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2400 > Exam # 4 > Flashcards

Exam # 4 Flashcards

1
Q

Normal Vaginal Secretions

A

They are normal

Clear to mlky white in color

little to no odor

no itching ir irritation.

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2
Q

Pathophysiology of Vulvovaginal infections

A

Common problem

Vagina is normally protected by maintained acid PH, - lactobacillus acidophilus

Vaginal epithelium is responsive to estrogen, which induces glycogen formation, which breaks down into lactic acid: therefore decreased estrogen deceases acid production.

With perimenopause and menopause, decreased estrogen is related to more susceptibla to vaginal and labial atrophy and tissue is more susceptiable to infection.

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3
Q

Candidiasis

A

Fungus - yeast

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4
Q

Candidiasis fungus infections

Risk Factors

A

use of antibiotics

diabetes

HIV

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5
Q

Candidiasis fungus infections

S/S

DX

Treatment

A

Itching, White - cottage cheese like appearance.

Microscope exam to DX.

Treatment: is fluconazole PO or miconazole vaginally.

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6
Q

Vulvovaginal Infection

Gardnerella

A

AKA bacterial vaginosis - normal flora but overgrown d/t absence of lactobacilli.

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7
Q

Vulvovaginal Infection

Gardnerella

Risk factors

S/S

DX

treatment

A

RF: douching, smoking, mulitple sex partners.

S/S: can be asymptomatic, discharge grey yellowish white color fishlike odor more noticeable after intercourse.

DX: Whiff test - slide with drop of potassium hydroxide.

Treatment: Metronidazole treatment

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8
Q

Vulvovaginal Infection

Trichomonas vaginalis

A

Flagellated protozoan causes this STI, Aka Trich.

Usually asymptomatic.

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9
Q

Vulvovaginal Infection

Trichomonas vaginalis

RF

S/S

Treatment

A

RF: Increases risk of contracting HIV,

S/S Thin Frothy, yellow to yellow-green, malodorous discharge causes burning and itching.

DX: Microscopic exam reveals motile oragnisms.

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10
Q

Risk Factors for Vulvovaginal Infections

A

Premenarche, perimenopause, menopause, low estrogen levels.

Pregnancy or oral contraceptives

poor hygiene

tight garments and synthetic clothing

freq douching

antibiotics

Allergies, diabetes, intercouse with an infected partner, oral gential contact, HIV.

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11
Q

Assessment of patient with vulvovaginal infection

A
  • exam as soon as possible after onset of symptoms.
  • instruct pt not to douche b4 assessment.
  • Pt HX: - Physical and chemical factors
  • psychogenic factors
  • medical conditiond
  • use of medications
  • sexual activity and hx.
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12
Q

Nursing Dx - Vulvovaginal Infection

A
  • Impaired comfort related to burning, odor, or itching from the infectious process.
  • Anxiety related to stressful symptoms
  • Risk for infection or spread of infection- should refain from sexual activity till after treatment for both partners if trichomonas infection.
  • Deficient knowledge about proper hygiene and preventive measures.
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13
Q

Goals for patient with vulvovaginal infection

A

Goals: - Relief of impairment comfort

  • reduction of anxienty related to symptoms
  • prevention of reinfection of sexual partner.
  • Acquisition of knowledge about methods for preventing vulvovaginal infections and managing self-care.
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14
Q

Interventions for patient with vulvovaginal infection.

A
  • Sitz baths help relieve discomfort.
  • Explanation of the cause of symptoms and methods to help prevent infections may help reduce anxiety.
  • Douching is usually avoided: however, therapeutic douching may be prescribed to reduce odors and remove excessive drainage.
  • PT edu includes: Handwashing, proper hygiene, preventive strategies, measures to reduce risk, information regarding medications and information regarding self-exam.
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15
Q

education for patient with vulvovaginal infection.

A
  • Treatment in indicated may include sexual partner.
  • Instruct pt to wear loose fitting cloths and loose fitting cotton underwear.
  • abstain from sexual intercourse until treatment is completed.
  • Avoid irritation to vaginal tissue and tight clothing.
  • sitz baths to decrease irritation.
  • Topical cortisone cream to vulve.
  • Edu pt on medication admin (suppository applicators.)
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16
Q

Genital Viral Infections

A

HPV

Herpes type 2 infection (herpes genitalis)

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17
Q

HPV - The most common sexually transmitted disease among sexually active young people.

A

***ASSOCIATED WITH CERVIAL DYSPLASIA AND CERVICAL CANCER: NEED ANNUAL PAP SMEARS.

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18
Q

Treatment of HPV.

A
  • Exteral gential warts: topical applications or surgical removal.
  • Prevention

Vaccine boys and girls at age 11 or 12 years old.

Cervical screening as recommended.

