Exam 5 review

What are hypertonic solutions?

1. 3% NaCl 2. D5NS 3. D5/.45NS

Dosage for misoprostol for PPH?

800-1000 mcg rectally.

two types of ovarian cysts

Functional and nonfunctional

signs and symptoms of a ____________ include new onset of acute pain out of proportion with laceration. Very rapidly. May see purplish, or bluish mass that is firm or tense to touch. NEW ONSET RECTAL PRESSURE IS A HUGE SIGN. Get a provider cause it will need surgical..

Hematoma

If colposcopy comes back positive then what do we do?

LEAP

__________ incontinence, which may be caused by an obstruction of the bladder outlet.

Overflow

Cervical cancer screening detects __________ screening as well as early disease when it can still be managed.

precancerous

colposcopy

the direct visual examination of the tissues of the cervix and vagina

A single dose of metronidazole is used to treat?

trichomoniasis

Vaginal pessaries is what?

For cyctocele it can go up into the vaginal to elevate the bladder. fitted in the office and just needs to be taken out every so often to wash it.

Ceftriazone 250 mg IM and azithromyin 1 gm is used to treat?

Gonorrhea and Chlamydia

cervical cancer risk factors

-Human papilloma virus (HPV) infection -Smoking -Early age at first sexual intercourse. -Multiple sexual partners and/or partners who have multiple partners. -Multiple pregnancies

What are hypotonic fluids?

0.45% normal saline (half normal saline

A nurse is reviewing the various treatment options with a client diagnosed with uterine fibroids. The nurse determines that the teaching was successful based on which statement? 1 "If I use hormone therapy, my fibroids may grow back when I stop the medication." 2 "A myomectomy will not allow me to keep my uterus." 3 "Uterine artery embolization is associated with minimal pain." 4 "Laser surgery won't affect my ability to have children."

1

A postpartal woman is developing a thrombophlebitis in her right leg. Which assessments would the nurse make to detect this? 1 Bend her knee, and palpate her calf for pain. 2 Ask her to raise her foot and draw a circle. 3 Blanch a toe, and count the seconds it takes to color again. 4 Assess for pedal edema.

4 Calf swelling, erythema, warmth, tenderness, and pedal edema may be noted and are caused by an inflammatory process and obstruction of venous return.

Treatment for genital herpes?

Acyclovir valacyclovir or famciclovir VIR= are typically indicators for herpes.

Two types of HPV strains are responsible for the majority of cervical cancer. What are those strains?

Genotypes 16 and 18

If a colposcopy was done for cervical cancer then a _______ is done

LEAP. where they take part of the cervix. (Risks future pregnancy. Risk for preterm delivery, risk of loss baby in 2nd trimester. Risk for PPROM, preterm delivery).

A risk factor for uterine atony can be associted with what drug? It acts as a smooth muscle relaxin, so basically it relaxes the uterus when the uterus should be contraction?

Magnesium Sulfate

Risk factors for hematomas include?

Risk factors include first birth, preeclampsia, prolonged first and/or second stage of labor, vulvar varicosities, multifetal pregnancy, fetal macrosomia, maternal obesity, and clotting disorders

________ incontinence is due to increased intrabdominal pressure

Stress (sneezing gives intrabdominal pressure)

treatment for chlamydia

azithromycin (1 gm for 1 dose) or doxycycline (100 mg twice daily for 7 days if azithromycin allergy)

Nursing diagnosis for PCOS would include?

can include mental health and should be considered.

The first priority in caring for a woman with postpartum psychosis is?

her safety and the safety of her infant.

Causes of PCOS? Most commonly appears in adolescence and persists throughout the reproductive life span.

hypertension, dyslipidemias, hyperinsulinemia.

Signs of hemorrhage?

hypotension, tachycardia, diaphoresis and tachypnea

What do hypertonic solutions do?

pull fluid into the vascular space by osmosis, resulting in an increased vascular volume, which can lead to pulmonary edema

What is the gold standard for HSV diagnosis? 1 culture 2 shave biopsy 3 excisional biopsy 4 punch biopsy

1

A 40-year-old woman with gray, runny vaginal discharge that has a foul, fishy odor has been told that she most likely has vaginosis. What most likely contributed to her present condition? 1 unprotected sex with a new partner who is a carrier of the relevant bacteria 2 autoinoculation from a cold sore, wart, or oral fungal infection 3 a sharp reduction in the number of lactobacilli in the client's vaginal flora 4 proliferation of sexually-transmitted protozoa

3

Are ABG's helpful during pregnancy to help determine PE?

No because pregnancy has a natural state of Respiratory alkalosis.

What is a isotonic solution?

Normal saline and lactated ringers.

The four T's that cause postpartum hemorrhage are?

Tone (uterine atony. most common) Trauma (lacerations, instruments used etc.) Tissue (left over placental fragments) Thrombosis (coagulopathies- least common)

PrEP therapy for HIV?

combination of antiretrovirals taking daily in high risk population. The PREP appears to eliminate transmission of HIV virus to be eligible patients have to test negative prior to start of PREP. Every 3 months get tested and look at renal function. Expensive but there is federal funding. SO if partner has HIV then PREP and condoms can help decrease chances of getting it.

Factors contributing to mastitis include?

delayed breast emptying poor drainage of one or more duct inconsistent pressure on breast (like poor fitting bra) oversupply of milk or nipple trauma.

cystitis pertains to the ?

inflammation of the bladder (UTI in lower tract)

Trichomoniasis may be treated with ?

a single dose of Metronidazole.

If the patient does not want mammogram due to radiation then a breast ___________ can be done

ultrasound

Ovarian cancer can be identified with ____________ or ________ scan followed by diagnosis after surgery by pathology

ultrasound or CT scan.

