Transitions Exam 4 (Final)
What is emotional abuse?
1. Promising, swearing, or threatening harm to victim. 2. Forcing victim to perform degrading or humiliating acts. 3. Threatening harm to children, pets or close friends. 4. Humiliating the woman by name-calling and insults. 5. Threatening to leave the woman and the children. 6. Isolation from family and friends. 7. Destroying valued possessions. 8. Controlling the victim's every move.
What are the phases of abuse?
1. Tension Building Phase: the batterer demonstrates power and control, characterized by anger, arguing, blaming and possibly minor battering incidents. Phase may be characterized by nagging about random things. 2. Acute Battering incident: something triggers the abuser- this may be unpredictable. The abuser loses control and betters the partner physically and or is very destructive 3. Honeymoon Phase: characterized by kind and loving behavior from the abuser, who may be trying to make up. This may also just be a period without violence or excessive tension.
Endometriosis: s/sx? dx? post surgery complications?
S/SX: Dyschezia (difficulty pooping), dysmenorrhea (cramps), dyspareunia (genital pain after sex), infertility, menorrhagia Dx: SURGERY nursing diagnosis for couple battling endometriosis: pain, infertility, etc... Tx: sx management: opioids, NSAIDS aromatase inhibitors: anostroxole or letrozole hormonal contraceptives gonadotropin-releasing hormone agonist or antagonist: Buserelin, goserelin, leuprolide, nafevelin, triptorelin, OR elagolix progestin therapy: mini-pill, depo-provera, progestin IUD synthetic androgen steroid hormone: danazol Post surgery: Infection. Bleeding. Possible injury to nearby organs such as your bladder and bowel. Fistula (an abnormal connection between two organs). Blood vessel damage.
Which statement is true about statutory rape? A) The victim of statutory rape shows psychotic behavior and depression B) Statutory rape is a sexual assault by a person who is known to the victim C) Statutory rape is unlawful intercourse in which one person is a minor and the other is over the age of consent D) The survivor of statutory rape refuses to report the assault
Statutory rape is unlawful intercourse in which one person is a minor and the other is over the age of consent
Describe nursing burnout, what is a recommendation on what nurses should do?
Stress Management course: Psychosocial training in decreased burnout among healthcare students Stress management workshop decreased burnout in health care students Stress Mindfulness: MBSR decreased burnout in healthcare professionals Mindful communication program decreased burnout in healthcare providers Cognitive behavioral therapy to increase coping mechanisms and provide an outlet to talk about issues Exercise Stretching exercise in workers decreased anxiety levels in healthcare students
What are protective factors against cancer (for women)?
multiparity, first pregnancy before age 30, hx of breast feeding, OCP use, tubal ligation, scalping ectomy, hysterectomy, risk reduction oophorectomy
What does pediatric parent education for end-of-life care look like?
prepare parents before they see their child, use the words "their condition is critical and they may not look like themselves" If child has died, immediately escort the parents to a quiet private room before delivering news
A nurse is working with a 25-year-old female patient who was recently diagnosed with breast cancer who states that she "feels like the world has been pulled out from my feet". What is the best nursing response? A) previous infection with human papillomavirus (HPV) B) being sexually active at a young age C) having a sexual partner who has multiple sexual partners D) tobacco use
previous infection with human papillomavirus (HPV) being sexually active at a young age having a sexual partner who has multiple sexual partners tobacco use
Ovarian Cancer: list s/sx, dx, results/findings, tx
s/sx: lack of a specific symptom, tumors are often large, menstrual function is upset but attributed to "time of life", weight gain, abdominal swelling/bloating, polyuria, edema, leg varicosities, cachexia dx: ultrasound, CT scan, presenting s/sx, blood work results/findings: ultrasound/CT: bloating, increase abdominal size, ascites, pelvic mass blood work: CA-125, HE4 tx: Evaluation by gynecologic oncologist - surgery! - removal of uterus, cervix, fallopian tubes, ovaries, staging, debulking - neoadjuvant chemotherapy -> surgery -> chemotherapy Chemo: Carboplatin- inhibits DNA synthesis Drugs: Paclitaxel: prevents cells from dividing
Breast Cancer: list s/sx, dx, results/findings, tx
