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NU 330 > Chapter 19 > Flashcards

Chapter 19 Flashcards

1
Q

3 main types of hysterectomy

A
  • partial
  • total
  • radical

(4th is hysterectomy with bilateral salpingo-oophorectomy)

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2
Q

radical hysterectomy

A

removal of
- uterus
- cervix
- fallopian tubes
- ovaries
- upper portion of the vagina
- lymph nodes

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3
Q

partial hysterectomy

A

removal of
- uterus

*cervix left in place

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4
Q

total hysterectomy

A

removal of
- uterus
- cervix

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5
Q

hysterectomy post op care

A
  • monitor:
    -VS
    -blood loss
    -LOC
    -lung sounds
  • use anti-embolism stockings
  • pain relief and assist w/ ambulation (standing)
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6
Q

polycystic ovary syndrome (PCOS)

A

cysts on the ovaries
- endocrine disorder
- genetic component

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7
Q

women with polycystic ovary syndrome (PCOS) are at risk for:

A
  • Type 2 DM
  • cardiovascular disease
  • HTN
  • cancer
  • hyperlipidemia
  • pregnancy/birth complications
  • sleep apnea
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8
Q

cystocele

A
  • anterior prolapse
  • wall btwn vagina and bladder weakens (prolapsed bladder)
  • bulging mass in the anterior wall of the vagina
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9
Q

rectocele

A
  • posterior prolapse
  • wall btwn vagina and rectum weakens (prolapsed rectum)
  • bulging mass in the posterior vaginal wall
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10
Q

s/sx of polycystic ovary syndrome (PCOS)

A
  • infertility
  • menstrual disorders
  • hirsutism (excess hair on mouth/chin)
  • ovarian cysts
  • obesity
  • pelvic pain
  • male pattern baldness
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11
Q

endometriosis

A

chronic inflammatory disease in which the presence and growth of endometrial tissue is found outside the uterine cavity

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12
Q

endometriosis s/sx

A
  • LBP
  • pelvic pressure
  • dyspareunia (genital pain)
  • infertility
  • premenstrual spotting and menorrhagia (heavy/prolonged bleeding)
  • diarrhea, pain with defecation, and constipation usually present when there are lesions of the bowel
  • bloody urine and dysuria usually present when there are lesions on the bladder
  • fixed retroverted uterus
  • enlarged and tender ovaries
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13
Q

dyspareunia

A

genital pain before, during or after intercourse

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14
Q

sexually transmitted infections are primarily transmitted

A

transmitted through sex

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15
Q

top 3 reported STIs

A
  • chlamydia
  • gonorrhea
  • syphilis
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16
Q

what population has the highest reporting of STIs

A

adolescent females

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17
Q

how can someone reduce the risk of an STI?

A
  • know your partner:
    -communicate with partner about STI
    -have regular pelvic exams, pap smears, HPV tests
  • be in a monogamous relationship
  • be with partner that has been screened and know to be negative
  • use condoms or dental dams (correctly)
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18
Q

vaginitis

A

inflammation of the vagina

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19
Q

common types of vaginitis

A
  • candida vaginitis (yeast infection)
  • bacterial vaginosis
  • trichomoniasis
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20
Q

candida vaginitis: what is it/causes it

A

aka yeast infection
*fungus lives on the surface of the body and grows when the vagina ecosystem is disturbed:
- hormone changes
- corticosteroids
- antibiotics

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21
Q

bacterial vaginosis

A

occurs when normal vaginal flora is disrupted

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22
Q

trichomoniasis

A

aka trichomonas vaginalis (STI)
*inflammation of the vagina and/or vulva

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23
Q

chlamydia

A
  • transmitted through digital-vaginal/vulva contact
  • most common bacterial STI in the US
  • most women are asymptomatic
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24
Q

gonorrhea: prenatal complications

A

premature rupture
- miscarriage
- preterm labor

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25
Q

syphilis

A

single painless ulcer (chancre) in the genital area, mouth, or point of contact
- transmitted through oral-anal contact
- shows up 10-90 days after contact
- lasts 4-6 weeks
- usually resolves w/out treatment (Penicillin G if needed)

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26
Q

condylomas are also called

A

genital warts

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27
Q

genital warts

A
  • painless warty growth in the vagina or on the vulva, perineum, or anal areas
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28
Q

s/sx of yeast infection

A
  • itching
  • white cheesy discharge
  • pain with sex
  • burning with urination
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29
Q

treatment of yeast infection

A
  • fluconazole
  • clotrimazole
  • miconazole
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30
Q

s/sx of bacterial vaginosis

A
  • fishy smelling vaginal odor
  • milky discharge that is thin, white or gray in color
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31
Q

treatment of bacterial vaginosis

A
  • metronidazole
  • clindamycin
  • tinidazole
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32
Q

management of trichomoniasis

A
  • metronidazole
  • partner needs to be tested and treated
  • condoms used to prevent future infections
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33
Q

how is trichomoniasis confirmed?

