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68WM6 Phs2 test 8

68WM6 Phase 2 test 8 Reproductive System

What is the main cause of Toxic Shock Syndrome? Acute bacterial infection, Menstruating, tampon use, Staph. Aureus
Flu-like s/s, High fever onset between 2-4 days of menses, N/V/D, myalgia, Hypotension, Hyperemia, Septic shock are all s/s of what? Toxic Shock Syndrome
Red macular palmar, decreased urine, increased BUN, pulmonary edema are signs of what? Toxic Shock Syndrome
What are 4 tests/methods to diagnose Toxic shock syndrome? Vaginal smear, BUN, ALT, AST, CPK - all elevated. Leukocytosis, thrombocytopenia
What kind of medications / tx regimes would you expect a pt with toxic shock syndrome to be on? IV Antibiotics, Ananlgesics, IV Fluid, Antimetics, O2, Adrenergic drugs. Monitor lab values
What would a pt tell you to make you believe they understand the pt teaching you just went over with them? Avoid superabsorbent tampons, alternate tampons with pads-change q4hr, handwashing, seek medical attn if fever presents during menses cycle, insert tampon carefully
What organisms can cause vaginitis? E. coli, T. vaginalis, Candida albicans, Gardnerella bacillus, staphy. & strept.
What are some common causes of vaginitis and what disorder is common in pts with vaginitis? Stress, malnutrition, aging, intercourse - Diabetes
Glucose in the urine, change in viginal pH/flora, hormone change, BCP use, systemic antibiotics, compromised immunity are all factors of what? Vaginitis
Leukorrhea, menstrual irregularities, dyspareunia, and backaches are all s/s of what? Cervicitis
s/s of vaginitis yellow, white, or grayish-white exudate, perineal pruritis, burning, edema, dysuria, and painful intercourse
What are three ways to diagnose viginitis? Visual exam, culture, bimanual exam
What would you expect the Dr to order for a pt with vaginitis? vaginal suppositories, ointments, creams and douching is frequently prescribed
What are 4 nursing interventions for a pt with vaginitis? abstinence, condom use, proper handwashing before and after med application, perineal irrigation, sitz bath, tx sexual partner
What is one of the most common disease r/t the female reproductive system? Cervicitis
What are two usual causes of cervicitis? vaginal infections/STD, lacerations r/t childbirth/abortions
Tx is much like vaginitis. What would you expect? Suppositories, ointments, and creams, proper handwashing, sitz baths
Malodorous purulent discharge, backache, pelvic pain, abd pain, fever, chills, malaise, N/V are all s/s of what? Pelvic Inflammatory Disease (PID)
what would be used to diagnose PID? Gram's stains of secretions, C&S, laparoscopy, ultrasound, leukocyte count, ESR
an acute, subacute, or recurrent, or chronic infection of the cervix, ovaries, fallopian tubes, or uterus that has extended to the connective tissues lying between the broad ligaments is what? Pelvic Inflammatory Disease
In relation to PID where does the infection enter the pelvic organs through? vagina, peritoneum, lymph glands, blood stream
S/S of PID include what? malodorous purulent discharge, backache, pelvic pain, severe abd pain, fever, chills, malaise, and N/V
what kind of tx regime would you expect the Dr to order for a pt with PID? systemic antibiotics, sitz baths, and no douching or sex
what are some nursing interventions for PID? monitor VS, avoid dehydration, pt support, palliative measures, discharge planning
Give 4 examples of antifungal agents: butoconazole, miconazol nitrate, nystatin, terconazol, topical amphotericin B
what are 3 contraindications of antifungals? hypersensitivity, liver failure, and kidney failure
what are 3 side effects of antifungals: rash, urticaria, pruritus
what are some things that a pt would tell you that would indicate they understand the teaching and instructions you have given them about antifungals? they understand how to use the medication, they know to take the full course of meds even if feeling better, they will report any skin irritation or lack of response to tx.
A young woman in her mid to late 20's presents with menstrual irregularities, pain during defecation, rectal bleeding, severe abd pain, and she thinks her period will start in about a weeks, what do think her diagnosis will be? Endometriosis
How does endometrial tissue usually appear in various places in the pelvic cavity? lymphatic circulation, menstrual backflow, and congenital displacement of endometrial cells.