s/sx: lump flet in the breast, inverted nipple, nipple discharge (clear or bloody), nipple pain, sores on the nipple and areola, enlarged lymph nodes under the arm Genetic mutations: BRCA 1 and 2 dx: mammogram (XRAY of breast), BRCA 1 and 2 positive, menstruating early, no children, and have not breastfed before and biopsy of mass tissue results/findings: mammogram shows: a mass, a cluster of calcifications, or both BRCA 1 and 2 Positive Biopsy is positive for cancer cells tx: Avastatin: interfers with VEGF (vascular endothelial growth factor) inhibiting the growth of new blood vessels at the tumor site Erbitux: interfers with EGFR which is often over-expressed in TNBC PARP inhibitors: inhibit poly ADP-ribose plymerase and enxyme used by cancer cells to repair DNA damage. Mastectomy Chemotherapy, Hormone therapy (deplete estrogen), and radiation
Cervical Cancer: list s/sx, dx, results/findings, tx
s/sx: no early symptoms, possible irregular bleeding or pain dx: PAP smear, HPV test results/findings: Squamous cell carcinoma in squamous cells, and adenocarcinoma in columnar glandular cells tx: chemo, radiation, surgery (hysterectomy)
Endometrial Cancer: list s/sx, dx, results/findings, tx
s/sx: non menstrual bleeding or discharge (post-menopausal bleeding, heavy bleeding), dysuria, pain during intercourse/in pelvic area/back pain, mass in pelvic area, weight loss dx: MMR mutation, hMSH2 and hMLH1 mutations, pelvic exam, papsmear, transvaginal ultrasound, endometrial sampling results/findings: unfavorable histology, estrogen, lunch syndrome, familial trend tx: surgery: hysterectomy, salpingo-oophorectomy, pelvic lymph node disection, curretage, Radiation therapy, hormone therapy (progesterone and antiestrogens) chemotherapy
What are the different types of primary factors associated with abuse?
substance use (drugs and alcohol), unresolved mental health issues, the young age of a parent, lack of education, difficulty bonding or nurturing with the child, prior history of child abuse, or other traumas, pregnancy, normalization of rape, marital conflict, cultural factors encouraging male dominance
Fran, a 52-year-old mother of two, was diagnosed with endometrial cancer and told she will need a total hysterectomy and removal of her ovaries and fallopian tubes. Fran is distraught and mentions her concern over losing her sexual relationship with her husband. What is the nurse's best therapeutic response? A) "You're 52 years old; your time of being sexually active is closing anyway." B) "I understand you're very concerned about your sex life; I'll provide you with a list of support groups in the area that assist women with the same concerns." C) "I'd like to make an appointment for you with a psychologist who works closely with us and our patients with your concerns. Is that something you'd like me to assist you with?" D) "Once you've discussed this matter with your husband, call the office and we'll provide you both with the number for a good marriage counselor."
"I'd like to make an appointment for you with a psychologist who works closely with us and our patients with your concerns. Is that something you'd like me to assist you with?"
Pediatric Nursing Diagnoses
*Anxiety/fear related to separation from support system and accustomed routine *Anxiety/fear related to distressing events/procedures *Powerlessness related to health care environment *High risk for injury/trauma related to unfamiliar environment, therapies, hazardous equipment *Altered growth/development related to chronic illness/disability, parental reactions, repeated hospitalizations
Contraceptives: OCP benefits? Why taking it if it associated with so many bad things?
-Lower risk of cancer of the ovaries and the lining of the uterus, ectopic pregnancy, ovarian cysts, and noncancerous breast disease. -Improvement in acne and excessive face and body hair. -Less severe menstrual cramps, called dysmenorrhea.
What are the stages of greif?
1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance
What is sexual abuse?
1. Forcing woman to have vaginal, oral, or anal intercourse against her will. 2. Biting the victims breasts or genitals. 3. Shoving objects into the victim's vagina or anus. 4. Forcing the woman to do something sexual that she finds disregarding or humiliating. 5. Forcing the victim to perform sexual acts on other people or animals.
What is physical Abuse?
1. Hitting or grabbing the victim so hard that it leaves marks. 2. Throwing things at the victim. 3. Slapping, spitting at, biting, burning, pushing, choking, or shoving the victim. 4. Kicking or punching the victim, or slamming her against things. 5. Attacking the victim with a knife, gun, rope or electrical cord. 6. Controlling access to health care for injury.
What is financial Abuse?
1. Preventing woman from getting a job. 2. Sabotaging a current job. 3. Controlling how money is spent. 4. Failing to contribute financially.
What is a SANE nurse? And what are the SANE nurse's role/responsibilities?
