NR142 Exam 2 female/male reproductive system
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| 1. Identify labs to monitor for menorrhagia | CBC incl H/H hct; iron & protein (albumin) levels, Electrolytes
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| 2. Identify nursing assessments related to hormone therapy replacement | Assess for osteoporosis, heart disease, stroke. Diet/nutrition incl calcium supplementation. Weight bearing exercises to keep calcium in bones.
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| 3. Identify nursing evaluations related to hormone therapy replacement | Hot flashes, osteoporosis, colorectal cancer. bleeding whn taking HT for 25days consecutively.used for shortest amt of time bc the risk of compl inc the longer a woman is on it. Evaluate bone density, diet, exercise, stress levels and weight gain
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| 4. Identify potential complications related to hormone therapy replacement | Pulmonary embolism, Osteoporosis, Heart disease, stroke, mood fluctuations. Contraindicated in hx of breast cancer, thrombus, liver function or uterine cancer
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| 5. Identify nursing interventions for the client post sexual assault | Priority – assess for injury. Call SANE nurse. Reassure that she is not alone,that was not her fault, assure confidential (is part of her med record),tell her about shelters, hotline phone numbers. DO not be judgmental if she goes back to the abuser
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| 6. Describe the process of ovulation | ovum becomes graafian follicle;ovum discharged into peritoneal area.Travels to fallopian tube. graafian foll becomes yellow corpus luteum & makes progesterone to prepares uterus for receiving egg. FSH stimulates ovaries to release estrogen (female sex or
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| 7. Identify nursing assessments related to Pelvic Inflammatory Disease (PID) | Assess for age at 1st intercourse, multiple sex partners, hx of std, previous pelvic infections. Physical assessment includes lower abd pain, purulent cervical/vaginal drainage, spotting after intercourse
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| 8. Identify nursing interventions related to Pelvic Inflammatory Disease (PID) | Antibiotics, corticosteroids, no sex for 3 weeks, treat partner, bed rest semi-fowlers position, oral fluids, sitz baths, and heat to lower abd
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| 9. Identify nursing education for the client with Pelvic Inflammatory Disease (PID) | Use precautions when having sex (prevent others infected & reinfection), reinfection symptoms incl abd pain, n/v, fever, malodorous purulent vaginal discharge, leukocytosis; explain how pelvic infections occur, how to avoid, S/S
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| 10. Identify nursing education for the client with polycystic ovarian syndrome | Oral contraceptives to suppress ovarian activity; lifestyle modification such as weight mgmt critical.d/t obesity, insulin resistance or impaired glucose tolerance, dyslipidemia, sleep apnea, infertility.
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| 11. Identify nursing interventions related to internal radiation implants | pt: Strict bed rest,private room,Foley cath, low residue diet, hygiene, monitor for dislodgement, side effects,emotional support,isolation. staff: time-distance shielding, no pregnant/under 18 visitors/nurses, do not touch device falls out;
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| 12. Identify risk factors for endometrial cancer | #1 cause is obesity d/t estrogen stored in adipose tissue; age >55 years (median 61 yrs), unopposed estrogen therapy (not used w/progesterone), nulliparity, truncal obesity, late menopause (>52), tamoxifen use
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| 13. Identify risk factors for cervical cancer | Sexual activity, mult sex partners, early age 1st coitus, HPV exposure, chronic cervical inf, obesity, sex w/uncircumcised men, early childbearing, HIV, Family Hx, smoking, low socioeconomic status, nutritional deficiencies (folate, beta carotene, vit C)
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| 14. Identify nursing assessments for a client post-hysterectomy | Monitor for complications such as urinary retention (bladder dysfunction), intestinal distention, thrombus, hemorrhage, shock, infection, bladder atony
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| 15. Identify nursing interventions for a client post-hysterectomy | Promote sleep/rest, psych & emotional support,pain mgmt, mgmt. menopausal sympt,catheter for voiding,improving body image, provide guidelines to activity, apply antiembolism stockings, change pt position frequently &exercise feet/legs, assist to ambulate
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| 16. Identify nursing education related to prolapsed uterus | Kegel exercises to strengthen muscles pre-op laxative/enema.post–hygeine, prevent constipation, avoid lifting/standing for prolonged periods, report pelvic pain, unusual discharge, inability to perform hygiene, vaginal bleeding, effects on sexual function
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| 17. Identify risk factors for Benign Prostatic Hyperplasia (BPH) | Elevated estrogen; smoking, heavy alcohol consumption, obesity, reduced activity level, hypertension, heart disease, diabetes, western diet (high animal fat, protein, refined carbs, low fiber)
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| 18. Identify nursing assessments related to Benign Prostatic Hyperplasia (BPH) | Urinary pattern, freq, nocturia, bladder neck obstruction symptoms, hesitancy, intermittency, reduced force & size of urinary stream, sense of incomplete bladder emptying, post void dribbling, hematuria, Labs: PSA, BUN, creat
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| 19. Identify nursing interventions for the client with Benign Prostatic Hyperplasia (BPH) | Catheterization if patient is unable to void, give BPH drugs (alpha-blocking agents, 5-ARI, alpha blockers, estrogens and androgens, antimuscarinic agent), relieve pain, Monitor and record the patient’s vital signs, intake, output, and daily weight
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| 20. Identify nursing education related to Benign Prostatic Hyperplasia (BPH) | Have bathroom available, encourage fluids but limit at bedtime d/t nocturia (bed-wetting), may be important to wear something like depends to prevent leakage, provide emotional support. What dietary measures would we need to educate our patients about
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| 21. Describe the purpose of the prostate-specific antigen (PSA) | Detects prostate cancer if increased levels found > 4.0 ng/ml. Used as a baseline to monitor effectiveness of treatment. If it spikes means cancer has spread
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| 22. Identify purpose of continuous bladder irrigation after TURP | Keep urethra & catheter open and free from blood clots to prevent obstruction from blood clots
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| 23. Identify potential complications of continuous bladder irrigations following TURP | Obstruction – first stop flow, check for kinks in catheter then manually flush, Atonic bladder – large dilated bladder that doesn’t empty which causes nerve damage; TURP syndrome – hyponatremia d/t irrigation – LOC changes, n/v
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| 24. Identify nursing assessments following prostatectomy | F/E balance (no signs and symptoms of fluid retention), participates in self-care (increases activity/ambulation, avoids straining/lifting),No compl (VS, wound healing ,level of urine output, drainage of catheter, understands changes in sexual function).
