Test 3 Ch 7 and then some

Define Endometriosis:

-The presence and growth of endometrial tissue outside of the uterus. -Endometriosis tissue is commonly found attached to the ovaries, fallopian tubes, the outer surface of the uterus, the bowels, the area between the vagina and the rectum, and the pelvic side wall. -These lesions create their own blood supply and respond to hormones released during the menstrual cycle in the same way as the endometrial lining within the uterus. -The woman with endometriosis experiences several "mini-periods" throughout her abdomen, wherever this endometriosis tissue exists.

A couple reports that the condom broke while they were having sexual intercourse last night. What would you advise to prevent pregnancy?

Obtain emergency contraceptives and take them immediately. Emergency contraceptives must be taken with 72 hours of unprotected sex. The methods currently available in the United States are (1) ulipristal acetate (UPA), an oral progesterone receptor agonist-antagonist (Ella); (2) levonorgestrel (LNG), an oral progestin (Plan B One-Step); (3) the copper intrauterine device (Cu-IUD); and (4) off-label use of combined oral contraceptives (Yuzpe method)

A 16-year-old client presents to the clinic with concerns that she has not begun menstruating. She states she runs cross country and typically runs 4 or more miles a day. Based on this history, what is the client likely experiencing:

Primary amenorrhea

Which activity will increase a woman's risk of CVD if she is taking oral contraceptives?

Smoking cigarettes

A woman will be taking oral contraceptives using a 28-day pack. The nurse should advise this woman to protect against pregnancy by

Taking the pills in order and taking one pill at the same time every day.

Amenorrhea

The absence of menstrual flow Primary amenorrhea is defined as either the: *absence of menses by age 14, with absence of growth and development of secondary sexual characteristics; or *absence of menses by age 16, with normal development of secondary sexual characteristics Secondary amenorrhea is the absence of regular menses for three cycles or irregular menses for 6 months in women who have previously menstruated regularly.

In helping a patient manage premenstrual syndrome (PMS), the nurse should:

To reduce the negative impact of premenstrual disorders on a woman's life, education along with reassurance and anticipatory guidance are needed for women to feel they have some control over this condition. Treatments may include vitamin supplements, dietary changes, exercise, lifestyle changes, and medications. Pharmacotherapies (particularly SSRIs and serotonin-norepinephrine reuptake inhibitors) represent the first-line treatment for the mood and behavioral symptoms of PMDD. Other medications may include other antidepressant and antianxiety drugs, diuretics, antiinflammatory medications, analgesics, synthetic androgen agents, OCs, and GnRH agonists to regulate menses. Lifestyle changes • Reduce stress • Exercise three to five times a week • Eat a balanced diet and increase water intake • Decrease caffeine intake • Stop smoking and limit the intake of alcohol • Attend a PMS or women's support group • Vitamin and mineral supplements • Multivitamin daily • Vitamin E, 400 units daily • Calcium, 1,200 to 1,600 mg daily • Magnesium, 200 to 400 mg daily Medications • NSAIDs taken a week prior to menses • OCs (low dose) • Antidepressants (SSRIs) • Anxiolytics (taken during luteal phase) • Diuretics to remove excess fluid • Progestins • GnRH agonists • Danazol

Which comment by a woman would indicate that a diaphragm is not the best contraceptive device for her?

"I am not comfortable touching myself down there" "I have a latex (or silicone) allergy"

A physician prescribes clomiphene citrate (Clomid, Serophene) for a woman experiencing infertility. She is very concerned about the risk of multiple births. The nurse's most appropriate response is:

"This is a legitimate concern. Would you like to discuss this further before your treatment begins?"

A couple is considering infertile after how many months of trying to concieve?

12 months

Premenstrual syndrome (PMS)

A constellation of recurrent physical, emotional, and behavioral symptoms that occur during the luteal phase or last half of the menstrual cycle and resolve with the onset of menstruation.

A 62-year-old woman tells the nurse that she has been experiencing pain during intercourse. The nurse should document that this woman is experiencing which of the following

Dyspareunia (Pain during, before, after sex)

The nurse is taking a history for a 64-year-old female patient who has a family history of breast cancer (mother, grandmother, sister). She has never been pregnant. She smoked cigarettes but quit 2 years ago, and reports consuming two alcoholic drinks per day. Today is her annual check-up, and she asks about her risk for breast cancer. What are her risk factors for developing this disease? (List all that apply.)

Age is the primary risk factor for breast cancer. Additional risk factors include family history with first-degree relatives, nulliparity, and alcoholic consumption of two or more drinks per day.

The most common cause of menstrual abnormality in a reproductive-age woman is?

Anovulation

A postmenopausal woman reports that she has started spotting again. Which action would the nurse take?

Anticipate that the doctor will assess her endometrium thickness.

When you are interviewing a client with uterine fibroids, what subjective data would you expect to find in her history?

Chronic pelvic pain Low back pain Iron-deficiency anemia secondary to bleeding Bloating Constipation Infertility (with large tumors) Dysmenorrhea Miscarriage Sciatica Dyspareunia Urinary frequency, urgency, incontinence Irregular vaginal bleeding (menorrhagia) Feeling of heaviness in the pelvic region

A woman with HPV is likely to present with which nursing assessment finding?

Clusters of genital warts

A sexually active 19-year-old presents to the clinic with postictal bleeding, dysuria, and a yellow discharge. Her cervix upon exam is red and friable. What might the nurse suspect?

Gonorrhea

The nurse is preparing to teach a class to a group of middle-aged women regarding the most common vasomotor symptoms experienced during menopause and possible modalities of treatment available. Which is an example of a vasomotor symptom experienced by menopausal women?

Hot flashes or night sweats.

Which contraceptive methods offers protection against sexually transmitted infections?

Latex Condom Female Condom

Which best describes the signs and symptoms of trichomoniasis in women

Malodorous, frothy yellow-green vaginal discharge, and vulvar itching

Side effects experienced by women taking GnRH agonists for the treatment of fibroids closely resemble those of?

Menopause

Define dysmenorrhea:

Pain during or shortly before menstruation.

To confirm a finding of primary syphilis, the nurse would observe which of the following on the external genitalia?

Primary syphilis is characterized by a chancre (painless ulcer) at the site of bacterial entry that will disappear within 1 to 6 weeks without intervention.

Which combination contraceptive has been approved for extended continuous use?

Seasonale

Throughout life, a woman's most proactive activity to promote her health would be to engage in?

consistent exercise

Which measure helps prevent osteoporosis?

weight bearing exercise