PrepU Chapter 51: Management of Patients with Female Reproductive Disorders

Which statement by the client demonstrates an understanding related to a Pap test?

"I need to have my first Pap test when I turn 21 or earlier if I become sexually active." -Screening should begin within 3 years of the initiation of sexual intercourse or at 21 years of age. The Pap test is a painless and relatively inexpensive method of early detection. Preventive measures for cervical cancer include regular pelvic examinations and Pap tests for all women, especially older women past childbearing age.

The nurse is obtaining the history from a client who is suspected of having pelvic inflammatory disease (PID). Which client statement would help support the suspicion of PID?

"I was 15 years old when I first had sex." -Risk factors for PID include early age at first intercourse, multiple sexual partners, frequent intercourse, intercourse without condoms, sex with a partner with a sexually transmitted infection, and a history of sexually transmitted infections or previous pelvic infections. Therefore, the statement about being 15 years old when the client first had sex suggest the presence of a risk factor that would support the suspicion of PID.

The nurse instructs a client with genital herpes on self-care management. Which client statement indicates that teaching has been effective?

"I will not touch the lesions when they occur."

An elderly client, who can void only while standing and pushing upward on the vagina, is ordered a pessary. Which comment from the client indicates a need for further teaching about this device?

"I will remove and clean it every day." -Pessaries should be removed, cleaned, and replaced periodically (at least every 2 months). If the client is unable to manage the pessary, then follow-up appointments should be made with the practitioner. Ill-fitting pessaries can cause irritation and erosion of tissue resulting in irritation, bleeding, or infection. The placement of the pessary should support the uterus in the pelvis and lessen urinary and pelvic symptoms.

A client has just been diagnosed with endometriosis. Which of the following would be most appropriate to provide the client with support and guidance about treatment options?

"It might help to include your partner in any of the discussions about options."

A client who wishes to preserve childbearing asks the nurse to explain how taking oral contraceptives will work in the management of endometriosis. Which is the best response by the nurse?

"Symptoms of endometriosis are increased during normal menstrual cycle."

A client reports loss of interest in sexual relations and discomfort during intercourse. Which is the best response by the nurse?

"These are normal, manageable symptoms of menopause." -Diminished libido and/or dyspareunia are common symptoms associated with perimenopause. Explaining that this can be a normal finding may help to alleviate worries for the client and provide hope for management of the symptoms. The nurse should avoid telling a client "not to worry" or "talk to someone else" because these can negate client feelings and shut down communication. HRT may not be recommended for this client.

The nurse reviews data collected while completing a health history with a female client. Which information does the nurse identify that increases the client's risk for developing uterine cancer? Select all that apply.

- Age 65 - Body mass index 32 - Menopause at age 55

A client reports intermittent pelvic pain that does not seem to have a predictable occurrence. She recalls that these episodes began approximately 8 months ago. Following months of physical and diagnostic tests, the physician diagnoses the client with chronic pelvic pain. Which choices could be used as possible treatment options? Select all that apply.

- Antidepressants - Analgesics - Oral contraceptives

A client has been diagnosed with genital herpes. Knowing that education is an essential part of nursing care of the client with a genital herpes infection, the nurse plans to include which method(s) to minimize HIV transmission? Select all that apply.

- Avoiding unprotected sexual intercourse - Avoiding multiple sexual partners - Avoiding IV drug use

An older client underwent a lumpectomy for a breast lesion that was determined to be malignant. Which factors increase the risk for breast cancer? Select all that apply.

- Daily alcohol intake - Increased age - Nulliparity - Obesity

A nurse is reviewing various treatment methods with a client diagnosed with a cystocele. Which of the following would the nurse describe as a nonsurgical method? Select all that apply.

- Kegel exercises - Pessary - Colpexin sphere

A client is ordered a vaginal cream for the treatment of a yeast infection. What teaching should the nurse include for inserting the vaginal medication?

Insert the medication into the vagina using an applicator.