After conducting a class for college students about cervical cancer prevention, the nurse determines that the class understands that steps can be taken to help prevent cervical cancer based on which statement? 1 More than 90% of squamous cervical cancers contain HPV DNA. 2 STIs will not cause cancer. 3 Proper use of OCs will help decrease the chance of developing cancer. 4 Using a condom is a good way to decrease the chance of developing cancer.

1

A client who is in her sixth week of gestation is being seen for a routine prenatal care visit. The client asks the nurse about changes in her eating habits that she should make during her pregnancy. The client informs the nurse that she is a vegetarian. The nurse knows that she has to monitor the client for which risks arising from her vegetarian diet? Select all that apply. 1 epistaxis 2 iron-deficiency anemia 3 decreased mineral absorption 4 constipation 5 low gestational weight gain

2,3,5

A patient who is not hemodynamically stable likely has an arterial bleed hematoma and requires two large-bore IVs for fluids and blood products, as well as immediate surgery. A complete blood count and clotting factors are ordered, particularly in the case of hemodynamic instability.

two large-bore IVs for fluids and blood products, as well as immediate surgery. A complete blood count and clotting factors are ordered, particularly in the case of hemodynamic instability.

A nurse is conducting a program about genital herpes infection at a community clinic. The nurse determines that additional discussion is needed when the group identifies which activity as a means of transmission? 1 kissing 2 sexual contact 3 giving vaginal birth 4 sharing contaminated needles

4

A nurse teaches a postpartum woman about her risk for thromboembolism. The nurse determines that additional teaching is required when the woman identifies which as a factor that increases her risk? 1 increase in clotting factors 2 vessel damage 3 immobility 4 increase in red blood cell production

4

causes of cervical cancer

HPV, diet, or family history

DVT's are often diagnosed with ____________? If the DVT is suspected to be in the pelvis then and ____ might be done.

Ultrasound Imaging. MRI cause ultrasound might not pick it up.

Diagnosing Chlamydia

Urinalysis or swab sampling. (Dirty catch. do not have them clean prior to UA) if testing for UTI at the same time then doing a swab is better cause they will want a clean catch for the UA)

A client with genital warts is receiving treatment with a local application of trichloroacetic acid. Which client statement indicates adequate understanding of the procedure? 1 "One or two treatments should get rid of the warts." 2 "I'm temporarily not contagious once the warts are destroyed." 3 "Once the warts are gone, then I know I'm cured." 4 "My partner doesn't need to be treated."

2

The nurse is caring for clients who have STIs. Which client is most at risk for becoming infertile due to the infection? 1 a woman diagnosed with trichomoniasis 2 a woman diagnosed with chlamydia 3 a woman diagnosed with syphilis 4 a woman diagnosed with herpes simplex virus

2

Vaginal cancer is associated with? Signs include Treatment includes?

HPV. Often Asymptomatic. if they do have symptoms it will include postcoital bleeding, postmenopausal bleeding, or a vaginal mass. Treatment similar to cervical cancer. Remove what we can see

Rectocele then _________ treatment is usually the first thing they go for.

surgery

Postpartum Hemorrhage (PPH) definition?

the loss of more than 500 ml or 1,000 ml of blood

endothelial injury means an injury to a ________.

injury to a blood vessel

Diagnosis of a PE is accomplished by a _____________ scan and ______________.

ventilation/perfusion (V/Q) scan and computer tomographic pulmonary angiography.

Signs of ovarian cancer

*Usually develop if disease has spread beyond ovaries or late in cancer* (ovarian cancer usually not identified until III or IV stage) Bloating increased abdominal girth. Pelvic and abdominal pain Trouble eating or feeling full quickly Urinary symptoms such as urgency or frequency

Miconazole (Monistat) and fluconazole is used to treat?

Candida yeast infections

signs of mastitis

tenderness, red area of breast, malaise, or fever

First line treatment for endometriosis includes _____________ and ________ contraception

(NSAIDs) and hormonal contraception

dosage for methergonovine (methergine)?

0.2 mg IM every 2 to 4 hours. or orally every 6 hours for 3 doses.

Tranexamic acid (TXA) dosage

1 gram IV over 10-20 minutes.

Which measurement best describes delayed postpartum hemorrhage? 1. blood loss in excess of 300 ml, occurring 24 hours to 6 weeks after birth 2. blood loss in excess of 500 ml, occurring 24 hours to 6 weeks after birth 3. blood loss in excess of 800 ml, occurring 24 hours to 6 weeks after birth 4. blood loss in excess of 1,000 ml, occurring 24 hours to 6 weeks after birth

2

severe hemorrhage is ______-_______ mL loss of blood. This patient has a week pulse pressure and needs blood products.

2000-3000 mL blood pressure systolic below 90 Pulse pressure below 25 mm Hg HR above 140

Mammogram screening guidelines

Age 19-39 annual mammogram when high risk group (1st degree relatives with breast cancer, positive for BRCA1 and BRACA2) Age 40+ mammogram every 1-2 years Age 50+ mammogram yearly

warfarin INR range typically should be?

An INR range of 2.0 to 3.0 is generally an effective therapeutic range for people taking warfarin

BRCA gene means what?

Either of two tumor suppressor genes (BRCA1 and BRCA2) that in mutated form tend to be associated with an increased risk of certain cancers and especially breast and ovarian cancers

what postpartum hemorrhage drug would you not give with asthmatic patients?

Carbopost (Hemabate)

Treatment is often _________ for chemotherapy

Chemotherapy

The most commonly diagnosed bacterial STI?

Chlamydia

Is the following statement true or false? People with HIV can obtain a vaccine that prevents them from acquiring AIDS.

False. Antiretroviral therapy reduces the progression from HIV to AIDS but there is no vaccine or cure for HIV or AIDS.

