Maternity Nursing Chap 3

Question 1

________ refers to the absence or cessation of menstrual flow.

Answer 1

-amenorrhea

Question 2

________ or painful menstruation is one of the most common gynecologic problems for women of all ages.

Answer 2

-dysmenorrhea

• heat minimizes cramping, massage lower back, soft rhythmic rubbing of the abdomen (effleurage), mediation, yoga, relaxation, acupunture
• treat with NSAIDs

Question 3

________ dysmenorrhea is a type of painful menstruation that occurs because of a physiologic alteration in some women.

Answer 3

primary

Question 4

Both ________ and __________ are necessary for primary dysmenorrhea to occur.

Answer 4

-estrogen and progesterone

Question 5

_________ is a type of painful menstruation that is acquired after age 25 and associated with pelvic pathology. Pain often begins a few days before menses.

Answer 5

• secondary dysmenorrhea

- a few days before menses

Question 6

________ is the appearance of physical and psychologic symptoms that begin in the luteal phase of the menstrual cycle. A diagnosis is only made if the following criteria are met: symptoms occur in the luteal phase and resolve within a few days of the onset of menstruation, symptom free period occurs in the follicular phase, symptoms are recurrent, symptoms have a negative effect on woman’s life, and other diagnoses have been excluded.

Answer 6

-premenstrual syndrome

Question 7

__________ is a menstrual disorder characterized by the presence of growth of endometrial tissue outside the uterus. This tissue responds to hormonal stimulation by growing during the proliferative and secretory phases of the menstrual cycle and bleeds during or immediately after menstruation, resulting in an inflammatory response with subsequent fibrosis and adhesions to adjacent organs.

Answer 7

-endometriosis

Question 8

The major symptoms of endometriosis are __________, __________, and __________. Many women also experience bowel symptoms such as diarrhea, pain with defecation, and constipation.

Answer 8

• dysmenorrhea
• hyspareunia
• infertility

Question 9

___________ is the term used to describe infrequent menstrual periods. One of the most common causes of scanty menstrual flow is the use of oral contraceptive pills.

Answer 9

• oligomenorrhea

- oral contraceptive pills

Question 10

_________ refers to bleeding between menstrual periods.

Answer 10

-metrorrhagia

Question 11

_________ is excessive or profuse menstrual bleeding.

Answer 11

-menorrhagia

Question 12

_________ is excessive bleeding with no demonstrable, organic cause. It is most commonly caused by anovulation when there is no surge of luteinizing hormone or if insufficient progesterone is produced by the corpus luteum to support the endometrium so it begins to involute and shed. This most often occurs when the menstrual cycle is just becoming established at menarche or when it draws to a close at menopause.

Answer 12

-dysfunctional uterine bleeding

Question 13

True or False: A pregnancy test is recommended as an initial step when a woman experiences amenorrhea.

Answer 13

True

Question 14

True or False: The pain associated with primary dysmenorrhea usually occurs at the onset of menstruation.

Answer 14

True

Question 15

True or False: The exact cause of premenstrual syndrome (PMS) is unknown.

Answer 15

True

Question 16

True or False: When a woman is experiencing primary dysmenorrhea, she should avoid exercise.

Answer 16

False: helps relieve the pain

Question 17

True or False: Oral contraceptives are the first line medications for the treatment of primary dysmenorrhea.

Answer 17

False: prostraglandin synthesis inhibitors, primarily nonsteroidal antiinflammatory drugs (NSAIDs)

Question 18

True or False: Endometriosis is a menstrual disorder primarily affecting Caucasian women during their late teens to early twenties.

Answer 18

False: usually develops in the third or fourth decade of life, occurs in approximately 10% of adolescents with disabling pelvic pain or abnormal vaginal bleeding, found equally in Caucasian and African American women. Higher in Asian women.

Question 19

True or False: Synarel (nafarelin) is a gonadotropic releasing hormone agonist administered at a dose of 200 mcg twice daily by nasal spray to treat endometriosis.

Answer 19

True

Question 20

True or False: The only definitive cure for endometriosis is a total abdominal hysterectomy with a bilateral salpingooophorectomy.

Answer 20

True

Question 21

True or False: Aspirin can be used to reduce the size of myomas (fibroids) before a myomectomy.

Answer 21

False: aspirin will increase bleeding, reduction is often accomplished with the use of a GnRH agonist.

Question 22

True or False: Sexually transmitted infections (STIs) are among the most common health problems in the US today.

Answer 22

True

Question 23

True or False: The majority of women contracting chlamydia are over 30 years of age.

Answer 23

False: sexually active women younger than 20 years

Question 24

True or False: Human papillomavirus (HPV) is the most common STI contracted by American women today.