1. Understanding the facts, the effects of violence on mental health and physical health, where to find information for themselves and their clients, how to properly care for the survivor. 2. Collects forensic evidence and provides access to crisis intervention, STI testing, emergency contraception. 3. Provide a safe and comfortable environment for the forensic examination. 4. Provide supportive care; a. Establish therapeutic and trusting relationship. b. Take to secure, isolated area away from family, friends and others so she can be open and honest about the assault. c. Provide change of clothes, access to shower and toiletries, and private waiting area for friends and family. 7. prevent pregnancy; a. Offer prevention means, like contraceptive pill (morning after pill, plan B). One dose withing 72-120 hrs of unprotected sex. Prevents ovulation, fertilization and implantation. Does not disrupt current pregnancy. Is not the same thing as the abortion drug mifepristone (RU-486). Is most effective if taken within 12 hrs of rape, less effective after that. 8. assess for PTSD 9. Follow-up care including counseling, medical treatment, crisis intervention. 10. Early intervention and immediate counseling can accelerate a survivor's recovery. Means implementation in initial hours, days or weeks after traumatic event.
What should you collect?
5. collect and document evidence; a. instruct victim to bring all clothing, especially undergarments, worn at the time of the assault to the medical facility. b. Do not shower or bath before presenting for care. c. SANE will collect evidence from the woman. 6. assess for STIs; a. pelvic examination to collect vaginal secretions to rule out STIs. b. Can be emotionally stressful for them, be gentle and sensitive, explaining every step of the process to minimize further emotional trauma.
When the nurse is alone with a client, the client says, "It was all my fault. The house was so messy when my partner got home, and I know my partner hates that." Which response would be most appropriate? A) "It is not your fault. No one deserves to be hurt." B) "What else did you do to make your partner so angry with you?" C) "You need to start to clean the house early in the day." D) "Remember, your partner works hard and you need to meet your partner's needs."
A) "It is not your fault. No one deserves to be hurt."
A nurse is assessing a client and suspects that the client may be experiencing premenstrual dysphoric disorder (PMDD). Applying the American Psychiatric Association criteria, the nurse would assess which symptoms? Select all that apply. A) Affective lability B) Sleep difficulties C) Dysuria D) Focused thinking
A) Affective lability B) Sleep difficulties
A client with trichomoniasis is to receive metronidazole. What should the nurse instruct the client to avoid while taking this drug? A) Alcohol B) Nicotine C) Chocolate D) Caffeine
A) Alcohol
Which nursing intervention should the nurse include in the plan of care for a child who is sedated, unconscious, and on a mechanical ventilator? A) Maintenance of intravenous (IV) hydration B) Out-of-bed transfer to wheelchair C) Whirlpool baths D) Active range-of-motion (ROM) exercises
A) Maintenance of intravenous (IV) hydration
A nurse is teaching a group of adolescent males about the male reproductive system. The nurse determines that the teaching was successful when the group identifies which activity(ies) as a function of the testes? Select all that apply. A) Sperm production B) Testosterone production C) Sperm transport D) Seminal fluid production
A) Sperm production B) Testosterone production
A nurse is working with parents of a 6-year-old who is dying of cancer. The nurse has been asked to help the family decide whether the 13-year-old sibling should be present during the death. Important aspects to consider when making this decision include all the following except: A) The hospital visiting hour policies B) The developmental age of the sibling C) The quality of the relationship between the two children D) The cultural practices within the family
A) The hospital visiting hour policies
Which nursing actions are appropriate when death is soon considering the developmental level of the adolescent? Select all that apply. A)Allow the adolescent to remain as independent as possible B)Include the adolescent in decision making C)Evaluate for fears of abandonment, destruction, and body mutilation D)Limit interactions with their friends to ensure dignity of the adolescent is maintained
A)Allow the adolescent to remain as independent as possible B)Include the adolescent in decision making C)Evaluate for fears of abandonment, destruction, and body mutilation
A child whose leg was injured in a school bus accident is brought to the hospital. The child is screaming and shouting in pain and demonstrates aggressive behavior. What should the nurses next action be to calm the child? A)Talk softly to the child with controlled body language B)Listen intently to the child's feelings C)Move sharp instruments away from the child's reach D)Temporarily move away from the child
A)Talk softly to the child with controlled body language
What are risk factors for ovarian cancer?
AGE (older), family hx, PCOS, infertility, nulliparity, early menarche, and or late menopause, PID, endometriosis, cigarette smoking, environment, location
What is the primary preventor? what are other prevention strategies?
