Ch 53

Question 1

Group of physical and emotional symptoms that occur in some women 7 to 10 days before menstruation

Answer 1

Premenstrual syndrome(PMS)
Or it’s more severe form premenstrual dysphoric disorder (PMDD)

Question 2

Diagnosis of PMS is based on data from an ___ in which the client keeps daily recordings of her symptoms for at least ___ months. The classic finding is that the client is symptom free during the period between the onset of menstruation and ovulation

Answer 2

Menstrual diary
2 months

Question 3

To supplement medical treatment, the nurse encourages the client to make healthful lifestyle changes, such as the following: SATA (3)

Answer 3

Reducing or eliminating caffeine
Eliminating alcohol & smoking
Exercising aerobically 30 minutes most days of the week

Question 4

Painful menstruation

Answer 4

Dysmenorrhea

Question 5

Dysmenorrhea is treated with ___ and by treating the underlying cause if one is identified

Answer 5

Mild nonnarcotic analgesics

Question 6

Knee to chest position to relieve discomfort

Answer 6

In dysmenorrhea

Question 7

The absence of menstrual flow

Answer 7

Amenorrhea

Question 8

Is infrequent menses

Answer 8

Oligomenorrhea

Question 9

Treatment of amenorrhea and oligomenorrhea

Answer 9

Focuses on the correction of the underlying cause

Question 10

A condition characterized by a cluster of signs and symptoms that include amenorrhea and oligomenorrhea

Answer 10

PCOS

Question 11

What age does polycystic ovarian syndrome affect

Answer 11

Women between 20 and 40

Question 12

Women with PCOS tend to have problems including: SATA (5)

Answer 12

Interference with menstruation and ovulation
Weight gain
Excessive growth of body hair,acne, thinning hair or baldness
Abnormal lipid levels
Hypertension

Question 13

PCOS is associated with multiple endocrine abnormalities such as overproduction and inefficient use of ___ and high __ levels

Answer 13

Insulin
Testosterone

Question 14

Excessive bleeding at the time of normal menstruation. It may be quantified as a menstrual flow that lasts more than 7 days

Answer 14

Menorrhagia

Question 15

Symptomatic relief is accomplished in Menorrhagia with __,___, and ___

Answer 15

NSAIDs
Progestins
Contraceptives with combinations of estrogen and progestin

Question 16

Detachments of the lining of the uterus

Answer 16

Endometrial ablation

Question 17

Vaginal bleeding at the time other than menstrual period (unexpected and irregular)

Answer 17

Metrorrhagia

Question 18

Post menopausal period begins __ after __

Answer 18

1 year after menstruation ceases

Question 19

This period refers to the time during which ovarian activity gradually ceases

Answer 19

The climacteric or perimenopausal period

Question 20

The cessation of the menstrual cycle (“change of life”)

Answer 20

Menopause

Question 21

Menopause normally occurs as a natural physiologic process between __ &__ yrs of age

Answer 21

45 & 55

Question 22

__ menopause that occurs when the ovaries are removed can occur at any age

Answer 22

Surgical

Question 23

Menopause occurs when ___ function diminishes

Answer 23

Ovarian

Question 24

In menopause __ and __ are reduced, ovulation gradually ceases, menstruation becomes irregular until it stops, and natural reproductive capacity ends

Answer 24

Estrogen & progesterone

Question 25

__ and menopause share many of the same symptoms, indicating the need for further evaluation to determine if a mood disorder is present

Answer 25

Depression

Question 26

During the perimenopausal period (the transitional period surrounding menopause) the women may experience vasomotor disturbances such as: These common symptoms often are the ones for which women seek treatment

Answer 26

Hot flashes accompanied by sweating, sleep disturbances, irritability or depression, vaginal dryness, diminished libido, dyspareunia (pain during sex)

Question 27

Medical management for menopause

Answer 27

HRT; made for each pt on an individual basis HRT or ERT is prescribed in the lowest appropriate does for the shortest time necessary.