Answer 24

False: Chlamydia is

-to treat chlamydia: doxycycline or azithromycin

Question 25

True or False: The VDRL and rapid plasma reagin tests are used as screening tests for syphilis.

Answer 25

True

Question 26

True or False: New human immunodeficiency virus (HIV) infections occur more often in African American women than in other groups of women in the US.

Answer 26

True

Question 27

True or False: Once HIV enters the body, seroconversion to HIV positivity usually occurs within 2 to 4 weeks.

Answer 27

False: within 6 to 12 weeks -first test to see if they have HIV is an antibody test

Question 28

True or False: Presence of HIV antibody in infants younger than 18 months of age is not diagnostic of HIV infection.

Answer 28

True

Question 29

True or False: Standard precautions are to be used once patients have been diagnosed with a blood borne infection.

Answer 29

False:

Question 30

True or False: Fibroadenoma is a rare benign condition of the breast most commonly seen in middle age women.

Answer 30

False: 2nd most common to fibrocystic changes

Question 31

True or False: One in ten American women develop breast cancer in their lifetime.

Answer 31

False: one in 8

Question 32

True or False: The most important predictor for breast cancer is age.

Answer 32

True

Question 33

True or False: It is estimated that most breast lumps detected by women are malignant.

Answer 33

False: only 20% to 25%

Question 34

Pelvic inflammatory disease (PID) is an infectious process that most commonly involves the _________, _________, and more rarely, the _________ and peritoneal surfaces.

Answer 34

- uterine tubes - uterus - ovaries

Question 35

___________ is estimated to cause one half of all cases of PID. Most PID results from the ascending spread of microorganisms from the vagina and endocervix to the upper genital tract. This spread most frequently happens at the end of or just after menses, following reception of an infectious agent. PID may also develop after an abortion, pelvic surgery, or childbirth.

Answer 35

-Chlamydia trachomatis

Question 36

Women who have had PID are at increased risk for ________, __________, and __________. Other problems associated with PID include dyspareunia, pyosalpinx, tuboovarian abscess, and pelvic adhesions.

Answer 36

- ectopic pregnancy - infertility - chronic pelvic pain

Question 37

Signs and symptoms of PID include ________ and one or more of the following: fever, chills, nausea and vomiting, increased vaginal discharge, symptoms of UTI, and irregular bleeding.

Answer 37

-pain

Question 38

The most important nursing intervention related to PID is __________ by education to avoid STIs and preventing lower genital tract infections from ascending to the upper genital tract.

Answer 38

-prevention

Question 39

Risk factors for hepatitis B:

Answer 39

- ethnic background - place of employment and type of job - types of contacts with other persons such as family and friends - multiple sex partners - intravenous drug use

Question 40

What are the probably risk factors for breast cancer?

Answer 40

- age, increases with age - previous history of breast cancer - family history of breast cancer - inherited genetic mutations in BRCA1 and BRCA2 genes - previous history of ovarian, endometrial, colon, or thyroid cancer - high breast tissue density - early menarch before age 12 - late menopause after age 55 - previous history of benign breast disease with epithelial hyperplasia - race (Caucasian higher) - Nulliparity or first pregnancy after age 30 - not breastfeeding - postmenopausal use of combined estrogen progestin replacement therapy - obesity after menopause - alcohol consumption of more than one drink per day - sedentary lifestyle - vitamin D low levels

Question 41

Women experiencing primary dysmenorrhea should be advised to avoid which of the following foods? a. red meats b. asparagus c. cranberry juice d. whole grain cereals

Answer 41

a. red meats

Question 42

the nurse counseling a 30 year old woman regarding effective measures to use to relieve symptoms associated with PMS might suggest that she: a. decrease her intake of fruits, especially peaches and watermelon b. reduce exercise during the luteal phase of the menstrual cycle when symptoms are at their peak c. take a vitamin supplement containing vitamin B6 twice a day d. avoid tobacco, alcohol, and caffeine

Answer 42

d. avoid tobacco, alcohol, and caffeine

Question 43

A 28 year old woman has been diagnosed with endometriosis. She has been placed on a course of treatment with danazol (Danocrine). The woman exhibits understanding of this treatment when she says: a. because this medication stops ovulation, I do not need to use birth control b. I will need to take this medication until I reach menopause c. I can experience decreased breast size, oily skin, and facial hair growth as a result of taking this medication d. I will need to spray this medication into my nose twice a day

Answer 43

c. I can experience decreased breast size, oily skin, and facial hair growth as a result of taking this medication

Question 44

Dysfunctional uterine bleeding is most likely to occur when women: a. experience ovulatory cycles b. weigh less than their expected body weight c. are experiencing signs of the onset of perimenopause d. secrete high levels of prostaglandin

Answer 44

c. are experiencing signs of the onset of perimenopause

Question 45

Infections of the female midreproductive tract such as chlamydia are dangerous primarily because these infections: a. are asymptomatic b. cause infertility c. lead to PID d. are difficult to treat effectively