A nurse is reviewing the health history of a client who has been diagnosed with endometrial cancer. Which of the following would the nurse identify as a factor increasing this client's risk? Select all that apply.

-Obesity -Nulliparity

Which statement is true regarding endometriosis?

It affects women of reproductive age.

Which client has the highest risk of ovarian cancer?

45-year-old woman who has never been pregnant -The incidence of ovarian cancer increases in women who have never been pregnant, are older than age 40, are infertile, or have menstrual irregularities. Other risk factors include a family history of breast, bowel, or endometrial cancer. The risk of ovarian cancer is reduced in women who have taken hormonal contraceptives, have had multiple births, or have had a first child at a young age.

Internal radiation, or brachytherapy, delivers a dose of radiation to a localized area inside the body through the use of an implant. The implant may be applied by a needle, seed, bead, or catheter, or can be given orally. Antineoplastic agents used in chemotherapy interfere with the cellular function of the cancer cells and cause cell death. Needle aspiration biopsy involves aspirating tissue fragments through a needle guided into the cancer cells?

A 30-year-old pregnant woman with diabetes

A patient reports to the nurse that she has a sense of pelvic pressure and urinary problems such as incontinence, frequency, and urgency. The problem has gotten much worse since the birth of her third child. What does the nurse suspect the patient is experiencing?

A cystocele

A client is being seen at the local community-based clinic where you practice nursing. Her healthcare provider has diagnosed the client with candidiasis and prescribed clotrimazole cream once daily for 7 days. You are providing education on how to administer the prescribed treatment. Which of the following techniques will the client use to administer this medication?

Administer cream at bedtime high into vaginal canal. -Administer cream or vaginal tablets high into vaginal canal; instruct client to remain recumbent for 10 to 15 minutes or administer at bedtime. Vaginal cream is administered high into vaginal canal; instruct client to remain recumbent for 10 to 15 minutes or administer at bedtime.

A client with a trichomoniasis infection is prescribed metronidazole. Which teaching will the nurse provide to the client about this medication?

Avoid all alcohol for 24 hours after taking the medication.

A client has undergone a total abdominal hysterectomy and bilateral salpingo-oophorectomy as treatment for endometrial cancer. When providing postoperative care to this client the nurse would be alert for signs and symptoms of which of the following?

Bladder dysfunction

During consultations with the oncologist, a client with cervical cancer is informed that radioactive materials will be inserted in the area of the tumor. She has to undergo these sessions over a period of 3 weeks. Which method of cancer treatment is being described?

Brachytherapy -Internal radiation, or brachytherapy, delivers a dose of radiation to a localized area inside the body through the use of an implant. The implant may be applied by a needle, seed, bead, or catheter, or can be given orally. Antineoplastic agents used in chemotherapy interfere with the cellular function of the cancer cells and cause cell death. Needle aspiration biopsy involves aspirating tissue fragments through a needle guided into the cancer cells.

Assessment of a client reveals evidence of a cystocele. The nurse interprets this as which of the following?

Bulging of the bladder into the vagina

Over the past 2 months, a client has been receiving treatment for multiple ear infections and tonsillitis. The client reports a curdy white vaginal discharge and burning with urination. What is the most likely cause of these symptoms?

Candida albicans

The nurse is collecting assessment data on a client who is reporting a vaginal discharge that is cottage cheese-like in appearance. Which pathogen is the most likely cause for this symptom?

Candida albicans -Candida albicans is a yeast infection that presents with a thick, curdy white discharge. Gonococcus is the organism that causes gonorrhea and presents with a yellow, mucopurulent discharge. Trichomonas vaginalis presents with a foamy, white, foul-smelling discharge and Gardnerella vaginalis is a watery, fishy-smelling discharge.

Culture of client's vaginal discharge reveals Gardnerella vaginalis. Which of the following would the nurse expect to assess?