S/S of tichomoniasis

Fishy and GREEN discharge. and burning

S/S of bacterial vaginosis

Fishy vaginal odor and thin white/gray vaginal discharge

Metronidazole is also called _______? it is listed as a antibacterial/antiprotozoal drug

Flagyl Antibacterial/Antiprotozoal

Cystitis/UTI treatment

Fluids, rest, antibiotics, antiemetic if nausea. Do urine analysis to treat right bacteria with right medication.

Most common STI in the United States

HPV

S/S of chlamydia

Often asymptomatic Dyspareunia: painful intercourse (bleeding after intercourse. cervix is delicate. and bleeds easily when its touched) males thick cloudy penile discharge testicular pain

Patients with ___________ may ovulate intermittently and should use contraception if they do not want to get pregnant.

PCOS

Symptoms of _________ are often nonspecific and include dyspnea, cough, sweating, and pleuritic chest pain.

PE

If untreated, trichomoniasis may lead to ____________.

PID- pelvic inflammatory disease. trichomoniasis is the most common nonviral STI and partner should be treated as well

___________ is the most common cause of infertility and sub-fertility in women

Polycystic ovarian syndrome (PCOS)

Treatment for PCOS

Treatment goals for PCOS are based on the specific clinical manifestation of the patient. Treat the symptoms. Basically if someone is not menstruating then it causes endometrial hyperplasia and can cause endometrial cancer. we try to protect their uterus. we may also try to reduce weight which can help with insulin and obesity issues.

PCOS causes higher risk for?

Type 2 diabetes (insulin resistance) Metabolic syndrome: obesity, elevated BP, high triglycerides, low HDL, higher risk for cardiovascular disease and endometrial cancer and sleep apnea

symptoms of a UTI include?

Urinary urgency and pain with urination, so it will need a urine analysis to check what is going on.

retrograde menstruation

backward flow of menstrual fluid that exits uterine tube (so menstrual tissue goes into Fallopian tubes out into the body instead of out through the cervix and the vagina)

VEGETARIAN SUPPLEMENTATION= needs ____.

needs B12. Beans, spinach rice, soy, cereal, green leafy.

______________ cysts- Dermoid cysts, which are benign ovarian tumors containing ectodermal, mesodermal, and endodermal tissues. They often contain teeth, hair, or nails.

nonfunctional ovarian cysts

Treatment for DVT for postpartum patients.

Anticoagulants for 3 months cause risk is high for 12 weeks postpartum. Heparin. Warfarin can be given if breastfeeding. not given during pregnancy though.

A nurse is caring for clients who have a history of genital herpes infection. The client most at risk for an outbreak of genital herpes is the client who reports: 1 headache and fever. 2 vaginal and urethral discharge. 3 dysuria and lymphadenopathy. 4 genital pruritus and paresthesia.

4

A woman comes to the clinic for an evaluation. During the visit, the woman tells the nurse that her menstrual cycles have become irregular. "I've also been waking up at night feeling really hot and sweating. The nurse interprets these findings as: 1 menopause. 2 perimenopause. 3 climacteric. 4 menarche.

2

A home health nurse notices the patient, who delivered 6 weeks ago, appears disheveled, the house is dirty, and the infant appears to be well-fed but is wearing a dirty onesie. What should the nurse do first? A. Notify the patients primary health care provider. B. Interview the patient using open-ended questions. C. Call child protective services due to the risk of postpartum psychosis. D. Realize the patient has a new baby and is likely sleep deprived.

B

Treatment for Mastitis

Cold compresses, NSAIDS, regular and complete emptying of breast, antibiotics (especially if fever)

Which of the following statements is false? A. Risks for pelvic prolapse include obesity and having a baby. B. Symptoms include vaginal pressure and pelvic pain. C. Treatment is indicated when the woman experiences distressing symptoms. D. Treatment always involves surgery.

D Treatment is indicated when the woman experiences distressing symptoms. Pelvic prolapse is not always treated. Treatment often involves the use of pessaries to help support pelvic organs.

Is the following statement true or false? A patient who had a spontaneous vaginal delivery 12 hours ago and is found to have a low-grade fever and slightly elevated white blood cell count probably has an infection that should be treated.

False. It is normal for women to have a low-grade fever and elevated white blood cell counts for 24 hours after delivery. If her temperature does not decrease after 24 hours or if her white blood cell counts continue to increase, she might have an infection that should be evaluated by her health care provider.

Care for 4th degree lacerations?

Fourth-degree tears usually require repair with anesthesia in an operating room — rather than the delivery room — and sometimes require more specialized repair. Healing also might take longer than a few weeks. Complications such as fecal incontinence and painful intercourse are possible.

If women does not respond to first lien treatment in endometriosis of NSAIDs and hormonal contraception then _______ may be used.

GnRH agonist.

What are hypotonic solutions used for?

Hypotonic fluids are used to treat patients with conditions causing intracellular dehydration, such as diabetic ketoacidosis, and hyperosmolar hyperglycemic state, when fluid needs to be shifted into the cell.

During pregnancy when someone is vegetarian or vegan they are at risk for B12 deficency. B12 can help for anemia to form __________ For neonates it works with folic acid for ____________

Need B12 for anemia. To form RBC For neonates it works with folic acid for neuro septal defects

what drug is the first line of defense in uterine hemorrhage? Give it IV as a Rapid bolus. If no IV is placed can give as IM at 10 units

OXYTOCIN

___________ is a UTI of the upper urinary tract and kidneys. Patients with pyelonephritis usually have a fever above 38°C and may report flank pain and nausea and vomiting. They also report tenderness in the area of the costovertebral angle following a light strike on the back over the kidneys.

Pyelonephritis

__________________ hematomas typically do require surgery or embolization of the bleeding vessels

Retroperitoneal

endothelial cells are thin layer of cells that line the interior surface of all _________?

The thin layer of cells that line the interior surface of all blood vessels. Only one cell thick in capillaries.

