Exam 4 (Ch 55, 56, & 58) (Mod 16) Flashcards
1
Q
Structures and Functions of Female Reproductive System
What are the 3 main functions of the female reproductive system?
A
- Production of ova
- Secretion of hormones
- Protection and facilitation of development of fetus in pregnant female
2
Q
Structures and Functions of Female Reproductive System
What are the pelvic organs of females?
A
Ovaries
Fallopian tubes
Vagina
Uterus found between bladder and rectum. Consists of fundus, body, cervix.
Pelvis consists of four bones held together by ligaments
External genitalia (vulva)
Breasts
3
Q
Gerontologic Considerations Effects of Aging Female Reproductive System
How can sexual practices be affected by aging?
A
Gradual change in sexual response
Negative social attitude toward sexuality in older adults
You play a vital role:
Provide accurate and unbiased information
Emphasize normality of sexual activity
4
Q
Gerontologic Considerations Effects of Aging Female Reproductive System
Altered estrogen production associated with menopause are responsible for what changes?
4
A
Decreased circulating estrogen and other sex steroids
Breast and genital atrophy
Decreased bone mass
Increased rate of atherosclerosis
5
Q
Assessment of Female Reproductive Systems
What are some catagories of questions should the nurse ask when assessing the female reproductive system?
6
A
Past health history
Co-morbidities
Medications
Surgery or other treatments
Genetic risk alert
Lifestyle choices
6
Q
Assessment of Female Reproductive Systems cont.
What are some patterns to assess?
A
Elimination pattern
Activity-exercise pattern
Functional health patterns
7
Q
Assessment of Female Reproductive Systems cont.
What are some aspects of functional health patterns that need to be assessed?
A
Disruptions in sleep–rest patterns
* Hot flashes and sweating with perimenopause
* Daytime fatigue from sleep disruption
Pelvic pain with pelvic inflammatory disease, ovarian cysts, endometriosis
Dyspareunia (Painful intercourse)
Emotional distress from changes that occur with aging, including pendulous breasts, vaginal dryness
8
Q
Physical Examination
What are some areas to inspection and palpation during the physical examination of the female reproduction system?
A
Breasts and axillae
Abdomen and genitalia
Internal pelvic examination
9
Q
Physical Examination
What should be inspected/palpated during examination of external genitalia?
A
Mons pubis
Vulva
Anus
Use gloves
10
Q
Physical Examination
What should be done during the breast examine/what should you look for?
A
Inspect and palpate in various positions
Symmetry, size, shape, skin color, vascular patterns, dimpling, unusual lesions
Special attention to axillary tail of Spence, where most malignancies develop
Palpate and inspect area around the areolae
11
Q
Physical Examination
What does the examination of the Internal pelvic involve?
Usually done by HCPs with advanced or specialized training
A
This examination involves use of a speculum and bimanual technique
Pap specimen can be obtained as vagina and cervix are observed for irregularities
12
Q
Diagnostic Studies of Reproductive Systems
What do urine and blood studies measure/help detect?
A
Measure and help detect many problems including:
* Ovarian function, syphilis, gonadal function, pregnancy, infertility, menstrual irregularities, causes of amenorrhea, decreased libido
13
Q
Diagnostic Studies of Reproductive Systems
What do cultures, smears, and nucleic acid amplification tests measure/help detect?
A
Measure and help detect:
Syphilitic lesions, vaginal abnormalities, gonorrhea, Chlamydia, trichomoniasis
14
Q
Diagnostic Studies of Reproductive Systems
What are some examples of radiologic studies?
A
Mammography
Ultrasound (US) of breasts, pelvis, testes
Ultrasound-guided biopsy
CT scan of pelvis
MRI
15
Q
Diagnostic Studies of Reproductive Systems cont.
What is a hysteroscopy?
Invasive procedures
A
Visual examination of the inside of the uterus using a hysteroscope.
16
Q
Diagnostic Studies of Reproductive Systems cont.
What is a hysterosalpingogram (HSG)?
