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female repro ms
female reproductive system for med surg
| Question | Answer |
|---|---|
| How is an endometrial aspiration performed? | flexible cannula inserted into uterus to wash out cells |
| How is an endometrial biopsy performed? | uterine sound dilates cervix, curette scrapes tissue for sample |
| What kind of anesthesia is used for D&C? | light or general |
| What can a D&C be done for? | dx and tx of many gyn prob, abnl bleeding, removal of fetal tissue after miscarriage |
| How is a laparoscopy done? | small incision below umbilicus, carbon dioxide into peritoneum, examine pelvic organs, treat pelvic conditions |
| What anesthesia is used for culdoscopy? | local or general |
| How is a culdoscopy done? | per vagina, incision made into posterior vaginal wall |
| What kind of procedure is a colposcopy? | office procedure |
| How is a colposcopy done? | speculum into vagina, colposcope w/light & magnifying lens, cervical bx &pap can be done, some vag tx can be done |
| How is a hysterosalpingogram done? | bowel prep to remove gas/feces, cannula inserted into cervix, contrast injected, films taken |
| What can a hystersalpingogram dx? | adhesions, fallopian tube patency, other structural abnormalities |
| What does an ultrsound use to work? | sound waves |
| What can an ultrasound visualize? | tumors, cysts, pregnancy structures |
| Why should a patient have a full bladder for an ultrasound? | separates uterus from other pelvic structures |
| The breast is how many lobes surrounded by fatty tissue? | 15-20 |
| What are the subdivisions of the lobes in the breast called? | lobules |
| What is the darker area bordering the nipple called? | areola |
| What are the hormones that control lactation? | prolactin, progesterone |
| What determines the size of breasts? | fatty tissue |
| How often should breast self exams be done? | monthly |
| How often should a clinical breast exam be done? | yearly by a HCP |
| What should be looked for during a breast exam? | palpate for masses, dimpling, flattening, rashes, ulceration, discharge |
| What do mammograms detect? | cysts and tumors |
| What are the two types of mammograms? | screening and diagnostic |
| When should mammograms be done? | every 1-2 years beginning at age 40 |
| What is the patient ed for having a mammogram? | avoid using deodorant on the day of the test, comparison to previous umages is essential |
| When is a breast ultrasound done? | closely evaluates lesions, useful for dense breast tissue |
| What does a breast biopsy do? | determine if a lesion is malignant |
| What is an incisional breast biopsy? | performed in OR, frozen quickly for exam by pathologist (frozen section), possibly will proceed w/procedure that will offer best chance of cure |
| What is an excisional biopsy? | removal of entire legion, examined by pathologist later, pt discharged and treatments discussed later |
| What is an aspiration biopsy? | out pt procedure sometimes w/mammogram or ultrasound guidance, local anesthetic, pathologist examines |
| Nursing care r/t breast biopsy | listen to concerns re cancer dx, minimal post procedure discomfort, alert physician to drainage/bleeding/fever/pain, wear supportive bra, keep f/u apt |
| What is the nurse's role in all reproductive disorders? | assessment of client, assist w/exams, assist w/relief measures, provide perioperative care, evaluate client progress, instruct on self-care including sexual functions |
| What causes PMS? | excess estrogen, hypothalmic-pituitary dysregulation |
| What are symptoms of PMS? | weight gain, headache, pain, irritability |
| What are the treatments for PMS? | healthful lifestyle changes, hormonal therapy |
| PMS causes what kind of symptoms? | physical and emotional |
| What are they symptoms of dysmenorrhea? | low abd pain and cramping |
| What are the treatments of dysmenorrhea? | non-narcotic analgesics, applications of heat, knee-chest position, adequate rest and diet |
| What is amenorrhea? | absence of menstrual flow |
| What is primary amenorrhea? | never had menstruation |
| What is secondary amenorrhea? | caused by something (pregnancy is main reason) |
| What is oligomenorrhea? | infrequent menses |
| What causes oligomenorrhea? | endocrine imbalances, stress, poor nutrition, associated conditions (polycystic ovarian syndrome, prematuire ovarian failure) |
