medical/surgical I - final exam

vulvar cysts

(bartholin cyst) obstruction of a duct in one of the paired vestibular mucous-secreting glands located in the posterior third of the vulva - infected cyst may cause discomfort. (benign)

vulvar dystrophy

(found in older woman) thickening of skin on the vulva or raised slightly (benign)

non-malignant conditions of breast

-breast pain -cysts -fibroadenomas -lobular carcinoma in situ

malignant conditions of breast

-ductal carcinoma in situ (DCIS) -invasive cancer infiltratiling ductal/lobular carcinoma medullary carcinoma mucinous carcinoma inflammatory carcinoma -paget's disease

signs of breast cancers

-thick mass -indentation -skin erosion -redness or heat -new fluid -dimpling -growing vein -refracted nipple -new shape or size -orange peel skin

cryptorchidism

A testicle that hasn't moved into the bag of skin below the penis before birth

True/False: The incidence of BPH among men older than 50 years of age is 65%.

FALSE: 50+ is 50%

active herpes/delivery

HPV - human papillomavirus: most common STD among young people. -genital warts manifest **VACCINATE (boys/girls 11-12 yrs old) Herpes type 2 infection -lifelong viral infection that is transmitted when the carrier is symptomatic Herpes simplex virus (HSV-2) -no cure. and can be transmitted to infants during birth if there are active warts.

PLISSIT: model of sexual assessment/intervention (examination of the testicles)

Permission -permission for nurse/patient to raise sexual issues Limited Information -giving patient limited info about sexual side effects of treatments Specific Suggestions -making specific suggestions based on a full evaluation of presenting problems Intensive Therapy -referral to intensive therapy

brachytherapy

Radiotherapy, radiation is placed in or next to area of body for the treatment of tumors

TERMS/CONCEPTS TO KNOW

TERMS/CONCEPTS TO KNOW

True/False: Two tumor markers that may be elevated in testicular cancer are human chorionic gonadotropin and alpha fetoprotein.

TRUE.

lactational abscess

a breast abscess that may develop as a consequence of acute mastitis

endometrial hyperplasia

a buildup of endometrial tissue that causes unopposed estrogen production

endometriosis

a chronic disease consisting of a benign lesion containing endometrial tissue from the pelvic cavity found outside the uterus

hydrocele

a collection of fluid most commonly located between the visceral and parietal layers of the tunica vaginalis of the testes, or collect in the spermatic cord causing scrotal swelling

phimosis

a condition where the foreskin (due to excessive tightness) around the penis cannot be pulled back past the glans

hypospadias

a condition where the opening of the penis on the underside rather than the tip

priapism

a condition with a prolonged erection of the penis, may or may not be related to sexual stimulation

paget's disease

a disease that disrupts the replacement of old bone tissue with new bone tissue.

orchiectomy

a surgical procedure in which one or both testicles are removed, (both is the surgical form of castration) -simple -subcapsular -inguinal

PCOS (polycystic ovarian syndrome)

a type of hormonal imbalance or cystic disorder that affects the ovaries through the hypothalamic-pituitary and ovarian network. -causes chronic anovulation and androven excess with small cysts

A patient diagnosed with epidiymitis is being discharged from the Emergency Department. Which of the following would be most important for the nurse to include as part of the client's discharge teaching? a. "keep your scrotum elevated on a folded towel until the swelling goes down." b. "if you have a fever, call the physician so he can order an antibiotic right away." c. "apply heat to the top of your scrotum to help reduce the swelling." d. "make sure you engage in sexual intercourse frequently to help drain the area."

a. "keep your scrotum elevated on a folded towel until the swelling goes down."

After a prostatectomy, when should the urine be light pink? a. 1 day b. 2 days c. 1 week d. 2 weeks

a. 1 day

The nurse if reviewing a femail patient's history, which includes the following information: age at menarche: 11 years old cesarean delivery: 2 pregnancies age at first pregnancy: 35 years alcohol use: 1-2 glass of wine/month Which of the following is a possible risk factor for developing breast cancer? (select all apply) a. age at menarche b. age at first pregnancy c. cesarean deliveries d. alcohol us

a. age at menarche b. age at first pregnancy

What should be included in the education plan for a patient after axillary lymph node dissection (ALND)? (select all that apply) a. avoid blood pressures, injections, and blood draws in affected extremity b. wear gloves for gardening c. maintain cuticles by cutting them d. use disposable razors for shaving armpits e. avoid lifting objects greater than 5-10 lbs

a. avoid blood pressures, injections, and blood draws in affected extremity b. wear gloves for gardening e. avoid lifting objects greater than 5-10lbs.