Invasive procedures
A
X-ray procedure using contrast dye to visualize the uterus and fallopian tubes.
17
Q
Diagnostic Studies of Reproductive Systems cont.
What is a colposcopy?
Invasive procedures
A
Visual examination of the cervix using a colposcope (magnifying instrument).
18
Q
Diagnostic Studies of Reproductive Systems cont.
What is a conization?
Invasive procedures
A
Surgical removal of a cone-shaped tissue sample from the cervix.
19
Q
Diagnostic Studies of Reproductive Systems cont.
What is a loop electrosurgical excision procedure (LEEP)?
Invasive procedures
A
Uses a thin, electrically charged wire loop to remove abnormal cervical tissue.
20
Q
Diagnostic Studies of Reproductive Systems cont.
What is a culdotomy?
Invasive procedures
A
Incision into the cul-de-sac (pouch of Douglas) behind the uterus.
21
Q
Diagnostic Studies of Reproductive Systems cont.
What is a culdoscopy and culdocentesis?
Invasive procedures
A
Visual examination of the pelvic organs through the cul-de-sac and aspiration of fluid from the cul-de-sac.
22
Q
Diagnostic Studies of Reproductive Systems cont.
What is a laparoscopy?
Invasive procedures
A
Minimally invasive surgical procedure to visualize the pelvic organs using a laparoscope.
23
Q
Diagnostic Studies of Reproductive Systems cont.
What is a dilation and curettage (D and C)?
Invasive procedures
A
Widening of the cervix and scraping of the uterine lining.
24
Q
Diagnostic Studies of Reproductive Systems cont.
What is a Basal Body Temperature Assessment?
Fertility Studies
A
Monitoring daily body temperature to identify ovulation.
25
# Diagnostic Studies of Reproductive Systems cont.
What is a Hysterosalpingogram (HSG) used to assess?
| Fertility Studies
Used to assess the patency (openness) of the fallopian tubes.
26
# Diagnostic Studies of Reproductive Systems cont.
What do Serum Estradiol, FSH, & Progesterone measure?
| Fertility Studies
Blood tests to measure hormone levels related to ovulation and ovarian function.
27
# Diagnostic Studies of Reproductive Systems cont.
What is Urinary LH (Luteinizing Hormone)?
| Fertility Studies
Urine test to detect the LH surge, which precedes ovulation.
28
# Breast Cancer
What are some key points to breast cancer epidemiology?
| 5
Many new cases are diagnosed each year in U.S. women.
Second most common cancer in women.
Second most common cause of cancer death in women.
Incidence is slowly decreasing.
Breast cancer survivors are the largest group of any cancer survivors.
29
# Breast Cancer
What is the etiology and risk factors for women for breast cancer?
Cumulative and interacting
* Family history
* Environmental factors (e.g., radiation)
* Genetics (e.g., BRCA1, BRCA2)
* Early menarche and late menopause
* Age 60 or older
Most who develop breast cancer have no identifiable risk factors
30
# Breast Cancer cont.
What can combined hormone therapy and estrogen alone therapy do in regards to breast cancer developement?
Combined Hormone Therapy (Estrogen + Progesterone):
* Increases the risk of breast cancer.
* Associated with larger tumor size and higher tumor stage at diagnosis.
Estrogen Alone: May increase breast cancer risk after 15 years of use.
31
# Breast Cancer cont.
What are the hereditary/genetic link for breast cancer?
Up to 10% of breast cancers are hereditary.
Genetic Link Strength: The genetic link is stronger if the affected family member:
Had a history of ovarian cancer.
Was premenopausal at diagnosis.
Had bilateral breast cancer.
Is a first-degree relative (mother, sister, daughter).
- Having a first-degree relative with breast cancer doubles the risk.
32
# Breast Cancer cont.
What are some breast cancer risk factors for men?
Hyperestrogenism: Elevated estrogen levels in men can increase risk.
Family history of breast cancer
Radiation exposure
* Thorough breast examination with physical examinations
* Possible genetic testing for men in families with BRCA mutations
33
# Breast Cancer cont.
What is a way that women with the BRCA1 or BRCA2 mutations can decrease their risk of breast and ovarian cancers?