Fishy-smelling watery discharge -Gardnerella vaginalis is associated with a gray-white, watery, fishy smelling vaginal discharge. The discharge associated with a candida infection is curdy white, thick and strong. Discharge due to Trichomonas vaginalis is yellow-white, foamy, and foul.

A nurse practitioner examines a patient suspected of having endometriosis. The nurse knows that although a definitive diagnosis could not be made without diagnostic treatment (transvaginal ultrasound), the most frequent symptom is:

Chronic pelvic pain.

In which group is it most important for the client to understand the importance of an annual Papanicolaou test?

Clients infected with the human papillomavirus (HPV)

Which condition is a downward displacement of the bladder toward the vaginal orifice?

Cystocele -A cystocele results from damage to the anterior vaginal support structures. A rectocele is a bulging of the rectum into the vagina. Vulvodynia is a painful condition that affects the vulva. A fistula is an abnormal opening between two organs or sites.

A nurse is preparing a teaching plan for a client with a vulvovaginal infection. Which teaching would not be appropriate for the nurse to include?

Douche with a dilute vinegar solution twice a day.

The nurse documents the following history obtained from a female patient: No known allergiesDouching 2 to 3 times per weekUse of barrier methods for contraceptionRecent viral upper respiratory infectionEstrogen levels within acceptable parameters Which of the following would the nurse identify as a risk factor for the patient developing a vulvovaginal infection?

Douching

Which of the following is the descent of the small intestine into the vaginal vault?

Enterocele -The descent of the small intestine into the vaginal vault is termed enterocele. A rectocele is the extrusion of the rectum into the posterior vagina. A cystocele is the herniation of the bladder into the anterior vagina. A uterine prolapsed is the downward descent of the uterus into the vagina.

A client has just received a diagnosis of premature ovarian failure. How would this diagnosis be confirmed?

FSH level determination -POF is diagnosed by determining the level of FSH in a sample of blood. A higher-than-normal level of FSH combined with the history of irregular menses or premature cessation of menstruation suggests POF.

While caring for a patient who is treated for severe pelvic inflammatory disease (PID), the nurse insists on keeping her in a semisitting position. Which of the following is correct rationale for this positioning?

Facilitation of pelvic drainage and minimize the upward extension of infection

The client is asking if there is a pill that can be ordered to control the symptoms of menopause. Which assessment finding is most important in determining nursing care in association with hormone replacement therapy?

Family history of breast cancer -The risk of endometrial or breast cancer in women prescribed HRT may outweigh the benefits of relieving symptoms of menopause and preventing kyphosis or hip fractures associated with osteoporosis.

Which assessment finding will most likely influence the treatment regimen selected by a client with endometriosis?

Family planning -Selection of a more conservative option may be indicated to preserve the possibility for future childbearing. Pain, dysmenorrhea, and chocolate cysts are all symptoms associated with endometriosis and can influence decision for treatment.

A nurse is obtaining health history from a woman with suspected cervical cancer. Which of the following would the nurse identify as a possible risk factor?

History of chronic pelvic infections

A pelvic examination reveals that a woman's uterus is retroflexed. Which of the following best depicts this position?

In retroflexion, the uterus bends posteriorly

A young client presenting at the health clinic with fever and mucopurulent vaginal drainage is diagnosed with acute pelvic inflammatory disease (PID). Which long-term affect is of greatest concern in the care of this client?

Infertility

A patient is diagnosed with the most common type of uterine fibroid, an intramural fibroid. The nurse includes which information in teaching the patient about this type of fibroid?

It grows within the wall of the uterine muscle.

A client is in isolation after receiving an internal radioactive implant to treat cancer. Two hours later, the nurse discovers the implant in the bed linens. What should the nurse do first?

Leave the room and notify the radiation therapy department immediately. -If a radioactive implant becomes dislodged, the nurse should immediately leave the room and notify the radiation therapy department. The nurse shouldn't attempt to handle the implant or remain in the room with the implant.

