Unit 4 exam - Reproductive

Menopause symptoms

*HAVOCS* *H*ot flashes *A*trophy of the *V*agina *O*steoporosis *C*oronary artery disease *S*leep disturbances

Endometrial cancer risk factors

- Age: over 40 - Early menarche/ late menopause - Infertility (pg is protective) - Personal history of ovarian or breast cancer - Family hx of endometrial or breast cancer - Obesity/ high fat diet - Taking tamoxifen

Postmenopause symptoms

- Cardiovascular disease - Osteoporosis - Alzheimer's like dementia - Colon cancer

ovarian cancer risk factors

-Age over 40 or postmenopausal -Nulliparous (never given birth) -Northern American or Northern European descent -Personal history of breast, colon, or endometrial cancer -Obesity -Use of fertility drugs -Long-term use of hormone replacement therapy -Family history of ovarian cancer

Dysparenia associated conditions (4):

-vaginal spasms -lack of lubrication -genital lesions -abuse

HRT will help with 3 things what are they

1) vaginal dryness 2) hot flashes and sweats 3) osteoporosis

Two big concerns in post menopausal women

1. CAD 2. osteoporosis

Postmenopausal risks (3 items)

1. Depression 2. osteoporiesis 3. CAD

Questions to ask is menopause is approacing (3)

1. bleeding after intercourse 2. how long is your typical cycle 3. explain your cramps or pain felt during your cycle

What reduces endometrial cancer (3 items)

1. breastfeeding 2. multiple pregnancies 3. oral contraceptives

testicuar cancer sx (with lump in th escrotum)

1. feeling of heaviness 2. dull ache or heavy sensation in the lower abdomen, perianal, or the scrotal area 3. mass is nontender and firm NOT - bloating in the uooer abdomen, NO N&V

What happens when a tumor enlarges (2 items)?

1. frequent bleeding 2. heavy bleeding

Orchitis care plan

1. give pain meds 2. antibiotics 3. bed rest 4. scrotum elevated on an ice pack

Ovarian cancer symptoms (4 items)?

1. inc in abdomen girth 2. feeling full quickly 3. weight gain 4. menstrual changes

Cervical cancer symptoms (2 items)

1. leukorrhea - white discharge from the vigina 2. intermenstrual bleeding

Vulvar cancer symptoms (4 items)

1. vulvar bleeding 2. discharge 3. pain 4. burning

The nurse is explaining the clinical manifestations of breast cancer to a group of young women. Which characteristic is true for breast cancer? Select all that apply. A) Presence of nipple retraction B) Presence of peau d'orenge in the skin of the involved breast C) Presence of a lump in the lower outer quadrant of the breast D) Presence of a lump in the breast that is highly mobile and tender E) Presence of a lump that is irregular in shape and poorly delineated

A) Presence of nipple retraction B) Presence of peau d'orenge in the skin of the involved breast E) Presence of a lump that is irregular in shape and poorly delineated

Which manifestation would the nurse monitor for when providing immediate postoperative care for a patient who has undergone prostatectomy? A) Signs of infection B) Impaired physical immobility C) Problems with urinary control D) Reports of sexual dysfunction

A) Signs of infection. Infection possible because of closeness to anus Preoperative care: B) Impaired physical immobility C) Problems with urinary control D) Reports of sexual dysfunction

Which [reoperative care would the nurse perform for a patient who will be under going a TURP? Select all that apply. A) Treat any urinary infection with antibiotics B) Restore Urinary drainage and maintain fluid intake C) Inform the patient that surgery may affect sexual function D) Ensure the bladder irrigation is done before surgery E) Inform the patient that there will be no complication after surgery

A) Treat any urinary infection with antibiotics B) Restore Urinary drainage and maintain fluid intake C) Inform the patient that surgery may affect sexual function

Which symptom indicates to the nurse that a partial obstruction may be present in a patient with BPH? A) Urgency B) Nocturia C) Incontinence D) Difficulty starting to urinate

A) Urgency

Which sexual health information would the nurse provide a patient with breast cancer who chooses to undergo radical mastectomy and take hormone therapy? Select all that apply. A) Vaginal dryness may be present B) Mastectomy does decrease sexual satisfaction C) Hormone therapy may cause decreased sexual drive D) Sex should be avoided for a few months after surgery E) Lubrication may be used during sexual intercourse

A) Vaginal dryness may be present C) Hormone therapy may cause decreased sexual drive E) Lubrication may be used during sexual intercourse