| What is menorrhagia? | menstruation longer than 7 days |
| What causes menorrhagia? | endocrine and coagulation disorders |
| How can menorrhagia be managed? | NSAIDS, estrogen and progesterone, endometrial ablations |
| What is metorrhagia? | unexpexted and irregular bleeding |
| What causes metorrhagia? | pituitary or ovarian stimulation, uterie malignances and cervical irritation, breakthrough bleeding with HRT |
| What is the cessation of the menstrual cycle called? | menopause |
| What are the two types of menopause? | physiologic and surgical |
| What are the two periods of menopause? | climacteric and postmenopausal |
| What is the pathophysiology and etiology of menopause? | diminishing ovarian function, reduction in hormones, hypothalmic-pituitary stimulation |
| What are the assessment findings of menopause? | menstrual irregularites, vasomotor disturbances (hot flashes) |
| What is the medical management of menopause? | HRT, antidepressants, biophosphonates, symptomatic relief measures |
| What is the nursing management of menopause? | coping strategies, symptomatic relief measures, routine gynecologic and breast examinations |
| What is vaginitis? | vaginal inflammation |
| What can cause vaginitis? | chemical or mechanical irritants, pathogenic microorganisms, predisposing factors |
| What are the symptoms of vaginitis? | abn vaginal discharge, itching, burning, redness |
| What is the medical management of vaginitis? | anti-infective agents, treatment of sexual partner, sumptomatic relief measures |
| What is the nursing management for vaginits? | vaginal suppositories, sitz bath, douching (not usually done but medicated may be prescribed), prevention of recurrence and follow up |
| What is cervicitis? | inflammation of the cervix |
| What can cause cervicitis? | trauma of gynecologic procedures |
| What can chronic cervicitis lead to? | infertility |
| Assessment findings for cervicitis | hx of spotting or unusual bleeding, hyspareunia, unhealthy vaginial discharge, examination of cervix and vaginal smears |
| What is the medical management of cervicitis? | antiobiotics, douching, electrocautery, conization |
| What are the postelectrocautery instructions for cervicitis? | rest, no straining or heavy lifting, abstinence from sexual relations |
| What is pelvic inflammatory disease? | infection of pelvic organs except uterus |
| How is pelvic inflammatory disease contracted? | microorganisms entering through the cervix |
| Assessment findings for pelvic inflammatory disease | malodorous vaginal discharge, severe abd and pel pain, fever, menorrghagia, dysmenorrhea, dx by MRI, CT or US |
| Medical management of pelvic inflammatory disease | hospitalization, rest, symptomatic relief measures, emergency surgery for pelvic abscess |
| PID nursing diagnosis at risk for: | infection, spread of infection, impaired skin integrity, self-care and self-esteem, pain related to inflammation |
| Expected outcomes for PID | measures to detect, manage, and prevent infection/control of pain and enhancement of client comfort/perineal skin care |
| What should be monitored in patients with PID? | vital signs and leukocyte count |
| Toxic shock syndrome is what type of shock? | septic |
| How is TSS contracted? | unhygienic use of tampons, chemicals produced by bacteria |
| What is the medical management of TSS? | maintenance of body fluids, adrenergics, aerobic metabolism at the cellular level |
| What is the nursing management of TSS? | vital signs, cell count, renal functions, first does of antibiotics, perineal hygiene |
| What are the signs and symptoms of TSS? | fever and rash |
| What is endometriosis? | uterine lining tissue in other places which responds to hormones just as the uterus does. They fluff up and bleed which causes pain and scar tissue to build up |
| What can endometriosis cause? | adhesions and sterility |
| What are the assessment findings of endometriosis? | dysmenorrhea, chocolate cyst |
| What is the medical/surgical management of endometriosis? | removal of cysts, panhysterectomy |
| What is the nursing management of endometriosis? | diagnosis and relief measures, regular gynecologic checkups |
| What causes vaginal fistulas? | surgical injury, cancer therapy, congenital anomaly, ulcerative colitis |
| What is a vesicovaginal fistula? | opening between the bladder and vagina |