Prophylactic oophorectomy & mastectomy
## Footnote
Ovaries are main source of estrogen in premenopausal women
Oophorectomy does not decrease breast cancer risk in postmenopausal women
34
# Breast Cancer Screening Guidelines
At what age should average-risk women begin getting yearly mammograms?
What age for every 2 years?
Starting at age 45
Should be offered to begin screening at ages 40-44
Yearly ages 45 to 54
Every 2 years ages 55 and older
Continue screening mammograms as long as overall health is good
## Footnote
The American Cancer Society (ACS) does not recommend CBE among average-risk women at any age.
35
# Breast Cancer Screening Guidelines
What are some screening options women at increased risk may benefit from?
Earlier 3D mammography screening.
Breast MRI.
More frequent CBEs.
36
# Breast Cancer Screening Guidelines
What is a way to facilitate breast self-awareness?
Consistent Breast Self-Examination (BSE):
Consistent BSE can facilitate breast self-awareness, helping women understand the normal look and feel of their breasts.
Technique Review: Regular review of the proper BSE technique through return demonstration is recommended.
37
# Breast Cancer Diagnostic Studies
What are some radiologic studies used to diagnose breast cancer?
Mammography
* Digital mammography (More accurate in younger women)
* 3-D mammography (tomosynthesis)
Ultrasonography
MRI (For women at high risk)
38
# Breast Cancer Diagnostic Studies
What are some biopsy methods used to diagnose breast cancer?
Fine-Needle Aspiration (FNA): Uses a thin needle to extract cells from a suspicious area.
Core Needle Biopsy: Uses a larger needle to remove a small core of tissue.
Vacuum-Assisted Biopsy: Uses vacuum suction to collect tissue samples.
Excisional Biopsy: Surgical removal of the entire suspicious lump or area.
39
# Breast Cancer Gerontologic Considerations
Why does pendulous breast occur?
Explanation: Aging can lead to changes in breast tissue, resulting in pendulous (sagging) breasts.
Contributing Factors:
* Loss of subcutaneous fat.
* Loss of structural support.
* Atrophy (shrinking) of mammary glands.
* Decreased glandular tissue density.
40
# Breast Cancer Gerontologic Considerations
What are major risk for breast cancer that increase with age?
Increasing age is a major risk factor for breast cancer.
- More than half of all breast cancers occur in women age 65 or older
Older women are less likely to have mammograms
Screening and treatment decisions are based on health status, not age
41
# Clinical Manifestations of Breast Cancer
How is breast cancer detected?
Detected as lump, thickening, or mammography abnormality in breast
Rate of lesion growth varies
- If palpable, hard, irregular, poorly delineated, nonmobile, and nontender
- May be nipple discharge or retraction
42
# Breast Cancer Interprofessional Care
How is the treatment plan for breast cancer determined?
## Footnote
Wide range of treatment options is available to patient and HCP to make critical decisions
By:
Prognostic factors
Clinical stage of cancer
Biology of cancer
43
# Breast Cancer Interprofessional Care
What is the TNM system?
A widely used staging system for breast cancer.
Components:
Tumor Size (T): Describes the size of the primary tumor.
Nodal Involvement (N): Describes whether the cancer has spread to nearby lymph nodes.
Presence of Metastasis (M): Describes whether the cancer has spread to distant organs.
44
# Breast Cancer Interprofessional Care
What does the stage of breast cancer describe?
The size and extent to which it has spread
45
# Breast Cancer Treatment Options
What are some breast cancer treatment options?
| All options should be considered and discussed
Surgical intervention
Radiation therapy
Drug therapy
Hormone therapy
Immunotherapy and targeted therapy
46
# Surgical Therapy
What are the most common surgical procedures for operable breast cancer?
Mastectomy, with or without reconstruction
Lumpectomy: Removing the entire tumor with a margin of normal tissue
47
# Surgical Therapy
How is radiation therapy done after surgery?
