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Health and Illness Concepts I Nursing: N1210 > Maternity/Infant Health (Exam One) > Flashcards

Maternity/Infant Health (Exam One) Flashcards

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1
Q

The organization AWHONN focuses on what aspects of nursing?

A
  • Neonatal nursing
  • Obstetrics nursing
  • Women’s health
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2
Q

Why is health literacy a problem in the United States?

A
  • Many diverse population

- Differences in cultures and beliefs about healthcare

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3
Q

A low birth weight baby weighs less than what?

A

Less than 2500 grams

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4
Q

Babies of this race are most at risk of having a low birth weight?

A

Non-hispanic black babies

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5
Q

When are low birth weight babies most at risk, or most likely, to die?

A

Within the first year of life

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6
Q

How can babies being born at a low birth weight be prevented?

A
  • Access to prenatal care

- Access to community resources

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7
Q

Besides low birth weight, what factors influence infant mortality?

A
  • Sudden Infant Death Syndrome (SIDS)
  • Maternal medical conditions
  • Bacterial sepsis
  • Respiratory distress syndrome
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8
Q

What amount of women in the United States are obese?

A

One-third of women

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9
Q

What are the associated complications of obesity?

A
  • Hypertension

- Diabetes

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10
Q

Hypertension and diabetes associated with obesity can lead to what other complications?

A
  • Infertility
  • Congenital anomalies of the infant
  • Miscarriage
  • Fetal death
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11
Q

There has been an _____ in international infant mortality rates

A

Increase

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12
Q

What are the top three factors contributing to maternal mortality trends?

A
  • Hypertension
  • Hemorrhage
  • Infection
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13
Q

Who can provide prenatal care?

A
  • OBGYN

- Certified nurse-midwives

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14
Q

What is a lay midwife? In what setting is a lay midwife most common?

A
  • Unlicensed or uncertified midwife

- Home birth setting

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15
Q

Women are typically ____ during childbearing.

A

Healthy

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16
Q

List ways to decrease risk factors that could result in a poor pregnancy outcome.

A
  • Nutrition
  • No smoking or secondhand smoke exposure
  • No alcohol
  • Violence prevention
  • Support system
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17
Q

Why is there no safe limit of alcohol during pregnancy?

A

Everyone metabolizes alcohol differently

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18
Q

What question should the nurse ask the patient in private to help promote violence prevention?

A

“Do you feel safe at home?”

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19
Q

What are international concerns that also occur in the United States?

A
  • Female genital mutilation

- Human trafficking

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20
Q

What is female genital mutilation?

A
  • All or part of the female genitalia is removed

- Can cause complications during childbirth

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21
Q

How many women in the United States have experienced female genital mutilation?

A

Over 500,000

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22
Q

Human trafficking victims may experience what?

A
  • Hard labor
  • Sexual work
  • Organ donation
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23
Q

What is the leading cause of death in women?

A

Heart disease

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24
Q

The risk of violence _____ during pregnancy.

A

Increases

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25
Q

What is standard of care?

A

Level of practice that a reasonably prudent nurse would provide in the same or similar situation

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26
Q

A nurse who is unsure how to perform a skill within her scope of practice should do what?

A

Look at the policy and procedure manual

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27
Q

Define risk management.

A
  • System of checks and balances

- Make sure the nurse is doing everything they can to decrease the risk of injury to a patient

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28
Q

What is a sentinel event?

A

-Unanticipated event that results in the death or serious psychological or physiological harm of a patient

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29
Q

What is outcomes oriented practice?

A

Compares outcomes with clinical practice standards

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30
Q

A nurse should recognize that the most significant barrier for access to care is the pregnant woman’s what?

A

Inability to pay

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31
Q

Family planning prenatal care continues until the baby is how old?

A

One year old

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32
Q

Who does a nuclear family consists of?

A
  • Husband
  • Wife
  • Biological or adopted children
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33
Q

Are nuclear families increasing or declining in society?

A

Declining

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34
Q

What does an extended (multigenerational) family provide?

A

Social, emotional, and financial support for one another

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35
Q

Who does an extended (multigenerational) family consist of?

A
  • Aunts
  • Uncles
  • Cousins
  • Grandparents
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36
Q

Who does a married blended family consist of?

A
  • Husband
  • Wife
  • Children from prior relationships
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37
Q

A single-parent family is considered to be what?