The Dr orders oral contraceptives, gonadotropin-releasing hormone agonist, a synthetic androgen, and mentions the chance of surgery, what would the pt have requiring these treatments? Endometriosis
As the nurse what kind of tx could you perform on a pt with endometriosis? mild analgesics, teach bed rest, warm sitz bath, and warm compresses
Discharge teaching can start at the beginning of a pt's stay, what would you teach a pt with endometriosis? methods to reduce discomfort, regular gyn checkups, side effects of meds.
what is a GYN Fistula? an abnormal opening between two internal organs or between an internal hollow organ and the exterior of the body.
what are three types of GYN fistulas? 1. Urethrovagina 2. Vesicovaginal 3. Rectovaginal 3. Rectovaginal
what are some s/s of a GYN fistual? Urine, feces, or flaus in the vagina. infected external genitalia and vaginal wall
What are some ways to diagnose GYN Fistulas? Physical exam, methylene blue test, IVP, Indigo carmine test, cystoscopy
What kind of tx would you expect for pt with relaxed pelvic muscles? Vaginal hysterectomy, insertion of a pessary, estrogen therapy, marshall-marchetti
What are some things a pt would tell you making you feel they have a good understanding of relaxed pelvic muscles? do perineal exercises, avoid prolonged standing/heavy lifting, Low-fowler's position, and proper follow-up
What are some s/s of a pt with uterine displacement? backache, dysmenorrhea, infertility, luekorrheal discharge, tire easliy, muscles strain
What are two ways to tx a uterine displacement? insert a pessary, and surgical correction.
what are the 4 types of hysterectomys? abd, vaginal, salpingectomy, oophorectomy.
what are some of the reasons Estrogen would be used during tx? management of atrophic vaginitis, decrease risk of endometrial carcinoma in pts with an intact uterus, inoperable metastatic breast and prostate cancer, uterine bleeding r/t hormone imbalance
what are some contraindication for giving Estrogen? thromboembolic diseases, vaginal bleeding, liver dysfunction, pregnancy, lactation, hx of breast cancer
what are some side effects of Estrogen? headaches, MI, THROMBOEMBOLISM, edema, N, amenorrhea, dysmenorrhea, oily skin, gynecomastia(men), and breast tenderness
what are some advantages of pregestin over progesterone? greater potency, longer duration, effective in oral or sublingual dose.
in the category progetins, name some of the medroxyprogesterone: curretab, cyerin, depo-provera, depo-Sub Q Provera 104, Provera
Name 3 of the progesterone drugs: crinone, Endometrin, Prochieve, Prometrium
what is the main use of medroxyprogersterone? decrease endometrial hyperplasia in postmenopausal women receiving concurrent estrogen, tx secondary amenorrhea and abnormal uterine bleeding r/t hormone imbalance, tx advanced endometrial/renal carcinoma.
medroxyprogersterone has many effects on the body, name as many as you can.... secretory changes in endometrium, increase in basal body temp, changes in vaginal epithelium, relaxation of uterine smooth muscles, mammary alveolar tissue growth, pituitary inhibition, withdrawal bleeding
what are some of the contraindications of medroxyprogesterone? pregnancy, missed abortion, thromboembolic disease, cerebrovascular disease, severe liver disease, breast or genital cancer, porphyria
What are some side effects of medroxyprogesterone? Depression, PULMONARY EMBOLISM, thromboembolism, thrombophlebitis, ANGIOEDEMA, ALLERGIC REACTIONS-ANAPHYLAXIS
what is Megace/megestrol used for? palliative tx of endometrial and breast carcinoma, tx weight loss, anorexia, or cachexia r/t AIDS
What are the side effects of megace? carpal tunnel syndrome, alopecia, THROMBOEMBOLISMS, edema
One of the uses of this drug is a part of assisted reproductive technology in management of fertility and supports the inplantation of embryo and early pregnancy Progesterone
Some of the precautions related to the use of Progesterone are? Liver disease, renal disease, cardiovascular disease, seizures, and mental depression
side effects of progesterone include? PULMONARY EMBOLISM, THROMBOEMBOLISM, hepatitis, depression, ANGIOEDEMA, ANAPHYLAXIS
A couple highlighted uses of this hormone include palliative use for pts with prostate cancer, advanced breast cancer: GnRH - Gonadotropin-releasing Hormones
Examples of this hormone include goserelin (Zoladex), leuprolide(Depot, Viadur), and nararelin(Synarel-NASALLY) GnRH
What are some of the side effects of GnRH? Cerebovascular accident, MI, Pulmonary Edema, GI Bleeding, hot flashes
