Med Surg Reproductive CH12

A ________ is performed to evaluate living tissue in order to establish or confirm a diagnosis or to follow the course of a disease

biopsy

breast surgery post op

-avoid sleeping on the same side of the operation -avoid vaccinations, blood pressure monitoring, IV's, phlebotomy on arm of the operative side -exercises include, positioning to effect drainage and avoid lymphedema -psychosocial factors: body image and grief

toxic shock syndrome

-change tampons at least every 4 hours. -assess for elevated temperature

HPV vaccine:

-given to prevent cervical cancer to females 11-18 -does not require that they be sexually active

mammogram

-most reliable method for detecting breast cancer -false/positive results occur in --young women due to greater density of breast tissue

Breast self exam

-performed one week after period begins -Baseline 35-39 years -for menopausal and pregnant women, same day of choice -palpate nipple for discharge

conception

-sperm donors: screened for genetic defects, infections, high risk behaviors -vasectomy: wear condoms for a month following

oral contraceptives

-a combination of estrogen and pogesterone -suppresses ovulation -contraindicated when anticonvulsant therapy is in use

TSE:

-assessment begins at age 13 -characteristics include, testes feel smooth, egg shaped -best if done after a warm bath or shower

The pt, age 30, was diagnosed with primary genital herpes when she sought care for lesions on her vulva and perineum. Which instructions should the nurse give to her

"Condoms should be used during all sexual activity to prevent transmission of the virus, even when lesions are not present" Sexual transmission of HSV has been documented even in the absence of clinical lesions, and the use of condoms should be encouraged

Which stmt by the pt/family indicates that more teaching about HPV is necessary

"I understand I don't need to get the new HPV vaccine unless I am sexually active."

The nurse realizes that the pt who has had an abd hysterectomy needs further home teaching when she states

"I understand i can lift anything less than 20lbs" - If there has been an abdominal incision, there may be further restrictions on heavy lifting (nothing over 10 lbs)

A pt tells the nurse that his wife, who has been diagnosed with inoperable ovarian cancer, is talking about dying and fear of death. He asks the nurse for suggestions that will be of assistance to his wife. Which response byt he nurse would be most helpful?

"It is perfectly normal to want to talk about death. It is most helpful to support her by listening."

A gram-stain smear of the pts discharge reveals the presence of N.gonorrhoeae. He tells the nurse that he had sexual contact with a new gf but does not think he was exposed to gonorrhea because she did not appear to have any disease. Which info should the nurse include in response to his comment?

"Many women are not aware that they have gonorrhea because they often do not have symptoms of infection" - Most women remain asymptomatic but may show a greenish-yellow discharge from the cervix

The nurse has taught a 23-year-old pt how to perform a testicular self-examination. Which statement by the pt indicates the need for further teaching?

"The best time to perform TSE is just before intercourse" - Perform TSE after a bath or shower when scrotum is warm and most relaxed. The testes should feel smooth and be firm to touch

The nurse provides discharge teaching for a pt regarding her activity level as she recovers from her modified radical mastectomy. Which statement by her indicates to the nurse that the teaching has been successful?

"i should sleep on the side opposite of my mastectomy" The pt should be instructed to avoid sleeping on the involved arm

other surgeries

-TAH and BSO: expect surgical menopause is non menopausal women -foley catheter and urinary retention is an expectation in most gynecological surgeries due to inflammation

A patient diagnosed with breast cancer has been offered the treatment choice of breast conservation surgery with radiation or a modified radical mastectomy. Which statement by the patient concerning the lumpectomy with radiation indicates understanding of the procedure? 1. "It preserves the normal appearance and sensitivity of the breast." 2. "It provides a shorter treatment period with fewer long-term complications." 3. "It has about the same 10-year survival rate as the modified radical mastectomy." 4. "It has a much higher survival rate than the modified radical mastectomy."

1. "It preserves the normal appearance and sensitivity of the breast."