A
  • Non-traditional

- More socially vulnerable

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38
Q

A single-parent family can affect what?

A
  • Health status
  • School achievement
  • Promote high-risk behaviors
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39
Q

What two factors play the most powerful role in the actions of individuals and families?

A
  • Beliefs

- Values

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40
Q

Regarding assessment, the nurse will focus on what with a low-risk family?

A

Promoting healthy behaviors during pregnancy and delivery

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41
Q

Regarding assessment, the nurse will focus on what with a high-risk family?

A

Focus on additional illnesses (i.e. drug or alcohol abuse)

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42
Q

What is subculture?

A

A culture within a culture

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43
Q

What is acculturation

A

A person retains some of their own culture but adopts practices of the dominant society.

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44
Q

What is assimilation?

A
  • Loss of cultural identity

- Completely becoming a part of the dominant culture

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45
Q

What is ethnocentrism?

A
  • When one believes that their beliefs and values are the best
  • They are the only right way
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46
Q

Women make up what percent of the population?

A

51%

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47
Q

Why might a racial or ethnic minority be considered a vulnerable population?

A

Language barriers

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48
Q

Why might adolescent girls be considered a vulnerable population?

A
  • Lack of societal experience

- More likely to participate in high-risk behaviors (i.e. unprotected sex)

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49
Q

Why might older women be considered a vulnerable population?

A

More at risk for chronic illnesses

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50
Q

Why might incarcerated women be considered a vulnerable population?

A
  • More at risk for communicable diseases (i.e. STD’s)

- More likely to participate in high-risk behaviors

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51
Q

Why might women in rural areas be considered a vulnerable population?

A

Limited access to care

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52
Q

Homeless women are considered a vulnerable population because they are more at risk for what?

A
  • Infectious diseases
  • Lack of prenatal care
  • Anemia
  • Substance abuse
  • Chronic diseases
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53
Q

List examples of primary level prevention.

A
  • Immunizations
  • Carseats
  • Exercise
  • Nutrition
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54
Q

List examples of secondary level prevention.

A
  • Target a specific population
  • Screenings (i.e. mammograms, pap smears)
  • Contraceptives
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55
Q

List examples of tertiary level prevention.

A

Preventing further deterioration (i.e. rehab)

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56
Q

The structures of the female reproductive system develop and grow in response to which hormones?

A
  • Estrogen

- Progesterone

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57
Q

Age or decline in hormones can cause the female reproductive structures to do what?

A
  • Atrophy

- Become less effective

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58
Q

What is the uterus responsible for?

A
  • Receiving, implanting, and retaining a fertilized egg
  • Menstruation
  • Housing the fetus
  • Expulsion of the fetus during a vaginal birth
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59
Q

Where is the female egg fertilized by the sperm?

A

Fallopian tube

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60
Q

What is the endometrium? What happens to the endometrium during menstruation?

A
  • Vascular lining of the uterus

- Layers of the endometrium are shed during menstruation

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61
Q

What dilates or stretches during a vaginal birth?

A

Cervix

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62
Q

What is produced by the ovaries?

A

Ova (eggs)

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63
Q

What are the ovaries responsible for?

A
  • Ovulation

- Hormone production

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64
Q

The vagina is a passageway for what?

A
  • Menstrual flow

- Childbirth

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65
Q

Mammary glands are made up of what?

A

Lobules

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66
Q

Dimpling to the breast tissue may indicate what?

A

Malignancy (i.e. breast cancer)

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67
Q

Nodules or masses within the breast are always considered what?

A

Cancerous

68
Q

Growth of the breasts is stimulated by what?

A

Estrogen

69
Q

What are the functions of the breasts?

A
  • Lactation

- Sexual arousal

70
Q

Anatomically, where are the mammary glands found?

A

Between the second and the sixth rib

71
Q

What is menarche? What is the average age for menarche?

A
  • First menstrual period

- 13 years old

72
Q

What is puberty?

A

Transition between childhood and sexual maturity

73
Q

What is the purpose of the menstrual cycle?

A

Prepares the uterus for pregnancy

74
Q

How long does bleeding last during a menstrual period? What is the amount of blood lost during a menstrual period?

A
  • Five days

- 50 mL

75
Q

What is the average length of the menstrual cycle? What factors influence the menstrual cycle?

