Exam 5 Study Guide: Q Flashcards
what is it called when a patient is getting up all night to urinate?
nocturia
what are expected characteristics of urine?
clear yellow
no foul smell
is genital herpes painful?
yes
are genital warts painful?
no
during GU exam, a patient reports labia tenderness
is it an expected finding?
no
labia is usually darker than overall skin tone but should be nontender
when educating a client on safe sex, should they use a condom?
yes
can a condom be used twice?
no
can a diaphragm prevent STIs?
no
can someone still have an STI if they are symptom free?
yes
a client with tremors and psychosis likely have what?
neuro or late-stage syphilis
what is the goal of a head-to-toe assessment?
gather information thoroughly, accurately, and efficiently
does not prevent anything, not trying to go as quick as possible, not trying to make it easy to document
if a female is on birth control, will that prevent STIs?
no
why shouldn’t a client who smokes take birth control pills?
causes blood clots, PE, and death
what are important interventions when taking birth control pills?
take them at the same time every day
watch for abnormal bleeding
if a patient says they only check for lumps around areola and nipple, do they understand teaching about self-breast exams?
no
must use the pads of your 3 middle fingers to assess breast, nipple, areola, and the tail of spence, including the axilla
when is the best time to perform a self-breast exam?
4 - 7 days after menstrual cycle begins
- - breast tissue will be less full and tender
where is the most common location of breast lesions?
the upper outer quadrant and the tail of spence
does a family hx of breast cancer increase a client’s risk for breast cancer?
yes
a nipple that changes from protruded to inverted can be a sign of what?
benign or cancerous mass in the breast
- - must be reported to doctor
what are normal findings of a breast exam?
- left breast can be slightly larger than the right
- might have some striae
- pregnant women can have blue veins visible under the skin
- nipples should be symmetrical and on the same plane
what could cause the nipples to be asymmetric?
- underlying cancer may cause fibrosis in mammary ducts
- which pulls the nipple angle toward it
why do females get mammograms?
to detect early breast cancer
lymphedema with NO pain in the upper limb can be seen in which patients?
those that had a previous mastectomy on that side from the disruption of normal pathways of the lymph drainage from the breast area
what is the appearance of lymphedema?
swelling without pain
still able to palpate a pulse
not leathery
does not cause wounds
what is lymphedema or lymphatic obstruction?
long-term condition where excess fluid collects in tissues causing swelling (edema), typically caused by a blockage of lymphatic system
where does lymphedema or lymphatic obstruction typically occur?
the lymphatic system
- it is part of the immune system and vital for immune function
if a patient had a previous mastectomy, avoid BP and IVC on the affected arm.
if they had a bilateral mastectomy, where can you obtain a blood pressure?
thigh
calf
ankle
avoid using the upper limbs due to lymphatic system disruption
what is the purpose of the lymphatic system?
detect and eliminate microorganisms from the body
- also absorbs lipids from the small intestine and reabsorbs fluid from interstitial tissues
what can palpable lymph nodes indicate?
systemic infection or malignancy
the absence of menstrual period for 13 months in a 50 yo woman indicates what condition?
menopause
- occurs around 45 - 55 yo when a menstrual period has not occurred in more than a year
what is gynecomastia?
enlarged male breast tissues
what are some causes of gynecomastia?
medications
disease
an adolescent with weight gain
what is tanner staging?
assessed sexual maturation in males and females
- objective classification system that providers use to document and track the development and sequence of secondary sex characteristics of children during puberty
what structures are in the urinary tract?
bladder
kidney
ureters
urethra
where can you palpate the bladder?
palpable below umbilicus above symphysis pubis along midline
- not rigid/nodular or at umbilicus
- if distended and they complain of pain, DONT palpate or use bladder scanner
what is the position used for female genitourinary exam?
lithotomy position
clients feet in stirrups to assist provider with external internal exam
have client void prior to exam and keep the head of bed elevated
what are important points to remember when performing a female GU exam?
- maintain professional boundaries
- explain things before you start
- ask if they have any questions before starting
- maintain privacy
- use therapeutic communication throughout exam
what are expected findings on a female GU exam?
- labia minora is darker than the overall skin tone
- perineum is smooth
- introitus has uneven edges d/t remnants of a hymen membrane
- should be nontender
what are prep instructions for a patient preparing for a pep smear?