The nurse is assisting the health care provider with a Pap test. What condition will be diagnosed by this diagnostic study? 1. Cervical cancer 2. Breast cancer 3. Pelvic inflammatory disease 4. Ovarian cancer

1. Cervical cancer

A patient visits her health care provider because of an increase in her abdominal girth and dyspnea during the past month as a result of pressure on her diaphragm. She is diagnosed as having ovarian cancer. The cause for these manifestations can be explained by what physiological occurrence? 1. Development of ascites 2. Metastasis to the bowel 3. Dilation of the alveoli 4. Bladder distention

1. Development of ascites

A 20-year-old patient goes to the health care provider's office with vaginal pruritus, burning, dull pelvic pain, and purulent vaginal discharge. A diagnostic test reveals she has chlamydia. What nursing intervention would best promote a successful patient outcome? 1. Encourage her to have her sexual partner(s) seek medical care as soon as possible to avoid reinfection of the patient. 2. Recommend she abstain from sexual contact while lesions are present. 3. Provide social and emotional support because the edematous, draining lymph nodes may be disturbing to the patient's self-image. 4. Educate the patient that the causative organism is a spirochete that gains entrance into the body during intercourse.

1. Encourage her to have her sexual partner(s) seek medical care as soon as possible to avoid reinfection of the patient.

A 40-year-old patient has a history of multiple births in the past 15 years. Her health care provider is concerned she has a cystocele. What manifestations provide support to the diagnosis? 1. Rectal pressure 2. Dysmenorrhea 3. Hemorrhoids 4. Urinary frequency

1. Rectal pressure

A 73-year-old patient comes to the health care provider's office with a complaint of constant seepage of feces from her vagina, causing her embarrassment due to soilage and odor. These manifestations are most consistent with what condition? 1. Rectovaginal fistula 2. Vesicovaginal fistula 3. Urethrovaginal fistula 4. Rectocele

1. Rectovaginal fistula

A patient has reported to the emergency department. The health care provider suspects toxic shock syndrome. What manifestations confirm this suspicion? (Select all that apply.) 1. Sudden high fever 2. Vaginal hemorrhage 3. Diarrhea 4. Sudden hypertension 5. Headache

1. Sudden high fever 3. Diarrhea 5. Headache

At what age should a male be taught testicular self-exam (TSE)?

13 - young men should be taught to perform TSE monthly beginning at puberty

12. The American Cancer Society recommends that women have an annual screening mammography beginning at what age? 1. 21 years 2. 35 years 3. 40 years 4. 52 years

2. 35 years

The nurse is discussing breast self-examination with a 30-year-old premenopausal patient. When should the nurse advise is the best time for the patient to perform her monthly self-examination of the breasts? 1. During her menstruation 2. 7 to 8 days after conclusion of the menstrual period 3. The same day each month 4. The 26th day of the menstrual cycle

2. 7 to 8 days after conclusion of the menstrual period

The nurse is teaching a group of teenagers about contraception and sexually transmitted infections (STIs). The nurse asks the students if they know which is the most prevalent STI. Which response by the participants is correct? 1. Syphilis 2. Chlamydial infection 3. Gonorrhea 4. Genital herpes

2. Chlamydial infection

A 49-year-old obese diabetic patient has had a total abdominal hysterectomy. On the second postoperative day, the patient complains of increased pain in the operative site. She states, "It feels like something suddenly popped." With the symptoms presented, it would be likely that when the nurse removes the abdominal dressing she may note what occurrence? 1. The wound has a purulent exudate. 2. Dehiscence has occurred. 3. The wound is indurated and tender. 4. The wound is well approximated.

2. Dehiscence has occurred.

On the second postoperative day, a 63-year-old patient who underwent an abdominal hysterectomy complains of gas pains and abdominal distention. The patient has not had a bowel movement since surgery. Which nursing intervention will best stimulate peristalsis and relieve distention? 1. Offering carbonated beverages 2. Encouraging ambulation at least four times daily 3. Administering a 1000-mL soapsuds enema 4. Applying an abdominal binder

2. Encouraging ambulation at least four times daily

A 60-year-old patient underwent a vaginal hysterectomy for a prolapsed uterus. The nurse is aware that patients undergoing pelvic surgery are more susceptible to what postoperative complications? (Select all that apply.) 1. Wound dehiscence 2. Postoperative loss of libido 3. Atelectasis 4. Venous stasis 5. Thrombophlebitis

2. Postoperative loss of libido 4. Venous stasis 5. Thrombophlebitis

The nurse plans early and frequent ambulation for a patient who has undergone an abdominal hysterectomy to: (Select all that apply.) 1. prevent urinary retention. 2. prevent deep-vein thrombosis. 3. relieve abdominal distention. 4. maintain a sense of normalcy. 5. reduce postoperative nausea.