A
  • 28 days

- Physical, emotional and environmental factors

76
Q

What are prostaglandins (PGs)? Where are prostaglandins (PGs) produced?

A
  • Oxygenated fatty acids (i.e. hormones)

- Produced in uterus

77
Q

What do prostaglandins (PGs) play a key role in?

A
  • Moderate hormonal activity

- Ovulation

78
Q

What is climacteric menopause?

A

Transition phase between ovarian function and the decrease in hormone production

79
Q

What is menopause? When can menopause occur?

A
  • Last menstrual period
  • Noted after one full year of no bleeding
  • Can occur between 35 and 60 years of age
  • Average age of menopause is 51.4
80
Q

What happens in the four years prior to menopause?

A
  • Decrease in ovarian function
  • Decrease in the amount of ova released
  • Decrease in shedding of the uterus
81
Q

What are the two main female hormones?

A
  • Estrogen

- Progesterone

82
Q

How are gender issues a barrier in healthcare?

A
  • Females may only want to see female providers

- Males may only want to see male providers

83
Q

The average age for a female to first engage in sexual intercourse is what?

A

17 years old

84
Q

Women who become pregnant over the age of thirty-five are at an increased risk for what?

A
  • Congenital anomalies (i.e. down syndrome)

- Genetic anomalies

85
Q

How much folic acid should a childbearing woman intake per day?

A

400 mcg

86
Q

Specifically related to gynecology and obstetrics, what medical conditions are considered risk factors to a woman’s health?

A
  • Infertility
  • Miscarriage
  • Pre-term labor
  • Ovarian cysts
  • Sexually transmitted diseases (STDs)
87
Q

List lifestyle risk factors that have have a negative impact on the mother or on the fetus.

A
  • Unprotected sex
  • Female genital mutilation
  • Human trafficking
  • Domestic violence
  • Environmental or work place hazards
88
Q

How does the nurse know who to screen for anxiety and depression?

A

You don’t! Screen everyone!

89
Q

Substance abuse is considered what?

A

Anything from caffeine to cocaine

90
Q

Before performing any type of invasive procedure or exam, such as a pelvic exam, the nurse should obtain what?

A

Consent

91
Q

What position is the woman placed in when receiving a pelvic exam?

A

Lithotomy position

92
Q

What screening, or exam, is used for cervical cancer?

A

Pap smear

93
Q

Specimens can be collected to test for what specific infections?

A
  • Candida
  • Bacterial vaginitis
  • Group B Strep
  • Gonorrhea
  • Chlamydia
  • HSV (Herpes)
94
Q

When obtaining a reproductive health history from a woman, the nurse should always do what?

A

Explain the purpose for the questions asked and how the information will be used

95
Q

What is amenorrhea?

A

Absence of menstrual flow

96
Q

Amenorrhea is noted if

A
  • Menarche and secondary sexual characteristics are not present by age 13
  • Absence of mensis by age 15 with normal growth and development
  • Absence of mensis within 5 years of breast development
97
Q

Secondary amenorrhea occurs when what?

A

A woman experiences menstruation and then menstruation ceases for 6+ months

98
Q

What lab value is assess to determine pregnancy?

A

HCG

99
Q

In the female athlete triade the nurse will assess for what?

A
  • Osteoporosis
  • Amenorrhea
  • Insufficient nutrition
100
Q

What is dysmenorrhea?

A

Pain during or shortly before menstruation

101
Q

Severe dysmenorrhea can be associated with what?

A
  • Early menarche
  • Nulliparous
  • Lack of physical exercise
102
Q

What occurs during primary dysmenorrhea?

A

Excessive release of prostaglandins

103
Q

When prostaglandins are released, they cause what?

A

Arterioles within the uterus to spasm

104
Q

What are the treatments options for primary dysmenorrhea?

A
  • Apply heat to abdomen
  • Exercise
  • Relaxation techniques
  • Low sodium, low fat diet
  • Vitamin E supplements
105
Q

What drug provides optimal relief for primary dysmenorrhea?

A

NSAIDS

106
Q

What is secondary dysmenorrhea?

A

Menstrual pain acquired later in life (after 25 years old)

107
Q

What are the signs and symptoms of secondary dysmenorrhea?

A
  • Bloating
  • Pelvic fullness
  • Pain in the legs or lower back
108
Q

What are the causes of secondary dysmenorrhea?