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| 25. Identify education measures related to prostatitis | stimulate ejaculation to get infection out, refrain from sex, opioids, sitz baths, alpha blockers, take full course of antibiotics, encourage fluids but not too much as to affect drug levels, no diuretic foods such as coffee, tea, chocolate, cola, spices.
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| 26. Identify education measures following a vasectomy | Client will not notice difference in ejaculate, use alternative form of contraception for at least 6 weeks, does not affect production of hormones, ability to ejaculate, or physiologic mechanisms of erection or orgasm
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| 27. Identify nursing assessments related to erectile dysfunction (ED) | Medical, social, sexual history, complete physical exam, duplex Doppler ultrasonography, cardiovascular, endocrine (diabetes), testosterone level, hematologic, trauma, alcohol, BB meds, most common cause is vascular
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| 28. Identify nursing interventions for the client with erectile dysfunction (ED) | Drug therapy- no alcohol b4 sex, side effects HA, facial flushing, stuffy nose, don’t take w/nitrates; vacuum devices, vasodilating drugs, prosthesis. sense of isolation, self esteem, confidentiality, include both partners in discussions
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| 29. Identify nursing assessments related to priapism | problems urinating Usually neural or vascular. caused by thrombosis of corpora cavernosa, leukemia, sickle cell, DM, malignancies, abnormal reflex, drug effects (ED drugs), recreational drugs (cocaine), prolonged sexual activity. difficulty urinating
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| 30. Identify nursing assessments related to ectopic pregnancy | Sonography/HCG level, health history incl menstrual pattern, colicky pain to shoulders, pelvic/abd pain, some bleeding, GI . w/rupture agonizing pain, dizziness, faintness, n/v d/t peritoneal blood, air hunger, shock and signs of hemorrhage. Monitor VS.!
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| 31. Identify nursing interventions related to ectopic pregnancy | Grief process – support/listen, partner should participate, counseling referral ; mgmt of complications- continuous/freq monitoring of VS., LOC, amount of bleeding, I&O, lab values, bed rest. Complications r/t hemorrhage d/t rupture
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| 32. Identify causes of infertility in females | Female → ovulatory dysfunction, high prolactin levels, inflammation of fallopian tube, chlamydia, endometriosis, excessive exercise, starvation, polycystic ovary syndrome (PCOS), early menopause, uterine fibroids, pelvic adhesions
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| Identify causes of infertility in females | abnormal sperm production(from infections, genetics, or undescended testicles), cystic fibrosis, premature ejaculation, poor nutrition, obesity, alcohol, tobacco or drugs, freq exposure to heat (lowers sperm count), radiation and chemo treatments, age >40
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| 33. Identify risk factors for testicular cancer | Most common in ages 15-34, male with undescended testicles (cryptochidism), family hx, race/ethnicity (Caucasian), HIV, occupational hazards ie chemicals encountered in mining, oil/gas production, leather processing
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| 34. Identify nursing education related to orchiectomy | option of prosthesis. Some have decr hormone levels after removal. no sex 2-4 weeks after,no lifting heavy/straining,educate on s/s of infection. Increase fluids after surgery & high fiber diet to avoid constipation. follow up to monitor tx & reoccurrence
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| 35. Identify nursing assessments related to toxic shock syndrome (TSS) | Sudden onset, high temp (>102), HA, sore throat, vomiting, diarrhea, generalized rash, hypotension, Rash on palms and soles of hands/feet, confusion, muscle aches, redness of eyes/mouth/throat and headaches.
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| 36. Identify interventions related to Orchitis | Bed rest with scrotal elevation, application of ice, admin of analgesics and antibiotics. Treat partner if bacterial, mumps vaccine, nsaids or antiinflammatories
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| 37. Identify education measures related to Paraphismosis | Manual reduction by firmly compressing glans back while moving foreskin forward; incise constricting skin ring. Advise client that circumcision is indicated after inflammation/edema subside
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| 38. Endometriosis | implants outside,can move to lung/brain); drugs (incl nsaids, oral contracep,cAM, surgery, paiinful menses, incr risk for ovarian cancer & infertility. support sexual function, infertility. Educate to get help if dysmenorrheal/dyspareunia & manage pain
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