2. prevent deep-vein thrombosis. 3. relieve abdominal distention.

5. A 44-year-old patient is admitted for an abdominal hysterectomy. She is instructed that she will have a Foley catheter in place postoperatively. She asks the nurse how many days she will have the catheter in place. What is the best response by the nurse? 1. "The indwelling catheter will probably remain in place for 1 week." 2. "The indwelling catheter will be removed after you are fully awake from the anesthesia." 3. "The indwelling catheter will generally be removed on the first postoperative day." 4. "The indwelling catheter will remain in place for a few days postdischarge."

3. "The indwelling catheter will generally be removed on the first postoperative day."

A 23-year-old man is diagnosed with gonorrhea. Because of statements made in his patient interview, the nurse has established a nursing diagnosis of noncompliance. Which is the most effective way to overcome noncompliance for this patient? 1. Telephone follow-up 2. Case finding 3. Single-dose treatment of ceftriaxone (Rocephin) IM 4. Extensive patient education program

3. Single-dose treatment of ceftriaxone (Rocephin) IM

A 52-year-old patient has ductal cell carcinoma of the left breast. After a modified radical mastectomy, a Davol drain is placed in the left axillary region. What is the primary purpose of this drain? 1. To control numbness of her left incisional site 2. To improve her ability to perform range-of-motion exercises on her affected side 3. To facilitate drainage and to prevent formation of a hematoma 4. To prevent postoperative phlebitis in her affected arm

3. To facilitate drainage and to prevent formation of a hematoma

The recommended age for a baseline mammogram is between

35 and 39 years - The American Cancer Society recommends that mammograms be performed on women between 35 and 39 and annually for women 40 years of age and older

The nurse is educating a patient who has undergone a modified radical mastectomy in ways to prevent lymphedema. What should the nurse include in the information provided? (Select all that apply.) 1. Use a sling for the first 2 weeks after the procedure. 2. Expose the arm to sunlight to increase circulation. 3. Wrap the arm with elastic bandages during the night. 4. Avoid unnecessary trauma (e.g., venipuncture, blood pressure) to the arm on the operative side. 5. Elevate the hand and arm above the level of the chest.

4. Avoid unnecessary trauma (e.g., venipuncture, blood pressure) to the arm on the operative side. 5. Elevate the hand and arm above the level of the chest.

While discussing breast cancer with a group of women, what should the nurse stress as the greatest risk factor for breast cancer? 1. Being a woman over the age of 50 years 2. Experiencing menstruation for 40 years or more 3. Using estrogen replacement therapy during menopause 4. Having a paternal grandmother with postmenopausal breast cancer

4. Having a paternal grandmother with postmenopausal breast cancer

A 35-year-old patient has undergone a vasectomy. Teaching for this patient should include what information? 1. The procedure is reversible if he later changes his mind. 2. He should abstain from sexual intercourse until the incision is completely healed. 3. He should apply warm compresses to the scrotum four times a day. 4. He should return to the health care provider at regular intervals for sperm counts.

4. He should return to the health care provider at regular intervals for sperm counts.

The first lymph node most likely to drain the cancerous site in a patient with breast cancer is known as the: 1. axillary node. 2. contaminated node. 3. primary node. 4. sentinel node

4. sentinel node

Vaginal fistulas are caused by an ulcerating process resulting from

A. Cancer B. Radiation E. Weakening of tissue from pregnancies F. Surgical Interventions

An appropriate nursing intervention for the pt with a hydrocele is to

Apply ice packs

A pt, age 36, is scheduled for a unilateral orchiectomy for tx of testicular cancer. He is withdrawn and does not initiate interaction with the nurse. Which action by the nurse is most appropriate?

Assess his concerns related to his diagnosis and tx. -

On the second post-op day, a 63 year old pt who has had an abdominal hysterectomy complains of gas pains and abd distention. She has not had a bowel movement since surgery. Which nursing intervention will best stimulate peristalisis and relieve distention

encouraging ambulation at least 4 times per day

pelvic floor relaxation

exercises include: lying down with feet elevated, kegel, knee chest position, in addition, prevent constipation

testicular cancer

explore psychosocial and grief issues

_______ are benign tumors of the uterus

fibroids

What factor influences older women's reluctance to seek medical care for problems of the reproductive system