Answer 45

a. are asymptomatic

Question 46

A finding associated with HPV infection includes with of the following? a. white curdlike adherent discharge b. soft papillary swelling occuring singly or in clusters c. vesicles progressing to pustules and then to ulcers d. yellow to green frothy malodorous discharge

Answer 46

b. soft papillary swelling occuring singly or in clusters - topical ointment to treat - untreated warts may resolve on their own - cauliflower like mass

Question 47

A recommended medication effective in the treatment of vulvovaginal candidiasis (yeast infection) is which of the following? a. metronidazole b. clotrimazole c. penicillin d. acyclovir

Answer 47

b. clotrimazole

Question 48

When providing a woman recovering from primary herpes with information regarding the recurrence of herpes infection of the genital tract, the nurse tells her: a. fever and flulike symptoms precede a recurrent infection b. little can be done to controle the recurrence of infection c. transmission of the virus is only possible when lesions are open and draining d. itching and tingling often occur before the appearance of vesicles

Answer 48

d. itching and tingling often occur before the appearance of vesicles

Question 49

When assessing a woman with diagnosis of fibroadenoma, a characteristic the nurse would expect to find is: a. bilateral tender lumps behind the nipple b. milky discharge from one or both nipples c. soft and nonmovable lumps d. small, well delineated lump in the upper outer quadrant of one breast

Answer 49

d. small, well delineated lump in the upper outer quadrant of one breast

Question 50

cyclic bleeding:

Answer 50

-changes in amount, duration, interval, or regularity of menstrual cycle bleeding

Question 51

Treatment of gonorrhea:

Answer 51

-ceftriaxone or cefixime

Question 52

treatment of syphilis:

Answer 52

-penicillin

Question 53

Treatment of herpes:

Answer 53

-acyclovir, famciclovir, and valacyclovir

Question 54

Hepatitis A:

Answer 54

- infection is acquired primarily through a fecal oral route by ingestion of contaminated food, particularly milk, shellfish, or polluted water, or via person to person contact - influenza like symptoms

Question 55

Hepatitis B:

Answer 55

- common STI - much more contagious than HIV - found in blood sweat, tears, vaginal secretions, and semen

Question 56

Hepatitis C:

Answer 56

- virus infection - risk factors: STIs, multiple sex partners, history of blood transmissions, history of IV drug use - asymptomatic or general influenza like symptoms

Question 57

Prevention of genital tract infections:

Answer 57

- practice genital hygiene - choose underwear or hosiery with a cotton crotch - avoid tight fitting cloths - select cloth car seat covers instead of vinyl - limit time spent in damp exercise clothes - limit exposure to bath salts or bubble bath - avoid colored or scented toilet tissue - use condoms - void before and after intercourse - decrease dietary sugar - drink yeast active milk and eat yogurt - do not douche - if sensitive, discontinue use of feminine hygiene deodorant sprays

Question 58

Fibrocystic changes: | develop a week before menstruation begins and subsides a week after menstruation ends

Answer 58

- have to do with menstrual cycle - multiple lumps - nodular - palpable - movable - round, smooth - firm or soft - tenderness influenced by menstrual cycle - bilateral - may or may not have nipple discharge

Question 59

fibroadenoma changes: | increases in size in pregnancy and decreases in size as the woman ages

Answer 59

- single lump - well delineated - palpable - movable - round, lobular - firm - usually asymptomatic - unilateral - no nipple discharge

Question 60

Intraaductal papilloma changes: | rare, benign, develops within the terminal nipple duct, occurs in women between 30 and 50

Answer 60

- single or multiple - not well delineated - nonpalpable - nonmobile - small, ball like - firm or soft - usually nontender - unilateral - serous or bloody nipple discharge

Question 61

mammary duct ectasia:

Answer 61

- mass behind nipple - not well delineated - palpable - nonmobile - irregular - firm - painful, burning, itching - unilateral - thick, sticky nipple discharge

Question 62

What do they use to diagnosis breast cancer after lump is found on mammogram?

Answer 62

-needle aspiration, a core needle biopsy, or surgical excision

Question 63

What is a lumpectomy?

Answer 63

- removal of the breast tumor and a small amount of surrounding tissue - sampling of axillary lymph nodes usually occurs through a separate incision - surgery is usually followed by radiation therapy

Question 64

What is a simple mastectomy?

Answer 64

-removal of the breast containing the tumor

Question 65

What is a modified radical mastectomy?

Answer 65

-removal of the breast tissue, skin, and fascia of the pectoralis muscle and dissection of the axillary nodes

Question 66

What is a radical mastectomy?

Answer 66

-removal of the breast and underlying pectoralis muscles and complete axillary node dissection