A woman who is breastfeeding her 3 month old baby develops breast inflammation. Which of the following factors may contribute to this condition? (select all that apply) a. failure to alternate breasts at each feeding b. not nursing often enough c. lack of handwashing d. poor maternal nutrition e. bacteria on the mother or infant's skin

a. failure to alternate breasts at each feeding b. not nursing often enough c. lack of handwashing e. bacteria on the mother or infant's skin

variscocele

abnormal dilation of the pampiniform venous plexus and internal spermatic vein of the scrotum

orchitis

acute inflammatory response of one or both testes as a complication of systemic infection

BPH (benign prostate hyperplasia)

age related prostate gland enlargement that cause urination difficulty. -affects 50% of men 50+ -affects 80% of men 80+

epididymitis

an infection of the epididymis, usually spreading from infected urethra, bladder or prostate

mastitis

an inflammation or infection of breast tissue, occurs most commonly in breast feeding women

A nurse is preparing to obtain a sexual history from a client using the PLISSIT model. Which question would be most appropriate for the nurse to ask first? a. "are you currently having sex, and if yes, with whom?" b. "may I ask you some questions about your sexual health?" c. "how old were you when you became sexually active?" d. "have you ever used any contraceptive measures?"

b. "may I ask you some questions about your sexual health?"

A nurse is caring for the following patients. Which of them would be at the greatest risk of developing vaginitis? a. A 25-year-old woman who douches infrequently b. A 30-year-old woman pregnant with diabetes c. A 38-year-old woman receiving antibiotics for a sinus infection d. A 45-year-old woman who has not yet undergone menopause

b. A 30-year-old pregnant woman with diabetes

The nurse is caring for a patient in the clinical setting who complains of vaginal discharge that is thick with a white cottage cheese-lie appearance. The patient states that she has pruritis and irritation. The symptoms seem to be more severe just before menstruation. What should the nurse expect to be included in the plan of care for this patient? a. clindamycin (cleocin) b. fluconazole (difulcan) c. metronidazole (flagyl) d. tinidazole (tindamax)

b. fluconazole (difulcan)

The nurse is caring for a patient after a hysterectomy. The patient presents with increased HR, decreased BP, weak pedal pulses, and decreased UOP. Which complication of a hysterectomy should the nurse be concerned about? a. bladder dysfunction b. hemorrhage c. pain d. venous thromboembolism

b. hemorrhage

A patient has been diagnosed with polycystic ovarian syndrome. Which of the following findings would hte nurse expect to assess? (select all that apply) a. menorrhagia b. obesity c. hirsutism d. infertility e. painful vaginal itching f. sleep apnea

b. obesity c. hirsutism d. infertility e. sleep apnea

A nurse is caring for a patient who has been diagnosed with prostate cancer and is scheduled for brachytherapy next week. The patient and his wife are unsure of having the procedure because their daughter is 3 months pregnant. What is the most appropriate teaching the nurse should provide to this family?

b. the patient should avoid close contact with his daughter for 2 moths.

which diagnoistic screening tests should be recommended for a 30-year-old woman? a. annual mammogram b. cholesterol and lipid profile c. pap smear every 3 years after onset of intercourse d. thyroid-stimulating hormone test

c. pap smear every 3 years

The nurse is assessing the breast of a female patient. Upon assessment, the nurse notices that the patient's skin of hte breast is thick and hard, as well the skin pores are enlarged. The patient states that she thinks it looks like an "orange peel". How would the nurse document this assessment finding in her notes? a. cellulitis b. nipple inversion c. peau d'orange d. retraction of the skin

c. peau d'orange

which of the following positions is used for a pelvic examination? a. semi-fowler's b. trendelenburg c. supine lithotomy d. side lying

c. supine lithotomy

The patient tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. Which assessment finding would strongly suggest that this client's lump is cancerous? a. the right nipple is everted and the mass is mobile b. the right axillary lymph nodes are not palpable c. the mass is hard, immobile, and has irregular borders d. the mass is soft, mobile and easily delineated

c. the mass is hard, immobile, and has irregular borders

testicular cancer

cancer in testicles, location of sperm and hormone production. **most common cancer in men ages 15-40 -highly treatable/curable -men should perform regular testicular self-exams

prostate cancer

cancer in the walnut-sized gland that produces seminal fluid -second most common cancer, 2nd most common cause of cancer death in men. -early disease has few/no symptoms.