The nurse in the gynecology clinic is interviewing a patient who informs the nurse that her mother and aunt had carcinoma of the cervix. What does the nurse recognize are two chief symptoms of early carcinoma that the patient should be questioned about?

Leukorrhea and irregular vaginal bleeding or spotting

A woman comes to the emergency department reporting vaginal discharge and pelvic pain that increases with urination. The client also reports nausea and vomiting, headache, and anorexia. A pelvic examination reveals cervical motion tenderness. The client is diagnosed with acute pelvic inflammatory disease (PID) and is admitted. Which of the following would be most appropriate to include in this client's plan of care?

Maintaining bedrest in the semi-Fowler's position

On a visit to the gynecologist, a client complains of urinary frequency, pelvic discomfort, and weight loss. After a complete physical examination, blood studies, and a pelvic examination with a Papanicolaou test, the physician diagnoses stage IV ovarian cancer. The nurse expects to prepare the client for which initial treatment?

Major surgery -Ovarian cancer usually requires aggressive treatment — initially, surgery. The client will require a total abdominal hysterectomy and bilateral salpingo-oophorectomy with tumor resection, omentectomy, appendectomy, and lymphadenectomy. Radiation therapy is palliative for a client in this advanced stage of the disease. Chemotherapy also is largely palliative during this stage; however, prolonged remissions have been achieved in some clients.

Which of the following is a term used to describe excessive menstrual bleeding?

Menorrhagia -Menorrhagia is excessive menstrual bleeding. Amenorrhea is the absence of menses. Dysmenorrhea is painful menses. Metrorrhagia is excessive and prolonged menstrual bleeding.

Which is the main cause of anemia in a client with active uterine leiomyoma?

Menorrhagia -Uterine leiomyomas or fibroids cause menorrhagia, which in turn can cause anemia. Poor dietary intake of iron does not cause anemia but aggravates the problem. Though there can be a feeling of pressure in the pelvic region, this does not cause anemia.

Which drug is the most effective treatment for trichomoniasis?

Metronidazole

Which of the following is the preferred medication for bacterial vaginosis?

Metronidazole -The preferred medication for treatment of bacterial vaginosis is metronidazole 500 mg twice daily for seven days. Monistat, Gyne-Lotrimin, and Terazol are used in the management of candidiasis.

A client has a history of dysmenorrhea. During monthly menses, the client experiences incapacitating cramping and passes large clots. The client's primary care physician initiates conservative treatment. What interventions would the physician to recommend?

NSAIDs

While caring for a client who is being treated for severe pelvic inflammatory disease (PID), which nursing action minimizes transmission of infection?

Performing hand hygiene when entering the room -While caring for a client hospitalized with PID, the nurse has to reduce the risk of the spread of pathogenic microorganisms. Meticulous hand hygiene minimizes the transmission of infection. There is no reason to restrict visitors in this situation; however, visitors need to be educated in proper hand hygiene. Reverse isolation is not indicated for this client. A sitting position will not aid in preventing nosocomial infections.

A client is admitted to the health care center with abdominal pain, nausea, and vomiting. The client has a body mass index (BMI) of 30 and reports irregular menstrual cycles and feeling tired all the time. The nurse suspects the client's symptoms to indicate which condition?

Polycystic ovary syndrome (PCOS)

Following a radical vulvectomy, the nurse is preparing the client for discharge to home. Which care intervention would be considered the priority for this client?

Prevention of wound complications -Prevention of complications and infection is paramount due to the location of the wound. The perineal area provides a warm, dark environment that supports the growth of microorganisms that can be introduced into the wound. With a radical vulvectomy, it is likely to find surgical drains and urinary catheter that can also interfere with the maintenance of the wound. Relieving edema to the lower extremities may be a necessary part of care if the lymph nodes and blood vessels are disturbed. The client may have a colostomy and care instructions should be provided. Alteration in sexual function needs to be addressed but not a priority for the initial stage of healing.