What is a 4th degree laceration?

They extend through the anal sphincter and into the mucous membrane that lines the rectum

Candida treatment

over the counter miconzazole (MONISTAT) and Fluconazole

pyelonephritis involves the __________?

kidney

Phelonephritis is a UTI of the upper tract associated with the _________(what organ)? Symptoms include?

kidney infection flank pain, nausea and vomiting, and fever, CVA tenderness. (Costo-vertebral Angle tenderness; tenderness over the kidney's)

HPV can also cause ________ and __________ cancer.

rectal cancer, and neck/oral cancer.

Women who delivery ________ position are at higher risk for hematoma.

standing position. Risk because of pressure that sets there during delivery.

How much calcium is needed in pregnancy?

1200 mgs

The nurse is reviewing with a new client the diagnosis of polycystic ovarian syndrome (PCOS). Which long-term health problems would the nurse review as a risk with this syndrome? 1 migraine 2 celiac disease 3 type 2 diabetes 4 cellulitis

3

Is incontinence a normal part of aging?

ABSOLUTELY NOT

Dangers of Chlamydia related to pregnancy?

Chlamydia can cause infertility and ectopic pregnancy by causing inflammation of the fallopian tubes leading to scarring. (prevent ovum from properly traveling and implanting)

Women who have a recurrent yeast infection should be assessed for ________ and _________

Diabetes and HIV.

Gonorrhea can cause infertility and _________ pregnancy.

Ectopic

The new trend in HIV

Heterosexual women are starting to increase in getting HIV

what is GnRH agonists?

Leuprolide (Lupron). used for 3-6 months. Suppresses FSH and LH that involve in menstruation to cut down and stop menstruation.

what is a side effect of carbopost that we should warn the patients about? with this what other drug should we give with it?

Worst diarrhea ever! 2-3 minutes after giving the drug Give Imodium/ lomotil

Risk of incontinence

aging (because of weakened pelvic floor) past pregnancy vaginal birth obesity family history

First line treatment for gonorrhea

ceftriaxone (250 mg IM) and Azithromycin (for chlamydia 1 gm)

If patient gets gonorrhea they should also be tested for __________ because co infections are common

chlamydia

Lupron (leuprolide) indications?

for endometriosis to suppress LH and FSH. used after NSAIDS and hormonal contraception fails.

Risk factors for postpartum depression?

history, stress, low economic status, poor social support, genetics, unplanned pregnancy, colic infant, anxiety disorders

vaginitis means

inflammation of the mucosa in the vagina

Cervical cancer screening is done primarily with the collection of a small number of cervical cells called the ___________ test

pap test/ pap smear

risks for bacterial vaginosis

shaving/waxing, smoking, douching, multiple sex partners.

_____________ is a disease that include bleeding from the skin, easy bruising, and extended mucosal bleeding. Women with this typically have a history of heavy menses. Ingesting aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) may provoke symptoms.

von Willebrand Disease (VWD)

Candida infections have a ____________ vaginal discharge. Other signs and symptoms include?

yeast infection. thick cottage cheese Dyspareunia and soreness

Postpartum hemorrhage treatment includes.

-Call for help -Fundal massage of a boggy uterus -If fundus is firm assess for lacerations or hematoma for bleeding -Bladder catheterization if inability to void -Establish IV access -administer medication (oxytocin, hemebate, methergine etc.) -Oxygen! (shortness of breather of lightheadness then do a NONREBREATHER at 10-15 liters)

Testing for HIV consist of what test?

-The enzyme-linked immunosorbent assay (ELISA) test detects the presence of HIV antibodies. -The Western blot test is a more expensive confirmatory test.

A client arrives in the emergency department accompanied by her husband and new 10-week-old infant, crying, confused, and with possible hallucinations. The nurse recognizes this could possibly be postpartum psychosis as it can appear approximately when? 1 within 3 months of giving birth 2 within 4 months of giving birth 3 within 2 months of giving birth 4 within 5 months of giving birth

1

A client who has been treated for recurring gonorrhea visits the sexual health clinic reporting dysuria, urinary frequency, and whitish-yellow vaginal discharge. A pelvic examination reveals cervicitis. How would the nurse interpret these findings? 1 the possibility of a chlamydia infection 2 an acute stage of the gonorrheal infection 3 a reaction to the gonorrheal medications 4 a positive pregnancy test

1

A female client with an anal gonorrheal infection experiences painful bowel elimination and a purulent rectal discharge. The nurse would expect which finding once the microorganism disseminates throughout the body? 1 painful joints 2 sore throat 3 intermenstrual bleeding 4 painful urination

1

A multipara client develops thrombophlebitis after birth. Which assessment findings would lead the nurse to intervene immediately? 1 dyspnea, diaphoresis, hypotension, and chest pain 2 dyspnea, bradycardia, hypertension, and confusion 3 weakness, anorexia, change in level of consciousness, and coma 4 pallor, tachycardia, seizures, and jaundice

1

A nurse is reviewing the history and physical examination of a client diagnosed with secondary dysmenorrhea for possible associated causes. Which etiology would the nurse need to keep in mind as being the most common? 1 endometriosis 2 multigravida status 3 hormonal imbalance 4 perimenopause

1

A woman comes into the health clinic complaining of thick, cottage cheese-like vaginal discharge, with white patches on her labia that worsens before her menses. She complains of intense pruritus and dyspareunia. The health care provider would order which preparation for treatment? 1 Fluconazole 2 Tetracycline 3 Clindamycin 4 Acyclovir

1

A woman seen in the emergency walk-in clinic is diagnosed with chlamydia trachomatis. She asks the nurse how this disease is different from other sexually transmitted infectious diseases. What is the nurse's best response? 1 "This STI is characterized by an infection of your cervix." 2 "This STI is an infection that will cause itching in the genital area." 3 "This STI is an infection that results in ulcers in the genital area." 4 "This STI is an infection that will result in the formation of genital warts."