Infections often disappears as the results of an effective immune system response.

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19
Q

Herpes type 2 infections (herpes genitalis)

A

A recurrent lifelong viral infection

***AN STD THAT ALSO MAY BE TRANSMITTED BY CONTACT AND THAT MAY BE TRANSMITTED WHEN THE CARRIER IS ASYMPTOMTIC.

A causes painful itching and buring herpetic lesions.

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20
Q

Treatment of HSV-2

A

No cure

Antiviral agents (acyclovir), valacyclovir, and famciclovir can supress symptoms.

  • recurrance may be associated with stress, sunburn, dental work, inadequate rest, and inadequate nutrition.
  • Risk for infants delivered vaginally to become infected; therefore, C-Section delievery may be performed.
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21
Q

Pelvic Inflammatory Diease (PID)

A
  • inflammatory condition of the pelvic cavity that may begin w/ cervicitis and involve the uterus (endometritis), fallopian tubes (salpingitis), ovasies (oophoritis), pelvis peritoneum, or pelvic vascular system.
  • Gonorrheal and chlamydial organisms are common causes, but most cases are associated with more than one organism.
  • Short and long term consequences can occur.
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22
Q

PID Nursing Assessment

A
  • Vaginal Discharge
  • Dyspareunia - painful intercourse
  • Low abd pelvic pain, and tenderness that occurs after menses that may increase with voiding or with defecation.
  • Other symptoms : Fever, general malaise, anorexia, nausea, headache, and possible vomiting.
  • Pelvic Exam - intense tenderness may be noted on palpation of the uterus or movement of the cervix (cervical motion tenderness).
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23
Q

PID : Treatment

A
  • Broad - spectrum antibiotics.
  • Treat sexual partner to prevent reinfection.
  • Analgesics for pain and relief.
  • Adequate rest and nutrition.
  • Pt education: How to prevent reinfection.
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24
Q

HIV and AIDS

A
  • 25% living with HIV are women
  • Counseled about safer sex and informed about the dangers of unprotected sex.
  • BC there is a risk of perinatal transmission, decisions to conceive or to use contraception, must be based on education, accurate information, and care.
  • Prgenant women are advised to have an HIV test. The use of antiretroviral agents by pregnant women significantly decreases perinatel transmission of HIV infection.
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25
Q

Structural Disorders

A
  • Fistulas of the vagina abnormal opening between two internal hollow organs or between internal hollow organ and the exterior of the body-often require surgical repair.
  • Pelvic organ prolapse: Cytocell, Rectocele, Enterocele.

*All can cause dyspareunia*

  • Treatment: Surgical, Medical - Pessaries, pelvic floor muscle training.
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26
Q

Structural Disorders: Nursing Management

A
  • Implementing preventive measures
  • per/post operative care
  • Promoting home and community-based care.
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27
Q
A

Cystocele - damaged to anterior vaginal wall, surgical correction called anterior colporrhaphy.

  • Risk Factors are from damage to vaginal support d/t injury and strain during childbirth. usually appears later when gential atrophy occurs associated with aging but young mulitparous, premenopausal women may be affected.
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28
Q
A

Rectocele damage to posterior vaginal wall, surgical correction - posterior colporrhaphy.

  • Risk factors are from muscle tears below the vagina may effect muscles and tissues of pelvic floor which may occur during childbirth.
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29
Q
A

Enterocele a protrusion of intestinal wall into vaginal, from weakening of support structures of the uterus itself. This can lead to prolapsed uterus through vagina.

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30
Q

Symptoms of Cystocele:

A

Pelvic pressure, urinary problems - incontinence, frequency and urgency, back pain.

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31
Q

Symptoms of Rectocele:

A

Constipation, uncontrolled gas, fecal incontinence.

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32
Q

Symptoms of prolapse

A

Prolapse, pressure and ulceration, bleeding.

All can cause dyspareunia.

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33
Q
A

Complete prolapse of the uterus.

34
Q

Nursing interventions for symptoms of csytocele, rectocele, prolapse.

A

Kegal excercise - contracting vaginal muscles to strengthen weakened muscles - more effective if done in eariler stages. Recommended for all women even without weakened pelvic floor. These are advised for pregnant and postpartum women.

35
Q

Benign Disorders

A
36
Q

Endometriosis Pharmacotherapy

A
37
Q

Malignant disorders of the female reproductive tract.

A
38
Q

Treatment of Reproductive Malignancies.

A
  • Surgury, chemotherapy, radiation, or a combination of these.
  • Treatment may be curative or palliative.
  • Care of the surgery patient is similar to care of patients with other abdominal surgeries.
39
Q

Hysterectomy

A
40
Q

Assessment of the pt undergoing a Hysterectomy.