A

microscopic evaluation

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34
Q

what is a clear sign of trichomoniasis?

A

copious amounts of green discharge

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35
Q

why do we put erythromycin in the baby’s eyes after birth?

A

to prevent newborn blindness from contraction of gonorrhea through their eyes

36
Q

s/sx of gonorrhea

A
  • silent, sometimes burning on urination
  • backache
  • pain during sexual intercourse
37
Q

name the infection: copious amounts of green discharge

A

trichomoniasis

38
Q

name the infection: fishy odor

A

bacterial vaginosis

39
Q

name the infection: mucopurulent cervical discharge

A

chlamydia

40
Q

name the infection: white cheesy discharge

A

candidiasis (yeast infection)

41
Q

name the infection: silent- or burning on urination

A

gonorrhea

42
Q

UTI

A

infection of the urinary system
- bladder, urethra, ureters, kidneys

43
Q

why are UTIs more common in women?

A
  • shorter urethra in close proximity to the vagina and anus: closer proximity to bacteria that does not belong in the urinary tract system (most common UTIs are cystitis and urethritis)
  • more common in older women because of suppressed immune system, weakened bladder muscles (incomplete emptying), decreased estrogen (alters normal vaginal flora- E. coli)
44
Q

s/sx of UTI

A
  • dysuria
  • frequency
  • feeling of bladder fullness
  • tenderness
  • cloudy, foul-smelling urine
  • LBP
  • low-grade fever
45
Q

treatment of UTI

A

antibiotics
- ciprofloxin
- nitrofurantoin macrocrystals
- bactrim

46
Q

nursing actions for patient with UTI

A
  • drink 2-4 quarts of fluid daily
  • void q2-4 hours
  • empty bladder pre and post intercourse
  • wipe front to back
  • wear cotton
  • avoid tight fitting clothing
  • avoid caffeine and ETOH
  • patient teaching: s/sx of UTI
47
Q

organs are supported by __ , ___ , and ____

A

muscles, ligaments, and fascia

48
Q

pelvic organ prolapse

A

weakened structures (muscles, ligaments, fascia) lead to organ prolapse

49
Q

common disorders associated with pelvic organ prolapse

A
  • cystocele
  • rectocele
50
Q

risk factors for prolapse organs

A
  • large babies
  • vaginal deliveries
  • assisted deliveries- forceps or vacuum
  • poor repairs of episiotomy or lacerations
  • obesity
  • low levels of estrogen (menopause)
51
Q

uterine prolapse

A

the uterus descends out of the vagina

52
Q

s/sx of uterine prolapse

A
  • uterine protrusion
  • LBP
  • heaviness in the pelvis region
  • sensation uterus is falling out
53
Q

treatment of uterine prolapse

A
  • pessary
  • surgery
54
Q

what happens as a result of (s/sx) of cystocele

A
  • stress incontinence
  • bladder infections
  • fullness/pressure in vaginal area
55
Q

what happens as a result of (s/sx) of rectocele

A
  • constipation
  • irritation of vaginal mucosa
56
Q

nursing actions for cystocele and rectocele

A
  • teach kegel exercises
  • prevent constipation to prevent straining
  • avoid heavy lifting
  • discuss weight loss strategies
57
Q

urinary incontinence

A

loss of bladder control
- stress incontinence
- sudden urge

58
Q

what is female stress incontinence?