1

After assessing a woman who has come to the clinic, the nurse suspects that the woman is experiencing abnormal uterine bleeding. Which statement by the client would support the nurse's suspicions? 1 "I've been having bleeding off and on that's irregular and sometimes heavy." 2 "I get sharp pain in my lower abdomen usually starting soon after my period comes." 3 "I get really irritable and moody about a week before my period." 4 "My periods have been unusually long and heavy lately."

1

Eight days after birth the woman notices a return to red lochia. What condition does the nurse anticipate this patient is experiencing? 1 Retained placental fragments 2 Perineal hematoma rupture 3 Genital tract infection 4 Disseminate intravascular coagulopathy

1

How often should women diagnosed with human papillomavirus (HPV) have Papanicolau testing? 1 Yearly 2 Every 6 months 3 Every 2 years 4 Every 3 years

1

The nurse has administered the HPV vaccine to a 15-year-old girl. The nurse provides instructions for the girl to return in which time frame for the second innoculation? 1 2 months 2 4 months 3 6 months 4 8 months

1

The nurse reviews the medical record of a woman diagnosed with ovarian cancer, stage II. The nurse interprets this information, understanding that the disease: 1 involves one or both ovaries and extends into the pelvis. 2 has spread to the lymph nodes and other organs within the abdomen. 3. has metastasized to distant sites. is limited to the ovary. 4. Disease limited to the ovary characterized

1

When preparing a teaching plan for a female adolescent with a sexually transmitted infection (STI), the nurse plans to address the fact that the adolescent is at increased risk for cervical cancer. Which STI would the adolescent most likely have? 1 genital warts 2 genital herpes 3 syphilis 4 chlamydia

1

Which statement would be most appropriate when explaining endometriosis as a cause of a woman's infertility? 1 "Ovulation does take place; however, the misplaced endometrial tissue interferes with transport of the ovum." 2 "Your uterine cervix fails to close because it is engorged with tissue." 3 "Menstrual sloughing does not occur, so there is never a new base for embryo growth." 4 "You do not ovulate because of endometrial implants on the ovaries."

1

A 30-year-old woman asks the nurse if she should continue to have a Papanicolau test every year. How should the nurse respond? 1 "You can now start getting screened with a Papanicolau test every 3 years." 2 "You will need Papanicolau and human papillomavirus (HPV) tests every 2 years." 3 "You will need to have a Papanicolau test every 2 years until you are 50." 4 "You are at low risk for cervical cancer so you will only need human papillomavirus (HPV) testing every year."

1 After the age of 30 years, women may continue to be screened with the Papanicolau test alone every 3 years. Alternatively, they may be screened with a combination of a Papanicolau test and HPV testing every 5 years. There is no need to screen more often because women over 30 are less likely to have transient HPV infections

A 24-year-old female presents with vulvar pruritus accompanied by irritation, pain on urination, erythema, and an odorless, thick, acid vaginal discharge. She denies sexual activity during the last six months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of antimicrobial medication is most likely to clear her symptoms? 1 an azole antifungal agent 2 penicillin antibiotic 3 a quinolone antibiotic 4 an antiviral agent

1 The character of the discharge and the lack of recent sexual activity suggest infection with Candida, which can exist asymptomatically and flare up only if conditions, such as an imbalance in normal vaginal flora resulting from antibiotic treatment, diabetes, or oral contraceptive use, enable the fungus to proliferate. Candidiasis responds well to treatment with azole antifungal agents.

A nurse is reading a journal article about care of the woman with pelvic organ prolapse. The nurse would expect to find information related to which disorder? Select all that apply. 1 rectocele 2 fecal incontinence 3 cystocele 4 urinary incontinence 5 enterocele

1,3,5

A 24-year-old woman has presented to an inner city free clinic because of the copious, foul vaginal discharge that she has had in recent days. Microscopy has confirmed the presence of Trichomonas vaginalis. What is the woman's most likely treatment and prognosis? 1 Abstinence will be required until the infection resolves, since treatments do not yet have proven efficacy. 2 Oral antibiotics can prevent complications such as infertility and pelvic inflammatory disease. 3 Antifungal medications are effective against the anovulation and risk of HIV that accompany the infection. 4 Vaginal suppositories and topical ointments can provide symptom relief but cannot eradicate the microorganism.

2

A nurse is teaching a group of pregnant women about the importance of good nutrition during pregnancy. After describing the B vitamins, the nurse determines that the teaching was effective when the group states which food as the best source of vitamin B12? 1 Carrots 2 Beef 3 Bread 4 Lemons

2

The nurse assesses the client who is 1 hour postpartum and discovers a heavy, steady gush of bright red blood from the vagina in the presence of a firm fundus. Which potential cause should the nurse question and report to the RN or primary care provider? 1 Uterine atony 2 Laceration 3 Perineal hematoma 4 Infection of the uterus

2

The nurse is caring for a postpartum woman who exhibits a large amount of bleeding. Which areas would the nurse need to assess before the woman ambulates? 1 Attachment, lochia color, complete blood cell count 2 Blood pressure, pulse, reports of dizziness 3 Degree of responsiveness, respiratory rate, fundus location 4 Height, level of orientation, support systems

2

The nurse notes that a client's uterus, which was firm after the fundal massage, has become boggy again. Which intervention would the nurse do next? 1 Perform vigorous fundal massage for the client. 2 Check for bladder distention, while encouraging the client to void. 3 Use semi-Fowler's position to encourage uterine drainage. 4 Offer analgesics prescribed by health care provider.

2

A postpartum client is showing signs and symptoms of a pulmonary embolism. What should the nurse do? 1 Start oxygen at 2 to 3 liters per minute via nasal cannula. 2 Raise the head of the bed to at least 45 degrees. 3 Lay the client flat and start oxygen. 4 Sit the client up 90 degrees and call the RN.