Delivery: Radiation therapy is typically delivered to the entire remaining breast tissue after lumpectomy.
Boost: A "boost" of radiation is often given to the tumor bed (the area where the tumor was removed).
Purpose: To kill any remaining cancer cells and reduce the risk of recurrence.
48
# Surgical Therapy
Why might chemotherapy be given before radiation therapy?
## Footnote
Chemotherapy may be given before radiation therapy in certain cases (neoadjuvant chemotherapy).
To shrink the tumor before surgery or radiation, or to treat cancer that has spread to lymph nodes.
49
# Surgical Therapy
What is axillary node dissection?
Purpose?
Explanation: Surgical removal of lymph nodes in the axilla (armpit).
Purpose: To determine if cancer has spread to the lymph nodes and to remove any cancerous nodes.
50
# Surgical Therapy
What is lymphedema?
Mechanism?
Explanation: A potential complication of axillary node dissection.
Mechanism: Occurs when lymph fluid cannot drain properly from the arm, leading to swelling.
51
# Surgical Therapy Mastectomy (1 of 3)
What is a total or simple mastectomy?
Removes the entire breast tissue.
Does not include removal of axillary lymph nodes or chest wall muscles.
52
# Surgical Therapy Mastectomy (1 of 3)
What is modified radical mastectomy?
Removes breast and axillary lymph nodes
Preserves pectoralis major muscle
More extensive than a simple mastectomy.
53
# Surgical Therapy Mastectomy (1 of 3)
What is nipple-sparing mastectomy?
Rationale?
Removes the underlying breast tissue but preserves the nipple and areola.
Rationale: Aims to improve cosmetic outcomes and body image.
May be suitable for certain types of breast cancer.
54
# Surgical Therapy Mastectomy (3 of 3)
What are the 2 main types of reconstruction?
Timing?
Implant Reconstruction:
- Explanation: Uses silicone or saline implants to create a breast mound.
Tissue Flap Reconstruction:
- Explanation: Uses the patient's own tissue (from the abdomen, back, or buttocks) to create a breast mound.
Breast reconstruction can be done with the mastectomy, or it can be delayed
| Reconstruction is optional
55
# Radiation Therapy
What are the adjuvant therapy goals?
| 3
Local Recurrence Prevention: Prevent local cancer recurrences after breast-conserving surgery (lumpectomy).
Lymph Node Recurrence Prevention: Prevent local and lymph node recurrences after mastectomy.
Pain Relief: Relieve pain caused by local, regional, or distant spread of cancer.
56
# Radiation Therapy
When is external radiation done?
What is the descision based on?
Side effects?
Done after breast cancer surgery
Decision based on chance that residual cancer cells are present
Includes radiating axilla and/or supraclavicular nodes when indicated
Does not prevent distant metastasis
Side effects: Fatigue, skin changes, breast edema may be temporary side effects
57
# Radiation Therapy
Where is brachytherapy delivered?
Duration?
Delivery: Delivered directly into the cavity left after lumpectomy.
Treatment Duration: Requires only five treatments.
58
# Radiation Therapy
What is the purpose of palliative radiation therapy?
Application?
Purpose: Decreases pain by reducing the primary tumor mass.
Application: Used to treat symptomatic metastatic lesions in bone, soft tissue organs, brain, and chest.
59
# Chemotherapy
What is the mechanism of cytotoxic drugs?
Combination therapy benefits?
Duration?
To destroy cancer cells.
Combination Therapy: Combination drug therapy is usually superior to using a single drug.
Duration: Usually given for 3 to 6 months.
| In cases with metastasis chemotherapy may be given for life
60
# Chemotherapy
Why is the combination of drug effective?
Combinations of drugs are effective because they have different mechanisms of action.
They work during different parts of the cell cycle (the process of cell division).
61
# Chemotherapy
What are some side effects related to drug combination, schedule, & dosage?
GI Tract: Causes nausea, anorexia (loss of appetite), and weight loss.
Bone Marrow: Leads to anemia (low red blood cell count).