Abstinence! condoms, limit number of lifetime sex partners, regular check-ups, dont smoke
Define ACES
Adverse Childhood Experiences: potentially traumatic events that occur in childhood (0-17 years) Examples: domestic violence. parental abandonment through separation or divorce. a parent with a mental health condition. being the victim of abuse (physical, sexual and/or emotional) being the victim of neglect (physical and emotional) a member of the household being in prison.
How to handle informed consent in minors?
Always call and inform parents of child in hospital If teen is over 16 and pregnant, you cannot tell parents
What are some menstrual abnormalities?
Ammennhorhea: no menses Dysmmennorhea: painful Hypomenorrhea: light menses Menhorrhia: heavy for >7 days, clots, in between Oligomennhorhea: infrequent
A client who is receiving external beam radiation therapy as part of her treatment for breast cancer comes to the clinic for a follow-up visit. The nurse determines that the client is experiencing side effects of the treatment based on which findings? Select all that apply. A) Anorexia B) Skin pallor at the site C) Breast swelling D) Infection
Anorexia, breast swelling
What is intimate Partner Violence?
Any behavior within an intimate relationship that results in a physical, psychological, or sexual harm. Such as physical aggression, psychological abuse, forced sexual coercion, and other behaviors designed to control another person
A 42-year-old woman is scheduled for a mammogram. Which statement would the nurse include when teaching the woman about the procedure? A) "The room will be darkened throughout the procedure." B) "Each breast will be firmly compressed between two plates." C) "Make sure to refrain from eating or drinking after midnight." D) "A dye will be injected to highlight the breast tissue and its ducts."
B) "Each breast will be firmly compressed between two plates."
Brad, RN, is listening to their friend Cheryl, RN, describe an event earlier in the shift in which a 2-week-okd infant died after an unsuccessful resuscitation. Cheryl states, "the charge nurse wants me to attend the debriefing meeting and the parents want me to come to the funeral, but I don't want to have anything more to do with this. I'm just exhausted." Brad's best response is: A) "You're right Cheryl. Just avoid them because you can't let this get you down." B) "I'm sorry you had to experience that case but going to the debriefing is your professional duty and builds trust among the team. I'm so sorry this happened, Cheryl." C) "This is bad for you. Do you have a good lawyer?" D) "Why are people so dramatic about death? It happens every day."
B) "I'm sorry you had to experience that case but going to the debriefing is your professional duty and builds trust among the team. I'm so sorry this happened, Cheryl."
The nurse has been taking vitals on a client in the ob-gyn clinic and notices the client is starting to cry. The vitals are WNL, and the nurse is aware the client is present for follow-up on her treatment for endometriosis. Which of the following statements by the client requires immediate attention? A) "I haven't been able to sleep because my aunt told me I might need a hysterectomy." B) "The cramping is a little better, but I have this deep pain and heat in my calf that won't go away." C) "I feel like I'm letting my husband down because it still hurts when we have sex." D) "I have heard that if I need a laparoscopy, I will have very sore pelvis afterwards."
B) "The cramping is a little better, but I have this deep pain and heat in my calf that won't go away."
The nurse is assessing a female client who is having difficulty experiencing an orgasm. Which action should the nurse point out as often being necessary for an orgasm in females? A) Penile penetration B) Clitoral stimulation C) Uterine stimulation D) Sensory deprivation
B) Clitoral stimulation
When teaching a group of postmenopausal women about hot flashes and night sweats, the nurse would address which primary cause? A) Poor dietary intake B) Estrogen deficiency C) Active lifestyle D) Changes in vaginal pH
B) Estrogen deficiency
A school-age child diagnosed with congenital heart block codes in the Emergency Department. The parents witness this and stare at the resuscitation scene unfolding before them. Which is the best nursing intervention in this situation? A) Ask the parents to help provide CPR for the child B) Give the parents the option to be at the bedside of their child C) Direct the parents to step outside of the room during each electro cardioversion D) Ask the parents to leave the room until resuscitative measures are finished
B) Give the parents the option to be at the bedside of their child
During a prenatal examination the nurse observes bruises on the client's arms and a black eye. When asked about the bruises, the client states, "It was an accident. My spouse just had a bad day at work, and I was late getting dinner prepared. But my spouse is being so kind now; my spouse brought me flowers yesterday. My spouse is looking for a new job, so it will not happen again." This client is in which phase of the cycle of violence? A) Resolution and reorganization phase B) Honeymoon phase C) Tension-building phase D) Acute explosion or incident phase
B) Honeymoon phase
Which of the following statements by a nurse to a perimenopausal patient is the most appropriate? Select all that apply. A) If you feel better taking herbal remedies, you should do it; many of them can work wonders for you and are safe to take with medicine. B) If you feel better taking herbal remedies, bring in a list at your next appointment so your provider can be sure there's no interactions with your other medications or medical concerns. C) If you feel better taking herbal remedies, let me give you a good website from the USDA that talks about how they work and what to watch for. D) If you feel better taking herbal remedies, the provider won't be able to give you any other medications while you are on them.