A
  • Pelvic pathology (i.e. endometriosis)

- Fibroid development in pelvic cavity

109
Q

What symptoms will be seen in premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD)?

A

Cyclic symptoms

110
Q

List the cyclic signs and symptoms of premenstrual syndrome (PMS).

A
  • Fluid retention
  • Pelvic fullness
  • Breast tenderness
  • Weight gain
  • Depression
  • Irritability
  • Cravings
  • Headache
  • Fatigue
111
Q

What are the treatment or management options for premenstrual syndrome (PMS)?

A
  • Healthy diet
  • Exercise
  • Relaxation
  • Quit smoking
  • Encourage supplements
112
Q

What supplements may be beneficial in relieving symptoms of premenstrual syndrome (PMS)?

A
  • Calcium
  • B6
  • D3
113
Q

What is endometriosis?

A
  • Presence and growth of endometrial tissue outside of the uterus
  • Can occur anywhere in the body
114
Q

List the signs and symptoms of endometriosis?

NOTE: Need to know these!

A
  • Dysmenorrhea
  • Painful intercourse that can progress overtime
  • Abnormal uterine bleeding
  • Infertility
115
Q

What are the management options for endometriosis?

A
  • NSAIDS
  • Medications that suppress estrogen
  • Birth control
  • Surgery
116
Q

Why is a women with endometriosis prescribed birth control? How long is it usually prescribed?

A
  • Decrease adhesions
  • Reduce pain
  • 6 to 12 months
117
Q

What is the definitive cure for endometriosis?

A

Abdominal hysterectomy (complete removal of uterus)

118
Q

What are the physiological characteristics of menopause?

A
  • Anovulation
  • Menstrual cycle lengthens
  • Ovulation occurs less frequently
  • Progesterone is not produced
  • Elevated FSH
119
Q

List the physical changes associated with menopause.

A
  • Lighter or heavier bleeding
  • Vaginal atrophy
  • Decrease in libido
  • Vaginal dryness
  • Incontinence
  • Vasomotor instability (hot flash)
  • Changes in mood or behavior
120
Q

What are the health risks of perimenopausal women?

A
  • Osteoporosis

- Coronary artery disease

121
Q

Why are perimenopausal women at an increased risk for developing osteoporosis?

A
  • Decreased levels of estrogen

- Estrogen is responsible for converting Vitamin D to calcitonin

122
Q

Hormonal therapy increases a woman’s chance of developing what?

A
  • Breast cancer

- Increases risk for developing breast cancer up to 5 years after stopping hormonal therapy

123
Q

What are the signs and symptoms of hormonal therapy?

A
  • Headache
  • N/V
  • Brown spots on skin
  • Depression
124
Q

What medications are used in menopausal hormonal therapy?

A
  • Estrogen
  • Estrogen and Progesterone Combo
  • SSRI
  • Gabapentin
  • Clonidine
125
Q

What supplements have been found effective as alternative therapies for menopausal symptoms?

A
  • Soy

- Vitamin E

126
Q

What nursing management should be provided to a menopausal woman?

A
  • Sexual counseling
  • Well balanced diet
  • Exercise
  • Medication education
  • Encourage support groups
127
Q

What is micromastia?

A

-Underdevelopment of breast tissue

128
Q

What is macromastia?

A
  • Large, heavy breasts

- Women often complain of back and shoulder pain

129
Q

What are developmental anomalies of the breast?

A
  • Noticeable change in size of breasts
  • Breasts are asymmetrical
  • Can cause difficulty breastfeeding
130
Q

What are the two initial evaluation goals in relation to the pathophysiology of benign breast disease?

A

1) Distinguish between benign and malignant

2) Assess the risk of breast cancer

131
Q

What is the most common benign problem of the breast?

A

Fibrocystic changes

132
Q

Fibrocystic changes are related to an imbalance of what?

A

Estrogen and progesterone

133
Q

What are the clinical manifestations of cystic masses?

A
  • Lumpiness with or without pain

- Pain may be noticed around time of menstrual cycle

134
Q

Breast pain related to fibrocystic changes is most common around what time?

A
  • One week before menstruation or one week after menstruation
  • Most common in younger women
135
Q

List characteristics of fibrocystic masses of the breast.