A

condition in which females fail to control their urination in certain situations

59
Q

treatment of urinary incontinence

A
  • bladder training
  • schedule trips
  • limit caffeine and alcohol
  • weight loss
  • kegel exercises
  • pessary or vaginal insert
  • surgery
60
Q

breast disorders

A

fibrocystic disease
breast cancer

61
Q

fibrocystic disease

A
  • benign cysts and fibrous tissue develop in the breast
62
Q

how common is fibrocystic disease

A

50%

63
Q

management/teaching for patient with fibrocystic disease

A
  • supportive bra
  • avoid caffeine, smoking and alcohol
  • apply heat to breasts
  • OTC pain meds (NSAIDs, acetaminophen)
  • oral contraceptives
64
Q

how is fibrocystic disease diagnosed

A

mammogram

65
Q

s/sx of fibrocystic disease

A
  • cyclic bilateral pain (usually in upper outer quadrants of breasts)
  • increased engorgement and density
  • increased nodularity
  • fluctuation in size of the cystic areas
66
Q

breast cancer risk factors

A
  • increased age (most invasive form found in 55+)
  • defects in the genes BRACA1 & BRACA2
  • family hx (2/10 dx)
  • dense breasts
  • personal hx of breast cancer in at least 1 breast
  • exposure to head or chest radiation
  • obesity
  • early periods, late menopause or hormone treatment
  • smoking
  • excess alcohol use
67
Q

breast cancer treatment

A
  • depends on stage
  • surgery
    -lumpectomy
    -partial/segmental mastectomy
    -simple mastectomy
    -modified radical mastectomy
  • radiation
  • chemotherapy
  • hormone therapy
  • targeted treatment (trastuzumab)
68
Q

breast cancer is diagnosed

A

(** in this order)
- mammogram
- ultrasound
- MRI
- breast biopsy

69
Q

after a woman has a mastectomy she may choose to do ____, which is done ____ (timing)

A

breast reconstruction surgery
- done at same time as mastectomy

70
Q

gynecological cancer (locations)

A
  • cervix
  • uterus
  • ovaries
  • fallopian tubes
  • vagina
  • vulva
71
Q

cervical cancer: primary cause

A

HPV

72
Q

cervical cancer is diagnosed via

A

pap smear

73
Q

growth rate of cervical cancer

A

typically, slow growing

74
Q

risk factors for cervical cancer

A
  • HPV
  • sex before 16
  • smoking cigarettes
  • STIs
  • multiple sex partners
  • birth control more than 5 years
  • birth to 3 or more children
75
Q

s/sx of cervical cancer

A
  • watery, pink/brown bloody or foul smelling discharge
  • abnormal bleeding btwn periods
  • dyspareunia
  • weight loss/gain
  • fatigue
  • pelvic or back pain
76
Q

intimate partner violences (IPV) includes

A
  • physical violence
  • sexual violence
  • stalking
  • psychological aggression
77
Q

who can IPV be committed by?

A
  • current partner
  • former partner
78
Q

risk factors for IPV

A
  • low self esteem
  • low academic achievement
  • adolescent or young adult
  • alcohol or drug abuse
  • having low friends
  • marital conflict
  • partner dominance and control in relationship
79
Q

characteristics of abusers

A
  • extreme jealousy
  • possessiveness
  • controlling behaviors
  • blaming partner for bad things
  • demeaning partner
  • controlling what the partner wears
80
Q

critical signs of IPV

A
  • repeated nonspecific complaints
  • overuse of healthcare system
  • hesitancy, embarrassment, or evasiveness in detailing hx of injury
  • time lag btwn injury and seeking care
  • untreated serious injuries
  • overly solicitous partner who stays close
  • head, neck, face, and areas covered by 1-piece bathing suit (bruises/cuts/harm)
  • during pregnancy- injuries to abdomen or breasts
  • bruises in various stages of healing
81
Q

nursing actions if you suspect your patient experiences IPV

A
  • universal screening
  • routine assessment
  • documentation of abuse
82
Q

common questions to ask your patient if you suspect (IPV)

A
  • has your partner ever hit you?
  • do arguments with your partner result in you feeling bad about yourself?
  • do you every feel frightened about what your partner says or does?
  • do you feel safe in your current relationship?
83
Q

licensed HCP are legislatively mandated reporters of ____

A
  • suspected abuse, neglect or exploitation of certain groups of people
84
Q

s/sx of UTI in older women

A

**differ from normal s/sx
- confusion/delirium
- agitation
- hallucinations
- poor motor skills/dizziness
- falling

  • fever- needs immediate treatment, serious infection
85
Q

most common bacterial STI in the US & leading cause of infertility and ectopic pregnancies

A

chlamydia

86
Q

type of hysterectomy used to treat some cases of reproductive cancer

A

radical hysterectomy

87
Q

type of hysterectomy that leaves the cervix in place

A

partial hysterectomy

NU 330 (18 decks)

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