Which of the following is an early symptom of vulvar cancer?

Pruritus with genital burning -Pruritus and genital burning are the most frequent early symptoms of vulvar cancer, followed by a bloody discharge from the vagina. Abdominal pain can be a result of formation of cysts in the ovary. Dyspareunia and fever accompanied by chills are not the early symptoms of vulvar cancer.

Which of the following is the extrusion of the rectum into the posterior vagina?

Rectocele -A rectocele is the extrusion of the rectum into the posterior vagina. A cystocele is the herniation of the bladder into the anterior vagina. The descent of the small intestine into the vaginal vault is termed enterocele. A uterine prolapsed is the downward descent of the uterus into the vagina.

Upon examination, the nurse practitioner notes a backward positioning of the client's uterus. How would the nurse document this finding?

Retroversion -In retroversion, the uterus turns posteriorly as a whole unit. In anteversion, the uterus tilts forward as a whole unit. In retroflexion, the fundus bends posteriorly. In anteflexion, the uterus bends anteriorly.

Which position occurs when the uterus turns posteriorly as a whole unit?

Retroversion -In retroversion, the uterus turns posteriorly as a whole unit. In anteversion, the uterus tilts forward as a whole unit. In retroflexion, the fundus bends posteriorly. In anteflexion, the uterus bends anteriorly.

A perimenopausal woman informs the nurse that she is having irregular vaginal bleeding. What should the nurse encourage the patient to do?

See her gynecologist as soon as possible.

Pelvic infection is most commonly caused by which of the following?

Sexual transmission

A client is surprised to learn of having a Bartholin cyst because of the absence of symptoms. Which treatment will the nurse anticipate being prescribed for this client?

Sitz bath - If a cyst is asymptomatic, treatment is unnecessary. Moist heat or sitz baths may promote drainage and resolution. If the cyst is large and drainage is needed, a Word catheter, marsupialization, or incision and drainage would be prescribed.

A client with heart failure is admitted to an acute care facility and is found to have a cystocele. When planning care for this client, the nurse is most likely to formulate which nursing diagnosis?

Stress urinary incontinence

Which STD seems to accelerate in HIV-positive clients?

Syphilis -Syphilis seems to accelerate in HIV-positive clients and proceeds directly from primary to tertiary disease in some clients. Chlamydia is associated with a high risk of HIV.

A client with vaginitis complains of itching and burning of the perineum. Which suggestion would be most appropriate to relieve the client's symptoms?

Take sitz baths frequently

To treat cervical cancer, a client has had an applicator of radioactive material placed in the vagina. Which observation by the nurse indicates a radiation hazard?

The client receives a complete bed bath each morning. -The client shouldn't receive a complete bed bath while the applicator is in place. In fact, she shouldn't be bathed below the waist because doing so puts the nurse at risk for radiation exposure. During this treatment, the client should remain on strict bed rest, but the head of her bed may be raised to a 30- to 45-degree angle. The nurse should check the applicator's position every 4 hours to ensure that it remains in the proper place. A client who wishes to preserve childbearing asks the nurse to explain how taking oral contraceptives will work in the management of endometriosis. Which is the best response by the nurse?

Which of the following is an expected outcome for a client 24 hours after an abdominal hysterectomy?

The client will perform leg exercises hourly. -During the first 24 hours after an abdominal hysterectomy, the client is at risk for development of thrombophlebitis because of potential interference with pelvic and leg circulation. Leg exercises are essential to promote circulation and prevent a thrombus. Bowel sounds may not be heard immediately after surgery. It may take up to 48 hours for peristalsis to return. Perineal pads are used after a vaginal hysterectomy, not an abdominal hysterectomy. In the early phases of recovery, the client will be more likely to focus on expressing feelings of discomfort rather than a positive body image.

A nurse is reviewing a client's medical history. Which factor indicates the client is at risk for candidiasis?