What are some nursing implications that should be done while tx a pt taking hormones? Assess BP, Assess for pain/swelling in legs, monitor liver function, may cause LDL decrease, triglyceride increase, shake hard before giving, administer DEEP IM,
What are some pt teaching r/t hormones? sudden discontinuatino my cause bleeding, stop taking if you think you're pregnant, smoking may increase side effects, report signs of swelling in feet or ankles, abnormal pain, depression, s/s of liver dysfunction, vaginal bleeding
More pt teaching r/t hormones: Breast, pelvic, abd exams, pap smear every 6-12 months, mammogram q 12 months
resolution of meupausal vasomotor symptoms, decreased vaginal itching / inflammation / dryness, control the spread of advanced breast cancer, and prevent osteoporosis is the goal of what? Estrogen
Regulate menstrual cycle, control the spread of endometrial/renal caner, and decrease endometrial hyperplasia in postmenopausal women are goals of what? Progestins
Reducing s/s of breast cancer, endometriosis, thinning of endometrium an improvement in preop hematologic parameters in pt with anemia are goals of: GnRH
what is fibrocystic breast condition? condition involving benign tumors of the breasts that usually occurs in women 30-50 y/o
What are some signs of abnormalities in the breast? changes in skin texture, discharge from nipple, atypical fullness/puckering, retraction of nipple
At what age does annual mammogram screening begin? 40
If you were going to teach your pt when the best time to do a BSE, what would you tell her? Mensturating women: 3-8 days after end of mensus, Post menopausal: first day of the month or a special day they can remember
What is the most common benign breast lesion? Fibrocystic Breast Disease
What are some s/s of Fibrocystic Breast Disease? diffuse tender cysts, usually occur bilaterally, mobile lumps, premenstrual pain or breast tenderness
What would you tell your pt to help with Fibrocystic breast disease? wear a padded/good supportive bra, analgesics/diuretics, dietary measures, hormonal contraceptives
Solid benign mass of connective tissue & glandular tissue: Fibroadenoma
What are some characteristics of Fibroadenoma? grows during pregnancy, shrinks after menopause, grows slowly- usually single nodule, not r/t menstrual cycle or considered pre-cancerous
What are some causes of acute mastitis? bacterial infection, occurs mostly during lactation, caused by poor hygiene or infant infection, tender/inflammed breasts obstructing milk flow. PT Teaching: use warm packs, well fitting bra, ABX helpful
what are indications of chronic mastitis? obese women, multiparous, difficulty nursing, inverted/cracked nipples, trauma to breasts, increased fibrosis of tissue
tansports sperm Vas Deferens
tightly coiled tube that emerges from top of each testis, decends along its posterior surface and leads into vas deferens Epididymis
produces 60% of volume of semen, and its alkaline fluid consists of fructose and other nutrients for sperm cells Seminal vesicle
secretes thin, milky, alkaline fluid which neutralizes semen, adds to sperm motility prostate gland
Cowper's Gland/Bulbourethral Glands secretes mucus/fluid that partly lubricates end of penis in preparation for intercourse
Sperm need to develope in a region that is ___-____ degrees cooler than the body temp 2-3
At puberty, they release progesterone and produce female sex hormone estrogen. This also releases mature egg cell during mentrual cycle. Ovaries
what are the three layers of the Uterus? Endometrium, myometrium, perimetrium
What are some of the things you may have to do/consider with a pt with phimosis? manage a circumcision, dressing change, manage bleeding, assess urine flow, teach proper hygiene
Describe what the pt is experiencing while dealing with hydrocele: enlarged scrotum, pain, fluid between the membrane covering the testicle & membrane enclosing the testicle.
when the veins of the scrotum become dialated, obstructed, and malfuntion causing low fertility is what? Varicocele
What are nursing interventions for a pt with vercoele? best rest, scrotal support, ice on incision site, medication for discomfort prn
this is caused from anything from a simple leg crossing to severe exercise, severe pain results from the spermatic cord kinking an artery? Testicular torsion
What would you do to help a pt with testicular torsion? POST-op, apply scrotal support, inspect dressings for drainage, admin antibiotics. DO NOT elevate pre-op.