ovarian cancer

cancer of the ovaries

brest lumps

caused by infection, cancers, injury and requires a biopsy for tissue sampling to know if cancerous.

vulvodynia

chronic vulva pain syndrome (benign)

The nurse is caring for a patient who has been diagnosed with prostatitis. The nurse determines that the self-care discharge teaching was successful when the client makes which of the following statements? a. "I will take the antibiotic until all the symptoms are gone." b. "If I have discomfort, a cool shower will give me relief." c. "I need to make sure I drink lots of fluids." d. "I should avoid fluids like coffee and tea."

d. "I should avoid fluids like coffee and tea."

The nurse teaching community education is asked by a client without health insurance why she needs a mammogram if she is completing breast self-examinations at home. The nurse is most correct to respond stating which of the following? a. "mammograms are just better." b. "mammograms provide a baseline that shows changes in breast tissue." c. "mammograms provide a reassurance that there is no breast cancer present." d. "mammograms can detect cysts or tumors too small to palpate."

d. "mammograms can detect cysts or tumors too small to palpate."

Within what time frame is collateral circulation usually developed in a woman after a mastectomy? a. 1 week b. 2 weeks c. 3 weeks d. 4 weeks

d. 4 weeks

Which woman is at highest risk for cervical cancer? a. A 25-year-old woman who smokes and has multiple sexual partners b. A 40-year-old woman who had her first child at age 10 years and has been exposed to HPV c. An 18-year-old woman who has just had her first sexual encounter d. An obese 30-year-old woman who has nutritional deficiencies and a family history of cervical cancer

d. An obese 30-year-old woman who has nutritional deficiencies and a family history of cervical cancer.

Which of the following is a downward displacement of the bladder toward the vaginal orifice? a. rectocele b. enterocele c. fistula d. cystocele

d. cystocele

peau d'orange

dimpling of the skin

adenomyosis

endometrial tissue invades the uterine wall

peyronie's disease

fibrous scar tissue inside the penis that causes a bend in the penis, as well as painful erections

pelvic inflammatory disease (PID)

inflammation of pelvic cavity that may extend from cervicitis to uterus, fallopian tubes, ovaries, pelvic peritoneum or pelvic vascular system. patient & partners: treat with antibiotics.

candidiasis

inflammation of vaginal epithelium, producing itching, reddish irritation and white, cheese-like discharge clinging to epithelium; treat with miconazole (moistate) and clotrimazole (gyne-lotrimin)

vulvitis

inflammation of vulva, irritation from a vaginal discharge (benign)

vastectomy

male sterilization, involves the surgical interruption of both vas deferns

ovarian cysts

may be simple enlargements of normal ovarian elements, or graafian follical or corpus luteum which may arise from abnormal growth

urethral stricture

narrowing of the urethra

bacterial vaginosis

overgrowth of bacteria in the vagina

epispadias

rare type of malformation of penis in which the urethra ends in an opening on the upper aspect (dorsum) of the penis.

circumsision

removal of foreskin of penis

testicular torsion

roation of the testes, which twists the blood vessels in the spermatic cord and therefore impedes the arterial and venous supply to the testicle and surrounding structures in the scrotum

bowen's disease

squamous cell carcinoma in the situ (not metastasized or moved from the original tumor location) very early form of skin cancer

TURP (transurethral resection of the prostate)

surgery to treat BPH, as it removes the section of the prostate that is obstructing urine flow -chips away small chunks with electrical cutting loop

nipple inversion

the retraction of the alveolar tissue (nipple) to go inward as opposed to outward

cryotherapy

treatment that prevents cervical cancer but is not used to treat cervical cancer -use of very cold substances to freeze localized cancers such as prostate cancer, or deaden an irritated nurse

benign fibroids

tumors of the uterus

prolapse of the uterus

uterus falls through the vagina