- avoid anything in the vagina for 2 days prior
no douching or sexual intercourse
reschedule if have menses
does pap smear test for STDs?
no
what are expected findings on a testicular exam?
smooth
firm
common for one to be lower than the other
how should a client perform a testicular self-exam?
- perform after a warm shower
- roll the testicle between the thumb and finger
- palpate using thumb and first 2 fingers of the hand
- gentle, NOT firm palpation
- not 2 fingers on each hand
when there is an older client with a UTI, what are expected findings?
confusion
urinary incontinence
what are signs of a UTI?
- painful urination
- malodorous urine
- cloudy appearance of the urine
what causes older adults to have decreased control of the anal opening?
weakened perianal muscles
- which is an expected change
what are questions to ask when a client has difficulty emptying their bladder?
- does it burn when you urinate?
- what color is your urine?
- how often do you urinate?
how can prostatomegaly affect urinary catheter placement?
- causes restriction of the urethra making it difficult to advance the catheter
- should stop advancing cath and use coude catheter
what are symptoms of BPH? (benign prostatic hyperplasia)
- weak urine stream
- inability to empty bladder
- difficulty starting urination
- dribbling urine and nocturia
trouble advancing foley on male could be due to what condtion?
- enlarged prostate (BPH)
not because not enough lube or catheter too large/small
what are primary prevention measures against STIs?
HPV vaccine for females and males
condoms
abstinence
a chancre sore is specific to which infection?
syphilis
- silvery raised patch
what is neurosyphilis and symptoms of it?
- occurs in late syphilis
- causes:
- paresis
- tremors
- personality changes
- psychosis
a patient comes in complaining of yellow green discharge, pain with urination, and pelvic pain
you suspect what condition?
gonorrhea
cluster of fluid filled vesicles?
herpes
small, painful fluid-filled vesicles that break and become superficial ulcers?
genital herpes
what condition causes small, painless, fleshy growths that may appear singularly or in clusters?
genital warts
what are symptoms of chlamydia?
- symptom free
- yellow, purulent discharge
- frequent urination
what are important interventions for general herpes?
- keep area clean and dry
- avoid tight clothing (cotton is best)
- take medication as directed
- avoid sex during breakout
- practice safe sex
what causes bright-red blood stool and rectal itching?
hemorrhoids
what is rectal prolapse and symptoms of it?
- caused by a protrusion of the rectal wall through the anal opening
- bulging, moist, red, ringed-shaped membrane at the anal opening
what condition causes tarry black stools (melena)?
a upper GI bleed
inspecting perineum, you see a red, bulging, moist structure at ring opening, what is this called?
rectal prolapse
what is it called when an uncircumcised patient can’t retract the foreskin, becomes swollen, and is painful?
phimosis
painful sustained erection without sexual desire?
common with sickle cell anemia
priapism
what is the recommended age to begin colorectal screening?
50 years old
if there is a family hx of colorectal cancer
- know age when diagnosed and report to provider
what position is best for accentuating retraction of breast tissue?
hands pressed on hips
a patient with cardiac disease is taking digoxin.
how might this affect his breast?
gynecomastia
when palpating the central nodes, the nurse palpates?
high in the middle of the axilla
the nurse is inspecting the external genitalia of a premenopausal woman, what would be the normal color of the cervix?
pink
what is the normal pubic hair distribution of a 25 yo female client?
inverse triangle
a 25 yo female client presents in the ED with the chief complaint of lower abdominal pain.
what question would be most appropriate to identify a gynecological problem?
when was your last menstrual period?
the nurse is performing a pelvic exam on a 33 yo female client who is 10 weeks pregnant.
what would be the expected color of the cervix?
blue
a 30 yo female client is schedule for her annual gynecological exam, which includes a PAP test.
the PAP test is a screening test for?
cervical cancer
a 25 yo male client reports finding a lump in right testicle.
which finding describes normal consistency of the testes?
firm
the prostate specific antigen (PSA) test is a screening test for?
prostate cancer
on examination of the penis, the nurse notes a single, white, painless lesion.
the lesion described most likely is?
syphilis
while performing a newborn assessment on a baby boy, the nurse noted scrotal swelling.
this is referred to as?
hydrocele
the nurse is performing a cancer risk assessment and promoting cancer screenings at a health fair.
a 55 yo male seeking health information has never been screened for prostate cancer.
what is the recommended age for prostate cancer screening?
50 yo
