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female repro ms

female reproductive system for med surg

QuestionAnswer
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