Embarrassment and cultural factors

The pt, age 56, is a mother of nine children. She undergoes an anterior and posterior colporrhaphy for repair of a cystocele and rectocele. On her return from the postanesthesia care unit, the nurse would expect which finding on the assessment

Indwelling catheter- A retention catheter is usually inserted into the bladder to keep it empty and prevent pressure on sutures

During a laparoscopy, a small incision is made beneath the umbilicus to view the abdominal cavity. What is the purpose of insertion of a Foley catheter into the bladder

Maintain bladder decompression for an open view - Preparation of the pt includes insertion of a Foley catheter to maintain bladder decompression for an open view

A female pt, age 48, is undergoing a routine physical examination for the first time in 5 years. As a part of this examination she can expect to have a

Papanicolaou Smear- The American Cancer Society recommends that all women who are or have been sexually active or who are atleast 18 years of age have an annual Pap smear for 3 consecutive years and then every 3 years until middle age

A pt, age 23, seeks care at the health clinic because he has developed a profuse, purulent urethral discharge, and urination is painful. During assessment of the pt, it is most important that the nurse gather info related to

a hx of recent sexual contact with an individual with a sexually transmitted disease- the nurse should encourage notification of present and past sexual partners of the diagnosis and stress the need for them to promptly seek medical care

conization

a type of cervical biopsy

During physical assessment of a pt, age 64, which finding would the nurse consider abnormal?

Serous nipple drainage

A pt, age 26, has had a tubal insufflation (Rubin's test) to ascertain whether her fallopian tubes are patent. She complains of pain in her right shoulder. The nurses most appropriate response would be:

That is from the carbon dioxide passing from the fallopian tubes into your abdomen - Rubins insufflation test determines tubal patency. Carbon dioxide escapes into the abd cavity through the patent left Fallopian tube

A patient is scheduled to have a total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO). She has verbalized anxiety and has stated, "I won't be a woman anymore." In formulating a response, the nurse keeps in mind which facts about a TAH-BSO? (Select all that apply.) a. A TAH-BSO involves removal of the entire uterus, fallopian tubes, and ovaries. b. A TAH-BSO involves removal of the corpus of the uterus but leaves the cervical stump in place. c. The incidence of urinary retention postoperatively is greater with a hysterectomy than with any other type of surgery. d. This surgery will induce menopause. e. You will have three small incisions and will go home the day after the surgery.

a. A TAH-BSO involves removal of the entire uterus, fallopian tubes, and ovaries. c. The incidence of urinary retention postoperatively is greater with a hysterectomy than with any other type of surgery. d. This surgery will induce menopause.

What anatomic part of the male reproductive system often hypertrophies with age? a. Prostate gland b. Cowper gland c. Epididymis d. Ductus deferens

a. Prostate gland The part of the male reproductive system that often hypertrophies with age, making voiding difficult, is called the prostate gland. This is a doughnut-shaped gland that surrounds the neck of the bladder and the urethra. It contains muscular and glandular tissue. Cowper glands are two pea-sized glands under the male urethra. They provide lubrication during sexual intercourse. The epididymis is a tightly coiled tube structure that lies superior to the testes and extends posteriorly. With sexual stimulation, the walls of the epididymis contract and force the sperm along the seminiferous tubules of the testes into the vas deferens. The ductus deferens, also known as the vas deferens, is approximately 18 inches long, and rises along the posterior wall of the testes. This, along with nerves and blood vessels, is enclosed in a connective tissue sheath called the spermatic cord.REF: Page 551

What diagnostic test is useful for diagnosing cervical cancer and is recommended after a woman turns age 18? a. a papanicolau (pap) test b. colposcopy c. culdoscopy d. dilation and curettage (D&C)

a. a papanicolau (pap) test The diagnostic test that is useful for early detection of cervical cancer and is recommended after a woman turns age 18 is called a Papanicolaou (Pap) test, or Pap smear. This is a simple smear method of examining stained exfoliative peeling and sloughed off tissue or cells. The tissue sample is placed on a slide, sprayed with fixative, and sent to the laboratory for analysis. A colposcopy is a procedure that provides direct visualization of the cervix and vagina. Tissue is visualized for growths or other abnormalities or vascularity, and samples can be obtained for analysis. A culdoscopy is a procedure that provides direct visualization of the uterus and adnexa, and is performed under local, spinal, or general anesthesia. The area is examined for tumors, cysts, and endometriosis; removal of eroded or infected tissue may also be performed. Dilation and curettage (D&C) is a procedure performed for a biopsy, to correct cervical stricture, and to treat dysmenorrhea. The cervix is dilated and the inside of the uterus is scraped with a curette.REF: Page 558

Select the interventions that should be performed with caution, in the affected arm, on pts who have undergone a modified radical mastectomy

a. vaccinations b. taking of blood pressure or samples c. insertion of IV line - pts should be taught not to have any procedures involving the arm on the affected side- BP readings, injections, IV fluids, or the drawing of blood.

what is a vaginal fistula

an abnormal opening that connects your vagina to another organ, such as your bladder, colon or rectum.