Hair Follicles: Results in alopecia (hair loss).
"Chemobrain": Cognitive changes (e.g., memory problems, difficulty concentrating).
62
# Nursing Care of the Breast Cancer Client
What are some key components of obtaining a history of breast disorder to help establish a diagnosis?
Nipple Discharge: Assess the presence, color, consistency, and whether it's from one or both breasts.
Pain: Inquire about the presence, location, and characteristics of any breast pain.
Lump: Note the rate of growth, size, consistency, mobility, and shape of any lump.
Breast Asymmetry: Observe for any noticeable differences in breast size or shape.
Correlation with Menstrual Cycle: Determine if symptoms change with the menstrual cycle.
63
# Nursing Care of the Breast Cancer Client
What are the overall goals of nursing care of a pt. with breast cancer?
Actively take part in decision making
Adhere to therapeutic plan
Communicate about and manage side effects of adjuvant therapy
Access and benefit from support
Adhere to recommended follow-up
64
# Breast Health Promotion
What are some ways to reduce risk factors of breast cancer?
Maintaining a healthy weight
Exercising regularly
Limiting alcohol
Eating nutritious food
Never smoking/quitting
Comply with Screening Guidelines:
- Following recommended screening guidelines, including breast self-examination (BSE) and mammograms, is crucial for early detection.
65
# Breast Health Promotion
What are some risk reduction option for those at high risk?
Genetic testing for BRCA and other gene mutations for people with strong family history
Consider prophylactic oophorectomy after counseling about risks, benefits, and fertility issues
Consider prophylactic breast surgery
66
# Nursing Implementation Acute Care
What are key points of post-operative pain management?
Post-operative pain intensity varies among individuals.
Regularly administer analgesics as prescribed.
Premedicate the patient before exercises to minimize discomfort.
67
# Nursing Implementation Acute Care
What are some key pt. teachings?
Teaching drain care may be needed
Teach to report symptoms (Fever, inflammation, erythema, unusual swelling)
Teach patient to take measures to prevent and reduce lymphedema
* No BP readings, venipunctures, or injections
* Arm should not be dependent for long periods
* Prevent infection, burns, or compromised circulation
* Encourage exercise and maintaining normal weight
68
# Nursing Implementation Acute Care
What is a key nursing goal after breast cancer surgery?
Restoring arm function on affected side after breast cancer surgery is a key nursing goal
69
# Cervical Cancer
What is the epidemiology of cervical cancer?
| Historical Significance?
Mortality Decline, Why?
Racial Disparity?
Historical Significance: Once a common cause of cancer death in women.
Mortality Decline: Mortality rates have significantly declined due to early detection (Pap and HPV tests).
Racial Disparity: African American women have the highest mortality rate.
70
# Cervical Cancer
What are some risk factors of cervical cancer?
Infection with high-risk strains of HPV 16 and 18
Immunosuppression
Using OCPs for long period
Being exposed to drug DES
Giving birth to many children
Smoking
71
# Cervical Cancer Clinical Manifestations
What are some clinicla manifestations of cervical cancer?
No symptoms in early stages
Eventually, unusual discharge, Abnormal Uterine Bleeding (AUB), postcoital bleeding occurs
- Discharge initially thin and watery; becomes dark and foul smelling
- Vaginal bleeding first presents as spotting; becomes heavier and more frequent
Pain, weight loss, anemia, cachexia are late symptoms
72
# Cervical Cancer Diagnostic Studies
What are some cervical cancer diagnostic studies?
Purpose?
Procedure?
Co-testing (combined use of the Pap test and the HPV test)
Pap (Papanicolaou) Test
- Purpose: Helps find changes in cervical cells that may indicate precancerous or cancerous conditions.
- Procedure: Cervical cells are obtained from the cervix during a speculum examination.
HPV Test
- Purpose: Identifies high-risk HPV types 16 and 18, which are strongly associated with cervical cancer.
- Procedure: Cervical scrapings are tested for viral DNA or RNA.