Simethicone

Antiflatulent

Which treatment would the nurse anticipate incorporating into the plan of care for a patient with orchitis? Select all that apply. A) Exercising B) Analgesic medication C) Maintaining a usual routine D) Antibiotic treatment if organism is known E) Bed rest with scrotum elevated ice pack

B) Analgesic medication D) Antibiotic treatment if organism is known E) Bed rest with scrotum elevated ice pack

The nurse provides care for a 54-year old female patient who has had no menstrual periods for a year. The nurse identifies that the patient is at risk for which conditions? Select all that apply. A) Blood clots B) Depression C) Osteoporosis D) Bladder infections E) Endometrial cancer F) Coronary heart disease

B) Depression C) Osteoporosis F) Coronary heart disease

Which question assesses the cognitive-perceptual category of the functional health patterns in a patient with benign prostatic hyperplasia. Select all that apply. A) Do you experience nocturia B) Do you have bladder discomfort C) Do you experience urinary retention D) Do you have a sensation of incompetent voiding E) Do you experience anxiety about sexual dysfuntion

B) Do you have bladder discomfort D) Do you have a sensation of incompetent voiding

Which diagnostic test would the nurse prepare the patient for when the patient reports severe scrotal pain, nausea, and vomiting that began 1 hour ago? Select all that apply. A) Transillumination B) Doppler ultrasound C) Transrectal ultrasound D) Microscopic evaluation E) MRI

B) Doppler ultrasound

The nurse is educating a patient about the treatment of BPH that reduces the size of the prostrate and decreases prostate-specific antogen (PSA) levels. Which medication would the nurse discuss with the patient? A) Acetonide B) Finasteride C) Alpostadil D) Papverine

B) Finasteride

The nurse is performing an assessment on an older female patient. The nurse instructs the patient to contact her health care provider if she experiences which occurrence? A) Dysparenia B) Vaginal bleeding C) Skin becoming thinner D) Breasts becoming smaller

B) Vaginal bleeding

leiomyoma

Benign tumor of smooth muscle, such as that found in the heart, bladder, or uterus.Fibroids

Tamoxifen (Nolvadex)

Breast cancer medication Hormonal agent Stops growth of estrogen-dependent breast cancer cells Can cause endometrial cancer, hypercalcemia, N/V, PE, hot flushes, vaginal discharge or bleeding Increase Ca and vit D intake

A healthcare provider records the size of the tumor in a patient's breast to be 7 cm. The pathology reports two lymph nodes to be cancerous. Which stage of cancer is described? A) Stage 0 B) Stage 1 C) Stage 2 D) Stage 3

C) Stage 2

A patient who is postmenopausal seeks treatment at a clinic for unexpected vaginal bleeding. Which information does the nurse provide to the patient about diagnosing the cause of this bleeding? A) It's probably only the end of menopause B) You need a hysterectomy to treat this bleeding C) You will need a Papanicolaou (Pap) smear to see if you have endometrial cancer. D) You will need an endometrial biopsy to determine the cause of the bleeding.

D) You will need an endometrial biopsy to determine the cause of the bleeding.

perimenopause symptoms

Depression Headache Joint pain ↓ Libido Memory loss Poor concentration Sexual dysfunction Sleep problems Urinary frequency/urgency Vaginal dryness Vasomotor symptoms (e.g., hot flashes)

D&C

Dialation of the cervix and scraping of the endometrial tissue

Transrectal ultrasound & MRI

Dx of prostatic cancer

Microscopic evaluation

Dx prostatitis

Papaverine

Enhances blood flow into penis

Perimenopause symptoms

Hot flashes•Vaginal dryness•Sleep disorders•Headaches•Irritability•Anxiety or other variations in mood•Cognitive difficulties•Memory lapses•Joint aches •Decreased libido.

Acetonide

Increases testosterone levels

Postoperative TURP

Irrigate the urinary catheter is spasms of decreased urine flow is noted

Is a Pap test needed if a woman had a hystorectomy?

No

dermoid cyst

Ovarian cysts lined with a variety of cell types (hair, skin, teeth).

ovarian cancer symptoms

Swollen stomach (ascities), gas/bloating, long term stomach pain, indigestion, unusual vaginal bleeding, pelvic pressure. - feeling full

TURP preoperative care

Teaching about - restoring urinary drainage - prophylactic antibiotics - discussing ED concerns

Finasteride (Proscar)

Treatment of BPH - reduces size of prostrate and PSA levels

Bartholin's gland cyst

Vulva

cachexia

a condition of physical wasting away due to the loss of weight and muscle mass that occurs in patients with diseases such as advanced cancer or AIDS

Peau d'orange

a pitted or dimpled appearance of the skin, especially as characteristic of some cases of breast cancer or due to cellulite.