Use of corticosteroids -A small quantity of the fungus Candida albicans commonly exists in the vagina. Because corticosteroids decrease host defense, they increase the risk of candidiasis. Candidiasis is rare before menarche and after menopause. Using hormonal contraceptives, not spermicidal jelly, and pregnancy, not nulliparity, increase the risk of candidiasis.

A 34-year-old client has been diagnosed with endometriosis. What topic should the nurse emphasize during health education?

The importance of reporting a possible pregnancy as soon as it occurs

A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client?

This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually. -Women with condylomata acuminata are at risk for cancer of the cervix and vulva. Yearly Pap smears are very important for early detection. Because condylomata acuminata is a virus, there is no permanent cure. Because condylomata acuminata can occur on the vulva, a condom won't protect sexual partners. HPV can be transmitted to other parts of the body, such as the mouth, oropharynx, and larynx.

A patient diagnosed with endometriosis asks for an explanation of the disease. What should the nurse explain to the patient?

Tissue from the lining of the uterus has implanted in areas outside the uterus.

A 24-year-old client births a healthy female infant. This client was given diethylstilbestrol (DES) during her pregnancy. It is important that the nurse stresses frequent gynecologic examinations of the client's daughter when she reaches a certain age because of which concern?

To prevent the onset of vaginal carcinoma in the client's daughter

Which drug is the usual treatment for vulvar dystrophy?

Topical corticosteroids -Topical corticosteroids are the usual treatment for vulvar dystrophy. Antibiotics, antifungals, and progestins are not usual treatment for vulvar dystrophy.

A patient has been diagnosed with a vaginal infection and received a prescription for metronidazole (Flagyl). The nurse knows that this is the recommended treatment for a vaginal infection caused by what organism?

Trichomonas vaginalis -The most effective treatment for trichomoniasis is metronidazole or tinidazole (Tindamax). Both partners receive a one-time loading dose or a smaller dose three times a day for 1 week (CDC, 2010a).

When a female client reports a frothy, yellow-green vaginal discharge, the nurse suspects the client has a vaginal infection caused by which organism?

Trichomonas vaginalis -Trichomonas vaginalis causes a frothy yellow-white or yellow-green vaginal discharge. Candidiasis causes a white, cheese-like discharge clinging to the vaginal epithelium. Gardnerella vaginalis causes a gray-white to yellow-white discharge clinging to the external vulva and vaginal walls. Chlamydia causes a profuse purulent discharge.

Which is the primary assessment finding in identifying the possible cause of repeated episodes of vaginitis in a female client?

Type 2 diabetes mellitus -Unregulated blood sugars can result in alteration of the vaginal environment and promote the presence of glycogen in vaginal mucus, which supports the growth of microorganisms. Monitoring and controlling blood sugars would be key in a client with diabetes. A diet high in sugars or artificial sweeteners can promote vulvovaginal candidiasis, but a high-protein diet is not a risk factor. Tub baths are not associated with vaginitis. An increase in sexual activity, sex with multiple partners, and certain use of sex toys can be risk factors for vaginitis, but ongoing frequent sex with one partner is not.

Which of the following would be most important to determine when assessing a client being admitted for suspected toxic shock syndrome (TSS)?

Use of superabsorbent tampons -TSS is commonly associated with the use of superabsorbent tampons that are not changed frequently and internal contraceptives that remain in place longer than necessary. Assessing the use of oral contraceptives, psychological trauma, or menorrhagia is not required for diagnosing the cause of TSS.

The nurse is interviewing a postmenopausal client during an annual gynecologic exam. Which assessment finding presents the greatest concern in the care of this client?

Vaginal bleeding -Vaginal bleeding in a client after menopause is abnormal and a predominant symptom for vaginal cancers. The incidence of vaginal cancer is higher among woman infected with HPV and those who use a pessary but neglect to remove and clean it. Urinary stress incontinence is not a significant concern.