| What do you assess in a patient with a vaginal fistula? | vaginal drainage, meatus, vault |
| What should be promoted after surgery for a vaginal fistula? | sexual activity |
| What are the expected outcomes after repair of a vaginal fistual? | positive self-image, self-confidence, skin integrity |
| What is a cystocele? | prolapsed bladder |
| What is a rectocele? | front wall of the rectum bulging into the vagina |
| What causes pelvic organ prolapse? | weakness in muscles and fascia, urinary and bowel alterations |
| Signs and symptoms of pelvic organ prolapse | difficulty stanging for long or walking, with cystocele: uterovaginal prolapse |
| Medical and surgical managementof pelvic organ prolapse | pessary, kegel exercises, transvaginal repairs |
| Nursing management of pelvic organ prolapes | knee-chest postition, avoid heavy lifting, intermittent catheterization of difficulty voiding |
| What is retroverted uterus? | tipped backwards |
| What can retroversion of the uterus cause? | infertility |
| What are the assessment findings with retroverted uterus? | backache, dysmenorrhea, dyspareunia |
| Medical and surgical management of uterine retroversion | pessary, knee-chest pisition |
| Nursing management of retroverted uterus | uterine relocation |
| What is a uterine leiomyoma? | benign but uncomfortable uterine fibroid |
| Assessment findings for uterine leiomyoma | menorrhagia, dysmenorrhea, anemia |
| Medical and surgical management for uterine leiomyoma | D&C, myomectomy, hysterectomy |
| What are risk factors for cervical/endometrial cancer? | age, hx of diethylstilbestrol (DES), sexual activity |
| Medical and surgical management of cervical/endometrial cancer | surgery, hysterectomy, chemotherapy |
| Nursing management of cervical/endometrial cancer | heavy liftying, sexual activity, exercise, douching, peroperative/postoperative care, client and family teaching |
| Assessment findings for ovarian cysts and benign tumors | menstrual irregilarities, low abd discomfort, backache |
| How are ovarian cysts and benign tumors diagnosed? | pelvic exam, US, laparoscopy |
| Nursing management of ovarian cysts/benign tumors | pain relief measures gynecologic exams |
| Who is at increased risk for ovarian cancer? | hereditary, nulliparous women |
| Assessment findings for ovarian cancer | abd discomfort, urinary frequency |
| Medical/surgical management of ovarian cancer | oopherectomy, panhysterectomy |
| Nursing management of ovarian cancer | emotional support, pre/post op care |
| Who is at risk for cancer of the vagina? | older women, HPV infection, DES |
| What are they assessment findings for vaginal cancer? | abn vag bleeding, dyspareunia, vag canal examination, biopsy |
| Medical and surgical management of vaginal cancer | laser photovaporization treatments, total vaginectomy, radiotherapy |
| Nursing management of vaginal cancer | emotional support, physical comfort |
| Who has a high incidence of getting cancer of the vulva? | HPV and herpes |
| Assessment findings for cancer of the vulva | pruritis and genital burning, white raised patches on labia, bloody discharge, enlarged lymph nodes |
| Medical and surgical management of cancer of the vulva | vulvectomy, laser photovaporization |
| Nursing assessment of the patient undergoing surgery for cancer of the vulva | pain, skin integrity, Homans sign |
| Diagnosis planning and interventions for the patient undergoing surgery for cancer of the vulva | biopsy, surgery, self-care activities |
| Client education for tumors of the female reproductive system | maintain skin integrity and self esteem, promote sexual intimacy |
| Evaluation of expected outcomes for patients with tumors of the female reproductive system include | wound healing, reduction of dependent edema, sitz bath, stool softeners |
| What can large doses of vitamin B6 for dysmenorrhea cause? | sensory neuropathy |
| What food may help alleviate menopausal symptoms? | soy products |
| What foods can aggravate PMS symptoms? | salt and caffeine |
| What are possible issues with estrogen therapy? | diuretics, side effects, thromboembolism, risk of osteoporosis and renal calculi |
| What can androgen therapy do? | recalcification of bone |
| What happens with androgen therapy initially? | increased bone pain |
| What does alendronate do? | prevents bone resorption |
