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NUR 329 > Female GU > Flashcards

Female GU Flashcards

0
Q

Sexual history

A 
Pain with intercourse
Hx of sexual or physical abuse
Hx of STDs
Sexual preference
Ask r/ship status- single, involved, married
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1
Q

Health history of female GU

A 
Menstrual hx, preg hx, 
meds- current, hx, exposure, side effects
Pain with menses or intercourse
Vaginal discharge, odor, itching
Chronic illness or disabilities
Urinary and bowel function
Surgical/ procedure hx
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2
Q

PLISSIT

A 
Permission
Limited 
information
Specific
Suggestions
Intensive
Therapies
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3
Q

Examinations

A

Pelvic exam

Pap smear

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4
Q

Dx tests

A 
Colposcopy and cervical biopsy
Cryotherapy and laser therapy
Cone biopsy
Loop electrosurgical incision ( LEEP)
Endometrial biopsy
Dilation and curattage 
Laparoscopy (pelvic peritoneoscopy) 
Hysteroscopy
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5
Q

Def coloscopy

A

Microscope exam

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6
Q

Def Cryotherapy

A

Freezing of the cell

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7
Q

What is the most common std

A

HPV

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8
Q

What is the name of the vaccine for HPV

A

Gardasil

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9
Q

How many injections is the gardasil vaccine

A

3

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10
Q

What conditions is HPV assoc w/

A

Cervical dysplasia

Cervical cancer

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11
Q

What screening can be done to detect HPV

A

Annual Pap smear

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12
Q

List the menstrual disorders

A

Premenstrual syndrome
Dysmenorrhea
Amenorrhea

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13
Q

List the abnormal menstrual disorders

A

Menorrhagia
Metrorhagia
Post menopausal bleeding

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14
Q

List the female reproductive malignancies

A 
Cervical
Uterine
Vaginal
Vulvar
Ovarian
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15
Q

T/F- there are early s&s of female reproductive malignancies

A

False- usually no s&s

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16
Q

S&s of reproductive malignancies

A 
Depends on location
Vaginal discharge
Pain
Bleeding
Systemic systems
- weight loss
- anemia
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17
Q

What components are vital to dx of reproductive malignancies

A

Prevention
Screening
Early detection

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18
Q

Reproductive malignancy therapies

A

Chemotherapy
Radiation
Surgery
Combo

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19
Q

Is reproductive malignancy therapies curative or palliative

A

Both

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20
Q

What is the 3rd most common reproductive cancer

A

Cervical ca

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21
Q

How can cervical cancer be dx

A

Pap smear

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22
Q

List the cells of cervical cancer

A

Squamous cell carcinoma

Adrenocarcinoma.

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23
Q

Risk factors for cervical cancer

A 
Sexual activity before 18
Multiple sex partners
Sex partners who are not circumcised
Sexual partners who have had previous partners with cervical ca
Early childbearing 
HIV, exposure to HPV
Smoking
Fam hx
Nutritional deficiencies- folate, vitamin c
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24
Q

Cervical s&s

A 
Early- none
Thin watery vaginal discharge
Irregular bleeding
Pain or bleeding after intercourse
Dark, foul discharge
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25
Q

Late s&s of cervical cancer

A

Leg or rectal pain

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26
Q

Dx of cervical cancer

A

Abnormal pap
Biopsy- CIN III, or Carcinoma in situ
Invasive cancer
D&C to stage the cancer

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27
Q

What procedure may be done to stage the cervical cancer

A

D&C

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28
Q

Tx for Precursor or Pre-invasion lesions

A

Colposcopy
Cryotherapy
LEEP
Conization

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29
Q

Tx for invasive cancer

A 
Depends on stage and location
Hysterectomy
BIL lymphadenectomy 
Pelvic exenteration
Radical trachelectomy
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30
Q