At what age do we need to teach males to begin testicular self exams? 15
What male hormone is responsible for growth and development of male sex organs, hair distribution, vocal cord thickening, growth of prostate, testicles, and penis? Androgen
What are contraindications of Androgen? Pregnancy, lactation, breast/prostate cancer, liver/renal/cardiac disease, products that contail benzyl alcohol
Side effects of Androgen: male baldness, deepening of voice, confusion, depression, bitter taste, gingivitis, gum edema, ED,
What should you watch for in men taking Androgen? difficulty urinating r/t enlarged prostate, breast enlargement, persistent erections, increased urge to urinate
What should you assess for in women taking Androgen? virilism, unusual hair growth/loss, clitoral enlargement, acne, menstrual irregularities
What would you expect to see in lab results of a pt taking Androgen? Increase serum, ALT, AST, & bilirubin, choesterol levels, and suppressed clotting factors II, V, VII, X
What do you want to teach the pt to watch for that is taking Androgen? priaprism, dysuria, gynecomastia, edema, hepatits, unusual bleeding
what is the use and action of phosphodiesterase type 5 inhibitors? erectile dysfunction, pulmonary hypertension / smooth muscle relaxtion of corpus cavernosum-promotes increased blood flow and erection
What are 3 ED agents? sildenafil(Viagra), tadalafil(Cialis), vardenafil(Levitra)
What are some side effects of phosphodiesterase type 5 inhibitors? MI, sudden death, cardivascular collapse, abnormal vision, priprism, flushing, dizziness, headache
What types of medications should be cautiously used with phosphodiesterase type 5 inhibitors? anti-hypertensives, glipizide, substantial alcohol intake. (nitratesin, rifampin, alpha-blockers)
What kind of pt teaching would you do r/t phosphodiesterase type 5 inhibitors? Take 1 hour prior to sexual activity, DO NOT allow women to take, caution w/nitrates, not effective against STD's, see Dr. if erection lasts longer than 4 hours or if vision complications arise.
What is the medical management for a pt with prostatitis? antibiotics, periodic digital massage, sitz bath, analgesics
sudden severe pain, scrotal edema & tenderness, pus in urine, chills and fever, "duck walk" & "waddling gain" are clinical manifestations of what? Epididymitis
What would the nurse do for a pt with Epididymitis? support testicular area, encourage bed rest, ice compresses, pt education
What are some ways to medically manage Genital Herpes? Lidocaine, Acyclovir(Zovirax), Valacyclovir(Valtrex), Famciclovir(Famvir), and the lesions may heal spontaneously
How can you get Syphilis? Sexual contact, contact with infectious lesions, sharing of needles, prenatal infection. Caused by spirochete: Treponema pallidum
What are the four stages of Syphilis? Primary, Secondary, Latent, Tertiary
What are some noteable factors in each stage of syphilis. Primary-Approx 21 days after infection=small lesion Secondary-Rash on palms and feet. Latent-Symptoms disappear for many years Tertiary-Affects major organs 3-15 yrs after initial infection if untx.