B) If you feel better taking herbal remedies, bring in a list at your next appointment so your provider can be sure there's no interactions with your other medications or medical concerns.
An adolescent experiencing status asthmaticus is rushed to the Emergency Department by ambulance. The parents arrive and ask to see their child. The triage nurse at the reception desk knows that the adolescent was pronounced dead on arrival. What is the best action by the triage nurse currently? A) Ask the parents to please take a seat in the waiting room B) Immediately escort the parents to a quiet, private room C) Tell the parents that they must wait because only the healthcare provider can talk to them D) Immediately tell the parents, "I'm sorry, but your child didn't make it"
B) Immediately escort the parents to a quiet, private room
Isabella, 54, is at the healthcare provider's office after having routine annual laboratory testing drawn. Because she is postmenopausal, what changes in her blood work may be seen? A) Decreased hematocrit B) Increased cholesterol C) Increased WBC D) Decreased platelets
B) Increased cholesterol
A 16-year-old presents to the school clinic with a stiff neck, headache, fever of 103F, and purpuric lesions on the legs. Although the adolescent's physical need to take priority at the present time, which physiologic stressor may also be significant for this client? A) Fear of getting behind in schoolwork B) Separation from friends and permanent changes in appearance C) Separation from parents and home D) Fear of painful procedures and bodily mutilation
B) Separation from friends and permanent changes in appearance
A 58-year-old client comes to the clinic for evaluation. After obtaining the client's history, the nurse suspects endometrial cancer. Which information would lead the nurse to this suspicion? A) use of oral contraceptives between ages 18 and 25 B) onset of painless, bright red postmenopausal bleeding C) menopause occurring at age 46 D) use of intrauterine device for 3 years
B) onset of painless, bright red postmenopausal bleeding
Which of the following are symptoms and complications menopausal women may have? Select all that apply. A)Decreased likelihood of developing hypertension B)Increased chance of a prolapsed bladder C)Decreased progesterone D)Increased lactobacilli in the vagina
B)Increased chance of a prolapsed bladder C)Decreased progesterone
What is the dosage calculation for chemotherapeutic drugs?
BASED ON WEIGHT
Where does SANE nurse's role begin and end?
Begins once pt arrives to hospital, (possibly) ends in court
The nurse is screening for sexual abuse in a college student. Which question would be appropriate to ask? A) "Have you ever been treated for sexually transmitted infections?" B) "Is sexual intercourse ever painful for you?" C) "Do you ever feel threatened by your partner?" D) "Have you experienced recent changes in your sexual function?"
C) "Do you ever feel threatened by your partner?"
On the evening before a modified radical mastectomy, a client states, "I am afraid my spouse will not find me sexually attractive after my breast is removed." Which response by the nurse is best? A) "You shouldn't think about that tonight." B) "If your spouse really loves you, it won't bother your spouse." C) "You're worried about how your spouse will react to the change in your body." D) "Reconstructive surgery can be done so that your breast will look the same."
C) "You're worried about how your spouse will react to the change in your body."
A female client arrived by life flight to the hospital after experiencing multiple traumas in a motor vehicle crash involving a suspected drunk driver. Which statement is most important for the nurse to make to the parents before they see their child? A) "You should press charges against the drunk driver." B) "Your child's leg was crushed and might have to be amputated." C) "Your child's condition is very critical; their face is swollen, and she might not look like herself." D) "Don't worry, everything will be okay. We will take excellent care of your child."
C) "Your child's condition is very critical; their face is swollen, and she might not look like herself."
