Chapter 57: Management of Patients with Female Reproductive Disorders

A patient with genital herpes is having an acute exacerbation. What medication would the nurse expect to be ordered to suppress the symptoms and shorten the course of the infection?

D. Acyclovir

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?

D. Performance of pelvic muscle exercises.

A female patient 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?

A. Trichomonas vaginalis

Following a recent history of dyspareunia and lower abdominal pain, a patient has received a diagnosis of pelvic inflammatory disease (PID). When providing health education related to self care, the nurse should address which of the following topics? Select all that apply.

A and B. A. use of condoms to prevent infecting others. B. Appropriate use of antibiotics.

A public health nurse is participating in a campaign aimed at preventing cervical cancer. What strategies should the nurse include in this campaign? Select all that apply.

A, B, C, E, A. Promotion of HPV immunization B. Encouraging young women to delay first intercourse. C. Smoking cessation E. Using safer sex practices

A patient comes to the free clinic complaining of a gray white discharge that clings to her external vulva and vaginal walls. A nurse practitioner assesses the patient and diagnoses Gardnerella vaginalis. What would be the most appropriate nursing action at this time?

A. Advise the patient that this is an overgrowth of normal vaginal flora.

A nurse is caring for a pregnant patient with active herpes. The teaching plan for this patient should include which of the following?

A. Babies delivered vaginally may become infected with the virus.

A patient with trichomoniasis comes to the walk-in clinic. In developing a care plan for this patient the nurse would know to include what as an important aspect of treating this patient?

A. Both partners will be treated with metronidazole (Flagyl).

A nurse practitioner is examining a patient who presented at the free clinic with vulvar pruritic. For which assessment finding would the practitioner look that may indicate the patient has an infection caused by Candida albicans?

A. Cottage cheese like discharge.

The nurse is caring for a 63 year old patient with ovarian cancer. The patient is to receive chemotherapy consisting of Taxol and Paraplatin. For what adverse effect of this treatment should the nurse monitor the patient?

A. Leukopenia

The nurse is caring for a patient who has just been told that her ovarian cancer is terminal and that no curative options remain. What would be the priority nursing care for this patient at this time?

A. Provide emotional support to the patient and her family.

A female patient with HIV has just been diagnosed with condylomata acuminate (genital warts). What information is the most appropriate for the nurse to tell this patient?

A. This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test anually.

You are caring for a patient who has been diagnosed with genital herpes. When preparing a teaching plan for this patient, what general guidelines should be taught?

A. Thourough handwashing is essential.

When teaching patients about the risk factors of cervical cancer, what would the nurse identify as the most important risk factor?

B. Human Papillomavirus (HPV) This is the mose salient risk for cervical cancer, more so than smoking, late childbearing, and postmenopausal bleeding.

A patient has been diagnosed with endometriosis. When planning this patient's care, the nurse should prioritize what nursing diagnosis?

B. Acute pain related to misplaced endometral tissue.

A patient is post operative day 1 following a vaginal hysterectomy. The nurse notes an increase in the patient's abdominal girth and the patient complains of bloating. What is the nurse's most appropriate action?

B. Apply warm compresses to the patient's lower abdomen.

A 31 year old patient has returned to the post surgical unit following a hysterectomy. The patient's care plan addresses the risk of hemorrhage. How should the nurse best monitor the patient's postoperative blood loss?

B. Count and inspect each perineal pad that the patient uses.

A patient with ovarian cancer is admitted to the hospital for surgery and the nurse is completing the patient's health history. What clinical manifestation would the nurse expect to asses?

B. Increased abdominal girth.

A patient with genital herpes exacerbation has a nursing diagnosis of acute pain related to the genital lesions. What nursing intervention best addresses this diagnosis?

B. Keep the lesions clean and dry.

The nurse is caring for a patient with a diagnosis of vulvar cancer who has returned from the PACU after undergoing a wide excision of the vulva. How should this patient's analgesic regimen be best managed?

