Female reproductive disorders Flashcards

1
Q

Benign Breast disorders:

A
Breast pain
Cysts
Fibrocystic
Fibroadenomas 
Atypical ductal hyperplasia 
Lobular carcinoma in situ
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2
Q

What are the types of cysts?

A

Simple - require no intervention, can aspirate to relieve discomfort

Complicated - fluid inside, rarely malignant, aspirate to confirm it is complicated

Complex - wall is thick, solid, need biopsy to confirm it is benign

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3
Q

Fibrocystic breast disorder

A

Transient breast mass - typically r/t hormones

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4
Q

What are fibroadenomas (cause)

A

usually caused by cell abnormalities – causes a firm, round, movable nodule.

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5
Q

what is a risk atypical ductal hyperplasia

A

incidental finding, increases risk of cancer and

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6
Q

What is a risk with lobular carcinoma in situ

A

incidental finding, can indicate risk for cancer

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7
Q

Risk factors for breast cancer

A

Women, aging, inherited genetic mutation, family history, personal history, history of benign proliferative breast disease, history of high dose radiation to chest, hormonal factors, history of ovarian or endometrial cancer

obesity, alcohol consumption post-menopause, hormone replacement

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8
Q

Examples of screening and prevention of breast cancer

A
Screening recommendations
Prevention strategies in the high-risk patient
- long term surveillance 
- chemoprevention
- prophylactic mastectomy
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9
Q

Clinical manifestations of breast cancer

A
Dimpling
Nipple retraction
Skin ulceration
Nodule 
Hard/firm breast tissue
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10
Q

What are ways that breast biopsy can be obtained?

A
Fine needle aspiration
Ultrasound guided 
Stereotactic breast biopsy
MRI guided biopsy
Surgical biopsy
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11
Q

Types of breast cancer

A

Ductal carcinoma in situ
Infiltrating ductal carcinoma
Infiltrating lobular carcinoma
Medullary carcinoma

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12
Q

Surgical management of breast cancer

A
Lumpectomy
Simple mastectomy
Modified radical mastectomy
Radial mastectomy
Breast conversion therapy
Sentinel lymph node biopsy
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13
Q

What are complications of surgical management of breast cancer

A

Lymphedema
Hematoma and seroma formation
Infection

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14
Q

Breast cancer: reconstruction surgery

A

You can can reconstructive surgery for

  1. lumpectomy
  2. after mastectomy, this includes
    - tissue expander followed by permanent implant
    - tissue transfer procedures
    - nipple-alveolar reconstruction
    - prosthetics
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15
Q

Patient education - hand and arm care after axillary lymph node dissection (ALND)

A

Avoid blood pressures, injections, blood draws in the affected extremity
Sun screen (at least 15 spf)
Apply insect repellant to avoid insect bites
Wear gloves for gardening
Use cooking mitt for removing objects from oven
Avoid cutting with cuticles - push back instead
Avoid lifting >5-10 lb (increases pressure)
Avoid tight jewelry, clothing, bandages on arm
Avoid chemical hair removers
Observe area or 24 hours
If trauma or break in the skin occurs, wash area with soap and water and apply OTC abx ointment

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16
Q

Systemic therapy for breast cancer

A
Radiation
Neoadjuvant
Adjuvant 
Biologic
Endocrine 
Chemo
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17
Q

What is neoadjuvant for systemic therapy of breast cancer

A

Give before surgery to help decrease tumor size

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18
Q

What is adjuvant for systemic therapy of breast cancer

A

Given with surgery to eradicate any residual tissues involved

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19
Q

What is biologic systemic therapy for breast cancer

A

looking at monoclonal antibodies to target specific protein to reduce the occurence rate of the tumor

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20
Q

What is endocrine systemic therapy for breast cancer

A

Estrogen is a hormone that is produced by ovaries that can increase breast cancer growth - so tamoxifen can be prescribed to work on blocking the effects of estrogen on the breast tissue

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21
Q

MANAGING the sfx of adjuvant hormonal therapy in breast cancer: hot flashes

A
Wear breathable, layed clothing 
Avoid caffeine and spicy food
Perform breathing exercises 
Considered medications (medications, antidepressants)
Acupuncture
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22
Q

MANAGING the sfx of adjuvant hormonal therapy in breast cancer: vaginal dryness

A

Use vaginal moisturizers for everyday dryness

Apply vaginal lubrications during intercourse

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23
Q

MANAGING the sfx of adjuvant hormonal therapy in breast cancer: n/v

A

Bland diet

Try to take medication in evening

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24
Q

MANAGING the sfx of adjuvant hormonal therapy in breast cancer: Musculoskeletal symptoms

A

Take NSAIDS

Warm baths

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25
Q

MANAGING the sfx of adjuvant hormonal therapy in breast cancer: risk of endometrial cancer

A

Report any irregular bleeding

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26
Q

MANAGING the sfx of adjuvant hormonal therapy in breast cancer: Risk for thromoembolic events

A

Report and redness, swelling, or tenderness in the lower extremities or any unexplained SOB

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27
Q

MANAGING the sfx of adjuvant hormonal therapy in breast cancer: risk for osteoporosis or fractures

A

Undergo a baseline bone density scan
Perform regular weight bearing exercises
Take calcium supplements with vitamin D
Take biphosphonates (alendronate) or calcium as prescribed

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28
Q

What are examples of reproductive disorders

A

Amenorrhea
Dysmenorrhea
Abnormal uterine bleeding
PMS

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29
Q

What are the types of amenorrhea

A

Primary - not getting period until after age of 16; usually caused by some type of endocrine disorder