What is the leading cause of gun cancer deaths

A

Ovarian cancer

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31
Q

When is the peak for ovarian cancer

A

40-80

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32
Q

What decreases the risks for ovarian cancer

A

Pregnancy

OCP- oral contraception pill

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33
Q

T/F- there is no correlation bx ovarian cancer and breast cancer

A

False- there is a correlation

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34
Q

Why is dx ing ovarian cancer difficult

A

Difficult to detect

No early screening

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35
Q

What tests can dx ovarian cancer

A

Vaginal ultrasound
CA-125
Pelvic imaging

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36
Q

S&s of ovarian cancer

A 
Abdominal bloating/ incr abdominal girth
Pelvic pressure 
Back pain
Constipation, urinary urgency, indigestion, flatulence
Leg pain
Pelvic pain
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37
Q

Ovarian cancer medical mgmt

A

Tumor debulking/ removal
Borderline tumor- removal if affected ovary
Chemo

38
Q

How is ovarian cancer staged

A

TNM I- IV

39
Q

Pre-op protocols for ovarian surgery

A 
Barium enema
Cystoscope
UGI series
CT Scan
Chest x to r/o mets
40
Q

Complications of advanced ovarian cancer

A

Pleural effusion

Ascites

41
Q

Interventions to treat complications of ovarian cancer

A 
Thoracentesis
IVF
I& O
TPN
Comfort measures
42
Q

What is the most common gyn cancer

A

Uterine cancer

43
Q

Risk factors for uterine cancer

A 
>55
White> black (more deaths though)
Obesity
Unopposed estrogen therapy (estr w/o proegesterone)
Nullipaity
Truncal obesity
Late menopause
Use of tamoxifen
44
Q

S&s of uterine cancer

A

Irregular bleeding

Post menopausal bleeding

45
Q

What is uterine cancer aka

A

Endometrial cancer

46
Q

T/F- vaginal cancer is common

A

False- rare

47
Q

Risk factors for vaginal cancer

A 
Previous cervical, vaginal, vulvar cancers
In-utero exposure to DES
Previous radiation therapy
Hx HPV
Pessary use
48
Q

S&s of vaginal cancer

A 
No symptoms
Slight bleeding after intercourse
Spontaneous bleeding
Vaginal discharge 
Pain 
Urinary/rectal symptoms
49
Q

Tx of early vaginal lesions

A

Topical chemo

Local excision

50
Q

Detection of vulvar cancer

A

Pelvic exams
Pap smears
Self exam

51
Q

Risk factors for vulvar cancer

A

Smoking
HPV
HIV
Immunosuppressant therapy

52
Q

S&s of vulvar cancer

A

Long standing pruritis and soreness
Chronic dermatitis
Lump, mass, ulcer

53
Q

Late s&s of vulvar cancer

A

Bleeding
Foul smelling discharge
Pain

54
Q

Vulvar cancer tx

A 
Extra uterine bleeding 
Sonogram
TAH- total abdominal hysterectomy
TAH/BSO- bilateral salpingo oopherectomy 
Brachytherapy
Chemo
55
Q

Define fibroids

A

Aka myomas

Benign growth of muscle tissue

56
Q

Fibroids risk factors

A

Genetic predisposition

Age 25-40

57
Q

Fibroids are the most common reason for ______ secondary to _______

A

Hysterectomy

Menorrhagia

58
Q

S&s of fibroids

A 
Abnormal vaginal bleeding
Pain
Backache
Bloating
Constipation 
Urinary problems
Menorrhagia
Metrorrhagia
59
Q

Fibroids may interfere with ________

A

Fertility

60
Q

Surgical options for fibroids

A 
Myomectomy
Hysterectomy
Laparoscopic mayolysis/ cryomyolysis 
Uterine artery embolization (UAE)
Magnetic resonance guided u/s
61
Q

Meds for fibroids

A

Gonadotropin releasing hormone

Mifepresone

62
Q

Def endometriosis

A
  • Benign lesions that proliferate the uterine lining and can grow anywhere in the pelvic cavity
  • ectopic tissue bleeds into cavity with no outlet and causes adhesions and pain
63
Q

