued and persistent changes in breast lump/thickening in one side persistent nipple irritation asymmetrical breast swelling changes in skin color/texture nipple retraction, tenderness, or discharge

A client who has recently given birth arrives in a health care facility wanting to know ways to prevent sudden infant death syndrome (SIDS) in her infant. Which instructions should the nurse provide to address the concern?

Place the infant on his or her back to sleep.

During a routine examination, the nurse suspects a teenager is having unprotected sex. To encourage discussion, which action by the nurse would be best?

Be nonjudgmentally direct in the conversation.

danger signs of progestin (oral contraceptives) (mini-pills):

irregular bleeding weight gain increased incidence of ectopic pregnancy

danger signs of cervical cap:

irritation/allergic reaction abnormal pap test toxic shock syndrome

danger signs of sponge:

irritation/allergic reaction toxic shock syndrome if left in too long

1. A client is scheduled for cryosurgery to remove some abnormal tissue on the cervix. The nurse teaches the client about this treatment, explaining that the tissue will be removed by which method? Freezing Cutting Burning Irradiating

Freezing

1. The nurse is trying to get consent to care for an 11-year-old boy with diabetic ketoacidosis. His parents are out of town on vacation, and the child is staying with a neighbor. Which action would be the priority? Getting telephone consent with two people listening to the verbal consent Providing emergency care without parental consent Contacting the child's aunt or uncle to obtain their consent Asking the courts to grant permission on the child's behalf

Getting telephone consent with two people listening to the verbal consent

A client comes to the clinic reporting neck and back pain. The partner appears anxious and overprotective. The nurse suspects possible intimate partner violence. How might the nurse handle this examination?

Isolate the client to ensure privacy before questioning about possible intimate partner violence.

A student in clinical caring for a woman who has been diagnosed with ovarian cancer consults her nursing instructor. The student demonstrates an understanding of ovarian cancer when she states which information?

It is known as the "silent killer."

1. You are educating a group of women on later signs of breast cancer. Which of the following are signs that you would educate on? Select all that apply Lump or thickening in one breast Changes in skin color or texture Nipple retraction or discharge Lump or swelling in the groin Unusual breast swelling

Lump or thickening in one breast Changes in skin color or texture Nipple retraction or discharge Unusual breast swelling

1. The nurse would refer a client, age 54, for follow up for suspected endometrial carcinoma if she reports which information? Use of oral contraceptives between ages 18 and 25 Onset of painless, red postmenopausal bleeding Menopause occurring at age 46 Use of intrauterine device for 3 years

Onset of painless, red postmenopausal bleeding

A 56-year old patient comes to your clinic for evaluation with suspected endometrial cancer. Which of the following would be indicative of endometrial cancer? Taking the pill between ages 18 - 25 Onset of painless, red postmenopausal bleeding Menopause occurring at age 46 Use of an IUD for 3 years

Onset of painless, red postmenopausal bleeding

To assist the woman in regaining control of the urinary sphincter after bladder surgery, the nurse should teach the client to perform which action?

Perform Kegel exercises daily.

contraceptive injections are to be given every _a_ months, and the user may not be able to get pregnant up to _b_ months after discontinuation.

a: 3 b: 12

warning symptoms of oral contraceptives:

abdominal or leg pain (severe) chest pain headaches/dizziness eye vision loss or blurring severe leg pain

4 types of contraception

behavioral barrier hormonal permanent

maternal issues with HSV-2:

birth contamination skin/mouth sores mental retardation premature/low birth weight blindness death

cervical cancer s/s:

bleeding after intercourse abnormal changes in cellular lining or surface of cervix HPV infection (MUST BE PRESENT) cervical dysplasia (disordered growth of abnormal cells)

with the dramatic decline of estrogen, what happens to the brain during menopause?

brain: hot flashes, disturbed sleep, mood and memory problems

most common cancer in women:

breast cancer

PID treatment:

broad spectrum antibiotics prevention of other STIs

chlamydia s/s

dysuria urinary frequency dyspareunia cervical discharge endocervicitis PID ectopic pregnancy infertility inflammation of rectum/conjunctiva infected throat

trichomoniasis s/s:

dysuria vaginal discharge (yellow, green, or gray with odor) dyspareunia irritation or itching of genitals

when used to combat the effects of menopause, hormone therapy can cause what, if taken long term?

heart attach/stroke breast cancer

assessment of endometrial cancer:

history (abnormal painless vaginal bleeding) risk factors physical exam/pelvic exam transvaginal ultrasound

HSV-2 s/s:

itching, tingling and pain in genital area small pustules and blister like genital lesions that crust over and heal mild recurrence episodes dyspareunia urine retention fever headache malaise muscle aches