Secondary - already est. a regular cycle then it goes away (i.e., eating disorder)

30
Q

What are the types of dysmenorrhea

A

Primary: occurs at onset of period

Secondary: well after menstrual cycle; usually caused by some type of organic or structural cause (i.e., fibroids)

31
Q

What are symptoms you will experience during ovulation

A
Tender breasts
Increased sex drive 
Spotting 
mucus discharge 
Lower abdominal pain
increased body temperature
32
Q

when does PMS occur

A

week before period

33
Q

Bacterial vaginosis: risk factors

A
New or multiple sex partners 
douching 
increase in sexual activity 
retained foreign body in body (tampon, condom)
co-existing STI
34
Q

Bacterial vaginosis: manifestations

A

Malodorous vaginal discharge, greyish or white in color

Odor more noticable after intercourse or menses

35
Q

Bacterial vaginosis: medical/nursing management

A

Metronizole

36
Q

What is the primary cause of vulvovaginal candidiasis

A

Candidia

37
Q

vulvovaginal candidiasis risk factors

A

antibiotics, corticosteroids, pregnancy, increased sexual partners, sex toys, sexual partner who is not circumcised, diabetes

38
Q

vulvovaginal candidiasis s/s

A

Dysuria, redness, inflammation, itching, dysmenorria, pain with intercourse, thick-white curd-like discharge

39
Q

vulvovaginal candidiasis medical and nursing management

A

Monostat, fluconizole

education on proper hygiene

40
Q

Female prolapse: Cystocele

A

The herniation of the bladder into the anterior vagina

41
Q

Female prolapse: Rectorcele

A

The extrusion of the rectum into the posterior vagina

42
Q

Female prolapse: Enterocele

A

The descent of the small intestine into the vaginal vault

43
Q

Female prolapse: uterine prolapse

A

Downward descent of the uterus into the vagina

44
Q

Female prolapse: vault prolapse

A

Top of the vagina prolapses after a hysterectomy

45
Q

What can help with female prolapses?

A

Regular exercise, reconstructive surgery, kegels

46
Q

Female structural disorders: fistula

A

abnormal opening between 2 organs - usually between vagina and rectum

biggest issue – incontinence and infection

47
Q

What are signs and symptoms of a fistula

A

urinary or fecal incontinence

48
Q

What is medical management of fistulas

A

sitz bath
changing perineal pads
good hygiene
reconstructive surgery

49
Q

What are examples of benign disorders of the female reproductive system?

A

Cysts
Fibroids
Endometriosis

50
Q

What are functional (simple) cysts

A

rupture or hemorrage occassionally causing pain

- typically treated with NSAIDS

51
Q

What are nonfunctional cysts

A

developed as result of sloughed-off endometrial tissue and form a cystic mass on the ovaries

52
Q

fibroids - risk factors

A

african american

over weight

53
Q

Fibroids - s/s

A

usually asymptomatic unless it impacts other organs, then you will see

  • irregular bleeding
  • dysmenorrhea
  • pelvic pain
  • potentially infertility
54
Q

What is medical management of fibroids

A

hysterectomy
fibroid removal
NO ASPIRIN – increase risk for bleeding

55
Q

What is endometriosis

A

progressive, benign disorder impacting women in childbearing years

56
Q

What is cause of endometriosis

A

chronic inflammation

formation of adhesions

57
Q

Endometriosis

A
Chronic pelvic pain 
lower back pain
dysmenorrhea 
dysuria 
dyskensia (pain w defacation)
58
Q

Endometrosis

A

NSAIDS and surgical intervention

hysterectomy

59
Q

What are malignant conditions of the female reproductive tract

A

Cervical malignancies
Uterine malignancies
Ovarian malignancies
Vulva malignancies

– best screening tool is pap smear

60
Q

What are risk factors for malignant conditions of female reproductive tract

A
Intercourse with uncircumcised men
early age of intercourse 
multiple sex partners 
STI
Cig smoking
exposure to HPV
61
Q

Cervical cancer tx

A

radiation

62
Q

uterine cancer tx

A

removal of fallopian tubes and ovaries or full hysterectomy
radiation
chemo

63
Q

ovarian cancer s/s

A
bloating
changes in bowel/bladder habits 
irregular bleeding
UTI
weight gain 
gerd
64
Q

vulva cancer r/t what

A

HPV

65
Q

Vulva cancer s/s

A

itching, burning

66
Q

What are the types of hysterectomy

A

Total abdominal hysterectomy (TAH)

Total vaginal hysterectomy

67
Q

Total abdominal hysterectomy (TAH) teaching

A

no driving for 4-5 weeks
avoid heavy lifting, pushing, pulling
vaginal bleeding for 1 week

68
Q

Total vaginal hysterectomy (TVH) - what to know about it

A
less blood loss
quicker recovery 
short hospital stays
fewer infections 
less pain than abominal approach, which required incisions through abdominal muscles
69
Q

Hysterectomy - nursing management for surgical patient

A
pain
DVT, PE
wound infection
UTI
Return of bowel/bladder functions
Lungs - incentive spirometer 
early ambulation
discharge planning
70
Q

Trangender community - health disparities and nursing management

A

care for them how they want to be cared for - be respectfull

hormone therapy - think about the physical and emotional changes they experience –> high risk for SI

71
Q

Rectovaginal fistula

A

abnormal openings that occur between the vagina and the rectum, allowing fecal material and flatulence to leak into the vagina, causing fecal incontinence