A
  • Pt HX.
  • Physical and pelvic exam
  • Psychosocial and emotional responses
  • Pt knowledge
41
Q

Nursing DX of pt with Hysterectomy

A
42
Q

Collaborative problems and potential complications of a hysterectomy.

A
  • Hemorrhage
  • DVT
  • Bladder dysfunction
  • Infection
43
Q

Goals of a pt undergoing a hysterectomy

A
44
Q

Of a pt undergoing a hysterectomy.

A
45
Q

Complications of Hysterectomy

A
46
Q

Radiation Therapy

A
47
Q
A

Placement of Tandem and Ovoids for Internal Radiation Therapy

48
Q

Nursing Considerations related to intracavity Radiation Therapy

A
49
Q

Safety (Intracavity Radiation)

A
50
Q

Breast Assessment

A
51
Q
A
52
Q
A

Lymph Nodes

53
Q

Diagnostic Assessment

A
54
Q

Surgical Biopsy

A
  • Excisional Biopsy
  • Incisional Biopsy
  • Wire needle localization
55
Q

Nursing Management Surgical Biopsy

A
56
Q

Benign conditions of the Breast

A
57
Q

Malignant Conditions of the Breast

A
58
Q

Breast Cancer

A
59
Q

Risk Factors for Breast Cancer

A
60
Q

Guidlelines for Early Detection of Breast Cancer

A
61
Q

Assessment for Breast Caner

A
62
Q

DX Breast Cancer

A
  • Staging
  • Prognosis

Tumor size

Spread to lymph nodes?

Certein Genes (ERBB2)

63
Q

Surgical Management: BC

A
64
Q

NP: Assessment of a pt undergoing BC sx.

A
65
Q

Preop DX:

A
66
Q

NP: Postop DX

A
67
Q

Collaborative Problems and Potential Complications

A
68
Q

NP: Planning

A
69
Q

Preop Nursing Interventions

A
70
Q

Postop Nursing Intervention

A
  • Relieve pain and discomfort
  • Inform pt regarding common post op sensetions.
  • maintain privacy
  • bra with breast form
  • profvide information about home plan of care
  • support coping and adjustment - counseling anf referral
  • Monitor of potentional complications

-

71
Q

Potential post op complications

A

***Lymphedema***

hematoma or serome, infection

72
Q

***Nursing management*** for post op edema

A

position arm on op side on a pillow slightly elevated.

encourage hand activity on effected side (squeeze ball)

Use effected arm for reaching , brushing hair

Do arm exercise dail 4-6 weeks (wall climbing and rope pulling sewinging)

73
Q

***Lymphedema***

A

complication of chronic sweeling of an extremity due to interrupted lymphatic circulation. Common after axillary lymph node dissection.

74
Q

***edu pt self care***

Pt are taught arm exercises on the affected side

A

to perform 3X day for 20 minutes at a time until full range of motion is restored (usally 4-6 wks)

75
Q

*** once lymphedema develops it tends to

A

be chronic, so prevention is life long.

  • Wear gloves for grandening

maintain cuticles by pushing them back do not cut

use electric razor when saving arm pits

avoid lifting onjects more than 5-10 lbs

takes abput 4 weeks for collareral circulation to form- draining the area.

76
Q

***POst op D/C teaching***

A

arrange for reach for recovery to visit

have MD discuss with the patient reconstructince options

discuss the grief process with the pt and family.

77
Q

***TRAM***

A

Transverse rectus abdominal myocutaneous flap.

autologous reconstructions of breast using pt tissue to creast breast mound.

Donor sites may include abdominal muscle, buttocks muscle or back muscle.

A breast mound is creasted by tunnelin gabdominal skin , fat, and muscle to the mastectomy site.

78
Q

nonsurgical management of breast CA

A

radiation therapy

chemo

hormonal therapry

targeted therapry

79
Q

*** Gynecomastia ***

Know how to spell

A

normal is adolescent males, benign, and resolves

can be painful

feminizing testicular tumors, infection, cirrhosis.

certain meds can cause

ETOH use can cause.

Surgical removal is avaiable.

80
Q

**Male reporductive - gerontologic considerations**

A
  • Prostate enlarges and prostate secreations decrease
  • Scrotum hang lower , pubic hair becomes sparse and stiff
  • ***Testes decrease in weight, atrophy and aoften, Decrease in testosterone and progesterone levels
  • decrease in sexual function and libido, longer time till arousal.
  • *** Men maintain reproductive capacity as spermatogenesis continues, decreased sperm production.
81
Q

Male assessment

urinary function and symptoms

A

Sexual functions and manifestations of sexual dsyfunction

  • inabilaty to achieve or maintain and erection.

***- has both psychologic and organic causes***

82
Q

Male phyiscal assessment

A
  • digital rectal exam - to screen

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