Women's Reproductive Problems Chapter 54
What should the nurse emphasize when teaching a woman who has been diagnosed with pelvic inflammatory disease (PID)? The importance of contraception Benefits of hormone therapy (HT) Manifestations of further infection The importance of maintaining hygiene
Manifestations of further infection
The nurse is caring for a 25-year-old patient who has polycystic ovary syndrome (PCOS). When preparing to teach this patient, which classic manifestation should the nurse know is associated with the severity of symptoms, including infertility? Obesity Hirsutism Amenorrhea Irregular menstrual periods
Obesity
What should the nurse include when teaching about early detection of ovarian cancer? Report any pelvic or vaginal bleeding soon. Use estrogen with progestin for menopause. Obtain annual bimanual pelvic examinations. Receive a preventive bilateral oophorectomy.
Obtain annual bimanual pelvic examinations.
The nurse is providing education to a group of perimenopausal women. Which herbs and/or supplements would the nurse include in a discussion regarding effective alternative therapies for menopausal symptoms (select all that apply)? Soy Garlic Gingko Vitamin A Black cohosh
Soy Black cohosh
The woman, who has finished having children, has been suffering from endometriosis and is seeking a cure. The nurse should teach this patient about what treatment? Leuprolide (Lupron) Danazol (Danocrine) Nonsteroidal anti-inflammatory drugs Surgical removal of endometrial implants
Surgical removal of endometrial implants
A 60-year-old woman comes to the clinic reporting unexpected bleeding. What should the nurse tell the patient about diagnosing the cause of this bleeding? "It is probably only the end of menopause." "You will need a hysterectomy to treat this bleeding." "You will need a Pap smear to see if you have endometrial cancer." "You will need an endometrial biopsy to determine the cause of bleeding."
"You will need an endometrial biopsy to determine the cause of bleeding."
The nurse is teaching health promotion to a variety of women in a community center. When asked when a female should begin having a Pap smear, how should the nurse respond? A Every year beginning at age 30 B Every 3 years beginning at age 21 C Every 3 years beginning at age 18 if sexually active D Every year beginning at the onset of menarche and continuing until menopause
B Every 3 years beginning at age 21
The nurse is caring for a 26-year-old patient who is being discharged after an induced abortion. Which statement should the nurse include in the discharge teaching? A "Avoid sexual intercourse for 2 weeks." B "Heavy bleeding is expected for 24 hours." C "A temperature of 101o F (38.9 o C) is normal" D "Birth control pills should not be taken for 30 days."
A "Avoid sexual intercourse for 2 weeks." After an abortion teach the patient to avoid intercourse for 2 weeks. Contraception can be started the day of the procedure. Symptoms of possible complications include a fever and abnormal vaginal bleeding. These symptoms should be reported immediately.
A pregnant female is experiencing amenorrhea, morning sickness, and breast tenderness. In the ninth week after her last menstrual period, she is rushed to the hospital with severe left shoulder pain, blood pressure of 90/60 mm Hg, and heart rate of 112 beats/minute. What is the best diagnostic test to determine the cause of her problem? Serum hemoglobin 12-lead electrocardiogram A transvaginal ultrasound Serial β-human chorionic gonadotropin levels
A transvaginal ultrasound
What type of diet and activity pattern teaching should a nurse include for a patient during menopause?
An increase of Vit. D and calcium Also increase activity, weight bearing activities. This will help decrease the risk for osteoporosis
A 58-year-old woman is one-day postoperative following an abdominal hysterectomy. Which intervention should the nurse perform in order to prevent deep vein thrombosis (DVT)? Place the patient in a high Fowler's position. Provide pillows to place under the patient's knees. Encourage the patient to change positions frequently. Teach the patient deep breathing and coughing exercises.
Encourage the patient to change positions frequently.
What should the nurse advise a woman to do who is recovering from surgical repair of a fistula? Douche daily to prevent postoperative infection. Remove and cleanse her pessary on a daily basis. Resume normal activity to prevent adhesion formation. Ensure that she does not place stress on the repaired area.
Ensure that she does not place stress on the repaired area.
The patient at the clinic complains about her abdominal bloating, depression, and irritability related to her premenstrual syndrome. What should the nurse first recommend (select all that apply)? Take diuretics. Exercise regularly. Take antidepressants. Take antianxiety agents. Increase pork, chicken, and milk intake.
Exercise regularly. Increase pork, chicken, and milk intake.