Endometrial cancer treatment

abdominal hysterectomy Radiation for higher grade (III and up) Advanced and recurrent: radiation

Amenorrhea

absence of menstruation

hydatidform mole

an abnormal mass in the uterus

Doppler ultrasound

assesses blood flow within the testicle

leiomyoma

benign tumor of smooth muscle fibroids typically shrink after menopause

Hot flash supplements (3)

black cohosh soy flexseed

Metrorrhagia

bleeding from the uterus at any time other than normal menstruation

endometrial cancer (also called uterine cancer)

cancerous tumor forms in lining of uterus abnormal uterine bleeding in postmenopausal women

Pap smear

detects for cervical cancer do not get it during menses Start at age 21 (-29) every three years 30-65 every three years or 5 years with HPV

menorrhagia

excessive menstrual bleeding

Kegals

exercises to do that will strengthen the pelvic muscles to help treat incontinence

orchitis

inflammation of the testes

laproscopic

involves minimally invasive techniques with small incisions using scopes and cameras.

Testicular torsion Sx

pain, nausea, and vomiting

dysmenorrhea

painful menstruation

Dysparenia/ vaginismus

painful sex/ spastic contractioms of muscles surronding vagina entrance making penetration almost impossible

perimenopausal

period before menopause where decreased estrogen levels cause decreased vaginal lubrication, mood swings, and a decrease in sex drive

Cone biopsy (conization)

surgical removal of a cone-shaped segment of the cervix for diagnosis or treatment None invasive - stage 0 The tissue is viewed through a speculum

salpingectomy

surgical removal of a fallopian tube

hysterectomy

surgical removal of the uterus

myomectomy

the surgical removal of uterine fibroids

menopause

the time of natural cessation of menstruation; also refers to the biological changes a woman experiences as her ability to reproduce declines

brachytherapy

the use of radioactive materials in contact with or implanted into the tissues to be treated

Cryotherapy

therapeutic use of cold

Postmenopause

time beginning 12 months after the last menstrual cycle

LEEP (loop electrosurgical excision procedure)

uses a thin electric loop to excise a cone of cervical tissue Not invasive Stage 0

HRT can problems:

vascular thrombosis acute liver disease some types of uterine cancer Smoking increases risk of clots breast cancer, heart attack, stroke, and blood clots

Cystocele and Rectocele

weak vaginal wall allows protrusion of bladder or bowel as a bulge into vagina

cachexia

weakness and wasting of the body due to severe chronic illness

Candidiasis

yeast infection

A female patient tells the nurse, "I feel full quickly, gained weight, and have menstrual changes." The nurse assesses an increase in abdominal girth from the patient's previous visit and makes which inference from these findings? A) Vulvar cancer B) Cervical cancer C) Ovarian cancer D) Endomtrial cancer

C) Ovarian cancer

The nurse suspects that the tumor of a patient with cervical cancer has enlarged, resulting in heavy bleeding. Which other late-stage symptom does the nurse expect in this patient? Select all that apply A) Anemia B) Cachexia C) Weight loss D) Constipation E) Increased abdominal girth

A) Anemia B) Cachexia C) Weight loss When the tumor enlarges, it results in frequent and heavy bleeding. Late stage symptoms of cervical cancer include anemia, cachexia, and weight loss due to heavy bleeding. Heavy bleeding is a late complication of radiation therapy. Abdominal girth is a late symptom of ovarian cancer.

Which finding would the lead nurse to suspect cancer when a patient presents with a lump in the scrotum? Select all that apply. A) Feeling of heaviness B) aching in the lower abdomen C) Bloating in the upper abdomen D) Feeling of nausea and vomiting E) Nontender and firm scrotal mass

A) Feeling of heaviness B) aching in the lower abdomen E) Nontender and firm scrotal mass

A postmenopausal patient wishes to initiate hormone replacement therapy (HRT). The nurse discusses the risks and benefits associated with HRT and includes which information? Select all that apply. A) Increased risk for blood clots B) Increased risk for breast cancer C) Increased risk for endometrial cancer D) Decreased vaginal atrophy E) Decreased hot flashes F) Decreased vaginal atrophy F) Decreased joint pain

A) Increased risk for blood clots B) Increased risk for breast cancer C) Increased risk for endometrial cancer D) Decreased vaginal atrophy E) Decreased hot flashes F) Decreased vaginal atrophy

Which information would the nurse include in discharge teaching for a patient who underwent an axillary lymph node dissection? Select all that apply. A) Mangement od drains B) Upper limb exercises C) Deep-breathing exercise D) Self-monitoring of vital signs E) Self-administration of chemotherapy