While obtaining the history, the nurse learns the client's mother was treated with diethylstilbestrol (DES) during her pregnancy. The nurse determines that this client is at risk for which of the following?

Vaginal cancer

Which term describes an opening between the bladder and the vagina?

Vesicovaginal fistula -A vesicovaginal fistula may occur because of tissue injury sustained during surgery, vaginal birth, or a disease process. A cystocele is a downward displacement of the bladder toward the vaginal orifice. A rectocele is a bulging of the rectum into the vagina. A rectovaginal fistula is an opening between the rectum and the vagina.

A nurse who works in a gynecologist's office frequently cares for patients who are diagnosed with vulvovaginal candidiasis. The nurse should teach the patients how to manage and treat the most common symptom of:

Vulvar pruritus.

A client with HIV has recently completed a 7-day regimen of antibiotics. She reports vaginal itching and irritation. In addition, the client has a white, cheese-like vaginal discharge. Which condition is the client most likely experiencing?

Vulvovaginal candidiasis

A patient is receiving chemotherapy with paclitaxel as treatment for ovarian cancer. The patient arrives at the facility for laboratory testing prior to her next dose of chemotherapy. The results are as follows: Hemoglobin: 12.9 gm/dLWhite blood cell count: 2,200 /cu mmPlatelets: 250,000 /cu mmRed blood cell count: 4,400,00/cu mm Which result would be a cause for concern?

White blood cell count -The patient's white blood cell count is low, revealing leukopenia and placing the patient at an increased risk for infection. The other results are within normal parameters and would not be a cause for concern.

A client who had intracavity radiation treatment for cervical cancer 1 month earlier reports small amounts of vaginal bleeding. This finding most likely represents:

an expected effect of the radiation therapy. -After intracavity radiation, some vaginal bleeding occurs for 1 to 3 months. Intermittent, painless vaginal bleeding is a classic symptom of cervical cancer, but given the client's history, bleeding in more likely a result of the radiation. The passage of feces through the vagina, not vaginal bleeding, is a sign of rectovaginal fistula. Vaginal infections are indicated by various types of vaginal discharge, not vaginal bleeding.

Retroversion

backward turn of the whole uterus; also called tipped uterus

Which is the earliest and the most common symptom of endometrial cancer?

bleeding

rectocele

hernia of the rectum into the vagina

Cytocele

hernia of the urinary bladder

A client is experiencing symptoms associated with menopause. What is a likely recommendation to increase the client's interest in sexual activity?

low-dose androgens

Which abnormality is not considered a structural abnormality?

pelvic inflammatory disease -Pelvic inflammatory disease is an infection of the pelvic organs other than the uterus. These include the ovaries, fallopian tubes, pelvic vascular system, and pelvic supporting structures. Endometriosis is a condition in which tissue with a cellular structure and function resembling that of the endometrium is found outside the uterus. The atypical locations for endometrial tissue include the ovaries, the pelvic cavity, and occasionally the abdominal cavity. A fistula is an unnatural opening between two structures. The opening may be between a ureter and the vagina, between the bladder and the vagina, or between the rectum and the vagina. The term prolapse indicates a structural protrusion. Women experience any number of problems of this nature in the vagina. They include cystocele, rectocele, enterocele, and uterine prolapse.

enterocele

pouching sac of peritoneum between the vagina and the rectum

During the health history, a client informs the nurse that the client's mother was prescribed DES early in her pregnancy for the client. The nurse must stress the need for frequent gynecological examinations for this client in order to:

prevent the onset of cervical cancer.

A patient had a pessary inserted for long-term treatment of a prolapsed uterus. As part of a teaching plan, the nurse would advise the patient to:

see her gynecologist to remove and clean the pessary at regular intervals. -A pessary should be removed, examined, and cleaned by a health care provider at prescribed intervals. At this time, the vaginal wall should be examined for pressure points or signs of irritation.

uterine prolapse

the condition in which the uterus slides from its normal position in the pelvic cavity and sags into the vagina