The nursing student correctly identifies that ovarian cancer occurs more frequently in which age group? A) 25 to 50 years of age B) 35 to 55 years of age C) 55 to 75 years of age D) Over 70 years of age
C) 55 to 75 years of age
A school bus carrying children in grades K-12 crashed into a ravine. The critically injured children are transported by ambulance and admitted to the pediatric intensive care unit (PICU). Which is the most effective nursing intervention to calm the frightened children? A) Tell the children that the providers are competent B) Explain that the equipment being used is state-of-the-art C) Call the children's parents to come to the unit D) Assure the children that the nurses are caring
C) Call the children's parents to come to the unit
Which assessment finding is most indicative of physical abuse that would cause the nurse to advocate for the pediatric client? A) Sleep disturbances B) Genital pain C) Frequent unexplained injuries D) Poor hygiene
C) Frequent unexplained injuries
The nurse cares for a client after a tornado. Their partner and parents were killed in the tornado. The client reports insomnia, anorexia, inability to feel pleasure, and flashbacks of the tornado. The client's teenage children say, "They will not let us out of their sight." What is the priority nursing diagnosis for this client? A) Impaired parenting B) Compromised family coping C) Risk for post-trauma syndrome D) Social isolation
C) Risk for post-trauma syndrome
Which party does the nurse owe allegiance to while providing health care? A) The client's family B) The healthcare facility C) The client D) The healthcare provider
C) The client
The nurse is reviewing with a new client the diagnosis of polycystic ovary syndrome (PCOS). Which long-term health problems would the nurse review as a risk with this syndrome? A) Migraine B) Celiac disease C) Type II diabetes D) Cellulitis
C) Type II diabetes
What does palliative care look like?
Can be months to years, sx management, anyone living with or at risk of developing a life-limiting illness. GOAL: acheive best QOL - family meetings/counseling, expertise in managing physical and emotional symptoms, support in resolving conflicts, coordination in care
The mother of a dying 3-year-old child posts on Facebook: "Family and friends, Michael's heart is giving out. Looks like it will be tonight. He is surrounded by family and not in pain. I treasure every minute of being his mother. Thank you for your prayers." Which stage of grieving, according to Kubler-Ross, is the mother experiencing? A) Depression B) Denial C) Bargaining D) Acceptance
D) Acceptance
The nurse cares for the client a day after a radical mastectomy. The client is encouraged by the healthcare provider to participate in an exercise program. Which activity should the nurse suggest facilitating mobility on the affected side? A) Weeding the garden B) Walking C) Swimming D) Combing their hair
D) Combing their hair
Applying Erythromycin ointment to the eyes of a newborn infant immediately after birth is to help prevent blindness caused by which sexually transmitted infection (STI)? A) Bacterial Vaginosis B) Trichomoniasis C) HIV D) Gonorrhea
D) Gonorrhea
The nurse is speaking with a preschool-age child who's sibling recently died. Which feelings should the nurse anticipate from the preschool-age child? A) The child may feel that the sibling died because the parents did not like that sibling B) The child may feel that their bad behavior caused the siblings death as punishment C) The child may feel that the sibling died because of a fight D) The child may feel that having bad thoughts about the sibling caused the death
D) The child may feel that having bad thoughts about the sibling caused the death
A nurse is assessing a 45-year-old client. The client asks for information regarding the changes that are most likely to occur with menopause. Which should the nurse tell the client? A) The uterus tilts backward B) Cervical muscle content increases C) The outer layer of the cervix becomes rough D) The uterus shrinks and gradually atrophies
D) The uterus shrinks and gradually atrophies
After teaching a group of young adults about sexual violence, the nurse determines that the teaching was successful when the group identifies which act(s) as a type of sexual violence? Select all that apply. A) Female genital mutilation B) Bondage C) Infanticide D) Human trafficking E) Forced prostitution
Female genital mutilation Bondage Infanticide Human trafficking Forced prostitution
What is candidiasis? pt edu?
Fungal STI commonly with female partners and uncircumcised males S/SX: genital itching, genital discharge, (thick/white/curdled) DX: microscopic analysis, endocervical swab, oral swab, urethral swab TX: with antifungals PT edu: no sexual intercourse until resolved, no douches or chemicals, clean sex toys, dont have sex with dirty peen
The Gardasil vaccine is given to prevent _________ infection.
HPV
A 22-year-old woman comes to the clinic for an evaluation. Assessment findings are as follows: age of first intercourse: 15 years; intrauterine contraception inserted 2 months ago; monogamous partner; use of condoms for sexual activity; cigarette smoking since age 16, approximately 1/2 to 1 pack per day; oral temperature 100.4°F (38°C). The woman is diagnosed with pelvic inflammatory disease (PID). Which information from the woman's assessment would the nurse evaluate as increasing the woman's risk for this condition? Select all that apply. A) Age at first intercourse B) Intrauterine contraceptive device insertion C) Monogamous partner D) Cigarette smoking E) Using condoms
Intrauterine contraceptive device insertion Cigarette smoking Age at first intercourse
Who do you notify?