B. Scheduled analgesia should be administered around the clock to prevent pain.

A patient comes to the clinic complaining of tender, inflamed vulva. Testing does not reveal the presence of any known causative microorganism. What aspect of this patient's current health status may account for the patient's symptoms of vulvitis?

B. The patient has type 1 diabetes.

A middle aged female patient has been offered testing for HIV/AIDS upon admission to the hospital for an unrelated health problem. The nurse observes that the patient is visibly surprised and embarrassed by this over. How should the nurse best respond?

B. This testing is offered to every adolescent and adult regardless of their lifestyle, appearance, or history.

A 14 year old 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 mom is very concerned because daughter is having a lot of stabbing pain and burning. What might the nurse suspect is the prob with the 14 year old?

B. Vulvodynia

A student nurse is caring for a patient who has undergone a wide excision of the vulva. The student should know that what action is contraindicated in the immediate postoperative period?

C. Ambulation to a chair.

The nurse is planning health education for a patient who has experienced a vaginal infection. What guidelines should the nurse include in this program regarding prevention?

C. Avoid feminine hygiene products, such as sprays.

A 45 year old woman has just undergone a radical hysterectomy for invasive cervical cancer. Prior to the surgery the physician explained to the patient that after the surgery a source of radiation would be placed near the tumor site to aid in reducing recurrence. What is the placement of the source of radiation called?

C. Brachytherapy

A patient has returned to the post-surgical unit after vulvar surgery. What intervention should the nurse prioritize during the initial postoperative period?

C. Monitoring the integrity of the surgical site.

A 30 year old patient has come to the clinic for her yearly examination. The patient asks the nurse about ovarian cancer. What should the nurse state when describing risk factors for ovarian cancer?

C. Most cases of ovarian cancer are considered to be random, with no obvious causation.

When reviewing the electronic health record of a female patient the nurse readt that the patient has a history of edenomyosis. The nurse should be aware that this patient experiences symptoms resulting from what pathophysiologic process?

C. Proliferation of tumors in the uterine wall.

A patient diagnosed with cervical cancer will soon begin a round of radiation therapy. When planning the patient's subsequent care, the nurse should prioritize actions with what goal?

C. Protecting the safety of the patient, family, and staff.

A patient is being discharged home after a hysterectomy. When providing discharge education for this patient, the nurse has cautioned the patient against sitting for long periods. This advice addresses the patient's risk of what surgical complication?

C. Venous thromboembolism

A patient has been diagnosed with polycystic ovary syndrome (PCOS). The nurse should encourage what health promotion activity to address the patient's hormone imbalance and infertility?

C. Weight Loss

While taking a health history on a 20-year-old female patient, the nurse ascertains that this patient is taking miconazole (Monistat). The nurse is justified in presuming that this patient has what medical condition?

C. candidiasis

A 25 year old patient diagnosed with invasive cervical cancer expresses a desire to have children. What procedure might the physician offer as treatment?

D. Radical trachelectomy.

A 27 year old female patient is diagnosed with invasive cervical cancer and is told she needs to have a hysterectomy. One of the nursing diagnosis for this patient is disturbed body image related to perception of femininity. What intervention would be most appropriate for this patient?

D. Reassure the patient that she will still be able to have intercourse with sexual satisfaction and orgasm.

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

D. Frequent douching Risk factors associated with vulvovaginal infections include pregnancy, premenarche, low estrogen levels, and frequent douching.

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?

D. Leiomyoma

The nurse is providing preoperative education for a patient diagnosed with endometriosis. A hysterectomy has been scheduled. What education topic should the nurse be sure to include for this patient?

D. The bladder must be emptied prior to surgery and a catheter may be placed during surgery.

A student nurse is doing clinical hours at an OB/GYN clinic. The student is helping to develop a plan of care for a patient with gonorrhea who has presented at the clinic. The student should include which of the following in the care plan for this patient?

D. The patient should also be treated for chlamydia.

A patient has herpes simplex 2 viral infection (HSV2). The nurse recognizes that which of the following should be included in teaching the patient?

D. Treatment is aimed at relieving symptoms.