IUD

assess for string in the vagina which confirms the device is in place

Rubin's test

assess patency of the fallopian tubes. postop complications include pain in the shoulder due to carbon dioxide leakage.

The nurse is caring for a patient with toxic shock syndrome (TSS). She has a temperature of 102.5° F, and complains of feeling "awful." Which nursing intervention should receive the highest priority? a. Enforcing bed rest b. Administering the antibiotics on time c. Teaching the patient to change tampons every 4 hours d. Providing a quiet, therapeutic environment

b. Administering the antibiotics on time R: Administering the antibiotics on time is the top priority nursing intervention of those listed. TSS is an acute bacterial infection caused by Staphylococcus aureus. It can be quite serious—even fatal. Therefore, administering antibiotics on time is of paramount importance to rid the body of the bacterial infection and achieve the best possible patient outcome. Bed rest is an important nursing intervention, and because of a fever, this patient will most likely not ask to get out of bed anyway; however, of the four interventions, it is not the highest priority. Teaching the patient to change tampons every 4 hours is an important nursing intervention; however, of the four interventions, it is not the highest priority. The patient with TSS is likely to be more receptive to patient teaching after the infection is under better control and she is feeling better. Providing a quiet, therapeutic environment is an important nursing intervention; however, from a physiologic standpoint, it is not the highest priority.REF: Pages 577

The American Cancer Society recommends that baseline mammograms be performed on women

between the ages of 35 and 39

vaginal fistula causes include

cancer, radiation, pelvic floor relaxation, surgery

what is candidiasis

candida is a type of yeast that normally lives in small amounts in places like your mouth and belly, or on your skin without causing any problems. But when the environment is right, the yeast can multiply and grow out of control.

epididymitis:

cause include trauma

cervical mucus

clear and slippery when ovulation occurs

The nurse is assisting the physician in removing a small sample of tissue from the pts cervix to have it evaluated. This procedure is called a cervical ______

conization

infertility

consequence of infection of the reproductive system

The nurse is caring for a patient who reports that she has premenstrual syndrome (PMS). Which statement would be most useful to the patient? a. "Try a hot water bottle on your abdomen; that may help lessen the discomfort." b. "If you saturate more than 6 pads a day, you should notify your physician." c. "You might try a glass or two of wine at bedtime to help you relax." d. "Some research suggests that a diet high in complex carbohydrates, moderate in protein, and low in refined sugar and sodium may help ease the symptoms."

d. "Some research suggests that a diet high in complex carbohydrates, moderate in protein, and low in refined sugar and sodium may help ease the symptoms." Research suggests that a diet high in complex carbohydrates, moderate in protein, and low in refined sugar and sodium may help ease the symptoms of PMS. In addition, a physician may order supplements of vitamin B6, calcium, and magnesium. This response suggests the nurse has confused PMS with dysmenorrhea, because this response is a common remedy that might be tried for the pain of dysmenorrhea. This response suggests the nurse has confused PMS with abnormal uterine bleeding. Tampon and pad counts are an important way of quantifying the amount of bleeding a woman is having with her menstrual period. Research suggests that alcohol, caffeine, chocolate, and smoking should be reduced or eliminated in the woman who suffers from PMS. In addition, adequate rest, sleep, and relaxation are helpful.REF: Pages 567-568

The nurse is caring for a 42-year-old female being treated for infertility. She has a 5-year-old daughter, whom she and her husband conceived without medical intervention, and they would like another child. The woman is expressing frustration about not being able to conceive. Which statement accurately describes infertility and its treatment? a. The most fertile time of a woman's life is between the ages of 18 and 34. b. Fertility rates of men decrease dramatically after age 35. c. This patient has what is known as primary infertility. d. Approximately 50% of couples who undergo assessment and treatment for infertility are able to conceive.