MANDATORY REPORTING Required by law to report all alleged abuse
Is there screening for ovarian cancer?
NO
Who will be more likely to not survive ovarian cancer? Who will be more likely to survive?
Older women, weak, frail, low socioeconomic class, no support system Caught at earlier stage, young, healthy, good support system, high socioeconomic class
Contraceptives: Device selection and factor considerations, what are the differences?
Oral Contraceptive pill- hormonal Birth control sponge - barrier Female condom - barrier, STI prevention Male condom - barrier, STI prevention Cervical Cap - barrier Contraceptive patch Implant - hormonal Diaphragm - barrier Ring - hormonal IUD - hormonal or non hormonal, barrier
Due to a family history of breast cancer, Emily has decided to have genetic testing for BRCA1 and BRCA2. The nurse educates Emily that those genetic tests may also indicate an increased risk for what other concern? A) Human Papilloma Virus (HPV) B) Ovarian cancer C) Paget's disease D) Endometrial cancer
Ovarian Cancer
What are some contraception options? and considerations for Pt Teaching?
Pill, IUD, ring, implant, condoms, sterilization, etc... make sure looking at what is going on with that patient. Do they want kids? Do they want hormonal, non-hormonal?
What are developmentally appropriate beliefs in greif?
Preschooler: When talking with a preschooler (age 3- 5) about the death of a sibling, the nurse should be aware that at this stage, the cause of the death is often confusing for them. • They may even feel responsible for the death, simply because they "had bad thoughts" about their sibling, for example.
Describe appropriate hospice care?
Prognosis of 6 mo or less, underlying condition is irreversible, symptom management - create an environment of holistic care, manage pain, personal environment - IV hydration and passive ROM - Pain management
A 16-year-old client presents to the emergency department reporting a sexual assault in which they were raped. Which action will the nurse complete first? A) Provide the client privacy and assess for injuries B) Counsel the client to help increase self-esteem C) Arrange for a follow-up visit for treatment D) Assist the client with showering and hygiene
Provide the client privacy and assess for injuries
During a home visit, the nurse observes a 7-year-old child visibly panicked upon seeing her uncle. The nurse also finds that the child shows some signs of sexual abuse. What is the most appropriate nursing action in this situation? A) Instructing the child's parents to admit the child to a rehabilitation center B) Encouraging the parents to take the child on a vacation C) Raising concerns on behalf of the child and reporting to the proper authorities D) Advising the parents to encourage the child to meditate
Raising concerns on behalf of the child and reporting to the proper authorities
How is it possible for a woman who has had a hysterectomy to still have PMS?
She would still have PMS if only their uterus was removed.
A student nurse is following a preceptor in the ED. They receive a client who states she was sexually assaulted earlier in the evening while on a blind date with a man she met on a meet-up app. When the preceptor gets an urgent call to attend a code in the bay across the hall, she tells the student nurse to perform a head to toe on the client who was assaulted. Using the rationale learned in her class, the student is aware that: A) The assessment should be performed by a Sexual Assault Nurse Examiner (SANE). B) The client's needs are met, so she can be left alone for a few hours in the exam room. C) The assessment should be performed only by a medical doctor or gynecologist. D) The SANE RN should be called to the ED after another nurse does a pelvic exam first.
The assessment should be performed by a Sexual Assault Nurse Examiner (SANE).
Which statements are true regarding mandatory reporting? Select all that apply. A) The nurse is required to report cases of abuse and neglect B) The nurse is required to place the victim of abuse in emergency care C) The nurse's identity is openly declared D) The nurse may be charged for criminal misdemeanor for failing to report abuse
The nurse is required to report cases of abuse and neglect The nurse may be charged for criminal misdemeanor for failing to report abuse
What is TSS? s/sx? risks?
Toxic Shock Syndrome: bacterial infection S/SX: Pain areas: in the abdomen or muscles Whole body: high fever, low blood pressure, chills, dizziness, fainting, fatigue, or lightheadedness Gastrointestinal: diarrhea, nausea, or vomiting Skin: peeling or rashes RISKS: skin wounds, surgery, and the use of tampons and other devices, such as menstrual cups, contraceptive sponges or diaphragms. PREVENTION: change tampons every 3-6 hrs, wash hands before insertion
How can you assess infant pain?