1. During a clinical breast examination, the nurse palpates a well-defined, firm, mobile lump in a 60-year-old woman's left breast. The nurse notifies the primary care provider. What would the nurse anticipate the care provider to order next? Mammogram Hormone receptor status Fine needle aspiration Genetic testing for BRCA

mammogram

maternity issues with gonorrhea:

miscarriage PROM preterm rhinitis vaginitis urethritis inflammation of sites of fetal monitoring gonococcal opthalmia neonatorum leads to blindness and sepsis

cervical sponge:

moisten w/ water- otc- one size fits all place over the cervix and leave in place for 6 hours after intercourse. Throw away after While in place, it protects against pregnancy for up to 24 hrs w/out needing to add spermicide even w/ add'l sexual acts It contains nonoxynol-9 Side effects: increased risk of UTI

what happens to the body shape during menopause?

more abdominal fat; waist size that swells relative to hips

what causes bacterial vaginosis?

overgrowth of anaerobes, occurs when normal vaginal flora are decreased or absent

dyspareunia

painful sexual intercourse

symptoms of vaginal cancer:

painless bleeding abnormal discharge constipation pelvic pain

cervical cancer screening:

pap test (possible false negative) Thin-prep computer-assisted automated Pap test rescreening HPV-DNA typing

syphilis maternity issues:

passed in utero fetal/infant death skin ulcers rashes fever weakened/hoarse cry swollen liver/spleen jaundice and anemia deformations

PID s/s:

pelvic abscess subfertility recurrent or chronic episodes of disease chronic abdominal pain pelvic adhesions depression fever vaginal discharge CHANDELIER'S SIGN

PID:

pelvic inflammatory disease

the period where ovaries begin to fail, producing irregular and missed periods with occasional hotflash is called:

perimenopause

maternal risk factors from bacterial vaginosis:

preterm labor PROM chorioamnionitis PP endometritis PID

maternity issues with trichomoniasis:

preterm or low birth weight chance of passing to newborn during delivery

syphilis s/s:

primary: chancre on place of entrance of bacteria (vulva/vagina) secondary: rash on hands/feet, sore throat, lymphadenopathy, flu-like latent: n/a tertiary: tumors of skin, bone, and liver. CNS symptoms, cardiovascular symptoms. NON REVERSIBLE AT THIS STAGE

mammogram

radiographic image of the breast used to look for cancer

what happens to the skeletal system during menopause?

rapid loss of bone density that increases risk of osteoporosis

rectocele:

rectum sags and pushes against or into posterior vaginal wall

chancre:

red, round, superficial ulcer with a yellowish serous discharge that is a sign of syphilis

preventative and follow-up measures for endometrial cancer:

regular pelvic exam after 21 check on abnormal bleeding after menopause low fat diet (manage weight) exercise reduced estrogen through pregnancy report symptoms

what happens to the breasts during menopause?

replacement of duct and glandular tissues by fat

maternal issues with candidiasis:

risks of development increase with pregnancy

Hepatitis A:

spread through GI tract. acquired by drinking polluted water, eating uncooked shellfish from sewage-contaminated waters, or food prepared by hepatitis A carrier w/ poor hygiene, and form oral/anal sex. Easily passed on in household.

Which nursing plan is a good example of how to incorporate cultural diversity perferences into the labor and delivery unit?

supplying long-sleeved gowns and head scarves for a woman who request them

menopausal transition:

transition from a woman's reproductive phase of life to final menstrual period

t/f ovarian cancer is usually not detected until the later stages

true. there is no adequate screening test

1. When describing the various types of reproductive tract cancers to a local women's group, the nurse would identify which cancer as the least common type? Vulvar Vaginal Endometrial Ovarian

vaginal

Bacterial vaginosis s/s:

vaginal discharge or malodor vaginal pH of 4.5 fishy odor clue cells on wet-mount exam

what happens to the genitourinary system during menopause?

vaginal dryness, stress incontinence, cystitis

trichomoniasis cause:

vaginal intercourse with infected. direct genital contact with infected, damp/moist object (washcloth)

assessing ovarian cancer:

vague complaints early/late symptoms risk factors physical exam

HPV s/s:

wart-like lesions that are soft, moist, or flesh colored and appear on vulva and cervix, surrounding vagina and anus clusters that appear as cauliflower-like bumps raised/flat, small/large

A nurse is educating a group of students in the community clinic about pelvic organ prolapse. What can be a cause of this disorder?

weakening of pelvic support related to birth trauma

Chandelier sign

when manipulation of the cervix causes patient to lift buttocks off table during pelvic exam Positive Cervical motion tenderness (pain)

a woman is born with how many ova?

~2 million (only ~400 mature and are released)