2 Immediate action is crucial for the woman who develops a pulmonary embolism. Immediately raise the head of the bed to at least 45 degrees to facilitate breathing. Begin oxygen therapy at 8 to 10 liters per minute via facemask and notify the health care provider

A nurse is reviewing the history of a client diagnosed with pelvic inflammatory disease. Which factors would the nurse identify as placing the client at increased risk for this condition? Select all that apply. 1 29 years of age 2 multiple sex partners 3 intrauterine contraceptive device inserted 3 weeks ago 4 vaginal douching approximately once a week 5 residence in a suburban area

2, 3, 4

what age do we start doing PAP smears?

21. we DO NOT do them under the age of 21

Women should receive a clinical breast exam screen every 1 to 3 years between the age of _____- _____ and annually after 40.

29-39

After teaching a client diagnosed with candidiasis about preventative measures, the nurse determines that the teaching was effective when the client states she will take which action? 1 Avoid exposure to sun. 2 Use sunscreen regularly. 3 Avoid tight pants. 4 Exercise to prevent fatigue.

3

After teaching a client diagnosed with candidiasis about preventative measures, the nurse determines that the teaching was effective when the client states she will take which action? 1Avoid exposure to sun. 2 Use sunscreen regularly. 3 Avoid tight pants. 4 Exercise to prevent fatigue.

3

The nurse is assessing a primigravida woman who reports vaginal itching, a great deal of foamy yellow-green discharge, and pain during intercourse. The nurse suspects the woman has contracted which disorder? 1 Chlamydia 2 Simple yeast infection 3 Trichomoniasis 4 Gonorrhea

3

The nurse is teaching a client with newly diagnosed mastitis about her condition. The nurse would inform the client that she most likely contracted the disorder from which organism? 1 Escherichia coli 2 group beta-hemolytic streptococci (GBS) 3 Staphylococcus aureus 4 Streptococcus pyogenes

3

Which of the following would lead the nurse to suspect that a postpartum client is experiencing hypovolemic shock? 1 Lightheadedness 2 Severe localized pain 3 Cyanosis and oliguria 4 Increased rectal pressure

3

At what age do we start screening for HPV?

30

A client is being treated for gonorrhea. Which agent would the nurse expect the primary care provider to prescribe? 1 penicillin 2 tetracycline 3 levofloxacin 4 ceftriaxone

4

A client is diagnosed with a leiomyoma. The client asks the nurse what this is. The nurse describes this as a: 1 cyst. 2 pelvic organ prolapse. 3 fistula. 4 fibroid.

4

A client with a perineal hematoma undergoes an incision and drainage. Which of the following would be most appropriate after this procedure? 1 Administer prescribed magnesium sulfate 2 Monitor the client's fluid status 3 Check client's clotting study results 4 Pack the area to promote hemostasis and drainage

4

A client with primary syphilis is allergic to penicillin. The nurse would expect the primary care provider to prescribe which agent? 1 acyclovir 2 ceftriaxone 3 podophyllum resin 4 doxycycline

4

A pregnant client is complaining of a large amount of malodorous vaginal discharge that is foamy and yellow-green in color, vaginal itching and painful intercourse. When asked, she also reports that urination is somewhat painful. She is diagnosed with trichomoniasis. What treatment would the nurse anticipate the client receiving? 1 ceftriaxone IM 2 oral erythromycin 3 benzathine penicillin G IM 4 oral metronidazole

4

Assessment of a client reveals evidence of a cystocele. The nurse interprets this as: 1 herniation of the rectum into the vagina. 2 protrusion of intestinal wall into the vagina. 3 downward displacement of the cervix. 4 bulging of the bladder into the vagina.

4

When describing sexually transmitted infections and testing, the nurse explains that a client is typically tested for chlamydia, gonorrhea, and syphilis at the same time for which reason? 1 The symptoms of these diseases are the same, and culture tests alone can determine the disease that has infected the client. 2 The infecting bacterium in all cases is the same, and therefore clients have concurrent infections. 3 The infections spread through the same medium, and therefore clients have concurrent infections. 4 It is not unusual for clients to have concurrent infections with more than one sexually transmitted infection (STI).

4

Which complication is most likely responsible for a late postpartum hemorrhage? 1 cervical laceration 2 clotting deficiency 3 perineal laceration 4 uterine subinvolution

4

Which instruction should be given to a woman newly diagnosed with genital herpes? 1 Obtain a Papanicolaou test every 3 years. 2 Have your partner use a condom when lesions are present. 3 Use a water-soluble lubricant for relief of pruritus. 4 Limit stress and emotional upset as much as possible.

4

Which statement made by a client with a chlamydial infection indicates understanding of the potential complications? 1 "I'm glad I'm not pregnant; I'd hate to have a malformed baby from this disease." 2 "I hope this medicine works before this disease gets into my urine and destroys my kidneys." 3 "If I had known a diaphragm would put me at risk for this, I would have taken birth control pills." 4 "I need to treat this infection so it doesn't spread into my pelvis because I want to have children some day."

4

While obtaining the history, a client reports that her mother was treated with diethylstilbestrol (DES) during her pregnancy. The nurse determines that this client is at risk for which cancer? 1 vulvar cancer 2 breast cancer 3 cervical cancer 4 endometrial cancer

4

Mammograms every 1 to 2 years based on shared decision making (SDM) between the patient and provider between the ages of ?

40 and 49. then every year after 50

HPV can take up to ________ years to actually show changes in the cervix?

5-10 years

The nurse counsels a patient recently diagnosed with polycystic ovarian syndrome. Which of the following should be included in the patient education: A. The need to use reliable birth control B. The importance of annual testing for STIs C. Lifestyle behaviors to manage urinary incontinence D. Self-care measures for secondary dysmenorrhea

A

What is a hematoma?