Use the FLACC scale
How to relate to gender identity and how to handle it with patient interactions? What is the role of the nurse?
Use the identity the patient prefers
What is the plan of care for end of life?
Weeks or days of life: advanced directives, POLST, Death with dignity Symptom management: requires the use of best possible evidence to support specific pharmacologic interventions Actively Dying: Usual road: sedation, lethargy, and progresses to comatose state and death. Difficult road: restlessness, confusion, unpleasant hallucinations, delirium, seizures s/sx: Pain , Dyspnea, Fatigue, Cough , Constipation, Diarrhea, Incontinence, Anorexia, Cachexia, Nausea, Vomiting, Depression, Anxiety, Seizures
Define trauma
a sudden, unexpected, dramatic, forceful, or violent event
What is cryosurgery? What does the pt need to know?
a type of surgery that involves the use of extreme cold to destroy abnormal tissues, such as tumors. dont break the blister, may see clear drainage. This is normal. Wash with soap everyday, put Vaseline on it everyday, leave bandaged, report bleeding that does not stop to your HCP, report fever, redness/swelling that extends past treated area, hot to touch, bad smell, or discoloration to HCP
What is elder abuse?
adults 65 and older or residents in nursing facilities. Caregiver not feeding/bathing/providing caregiving responsibilities, emotional abuse, sexual abuse, financial abuse, etc...
What is preconception counseling? and what are some recommendations for conception?
an appointment with your healthcare provider that helps you plan for a future pregnancy -folic acid! - no alcohol - track ovulation - nutrition and healthy weight
What are good things to say to family who are greiving?
authentic, therapeutic presence and listening is important Call an interpreter to the bedside immediately if needed Ask the patient and her partner what they need most of all, and offer to call a chaplain to the bedside, or to make other calls for them Provide physical comfort - privacy, water, blankets, tissues Offer information if you have it but consider their state of mind and emotions. This is not typically a time for lots of detail Do not attempt to explain the unexplainable
What is menopause? s/sx/stages
cessation of menses for one full year or more, a decrease in estrogen production, normally occurring between ages of 45-55, results in a slowing then cessation of ovulation s/sx: weight gain, night sweats, enlargment of breasts, pain, hot flashes, dry skin, itching, thinning, tingling, soreness, stiffness, urinary incontinence, urinary urgency, vaginal dryness, painful intercourse Stages: 1. Pre menopause 2. Peri menopause: hormone changes occur but you still are menstruating s/sx: shortened cycle, skipped cycles, random heavy flows, hot flashes **look for triggers 3. Menopause: menstruation ceases 4. Post Menopause: 12 mo after last period Tx: Hormone replacement treatment: goal is to decrease discomfort from decrease in estrogen, nutrition, exercise
What is the SANE nurse's role in prosecution and plea?
describe the incident in the documentation with a dx of probable battering, providing testimony
What are some reproductive care strategies?
education for responsible and healthy sexuality, safe and appropriate contraception, and services for sexually transmitted diseases, pregnancy, delivery, and abortion.
Label the female anatomy
label
What is PCOS? s/sx?
multifactorial genetic condition that results in abnormal production of androgens by the ovaries, cause unknown, pathogenesis linked to LH S/SX: irregular/prolonged periods, fluid filled sacs or cysts, growth of extra unwanted hair, hair loss, acne and skin problems DX: Presence of hyperandrogenism, ovulatory dysfunction, polycystic ovaries TX: acne meds, anti-diabetic meds, caloric-restricted diet, hormone contraceptives INFERTILITY TX: letrozole (femara)
Define Violence
the use of excessive physical force, which causes or has obvious potential to cause harm or destruction
What is TIC for a sexual assault victim?
therapeutic communication, do not ask what the pt was wearing, always make sure they know what youre about to do, give them the option to say no, tell them they are in control of what happens from now on
What is HPV? What should you tell teenagers? Should they get HPV vaccine? Why? How do you prevent the spread of HPV?
virus that causes cervical cancer sexual transmission from male to female Vaccination protects you from HPV! abstinence, waiting until older to have sex, condoms, limit number of lifetime sex partners, regular check-ups, dont smoke
What causes infertility?
women: failure to ovulate, blockage of tubes (can be treated with hormone therapy), endometriosis, scar tissue from stds can also make it hard to get pregnant men: blockage of ducts, low sperm count, impaired flagella
