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Nursing Semester 3 > Cyndi - Week 9 - Exam 4 > Flashcards

Cyndi - Week 9 - Exam 4 Flashcards

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1
Q

what are the different cultural and ethnic disparities for women’s health?

A
  • Access differences
  • Insurance
  • Money
  • Quality of care
  • Health knowledge/advocacy
  • *Caucasian highest incidence - Hispanic/African American women increased death d/t Poverty level**
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2
Q

what are the different types of breast cancer? (4)

A

• Non‐invasive carcinoma
- DCIS‐ductal carcinoma in situ, LCIS‐lobular carcinoma in situ
• Invasive carcinoma
◦ Ductal – 80% -vascular - at risk for metastasis
◦ Lobular – 20%
• Inflammatory breast cancer
• Paget’s disease of the nipple - Hardening and thickening and sore; skin is dimpled/orange peeled
Misdiagnosed as mastitis

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3
Q

what are the risk factors for breast cancer?

A 
• Age (50% - 65 years or older)
• Ethnicity
• Hormone status
• Heredity
• Familial - ↑ risk if first degree 
• DNA testing BRCA 1, 2 mutations - BRCA repair tissue in breast - too much production - mutation
• Hormone status
• Access
• Other - Table 52‐2
*** Men’s risk factors 
• High estrogen levels - male with BRCA mutation
• Obesity d/t higher level of estrogen
• Teach breast self‐exam for early diagnosis!
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4
Q

what are the most common sxs for breast cancer?

A 
• New lump or mass
• Nontender lump
• 50% in upper outer quadrant of breast - close to lymph so can go into blood stream
• Nipple changes
OR
• Tender, soft, or rounded lump
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5
Q

what are the uncommon sxs for breast cancer?

A
  • Swelling of all or part of breast OR arm (lymphedema)
  • Skin irritation or dimpling
  • Breast or nipple pain
  • Nipple retraction (turning inward)
  • Redness, scalyness, thickening of nipple or skin
  • Nipple discharge (other than breast milk)
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6
Q

what are the diagnostic tests used for breast cancer?

A 
• radiologic 
• biopsy
• axillary lymph node status
• initial detection vs monitoring 
• Tumor size
• HER2 marker
• Hormone receptor status
- Estrogen
- Progesterone
• Cell proliferative indices
• Cancer markers 
- Diagnosis and monitoring
• DNA testing
• Genomic assay
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7
Q

what are the radiologic tests done for BC?

A
  • mammography (at 40; BRCA/hx at 25)
  • MRI
  • US
  • PET scan (gold standard)
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8
Q

what does a BC tissue biopsy consist of?

A
  • grading and staging

- tissue specimen tests for type of cancer

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9
Q

what does axillary lymph node status consist of?

A
  • lymphatic mapping
  • sentinel node dissection (the main node - most concentration of cancer)
  • *tissue that has estrogen/progest. receptors have greater risk
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10
Q

what is triple negative breast cancer?

A

don’t have HER2 marker, estrogen or progesterone; so it’s harder to tx

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11
Q

what is differentiation in breast cancer?

A

the extent to which cancerous cells resemble normal cells

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12
Q

how are tumors graded?

A

graded for how closely they resemble parent tissue

- grades 1 (better) to 3 (worse)

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13
Q

what is TNM staging based on?

A
  • 0 - 4 stages

- based on tumor size, node involvement, and metastasis

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14
Q

what are the complications of differentiation?

A
  • recurrence in local, regional, or distant sites
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15
Q

what are the different tx for BC?

A
  • meds
  • surgery
  • radiation
  • pt education
  • mastectomy post op care
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16
Q

what are the meds used for BC?

A
  • chemo (may have after surgery to clean up)
  • hormone therapy - Tamoxifen
  • biologic and targeted therapy - Herceptin
  • bisphosphonates - new adjuvant tx?
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17
Q

TEST: how does tamoxifen work?

A

its a estrogen receptor blocker

  • estrogen helps produce breast tissue
  • slows the process down
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18
Q

what surgeries are used as tx for BC?

A 
**primary tx**
◦ Lumpectomy
◦ Mastectomy -Radical vs modified radical
◦ Prophylactic
◦ Lymph node dissection
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19
Q

TEST: what is the difference between a radical mast and a modified radical mast?

A

radial mast: whole breast, lymph and pectoral

modified: whole breast and lymph (NO pec)

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20
Q

what is the pt education for BC tx?

A
  • tx plan (monitoring and follow up)
  • psychosocial issues
  • body/sexual image
  • health promotion
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21
Q

what is the post op care for mastectomies?

A
  • TEST site and arm care (prevent infection or lymphedema - no BP/IV blood draw on side - ues to arm on pillow and ROM exercises)
  • physical mobility - may have limited ROM on affected side
  • general post - op care TCDB
  • pain management
  • emotional support
  • reconstructive surgery
22
Q

what is cervical cancer?

A

normal cells progress from dysplastic to cancerous

23
Q

what are the causes of cervical cancer?

A
  • injury to cervix
  • HPV virus (gardasil vaccine)
  • *genetic link, mother/baby transmission
24
Q

what are the sxs of cervical cancer?

A
  • Initially asymptomatic
  • Bleeding between periods
  • Pain
  • Weight loss
25
Q

what are the diagnostics for cervical cancer?

A
  • pap test

- biopsy or colposcopy

26
Q

what are the characteristics of tx for cervical cancer?