A collection of blood in the body outside the blood vessel

HIV treatment

A decreased viral load indicates a positive response to prescribed HIV treatment, because viral load testing measures the presence of HIV viral genetic material Antiretrovirals.

A family member of a postpartum patient comes out of the patient's room to tell the nurse that the patient is pale, sweaty, and "isn't acting right." What should the nurse do first? A. Notify the patient's primary health care provider. B. Evaluate the patient's uterus and lochia. C. Obtain a set of vital signs. D. Reassure the family member that the patient is doing well.

B The patient may be experiencing excessive blood loss. The nurse should evaluate the patient's fundus and lochia because uterine atony is a primary cause of postpartum hemorrhage. After assessing the uterus and lochia, the nurse might need to obtain a set of vital signs and notify the patient's primary health care provider. The family should not be reassured that the patient is doing well at this time.

mammogram screening if the patient has the BRCA gene

Because of this elevated risk, recommended screening for women carrying a BRCA mutation is very different from that for the general population. These women are encouraged to perform breast self-exams from the age of 18 and to undergo clinical breast examinations every 6 to 12 months beginning at the age of 25. Women with BRCA mutations are advised to have annual breast MRIs from 25 to 29 years of age, and both annual breast MRIs and annual mammograms starting at the age of 30.

This technique consists of massage of the anterior wall of the uterus with a hand on the abdomen and massage through the vagina of the anterior uterine wall with the, other hand made into a fist going into the vagina.

Bimanual compression

outlines time, amount, type of fluid intake and time, each void. precipitating events. -record over 3-7 days can help with incontinence.

Bladder diary.

Bilateral BIRADS score of 1 means?

Breast Imaging Reporting and Data System Classifications: 0- inconclusive 1 - normal breast tissue (negative) 2 - Benign 3- Probably benign 4 - Suspicious of malignancy 5 - Highly suggestive of malignancy 6 - Proven malignancy (+ findings on bx)

If someone has HPV positive and pap smear shows some sort of cellular change/ growth what is the next step?

Colposcopy

Symptoms of a UTI limited to the bladder ________ include a frequent urge to urinate, known as urinary urgency, and pain with urination. A woman with a UTI may report blood in her urine (frank hematuria) or lower abdominal discomfort. This type of UTI generally does not produce systemic symptoms such as a fever or chills. The diagnosis is typically made on the basis of symptoms and laboratory test results that indicate the presence of white blood cells and/or bacteria in the urine.

Cystits

Which statement made by a patient requires further education by the nurse? A. "Because I have no risk factors for breast cancer, I do not need a mammogram until I am at least 40." B. "It is important for me to have awareness of what is normal for my breasts." C. "Since I am 52, I should schedule a mammogram every 1 to 2 years." D. "I should do monthly self breast examinations."

D

A 56-year-old patient who experienced menopause 4 years ago calls the clinic regarding uterine bleeding. The nurse expects the provider to evaluate the patient for: A. Ovarian cancer B. Abnormal cervical cells C. Perimenopausal symptoms D. Uterine cancer

D The provider will likely evaluate the patient for uterine cancer. Menopause is diagnosed after 1 year of no menstrual bleeding. After menopause is diagnosed, vaginal bleeding is indicative of uterine cancer not perimenopausal symptoms. Uterine bleeding is not an initial symptom of ovarian cancer. Abnormal cervical cells would be diagnosed with a Pap test and may indicate precervical cancer.

Hormone therapy in PCOS

Estrogen + progesterone to help regulate menstrual cycles and help with hyperanderogenism Progesterone can also help with endometrial hyperplasia= help against endometrial cancer Metformin- help with restoring menstrual regularity and insulin resistance

Patient education about using hormonal contraception in PCOS cause of pregnancy.

Even though women aren't having periods they can still ovulate and become pregnant. Just may be harder for pregnancy so if they don't want a baby. Use protection.

______________ cysts includes Follicular cysts that occur when the follicle does not rupture during ovulation. Commonly occurs with ___________. Generally asymptomatic unless rupture or torsion occurs.

Functional ovarian cysts polycystic ovarian syndrome

you should not use methergonovine/ methergine if the patent is ?

HYPERTENSIVE.

pelvic inflammatory disease (PID) and fertility

Higher risk for Ectopic pregnancies. inflammation of the Fallopian tubes leading to scarring. (prevent ovum from properly traveling and implanting)

__________ shock is Triggered when the volume of circulating blood decreases to a degree that the body's organs do not have enough oxygen to function properly. signs and symptoms include?

Hypovolemic shock. signs include hypotension, tachycardia, tachypnea, Oliguria, mental status change, cool pale clammy skin, slowed capillary refill.

For perineal wounds/ infection when would you give the patient antibiotics?

If cellulitis is present. or in severe lacerations.

What is INR?

International Normalized Ratio. Measures extrinsic coagulation pathway. Based on PT

Foods high in calcium if lactose intolerant

Lactose intolerant-dark green leafy veggies (biggest), fortified cereals-meat and poultry, fish have very small amoun

Oxytocin side effects for mom and baby?

Maternal Side Effects: Cardiovascular: dysrhythmias, chest pain, hypertension Neurological: seizures Respiratory: DYSNEA Gastrointestinal: nausea/vomiting Genitourinary: Severe uterine cramping, uterine rupture UTERINE TACHYSTOLE Water intoxicity Fetal Side Effects: Cardiovascular: BRADYCARDIA, ectopic rhythms Neurological: intracranial hemorrhage Respiratory: hypoxia, asphyxia

What postpartum hemorrhage drug would you NOT give for a hypertensive patient?

Methergine (methergonovine)

___________ drug is used for cervical ripening, but can also be used for PPH. Although it is not used as common, but is super cheap. Can cause GI upset and causes shaking and postpartum fever.