73
# Cervical Cancer Diagnostic Studies
What are the cervical screening guidlines?
Cervical cancer screening typically begins at age 21.
21 to 29 Years Old: Pap test every 3 years.
30 to 65 Years Old: Co-testing (Pap test and HPV test) every 5 years (preferred) or Pap test alone every 3 years.
74
# Cervical Cancer Diagnostic Studies
What should be done in a pap test comes back abnormal?
Followed with a colposcopy (visual examination of the cervix with a magnifying instrument) and a cervical biopsy is taken
75
# Cervical Cancer Interprofessional Care
At what age should HPV vaccination begin?
Name of vaccine?
What is the dosage schedule?
## Footnote
Vaccination is a key strategy for preventing HPV infection and subsequent cervical cancer.
Ages 11 to 12; may be given as early as age 9
Gardasil
Dosage: 2 to 3 intramuscular (IM) doses over a 6-month period, depending on age at first dose.
76
# Cervical Cancer Interprofessional Care
What types of HPV does Gardasil protect against?
Gardasil 9?
Gardasil: Protects against HPV types 6, 11, 16, and 18.
Gardasil 9: Protects against HPV types 6, 11, 16, 18, plus 5 additional HPV types.
77
# Ovarian Cancer Etiology and Pathophysiology (1 of 3)
What are some risk factors of ovarian cancer?
Personal or family history of cancer
Genetic predisposition
Family history of Lynch syndrome
Hereditary nonpolyposis colorectal cancer (HNPCC)
Endometriosis
Women who have never been pregnant (nulliparity)
Infertility
| Often affects postmenopausal women
78
# Ovarian Cancer Etiology and Pathophysiology (2 of 3)
What are some ways to reduced the risk of ovarian cancer?
Childbirth and Breastfeeding
Hormonal Contraceptive Pills: Using hormonal contraceptive pills for 5 or more years reduces risk.
## Footnote
Protective factors as they reduce the number of ovulatory cycles over the lifetime
79
# Ovarian Cancer Etiology and Pathophysiology (3 of 3)
What is a common complication of ovarian cancer?
Metastasizes where?
Intraperitoneal dissemination is common
Metastasizes to uterus, bladder, bowel, and omentum (early)
In advanced disease metastasizes to stomach, colon, liver, and other parts of body (late)
80
# Ovarian Cancer Etiology and Pathophysiology (3 of 3)
What are some symptoms of ovarian cancer?
May be nonspecific symptoms:
Pelvic or abdominal pain
Bloating
Urinary urgency or frequency
Difficulty in eating or feeling full quickly
81
# Ovarian Cancer Clinical Manifestations
What are the clinical manifestations of later stage ovarian cancer?
Abdominal enlargement with ascites
Unexplained weight loss or gain
Nausea
Abnormal vaginal discharge or bleeding
Adnexal mass or lymphadenopathy on physical exam
82
# Ovarian Cancer Diagnostic Studies
What are some diagnostic studies used for ovarian cancer?
Annual Bimanual Pelvic Exam (Ovaries should not be palpable in postmenopausal women. Palpable ovaries warrant further investigation.)
Ultrasound or MRI (Ovarian masses can be detected with abdominal or transvaginal ultrasound or MRI.)
Exploratory Laparotomy (An exploratory laparotomy (surgical incision into the abdomen) can establish a definitive diagnosis and stage of the disease.)
83
# Ovarian Cancer Diagnostic Studies
What are some steps women at an increased risk for ovarian cancer should take?
Screening in addition to annual pelvic
Tumor marker CA-125 and pelvic ultrasound
* CA-125 positive in 80% of cases
* CA-125 can be elevated with other cancers or with benign conditions
84
# Ovarian Cancer Interprofessional Care (1 of 4)
What are some methods of prophylactic care for women at high risk for ovarian cancer?
Removal of ovaries and fallopian tubes
- Oophorectomy does not eliminate the risk for cancer in the peritoneum
Oral contraceptives (OCPs)
85
# Ovarian Cancer Interprofessional Care (2 of 4)
What the steps of intial treatment for all stages of ovarian cancer?