A
  • Up to 80% of dysplasia resoles spontaneously
  • Cryotherapy can destroy abnormal tissue before it
    becomes cancerous
  • Vaccines can prevent 70% of cervical cancer
27
Q

what is the tx for invasive cervical cancer?

A
  • Conization - cut ouot a cone shape of the cervix
  • Surgery – hysterectomy
  • Radiation
  • Chemotherapy
  • Laser
28
Q

what is endometrial cancer?

A

cancer of the lining of uterus

**the most common female cancer

29
Q

what are risk factors of endometrial cancer?

A
  • Estrogen - long exposure
  • Smoking
  • Age
  • Obesity
  • Diabetes
  • Familial history
  • Late menopause or nulliparity
30
Q

what are the sxs of endometrial cancer?

A
  • abnormal uterine bleeding

- pain

31
Q

what are the diagnostic tests for endometrial cancer?

A

CA 125
Pelvic exam
Transvaginal ultrasound
Endometrial hysteroscopy+ biopsy

32
Q

what is the CA 125 gene?

A

antigen in blood with cancer; used for monitoring tx; precursor test for early sxs and for women with risk factors; used for women over 65

33
Q

what is the tx for endometrial cancer?

A
  • Hysterectomy with bilateral salpingo‐oophorectomy with
    lymph node biopsies
  • Radiation
  • Chemo
34
Q

what is the post op care for a pt who had a hysterectomy?

A 
Know which surgery pt had!!
◦ Abdominal  ‐ abd dressing
◦ Vaginal – perineal pad
◦ How much was removed
- Monitor urine output!
-  Regular post operative care
-  Grief response – body image
- Pt education
35
Q

what is the pt education for hysterectomies?

A
  • bathing, no bath for vaginal
  • pain
  • stools (possible constipation)
  • sexuality, depression (changes in libido common, may different about body; support group)
36
Q

what is ovarian cancer?

A

Malignant tumor of the ovary

• (Ovarian cysts are benign tumors)

37
Q

what are the risk factors for ovarian cancer?

A
  • Family history highest risk
  • Usually age over 40
  • Nulliparity, infertility, heavy menses, HRT
  • BRCA 1, 2 tumor suppressive gene mutations
  • High fat diet
  • Personal history of ovarian, breast, colorectal, or endometrial cancer
38
Q

what are the characteristics of ovarian cancer?

A
  • Poor survival
  • Many types
  • Historically a late diagnosis
    • Potential for earlier dx with CA 125
  • Intraperitoneal dissemination
    • Uterus
    • Bladder
    • Bowel
    • Omentum
    • Other
39
Q

what is BEAT?

A 
Bloating
Eating less and feeling fuller
Abdominal pain
Trouble with bladder 
**main sxs of ovarian cancer
40
Q

what are the other sxs of ovarian cancer?

A
  • Fluid accumulation‐enlarged abdomen
  • Pelvic or abdominal pain
  • Gas, indigestion, pressure, bloating, cramps
41
Q

what are the late sxs of ovarian cancer

A
  • Increased abdominal girth
  • Pain
  • Menstrual irregularities
  • Ascites
42
Q

how is ovarian cancer diagnosed?

A

New study shows CA 125 can screen for disease!!
• Lab test ‐ CA 125 level‐ cancer antigen 125
• Abdominal and transvaginal ultrasound
• Pelvic examination‐bimanual
• CT, MRI
• BRCA 1,2
• Tumor biopsy for staging – treatment determinant
• Laparotomy (diagnostic staging)

43
Q

Test: treatment for ovarian cancer relies on _______ and ______ for staging

A

tumor biopsy and BRCA1-2 testing

44
Q

what is the tx for ovarian cancer?

A
  • Surgery
    • Prophylactic oophorectomy for high risk
    • TAH with BSO with omentectomy and tumor debulking
    • Staging of tumor
  • Chemotherapy – intraperitoneal and systemic
  • Radiation – intraperitoneal and external
  • Palliative
    • Various comfort treatments for metastatic disease
45
Q

what is menopause?

A 
physiologic cessation of menses
• Considered complete at 1 year
since menses
• Gradual process
• Can occur suddenly after
hysterectomy/oopherectomy
• vaginal tissue atrophy; dryness; can tear
46
Q

what are the sxs of the perimenopausal stage?

A
  • Irregular menses
  • Vasomotor instability
    “Hot Flashes”
  • Atrophy of genitourinary tissues
  • Stress/urge incontinence
  • Mood changes‐depression,
    irritability, cognition
  • Osteoporosis
47
Q

what are the sxs of the post menopausal stage?

A
  • Cessation of menses
  • Vasomotor symptoms
  • Atrophy of genitourinary tissue
  • Stress/urge incontinence
  • Breast tenderness
48
Q

what is important to know regarding menopause?

A

determine if it really is menopause

  • long distance runner?
  • large weight loss?
49
Q

what are tx for menopause?

A
  • lifestyle changes
  • HRT for symptom relief
  • complimentary /alt therapy
  • black cohosh and soy*** test
50
Q

what are the lifestyle changes for menopause?

A
  • Avoid heat producing environment & food
  • Wear loose clothes and light bedclothes
  • Limit caffeine, alcohol
  • Meditation and exercise help some
  • Good nutrition
51
Q

what is the difference between rectocele and cystocele?

A

RECTOCELE OR CYSTOCELE: RECTUM PUSHES THROUGH VAGINAL WALL; BLADDER HAS COME DOWN AND PUSHES INTO VAGINAL OPENING; “feels like I’m sitting on an egg”

Nursing Semester 3 (29 decks)

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