Misoprostol (Cytotec)

_________ and _________ resistance are frequently associated with PCOS

Obesity (higher risk for metabolic syndrome and insulin resistance. (higher risk for obesity type 2)

a condition caused by a hormonal imbalance in which the ovaries are enlarged by the presence of many cysts formed by incompletely developed follicles

Polycystic ovarian syndrome (PCOS)

Uterine Cancer number one sign is?

Post menopausal bleeding Other S/s: watery/blood vaginal discharge, low back/abd pain, pelvic pain

____________ is a transient, self-limiting mood disorder that starts 2 or 3 days after delivery and resolves within 2 weeks.

Postpartum Blues- RESOLVES WITHIN 2 WEEKS.

_______________ is major depression with an onset during pregnancy or in the first 4 weeks after birth.

Postpartum Depression

_____________ is a rare disorder that affects a woman's sense of reality.

Postpartum Psychosis.

Primary PPH vs Secondary PPH

Primary is within the first Secondary or delayed is after 24 hours up to 12 weeks after delivery

___________ hematomas occur as a result of a birth and are an accumulation of blood in the vulva, vagina, or, rarely, the retroperitoneal space.

Puerperal hematomas

PCOS Diagnosis Process

Requires one indication from the abnormal uterine bleeding pattern and one from evidence of hyperandrogenism catergory AUB= abnormal for age or for time since first menses; symptoms persist for - years Hyperandrogenism= moderate to severe hirsutism; moderate to severe acne; persistent laboratory elevation of testosterone.

The causes of endometriosis is not well understood but often explained as ________________ menstruation

Retrograde

risks with leap

Risk for preterm delivery, risk for pregnancy lost in second trimester, higher risk for prom and pprom,

Patients with venous bleeding hematomas are likely hemodynamically stable and receive what kind of treatment?

The bleeding of a hematoma may be venous or arterial. Patients with a venous bleed are likely to be hemodynamically stable and receive a single large-bore IV line for fluids. Such patients are more likely to be managed conservatively.

To decrease risk of ovarian cancer can include? (protective factors)

To decrease risk of ovarian cancer can include combined oral contraceptives= estrogen and progesterone. other protective factors can be history of pregnancy and breast feeding

__________ drug is typically a 2nd choice for PPH. Needs to be given 3 hours after delivery or it is no longer effective.

Tranexamic acid (TXA)

Treatment for incontinence includes?

Treatment depends on the type of incontinence and contributing factors. Treatment may include pelvic floor exercises, weight loss, limiting alcoholic and caffeinated beverages, and avoiding dehydration

_______ incontinence, which is often referred to as an overactive bladder.

Urgency

Pelvic organ prolapse may involve prolapse of the Bladder= _________ Rectum=_________ Bowel=_________ or uterus

bladder (cystocele), rectum (rectocele), bowel (enterocele), or uterus.

Postpartum ________ does not affect their care of themselves of the baby

blues.

PCOS causes ___________ menstrual cycles and __________(excess face and body hair and acne)

causes irregular menstrual cycle) and hyperandrogenism (causes excess face and body hair and acne).

Signs of endometriosis

chronic pelvic pain worse in premenstrual period, dysmenorrhea, pain with sex (dyspareunia), tenderness of uterus, infertility

Mastitis antibiotic treatment includes what antibiotics? and is given when?

dicloxacillin or clindamycin for 10 to 14 days. Typically given if fever (flu like symptoms) or if mastitis last longer than 24 hours

Factors that place a pregnant woman at risk for thromboembolic disease include ______ veins leading to slower blood flow and pooling __________injury related to surgical intervention or placental detachment, and the increase of ________ factors in pregnancy to decrease the risk of hemorrhage

dilated veins leading to slower blood flow and pooling, endothelial injury related to surgical intervention or placental detachment, and the increase of coagulation factors in pregnancy to decrease the risk of hemorrhage

How does endometriosis cause infertility

formation of DENSE ADHESIONS which distort pelvic architecture and interefere with tubal motility. Inflammation interferes with the function of the ovaries, Fallopian tubes, and endometrium.

Carbopost dosage?

give 250 mcg IM every 15-90 minutes

What does oxytocin do?

increases uterine contractions during pregnancy and in cause of uterine atony postpartum. also and causes milk to be ejected

General symptoms of infection for postpartum patients?

o A fever that persists beyond the initial 24 hours after birth. (temperature can be raised right after delivery is normal) o A fever that begins 2 to 10 days after birth. o Elevated white blood cell count that continues to rise rather than fall. (WBC's will be elevated after birth is a normal finding so watch for the count to rise instead of falling can be sign of infection)

HPV screening includes First screening at age _____ regardless of sexual activity Then screening every ____ years until age 30. After age 30 women should get the pap test and HPV test every _____ years until age 65. or a pap test alone very 3 years.

o First screening at the age of 21 regardless of sexual activity. o Subsequent screening every 3 years until age 30. o After age 30, women should receive a Pap test and HPV testing every 5 years until age 65. Or a Pap test alone every 3 years.

Treatment for perineal wounds include?

removal of sutures and opening of the wound. Nurse interventions is comfort. Sitz bath, peri bottle, acetaminophen, bowel softener (colace and miralax)

symptoms of a DVT include:

unilateral swelling, pain or aching, localized redness, warmth, and tenderness

For HPV vaccine it is recommened up until age _____ If you are ___ - ___ years old it is 2 doses 6 months apart If you are over _____ then its 3 doses.

up until 45 11-15= 2 doses over 15 = 3 doses.

Treatment for pelvic prolapse

vaginal pessaries

Number one sign of pelvic prolapse

vaginal pressure

Typical blood loss after vaginal birth is ______ mL and ________ mL after cesarean delviery

vaginal= 500 mL C section= 1000 mL