A) Mangement od drains B) Upper limb exercises C) Deep-breathing exercises

A nurse is explaining the sentinel lymph node dissection for diagnosis of cancer to a patient suspected of having breast cancer. Select all that apply. A) It involves dissecting all of the axillary lymph nodes for testing B) It helps the surgeon identify the lymph nodes that drain first from the tumor site C) It involves injecting the radioisotope into the affected breast and intraoperatively identifying the sentinel node. D) It confirms that axillary lymph node dissection is more accurate than the sentinel lymph node dissection E) It ensures that if the sentinel node dissection is negative, then no further axillary surgery is required

B) It helps the surgeon identify the lymph nodes that drain first from the tumor site C) It involves injecting the radioisotope into the affected breast and intraoperatively identifying the sentinel node. E) It ensures that if the sentinel node dissection is negative, then no further axillary surgery is required

Which statement by the nurse best explains the advantage of radiation therapy to a patient with breast cancer who is hesitant to undergo radiation? Select all that apply. A) It helps to prevent the development of lymphedema B) It helps to relieve pain caused by local or distant recurrence C) It helps to prevent local and nodal recurrences after mastectomy D) It helps prevent local breast cancer recurrences after a breast-conserving surgery E) It ensures that there are no rashes or other skin changes associated with this surgery

B) It helps to relieve pain caused by local or distant recurrence C) It helps to prevent local and nodal recurrences after mastectomy D) It helps prevent local breast cancer recurrences after a breast-conserving surgery

While teaching a community group about women's health, which guidelines would the nurse include? A) Mammograms are necessary if you have a family history of breast cancer B) It is recommended that you undergo regular screening mammography starting at age 45 C) If you are not able to perform breast self-examination (BSE), you should go for regular mammograms D) If you are average-risk women and your healthcare provider performs a clinical breast examination annually, then you will not need a mammogram

B) It is recommended that you undergo regular screening mammography starting at age 45

Which response will the nurse make when a patient with fibrocystic breast changes asks, will these cysts turn into cancer? A) Yes, it is likely one or more of your cysts will become cancerous over time B) No, there is no risk of breast cancer at all. Usually, the cysts come and go C) Cysts do not turn into cancer. Call your healthcare provider if you develop new cysts that do not respond in a cyclic manner as usual D) Call your healthcare provider if you find that any of the cysts are sore around the time of menstruation, as this can mean a sign of breast cancer

B) No, there is no risk of breast cancer at all. Usually, the cysts come and go

The nurse is educating a patient regarding the risk factors for endometrial cancer and includes what information? A) Use of hormone replacement therapy is a risk factor for endometrial cancer B) Oral contraceptive use is a risk factor for endometrial cancer C) Multiple pregnancies places a woman at risk for endometrial cancer D0 Breastfeeding is a risk factor for the development of endometrial cancer

B) Oral contraceptive use is a risk factor for endometrial cancer

A female patient who is perimenopausal asks the nurse, "How can I decrease hot flashes and sweating that I experience at night? I don't want to take hormone therapy because of its risks." Which is the best response by the nurse? A) Maintain a consistent amount of bedding year-round to avoid fluctuations in temperature. B) Consider taking black cohosh, which has been found to be effective in treating hot flashes. C) Decrease heat production with a cool environment and increase circulation in the room. D) Restrict the intake of calcium to reduce restlessness that occurs with the hot flashes.

C) Decrease heat production with a cool environment and increase circulation in the room. limit caffeine and alcohol practice relaxation techniques

A patient with uterine fibroids causing heavy menstrual bleeding (HMB) informs the nurse that she wants to become pregnant. The nurse anticipates that the treatment plan will include which procedure? A) Cryotherapy B) Hysterectomy C) Myomectomy D) Microwave energy

C) Myomectomy

Which information does the nurse include when providing an educational program to a group of young women about the importance of Papanicolaou (Pap) testing for cervical cancer? A) Regular Pap testing can prevent cervical cancer B) A Pap test should be conducted in women who have had a total hysterectomy C) Regular Pap testing should begin at the age the woman becomes sexually active D) A Pap test should be conducted every 3 years in women aged 21 to 29 years

D) A Pap test should be conducted every 3 years in women aged 21 to 29 years

Which nursing intervention would the nurse include in the plan of care for a patient diagnosed with BPH following a transurethral resection of the prostrate (TURP)? A) Restoring urinary drainage B) Administering prescribed prophylactic antibiotics C) Discussing concerns related to erectile dysfuntion D) Irrigating the catheter manually if bladder spasms occur

D) Irrigating the catheter manually if bladder spasms occur