d. Approximately 50% of couples who undergo assessment and treatment for infertility are able to conceive. Approximately 50% of couples who undergo assessment and treatment for infertility are able to conceive. If this patient is expressing frustration, she may have the belief that the chances of conception are less than this; giving information may help alleviate her frustration. It is important to listen to the patient and support her feelings. The most fertile time of a woman's life is between the ages of 20 and 29. Fertility rates of women decrease dramatically with age; fertility rates of men do not change much with age. This patient has what is known as secondary infertility, because she was able to conceive a daughter in the past. Primary infertility refers to couples who have never conceived.REF: Page 574

Which statement is correct in regard to menopause? a. Menopause is considered to be complete after a woman has no menstrual period for a period of 6 months. b. Approximately 50% of postmenopausal women develop osteoporosis. c. The average age for a woman to experience menopause is age 45. d. It is recommended that menopausal women take the lowest effective dose of hormone replacement therapy for the shortest amount of time possible to relieve menopausal symptoms.

d. It is recommended that menopausal women take the lowest effective dose of hormone replacement therapy for the shortest amount of time possible to relieve menopausal symptoms. It is recommended that menopausal women take the lowest effective dose of hormone replacement therapy (HRT) for the shortest amount of time possible to relieve menopausal symptoms. Research has shown that long-term use of combination HRT estrogen, progestin combination heightened the risk of ischemic stroke, coronary heart disease, breast cancer, thromboembolism, and cognitive decline. Symptoms of menopause can last from a few months to several years before menstruation ceases permanently. Menopause is considered to be complete after a woman has no menstrual period for a period of 1 year. Approximately 25% of postmenopausal women develop osteoporosis. The average age for a woman to experience menopause is age 51, although it may begin anywhere between the ages of 35 and 60.REF: Page 569

The nurse is caring for a patient who is 24 hours postoperative following a modified radical mastectomy of the left breast. Which nursing intervention is most appropriate for this patient? a. Keep the patient flat in bed and turn every 2 to 4 hours. b. When measuring vital signs, take blood pressure using the left arm. c. Teach the patient not to lift heavy items with the affected arm for 6 to 8 days. d. Monitor the patient for signs of shock or hemorrhage.

d. Monitor the patient for signs of shock or hemorrhage. In caring for a patient postoperative after a modified radical mastectomy, it is important to monitor the patient for signs of shock or hemorrhage, as many large blood vessels are involved in the procedure. Drains may be placed in the axilla to facilitate drainage of the operative site. Following a modified radical mastectomy, the patient should be placed in a 45° Fowler position to promote drainage, as long as vital signs are stable. The position should be changed frequently, and deep breathing and coughing are encouraged. Following a modified radical mastectomy, no procedures should be performed on the operative side, including blood pressure measurement, venipuncture, injections, and intravenous insertion/fluid administration, because there is a risk of edema and infection. In caring for a patient postoperative following a modified radical mastectomy, the nurse should teach the patient not to lift heavy items with the affected arm for 6 to 8 weeks.REF: Page 596

What is the most serious type of female reproductive infection? a. Atrophic vaginitis b. Senile vaginitis c. Simple vaginitis d. Pelvic inflammatory disease

d. Pelvic inflammatory disease Pelvic inflammatory disease (PID) is the most serious of the four disorders listed, because it can lead to adhesions or sterility of the woman. The definition of PID is any acute, subacute, recurrent, or chronic infection of the cervix, uterus, fallopian tubes, and ovaries that has extended to the connective tissues lying between the broad ligaments. Sexually active women with more than one partner are at increased risk of developing PID. Atrophic vaginitis is inflammation of the vagina that occurs in women after menopause and upon aging. Low estrogen levels cause the vulva and vagina to atrophy and become susceptible to bacterial invasion. Senile vaginitis is another name for atrophic vaginitis. Simple vaginitis, inflammation of the vagina, is a common vaginal infection, often caused by Escherichia coli. Goals of treatment include (a) cure the infection, (b) prevent reinfection, (c) prevent complications, and (d) prevent infection of sexual partner(s).REF: Page 575

what is a true statement regarding illness and sexuality? a. alcohol abuse leads to an increased sex drive b. a patient who has had a spinal cord injury will never experience orgasm. c. a mastectomy will not affect a woman's sexual self-concept d.sexual dysfunction of a patient with diabetes mellitus can occur when the disease is not well-controlled