Question 28

It is believed that estrogen in small doses can help prevent __ and relieve menopausal symptoms such as __ ___ and __. The risks of endometrial or breast cancer & seriousness of future MI and stroke may outweigh the potential benefit of preventing hip fractures and kyphosis that are secondary to osteoporosis

Answer 28

Osteoporosis Hot flashes, night sweats, vaginal dryness

Question 29

Menopause = may need antidepressants

Answer 29

..

Question 30

FDA approved prescription substances made from soy and yams, are indistinguishable and similarly effective as those from naturally occurring estrogen and progesterone

Answer 30

Bioidentical hormones

Question 31

Nursing management with menopause: the nurse give the following suggestions:

Answer 31

Discuss with prescriber the benefits, risks and alternatives for HRT or ERT Contact the provider if breakthrough bleeding or other symptoms occur while taking hormonal replacements

Question 32

A condition in which the vagina is inflamed

Answer 32

Vaginitis

Question 33

Most common cause of vaginitis (chemical or mechanical)

Answer 33

Feminine hygiene products, allergic reactions, age related tissue changes (atrophic vaginitis with menopause) INFECTIONS

Question 34

Assessment finding with vaginitis

Answer 34

Abnormal vaginal discharge

Question 35

Although the vagina is self protected by mucus secreting cells and an acidic environment (pH of __ to __) the tissue still may become disrupted

Answer 35

3.4-4.5

Question 36

__ women, those with __, and those who take __ have an excess of glycogen in vaginal mucus, which supports the growth of microorganisms

Answer 36

Pregnant Unregulated diabetes Hormonal contraceptives containing estrogen

Question 37

Curdy white discharge (cottage cheese) Thick consistency Strong odor

Answer 37

Candida albicans

Question 38

Candida albicans Color of discharge: Consistency: Odor:

Answer 38

Curdy white (cottage cheese) Thick Strong

Question 39

Yellow white discharge Foamy consistency Foul odor

Answer 39

Trichomonas vaginalis

Question 40

Trichimonas vaginalis Color of discharge: Consistency: Odor:

Answer 40

Yellow white Foamy Foul

Question 41

Grayish white discharge Watery consistency Fishy odor

Answer 41

Gardenerella vaginalis

Question 42

Gardnerella vaginalis Color of discharge: Consistency: Odor:

Answer 42

Grayish white Watery Fishy

Question 43

Nursing management for vaginitis

Answer 43

Nurse may insert first vaginal med while teaching pt how to repeat (at bedtime) Avoid routine douching Lactobacillus acidophilus in capsule form or yogurt with active cultures of lactobacilli to replenish normal vaginal microorganisms Sitz baths to relieve itching, burning or swelling of vulva and perineum, Skin protectants containing zinc oxide to promote healing

Question 44

Inflammation of the cervix

Answer 44

Cervicitis

Question 45

In cervicitis the infection can travel upward through uterine and tubal structures leading to ___

Answer 45

Pelvic inflammatory disease (PID)

Question 46

In cervicitis inflammation and subsequent formation of scar tissue increase the potential for __ or ___

Answer 46

Ectopic pregnancy Difficulty conceiving

Question 47

Chronic cervicitis decreases the amount and quality of__ and alters __, both of which are underlying causes of infertility

Answer 47

Cervical mucus pH

Question 48

An infection of the pelvic organs other than the uterus, including the ovaries (oophoritis), fallopian tubes (salpingitis), pelvic vascular system, and pelvic supporting sutures

Answer 48

Pelvic inflammatory disease (PID)

Question 49

Most common pathogens related to PID

Answer 49

Gonicocci Chlamydia trachomatis

Question 50

In PID the infection can travel up to the uterus to the fallopian tubes (salpingitis) and ovaries (oophoritis) and can result in a __ or __ as pus from the infected tube leaks into the abdomen

Answer 50

Pelvic abscess Peritonitis

Question 51

A ruptured pelvic abscess requires __

Answer 51

Emergency surgery

Question 52

A type of septic shock, it is life threatening systemic reaction to the toxin produced by several kinds of bacteria

Answer 52

Toxic shock syndrome (TSS)

Question 53

PID = contact precautions

Answer 53

..