Total abdominal hysterectomy
Bilateral salpingo-oophorectomy (Surgical removal of both ovaries and fallopian tubes.)
Removal of as much of tumor as possible (tumor debulking)
86
# Ovarian Cancer Interprofessional Care (3 of 4)
What do treatment options depend on?
Grade & Stage of cancer
87
# Ovarian Cancer Interprofessional Care (3 of 4)
What is intraperitoneal and systemic chemotherapy?
Common agents?
Chemotherapy administered directly into the abdominal cavity (intraperitoneal) and throughout the body (systemic).
Common Agents:
Taxanes (paclitaxel or docetaxel).
Platinum agents (carboplatin or cisplatin).
88
# Ovarian Cancer Interprofessional Care (3 of 4)
What is intraperitoneal instillation of radioisotopes?
Radioactive substances are instilled directly into the abdominal cavity to target remaining cancer cells.
89
# Ovarian Cancer Interprofessional Care (3 of 4)
What is External abdominal and pelvic radiation therapy?
Radiation therapy delivered from outside the body to target the abdominal and pelvic areas.
90
# Ovarian Cancer Interprofessional Care (4 of 4)
What is targeted therapy?
Agents?
Mechanism of PARP inhibitors?
These drugs target specific molecules involved in cancer growth and spread.
Agents:
* Bevacizumab (Avastin): An angiogenesis inhibitor that blocks the formation of new blood vessels that feed tumors.
* Rucaparib (Rubraca): A PARP inhibitor.
* Olaparib (Lynparza): A PARP inhibitor.
Mechanism of PARP Inhibitors:
* Block DNA Repair
* BRCA-Associated Cancers
91
What is a hysterectomy?
Surgical removal of uterus
92
# Nursing Management Hysterectomy (Surgical removal of uterus)
What are some post-hysterectomy nursing management measures?
Food and fluid restrictions
Monitor for and manage abdominal distention (swelling).
Emphasize the importance of early ambulation (walking).
Initiate DVT prophylaxis
93
# Nursing Management Hysterectomy (Surgical removal of uterus)
What are some important factors of DVT prophylaxis?
Apply intermittent pneumatic compression devices
Frequent position changes
Avoid high Fowler's position
Avoid pressure under knees
Encourage leg exercises
94
# Nursing Management Hysterectomy cont.
What are the postop expectations?
No menstruation
Activity restrictions
Avoid intercourse for 4 to 6 weeks
Sensation will not return for several months after vaginal hysterectomy
Physical restrictions until healing is complete
95
What is Salpingectomy?
What is Oophorectomy?
Removal of fallopian tubes
Removal of ovaries
96
# Nursing Management Salpingectomy and Oophorectomy
What is the postop care of Salpingectomy & Oophorectomy similar to?
What might you see if a large ovarian cyst is removed?
Abdominal surgery patients
If large ovarian cyst is removed, may have abdominal distention
| Pt. may have an abdpminal binder
97
# Nursing Management Salpingectomy and Oophorectomy
What is surgical menopause?
Symptoms of menopause that is caused by sudden removal of the ovaries
| Can be more severe due to sudden withdrawal of hormones
97
A postmenopausal woman reports experiencing hot flashes and night sweats. Which of the following nursing interventions is most appropriate?
A. Recommend hormone replacement therapy without further assessment.
B. Educate the patient on lifestyle modifications and symptom management.
C. Advise the patient to increase her intake of red meat.
D. Suggest the patient use cold compresses to relieve symptoms.
B. Educate the patient on lifestyle modifications and symptom management.
98
A patient is scheduled for a pelvic examination. Which of the following nursing interventions are essential before the procedure? Select all that apply.
A. Provide privacy and ensure a comfortable environment.
B. Explain the procedure and its purpose.
C. Instruct the patient to empty her bladder.
D. Encourage the patient to ask questions.
E. Administer a sedative to reduce anxiety.
F. Apply warm compresses to the abdomen.
A, B, C, D
99
A 50-year-old woman with a family history of breast cancer is concerned about screening recommendations. Which of the following is the most appropriate nursing intervention?