d.sexual dysfunction of a patient with diabetes mellitus can occur when the disease is not well-controlled Sexual dysfunction of a patient with diabetes mellitus can occur when the disease is not well controlled, but the dysfunction generally disappears when the lack of control is diagnosed and treated. Impotence is found in approximately half of men with diabetes mellitus and is generally related to poor control. The abuse of alcohol, which is a central nervous system depressant, leads to a decreased sex drive and inadequate sexual functioning. Patients (both men and women) who have had spinal cord injuries have reported experiencing orgasms, despite interruption of peripheral nerves and spinal cord reflexes. A mastectomy will usually affect a woman's sexual self-concept and intimate physical interactions. Two variables that can influence a woman's sexual function are (1) sufficient self-love and acceptance, and (2) positive attitudes and feelings about sexuality.REF: Page 557

On the fourth post-op day after a modified radical mastectomy, the nurse finds the pt with her back to the nurse. She is crying and tells the nurse she feels ugly and is worried that her husband will not be in love with her anymore. The nurse bases subsequent nursing interventions on diagnosis

disturbed body image related to removal of her breast

PAP Smear

done on sexually active women, women 18 years and older for 3 consecutive years then every 3 years until menopause

Female infertility is most often related to

infections of the reproductive tract- infections of the reproductive tract such as pelvic inflammatory disease or STDs, are frequently associated with infertility

If severe or chronic pelvic inflammatory disease is present, the complication that may result is

infertility- Infections of the reproductive tract, such as PID or STDs are frequently associated with infertility

candidiasis s/s

inflammed vagina, vulva vaginal discharge has a cottage cheese appearance

laparoscopy

insert foley for bladder decompression

A mammorgram is the most useful method of diagnosing breast cancer because it

is the most reliable method of detecting breast cancer before it becomes palpable- mammography is radiography of the soft tissue of the breast to allow identification of various benign and neoplastic processes, especially those not palpable on physical exam

diaphragm

keep in place for at least 6 hours after sexual intercourse

The nurse admits a pt, age 72, who is scheduled for a vaginal hysterectomy. In what position will this pt be placed in the operating room for her surgery?

lithotomy

clomid

medication that induces ovulation

The discharge instructions should include arm exercises for which post-op patient

modified radial mastectomy

Postmenopausal women should be instructed to perform breast self-examination (BSE)

on the same date of their choice each month-more than 90% of cancers are detected by the pt, BSE for postmenopausal women should be done on the same day of the month each month

in vitro fertilization

ova and sperm are mixed then transferred to the uterus

A pt, age 46, is recovering from an abdominal hysterectomy. Post-op nursing interventions for her would include

preventing urinary retention.

______ are produced in the seminiferous tubules and stored in the epididymis

sperm - the two oval testes are enclosed in the scrotum, a saclike structure that lies suspended from the exterior abd wall. This position keeps the temp in the testes below normal body temp, which is necessary for viable sperm production and storage. Each testis contains one to three coiled seminiferous tubules that produce the sperm cells.

A 20-year-old college student regularly uses tampons while she is menstruating. She asks the nurse what outstanding sign she should report that might indicate toxic shock syndrome. The most correct response by the nurse would be to observe for

sudden elevated temperature

stress incontinence

the result of pelvic floor relaxation

menopause

the time following 1 year of menstrual cessation

A pt, age 41, has had a total abd hysterectomy and bilateral salpingooophorectomy for endometroisos. She asks for the nurse if she will have "hot flashes". The nurse's best response is based on the knowledge that

the uterus, ovaries, and fallopian tubes were removed, and she will have surgically induced menopause

Epididymitis may occur because of ______ to the testicle

trauma- symptoms can occur after trauma to the genital area, after instrumentation of the urethra and cystoscopy, and after physical exertion or prolonged sexual activity

hydrocele

use cold packs

genital herpes

use condoms even in the absense of lesions

The pt, age 52, is recovering from a modified radical mastectomy. After this procedure, the post-op elevation of a pts arm with proper positioning is important to prevent

vascular and lymph stasis, thus lymphedema.

False negative results in mammography occur in specific age groups because

younger women have greater density of breast tissue - because of the greater density of breast tissue, mammorgraphy is less sensitive in younger women, which may result in more false-negative results