Name 2 medications for Gonorrhea Ceftriaxone(Rocephin), Cefixime(Suprax)
What is the medical management for Trichomoniasis? Metronidazole (Flagyl)
Although this STD (Condyloma) can't be cured, some of the treatments you'll find are Podophyllin, surgical removal, and freezing them. Venereal Warts
Pts with DM are at risk for what? It is caused by Candida Tropicalis, and candida albicans Candidiasis
What are some medical interventions you would expect to be ordered for a pt with Candidiasis? Control DM, discontinue antibiotics/oral BCP's, Nystatin(Mycostatin)
This asymptomatic infection can cause several other infections such as: Cervisitis, Urethritis, Epididymitis, Sappingitis, PID, and (conjunctivitis/pneumonia in newborns) Chlamydia
What medications could you expect to see in a pt with Chlamydia? Tetracycline, Doxycycline(Vibramycin), Ofloxacin(Floxin), Axithromycin(Zithromax) and Erythromycin during pregnancy
What primary drug is used to treat Gonorrhea? Rocephin
What is the primary anti-infective used to treat Syphilis? Penicillin
What are the two most common STD's caused by chlamydia? Cervicitis and Urethritis
Which STD can result in sterility; genital herpes, Syphilis, or Gonorrhea? Gonorrhea
In which STD during nursing interventions mights a pt's urine turn dark orange or brown? Trichomoniasis
What are is one thing a pt taking Flagyl should NOT do? Consume alcohol-causes disorientation, headache, cramps, vomiting, and possible convulsions.
There are several things to teach your pt concerning STD's, name 5: number of partners, avoid contact, hygiene, mouthwash/gargle, barrier contraceptives, water-based lubricants, void after sex, avoid excess douching, seek tx, examinations
What are 4 uses of contraceptives? prevent pregnancy, regulate menstural cycle, emergency contraception(some, not all), tx of premenstrual dysphoric disorder(Yasmin, tx acne in women 14 y/o or older
what is the 2nd leading method of contraception? female sterilization
Post-op teaching for female sterilization includes? rest for 24 hours, no heavy lifting, mild analgesics, no sex for 1 week, watch for these s/s:fever, fainting, severe pain, bleeding from incision
What post-op teaching would you do for a male after sterilization? rest 48 hrs, ice to area, scrotal support x 2 days, mild analgesics, no strenuous activity x 1 wk, watch for these s/s: fever, severe pain, bleeding at site, swelling more than twice normal size, painful nodule
This contraceptive is expected to be approved by FDA soon and includes a 4 cm rod that is implanted and releases a hormone for 3 years that inhibits ovulation and thickens cervical mucus? Single-Rod Progestin implant
What contraceptive prevents ovulation for 12 weeks but can cause spotting, menstrual irregularities, and amenorrhea after 1 yr of use? Depo-Provera - Hormone injection
What are some side effects of Depo-Provera? weight gain(4lbs p/ys), headaches, nervousness, decreased libido, breast discomfort, depression
When could a pt on Depo-provera expect to be fertile after stopping? 10-18 months
This method contraceptive causes thickening of cervical mucus preventing sperm from entering upper genital tract and blocks luteinizing hormone resulting in inhibiting maturation of follicle and ovulation, also usually taken for 21 days with 7 "off" Oral contraceptives
This pill only contains progestin, and is taken daily with no hormone free days. although they may be less effective women that can't take estrogen are good canidates due to lack of side effects related to estrogen. Mini-pills
What are some side effects of oral contraceptiveS? nausea, breast tenderness, weight gain/loss, fluid retention, amenorrhea, melasma
Where do you place a transdermal contraceptive patch? dry skin; abd, upper torso, buttocks, upper outer arm
These side effects are most common to what type of contraceptive: headache, nausea, vaginitis, expulsion, vaginal discharge/discomfort Vaginal ring
Emergency contraceptives contain a high dose of what? Progestin
What is the time frame for most Emergency contraceptives? 72-120 hrs
Types of this contraceptive method include the Copper T 380a(ParaGard) and LNGIUS or Mirena Intrauterine Device
What is the most effective contraceptive method? Mirena-more effective than any other contraceptive method including sterilization
Side effects of IUD's? Cramping and bleeding upon insertion, perforation of uterus at time of insertion, expulsion
What do you teach pts with an IUD? check for "tail" weekly during first 4 weeks of use, after menses, and signs of expulsion
Side effects of and IUD: unusual vaginal pain, discharge, itching, low pelvic pain, fever, signs of preganancy
What type of contraceptive is fitted by a health care provider and should be checked size yearly, after weight gain/loss of >10 lbs, after each preg or abortion? Diaphram
What female contraceptive offers protection against STD'S? Female condom
What type of contraceptive is fitted by a health care provider and should be checked size yearly, after weight gain/loss of >10 lbs, after each preg or abortion? Diaphram
What female contraceptive offers protection against STD'S? Female condom
this contraceptive is placed in the vagina temporarily, left in place for about 6 hours after sex, and is pulled out slowly to ensure absorption of all semen. Sponge
This contraceptive is used by putting spermicide on both sides, inserted into vagina against cervix, can be left in place for up to 48 hrs with repeated use of spermicide. This does not have a loop to assist in removal. Size based on previous pregnancy. Cervical cap
This contraceptive is a silicone device with a central valve and loop for easy removal. Lea's Shield
What are the least reliable methods of contraception? Breastfeeding, coitus interruptus
What are some side effects of contraceptives? migrain headaches, depression, cerebral hemorrhage/thrombosis, coronary thrombosis, PE, edema, abd cramps, bloating, melasma, hyperglycemia, weight change, amenorrhea, dysmenorrhea
What are some nursing interventions r/t IM contraceptives? Shake well, Deep into gluteal or deltoid, rotate sites, >14 wks-make sure not pregnant, cancer pt-once weekly then monthly
PT teaching r/t contraceptives includes: 1st 3 weeks of oral contraceptives may require secondary method, sudden discontinuation could cause bleeding, smoking increases risk for side effects-especially women >35 y/o.