A. Reassure her that annual mammograms are not necessary.
B. Provide information on the benefits and risks of mammography and encourage shared decision-making.
C. Advise her to have a genetic test for BRCA mutations immediately.
D. Recommend a breast self-examination every six months.
B. Provide information on the benefits and risks of mammography and encourage shared decision-making.
100
A patient scheduled for a breast biopsy asks about the different types of biopsies. Which of the following should the nurse include in the patient education? Select all that apply.
A. Fine-needle aspiration (FNA)
B. Core-needle biopsy
C. Excisional biopsy
D. Incisional biopsy
E. Stereotactic biopsy
F. Liquid biopsy
A, B, C, D, E
101
A patient who underwent a modified radical mastectomy is at risk for lymphedema. Which of the following nursing interventions is most appropriate?
A. Encourage the patient to perform strenuous arm exercises.
B. Teach the patient to avoid taking blood pressures on the affected arm.
C. Apply heat to the affected arm to promote circulation.
D. Elevate the affected arm in a dependent position.
B. Teach the patient to avoid taking blood pressures on the affected arm.
102
Which of the following are important components of nursing care for a patient undergoing chemotherapy for breast cancer? Select all that apply.
A. Administering antiemetics as prescribed.
B. Monitoring for signs of infection.
C. Encouraging a high-protein diet.
D. Providing emotional support.
E. Teaching the patient about potential side effects.
F. Limiting fluid intake to prevent nausea.
A, B, C, D, E
103
A postmenopausal woman with a family history of ovarian cancer is concerned about screening. Which of the following is the most appropriate nursing intervention?
A. Recommend an annual CA-125 test.
B. Advise her to have prophylactic surgery immediately.
C. Educate her about the limitations of screening and discuss risk reduction strategies.
D. Reassure her that postmenopausal women are not at risk.
C. Educate her about the limitations of screening and discuss risk reduction strategies.
104
A patient scheduled for a total abdominal hysterectomy and bilateral salpingo-oophorectomy for ovarian cancer asks about potential side effects. Which of the following should the nurse include in the patient education? Select all that apply.
A. Hot flashes.
B. Vaginal dryness.
C. Decreased bone density.
D. Increased libido.
E. Improved mood.
F. Weight gain.
A, B, C
105
A patient who underwent a hysterectomy reports severe abdominal pain and distention. Which of the following nursing interventions is most appropriate?
A. Administer pain medication as prescribed.
B. Encourage early ambulation.
C. Apply warm compresses to the abdomen.
D. Monitor for signs of infection.
A. Administer pain medication as prescribed.
106
A patient scheduled for a salpingectomy and oophorectomy expresses concern about potential menopausal symptoms. Which of the following should the nurse include in the patient education? Select all that apply.
A. Symptoms can be more severe due to sudden withdrawal of hormones.
B. Hormone replacement therapy may be an option.
C. Regular exercise can help manage symptoms.
D. Dietary modifications can reduce symptom severity.
E. Symptoms will resolve within a few weeks.
F. There are no effective treatments for menopausal symptoms.
A, B, C, D
107
What is the primary mechanism by which estrogen may influence breast cancer development?
A. Direct stimulation of tumor growth
B. Increased tumor size at diagnosis
C. Increased rate of cellular mutations
D. Altered immune response
A. Direct stimulation of tumor growth
108
Which of the following are important aspects of breast health promotion that should be included in patient education? Select all that apply.
A. Maintaining a healthy weight
B. Limiting alcohol consumption
C. Never smoking/quitting
D. Regular exercise
E. Limiting sun exposure
F. Increasing red meat intake
A, B, C, D
109
Why are food and fluid restrictions typically implemented after a hysterectomy?
A. To prevent nausea and vomiting.
B. To reduce abdominal distention.
C. To promote bowel function.
D. To minimize pain.
B. To reduce abdominal distention.