Endometriosis risk factors

A

Family hx

64
Q

Endometriosis can cause ______ and ______

A

Infertility

Chronic pelvic pain

65
Q

Endometriosis s&s

A 
Dysmenorrhea 
Dyspareunia 
Pelvic discomfort
Dyschezia - constipation
Infertility
Depression
66
Q

Endometriosis dx

A

Menses pattern
Limited urine mobility
Fixed tender nodules on bi manual exam
Laparoscopic to stage I-IV

67
Q

Medical mgmt options for endometriosis

A

Based on desire for pregnancy and stage of disease
Symptom mgmt
Hormonal therapy
Surgical

68
Q

Symptom mgmt for endometriosis

A

NSAIDS

OCP

69
Q

Hormonal therapy for endometriosis

A

Androgens

Gn-RH Agonists

70
Q

Surgical interventions for endometriosis

A 
Laparoscopic fulgeration 
Endoagulation
Electrocoagulation
TAH
TAH/ BSO
71
Q

Nsg focus for endometriosis

A

Address inability to conceive

Symptom mgmt

72
Q

Name the 2 types of hysterectomies

A

Total

Radical

73
Q

Hysterectomy approaches

A

Laparoscopic
vaginal
Incisional through abdomen

74
Q

Potential complications of hysterectomy

A

Bleeding
* DVT*
Bladder dysfunction

75
Q

Risk factors for breast cancer

A 
Female, age, fam and personal hx (genetic mutations)
Hormonal factors
Exposure to radiation
Hx of benign breast disease
Obesity
High fat diet
ETOH intake
76
Q

Early detection of breast cancer

A

20-30 yo- CBE q 3 yrs, SBE monthly
> 40- CBE annually, mammography annually
If pt has significant hx, screening may be done earlier or in shorter intervals - MRI, u/s

77
Q

List the breast disorders

A

Benign

Malignant

78
Q

Benign breast disorders

A

Breast pain
Cysts
Fibroadenomas
benign proliferative breast disease

79
Q

Benign proliferative breast disease types

A

Atypical hyperplasia

Lobular carcinoma in situ

80
Q

Breast cancer dx tests

A 
Mammography
Galactography 
Ultrasonography 
MRI
Biopsy
81
Q

Types of biopsies for breast cancer

A
  • Percutaneous- fine needle aspiration, core biopsy

- surgical- excision, incision, wire needle localization

82
Q

Breast cancer surgical mgmt

A 
Breast conservation tx
Total mastectomy
Radical mastectomy
Sentinel node biopsy
Axillary lymph node dissection
Breast reconstruction surgery
83
Q

Def DIEP flap

A

Breast reconstruction surge in which blood vessels inferior epigastric perforators and the skin and fat connected to them are removed from the lower abdomen and transferred to chest to reconstruct chest without extracti abdominal muscle

84
Q

Benefits of DIEP Flap

A

Less painful

Quicker recovery time

85
Q

Medical mgmt of breast cancer

A

Radiation
Chemo
Hormonal
Targeted

86
Q

Radiation therapy for breast cancer

A

External beam

Brachytherapy

87
Q

Hormonal therapy for breast cancer

A
  • Estrogen and progest assay receptor
  • Selective estrogen receptor modulators - tamoxifen
  • Aromatase inhibitors- anastrazole, lestrozole, exemestane
88
Q

Targeted therapy for breast cancer

A

Seeds

89
Q

Potential complications of breast surgery

A

Lymph edema
Hematoma, seroma formation
Infection

90
Q

Arm exercise quantity post op

A

TID X 20 min

91
Q

Benefits of arm exercises

A
  • incr circulation and muscle strength
  • prevents stiffness and contractures
  • restores ROM
92
Q

Breast drain mgmt

A
  • referral for home care
  • removed when < 30 mL drains in a 24 hr period (7-10 days)
  • drain site and incision care

NUR 329 (6 decks)

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