Pt teaching: report what signs and symptoms r/t contraceptives? blurry vision, fluid retention(ankles, feet, weight gain), depression, hepatic dysfuntion(yellow skin/eyes, dark urine, light-colored stools), hx of breast cancer-monitor s/s
What are some desired outcomes of using Estrogens? prevent osteoporosis, control spread of metastatic breast cancer, decreased vaginal itching/inflammtion/dryness r/t menopause, resolve menopausal vasomotor symptoms.
What are some desired outcomes of using Androgens? decreased s/s of endometriosis, relief of pain/tenderness in fibrocystic breast disease.
What are some desired outcome of using GnRH? decreased s/s of advanced breast cancer and endometriosis, thinning of endometrium before endometrial ablation for dysfunctional uterine bleeding, improve hematologic parameters in pt w/anemia r/t uterine fibroids
what are some causes of cervical cancer? Herpes, HPV, genital warts(condyloma), sex at early age w/many partners
s/s of cervical cancer? postcoital bleeding, leukorrhea, pressure on bladder/bowel, spotting between periods, pain radiating to lower extremities
what is the most common malignancy? endometrial cancer
what is the most common sign/symptom of endometrial cancer? bleeding. Others-pain(late), watery malodorous vaginal discharge, fever, bowel/bladder dysfunction(late)
the most common cause of GYN death in US? Ovarian cancer
These are used to diagnose Ovarian cancer? Ultrasound, CT Scan, laparotomy, CA 125 increase
What are risk factors for breast cancer? age over 50, family hx, genetics, chronic alcohol use, ethnicity, nulliparity, having children after age 35
s/s of brest cancer reddened or dark skin, puckering/dempling of tissue(orange peel), nipple discharge, axillary tenderness, lump in breast
What is the single most important prognosticator r/t breast cancer? Positive/negative axillary lymph node involvement
What is the age range affected by breast cancer? 15-54
At what age should a CBE and mammogram be done yearly? after age 40
Positron Emission Tomography and Genetic Markers BRCA1 & BRCA2 are used to diagnose what? Breast cancer
What is used to CONFIRM breast cancer? Biopsy
Stage 1 breast cancer <2 cm, no regional or distant spread
stage 2 breast cancer >2cm <5cm with or w/o moveable axillary nodes but no metastasis
stage 3 breast cancer up to 5cm with regional spread or >5cm w/o regional spread or metastasis
stage 4 breast cancer tumor of any size, w/ or w/o regional spread but distant metastasis
s/s of testicular cancer enlarged scrotum, firm, painless, smooth mass and pt may complain of feeling of heaviness
at what age should males begin TSE's? AGE 15
what three factors are r/t cancer of the penis? uncircumcised, poor hygiene, hx of STD's
what age group of men are most likely to develope testicular cancer? 25-35
nursing interventions r/t cancer of the penis include: emotional support, monitor urine output, elevate scrotum, comfort measures
Created by: jrstrader