A
  • Moveable
  • Soft
  • Well differentiated
136
Q

Breast pain is also known as what?

A

Mastalgia

137
Q

Breast pain is _____ in breast cancer.

A

Uncommon

138
Q

What are the risk factors for developing cellulitis of the breast?

A
  • Obesity
  • Macromastia
  • Previous surgeries to or around breast
  • Radiation
  • Smoking
  • Diabetes
  • Nipple piercings
139
Q

What percentage of breast lumps are discovered by the patient?

A

90%

140
Q

When is the breast self exam (BSE) best performed?

A
  • 5 to 7 days after menstrual period every month

- Perform in same pattern every time

141
Q

Clinical breast exams ,performed by a healthcare provider, should begin in a woman’s _____. Routine mammograms should be conducted every year after a woman turns _____.

A
  • Twenties

- Forty

142
Q

What are the three most important nursing actions related to benign breast conditions?

A

1) Discuss intervals for breast screening
2) Provide written education
3) Therapeutic communication

143
Q

What are the risk factors for developing breast cancer?

A
  • Early menarche
  • Family history
  • Non-hispanic white
  • Nulliparous
144
Q

The presence of BRCA 1 and BRCA 2 genetic mutations tells a woman what?

A

She has an 85% chance of developing breast cancer

145
Q

If BRCA1 and BRCA2 genetic mutations are present, but the woman exhibits no signs or symptoms of breast cancer development, the physician will recommend she do what?

A

-Have biannual breast exams with imaging

146
Q

Chemoprevention be given when what two factors are present?

A
  • Genetic mutations are present

- Extensive family history is present

147
Q

___ in ___ women will develop a breast malignancy.

A

1 in 8

148
Q

What is the survival rate for breast cancer or breast malignancy?

A

83% for ten years after diagnosis

149
Q

Nipple carcinoma is often connected with what disease?

A

Paget’s disease

150
Q

Inflammatory breast cancer is often _____.

A

Misdiagnosed

151
Q

Inflammatory breast cancer is often mistaken for what conditions?

A
  • Mastitis

- Cellulitis

152
Q

Inflammatory breast can usually presents as a stage ____. It is _____ _____.

A
  • Two

- Very aggressive

153
Q

The most common type of breast cancer is what?

A

Invasive Ductal Carcinoma

154
Q

The rate of breast cancer growth depends on the effects of what?

A
  • Estrogen

- Progesterone

155
Q

What are the four common places that breast cancer will spread to?

A
  • Bones
  • Lungs
  • Brain
  • Liver
156
Q

What is the gold standard for diagnosing breast cancer?

A
  • Mammogram

- Not 100%

157
Q

What is a lumpectomy?

A

Removal of tumor and small margin of healthy tissue that surrounds it

158
Q

What is a mastectomy? When is this option utilized

A
  • Removal of breast including nipple and areola
  • Most invasive
  • Utilized when other treatment therapies have not worked or the patient has a very large/multiple tumors
159
Q

When would a prophylactic mastectomy be done?

A
  • Patient presents with genetic mutations

- Patient has strong family history of breast cancer

160
Q

Radiation is considered what? It is often performed in addition to what surgeries?

A
  • Most conservative approach
  • Lumpectomy
  • Mastectomy
161
Q

Radiation can cause what?

A
  • Fatigue
  • Heaviness to the breast
  • Irritation
162
Q

Women taking the oral anti-estrogen medication Tamoxifen will follow these specific guidelines:

A
  • Annual pap smear
  • Annual eye exam
  • Liver function tests every six months
  • Bone density screening every three years
163
Q

What are the adverse affects of Tamoxifen?

A
  • Weight gain
  • Hot flashes
  • Higher risk for developing deep vein thrombosis
164
Q

What is the most common type of therapy for tumors? How is it administered?

A
  • Chemotherapy

- IV, SubQ, PO

165
Q

The nurse should not perform these actions on the side of the body where a mastectomy has been performed?

A
  • Take blood pressure
  • Insert an IV
  • Draw blood
166
Q

Women under the age of 40 who develop breast cancer are at an increased risk for what?

A

Recurrence later in life

167
Q

When assessing for breast cancer, the nurse always wants to assess for?

A
  • Unilateral changes

- Changes that only affect one breast

Health and Illness Concepts I Nursing: N1210 (12 decks)

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