What diagnostic test is the final determinate for any cancers?
Fine-Needle Aspiration
What should be included in nursing responsibilities when providing immediate care for a female patient who has experienced a sexual assault? Administering a pregnancy test Close monitoring of the patient's vital signs Ensuring the patient is left alone when possible Informing the patient about possible financial support
Informing the patient about possible financial support
During menopause, women experience hot flashes. Why is this?
It is due to the vasomotor instability
What hormone is present if a women is pregnant?
hCG
A 23-year-old woman who is admitted with a possible ectopic tubal pregnancy reports sudden intense pelvic pain radiating to the left shoulder. Which action by the nurse should receive the highest priority? A Observe the amount of vaginal bleeding every 15 minutes for 1 hour. B Check the vital signs and immediately notify the health care provider. C Administer the prescribed pain medication and reassess in 30 minutes. D Assess the fetal heart tones and determine the presence of fetal movement.
B Check the vital signs and immediately notify the health care provider. A ruptured ectopic pregnancy may produce pelvic or abdominal pain and vaginal bleeding. If the tube ruptures, the pain is intense and may be referred to the shoulder. External vaginal bleeding may not be an accurate indicator of actual blood loss. Vital signs should be monitored closely along with observation for signs of shock. A ruptured ectopic pregnancy is an emergency because of the risk of hemorrhage and hypovolemic shock. The patient may need a blood transfusion and IV fluid therapy. In addition, the patient will need emergency surgery. Fetal assessment is not indicated for an ectopic pregnancy
The nurse obtains a history from a 42-year-old patient diagnosed with premenstrual syndrome (PMS). It is most important for the nurse to follow up on which patient statement? A "Exercise is relaxing and reduces anxiety and irritability." B "Milk, beans, and soy nuts may decrease symptoms of PMS." C "Evening primrose oil will reduce bleeding during my period." D "A low-salt diet decreases weight gain and bloating before my period."
C "Evening primrose oil will reduce bleeding during my period." Evening primrose oil may increase the risk of bleeding. Foods rich in vitamin B6 (e.g., pork, milk, egg yolk, legumes) promote serotonin production, which improves the symptoms of PMS. Aerobic exercise can have a relaxing effect and can reduce PMS clinical manifestations. Limiting salt intake and increasing calcium intake have been proposed to alleviate fluid retention, weight gain, bloating, breast swelling, and tenderness.
The nurse provides drug teaching for a 30-year-old woman who is prescribed clomiphene (Clomid). It is most important for the nurse to follow up on which patient statement? A "Hormone production and release will be increased." B"This drug is like estrogen and is used to treat infertility." C"I should avoid intercourse while taking this medication." D"This medication will stimulate my ovaries to produce eggs."
C"I should avoid intercourse while taking this medication." Clomiphene is an oral medication administered for infertility. The medication is a selective estrogen-stimulation modulator that stimulates ovulation, making pregnancy after intercourse or artificial insemination more likely. The drug increases gonadotropin-releasing hormone production. In addition, the release of the follicle-stimulating hormone and luteinizing hormone is increased.
A 55-year-old woman diagnosed with endometrial cancer is receiving brachytherapy. The nurse is most concerned if what is observed? A The patient develops foul-smelling vaginal discharge. B The patient has 5 to 8 liquid stools over a period of 24 hours. C The patient uses a bedpan instead of a bedside commode or toilet. D The patient requests a nursing assistant to stay in the room for company.
D The patient requests a nursing assistant to stay in the room for company. Brachytherapy is internal radiation applied directly to the tumor. Health care providers should limit close contact with the patient to less than 30 minutes per day. Internal radiation causes the destruction of cells and results in a foul-smelling vaginal discharge. Internal radiation may cause systemic reactions such as nausea, vomiting, diarrhea, and malaise. The patient receiving brachytherapy is placed in a lead-lined private room and on absolute bed rest.
When should women have annual mammograms? A. 20 years old B. 30 years old C. 50 years old D. 40 years old
D. 40 years old
Because of the risks associated with hormone therapy (HT), a 50-year-old patient does not want to take HT and asks the nurse how she can handle her perimenopausal symptoms of hot flashes and sweating at night. What should the nurse first advise this patient? Increase warmth to avoid chills. Good nutrition to avoid osteoporosis Vitamin B complex and vaginal lubrication Decrease heat production and increase heat loss.
Decrease heat production and increase heat loss.