| What causes mastitis? | plugged lactiferous ducts, staphylococcus aureus |
| What are the assessment findings for mastitis? | fever, malaise, breast tenderness, pain, redness and hardness, crack in nipple or areola, enlarged axillary lymph nodes, culture and sensitivity test |
| Medical management of mastitis | antibiotics, analgesics, heat application, if lactating breasts are emptied using a breast pump, systemic antibiotics |
| Nursing management of mastitis | obtain health history, prepare client for physical exam, collect breast milk specimen, client teaching |
| What does the client teaching for mastitis include? | self-administering antibiotics, principles of medical asepsis, breast feeding techniques and alternatives |
| What is a complication of mastitis? | breast abscess |
| Assessment findings of breast abscess | signs and symptoms of mastitis, pus may drain from nipple, phys exam, culture and sensitivity test |
| medical and surgical management of breast abscess | hospitalization, contact isolation, IV antibiotics, incision and drainage of abscess |
| Nursing management of breast abscess | remove and reapply dressings, use aseptic technique, emotional support, prmote comfort, application of tight fitting bra |
| How can the nurse promote comfort with a breast abscess? | binder, zinc oxide, arm and shoulder support, axillary hair, breast milk removal |
| What causes fibrocystic breast disease? | hormonal changes during menstrual cycle, aggravated by caffeine and nicotine |
| Signs and symptoms of fibrocystic breast disease | tender, painful breasts;multiple lumps in breast tissue; influence of menstrual cycle |
| Diagnostic findings of fibrocystic breast disease | physical and cytologic exam, incisional biopsy, mammogram, ultrasound |
| Medical and surgical management of fibrocystic breast disease | analgesicas, oral contraceptives, cyst removal, mastectomy |
| Nursing management of fibrocystic breast disease | health hx, diagnostic tests prep and support, client teaching |
| What client teaching would you do for fibrocystic breast disease? | BSE, medication use, physical examination, diet, activity, breast care |
| What influences fibroadenoma? | hormones |
| What kind of nodule is it when a patient has fibroadenoma? | single nodule, no change with menstrual cycle |
| Assessment findings for fibroadenoma | painless and nontender lump, encapsulated mobile and firm lesion, ultrasound, excisional biopsy |
| Fibroadenoma medical and surgical management | observation, excision or tumor removal |
| Nursing management for fibroadenoma | provide emotional support, client teaching |
| What are the risk factors for breast cancer? | female, >50 years old, family history |
| What is breast cancer? | mass of abnormal cells |
| Signs and symptoms of breast cancer | painless mass in breast, bloody discharge from nipple, dimpling of skin, nipple retraction, asymmetrical breast size orange peel skin |
| What drug is used for breast cancer? | tamoxifen |
| Surgical management of breast cancer | lumpectomy, partial mastectomy, segmental mastectomy, mastectomy, sentinel node mapping, lymphedema |
| When is radiation therapy used in breast cancer? | before/after surgery, prophylactically |
| Side effects of radiation | fatigue, skin redness, rash, minor discomfort, pain |
| Nursing management of breast cancer | emotional support, pre/post op care |
| What client teaching would you give for breast cancer? | complications:lymphedema, self care measures, chemotherapy side effects, wound care, exercise, prosthesis care |
| Where can breast cancer spread to? | pulmonary systems, brain, liver, skeletal |
| Medical management of metastatic breast cancer | palliative treatment, intramuscular androgen therapy, radiation therapy |
| What drugs are used as chemoprevention for breast cancer? | tamoxifen, raloxifene |
| What is refashioning of the area of a mastectomy called? | breast reconstruction |
| What is breast size reduction called? | reduction mammoplasty |
| What does opposite breast reduction do? | correct asymmetry, reduce healthy breast to resemble size of a reconstructed breast |
| What is a breast lift called? | mastopexy |
| What does mastopexy correct? | ptosis/drooping |
| Nurse's role in breast augmentation | pre/post op care: semi-fowler's position, pain management/client teaching |
Created by:
angepu
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