MDC 3 Exam 1 Study Flashcards
What are risk factors for breast cancer
female, older than 65 years old, estrogen use, family history, BRCA 1 or 2, first child after 30, nulliparous, alcohol/smoking, high socioeconomic status, post menopausal
What is the only test to definitively diagnose breast cancer
biopsy
MRI, labs, pathology
What are screening tests for breast cancer
Mammograms women 45+ get yearly, self-exams monthly, ultrasound
nursing expectations post-op for gynecological cancers
Monitor VS, bowel sounds, I&O, encourage mobility gradually, bed rest for first-night post op, CBC, limit driving or stairs, avoid heavy lifting, vaginal rest
S/S of gynecological cancers
abnormal bleeding, urethral burning for longer than 24 hrs, fatigue, diarrhea, fever, abdominal pain
Preventative for cervical cancer
HPV vaccine 9-26 years old, or before first sexual encounter
uterine leiomyoma s/s
may have no s/s, bleeding, pain, pelvic pressure, abdominal distention, heavy bleeding, anemia symptomrs
vulvovaginitis interventions
cotton underwear, loose clothing, clean inner labia with water and not soap, no douches or perfumes, no sex until infection clears and treatment is finishing
toxic shock syndrome interventions
change tampons every 4-6 hrs, wash hands, no tampons at night, use smallest effective tampon, do not use internal contraceptives if history of TSS, provide a comfortable environment to discuss treatment plans
endometrial/uterine cancer
most common malignancy, slow growing, 95% survival rate if caught early
s/s: abdominal uterine bleeding, especially post menopausal, painful intercourse and urination, abdominal discharge that is watery and bloody, pain in lower back, abdomen, pelvis
endometrial cancer diagnostics
the best one: endometrial biopsy
transvaginal ultrasound, CBC, CXR, abdominal ultrasound, liver or bone scans for suspected metastasis, renal function scans
BPH s/s
swollen prostate, difficulty starting urination, decreased urine stream pressure, intermittent, dribbling, retention, increase UTI, frequency/urgency, incontinence, pain
BPH education
Decrease alcohol and caffeine, urinate every 2-3 hr, catheter education, avoid anticholinergics, antihistamines, and decongestants (all-cause urinary retention)
BPH risk factors
over 60 years old, obese, sedentary lifestyle, smoking and drinking, ED, diabetes, first degree relative diagnosed
BPH diagnostics
DRE to determine the size and if the discharge is present, uroflowmetry, transrectal ultrasound, cystoscopy,
BPH medications
alpha reductase inhibitors (-ide) : finasteride
alpha-blockers ( - sin) : doxazosin
PDE5 inhibitors ( - fil): sildenafil
NSAIDS
Saw palmetto
BPH post-op care
bleeding, infection, pain management, mobilize early, CBC if ordered, precise I&O, urologist removes foley
prostate cancer risk factors
older than 50, african american, obesity/diet, family history
prostate cancer s/s
early stages has none, late-stage blood in urine
screening prostate cancer
DRE if required, PSA
prostate cancer diagnosis
PSA, DRE, transrectal ultrasound, look for lesions, biopsy (definitive), CT/MRI/Bone Scan/Liver function (suspected metastasis), elevated serum acid phosphatase (advanced), elevated alkaline phosphatase (bone metastasis)
Testicular cancer
self examination, sperm bank options, emotional support since it effects a younger population
erectile dysfunction risk factors
HTN, CAD, DM, older than 50, hypercholesterolemia, smoking, drugs, alcohol, obesity, sedentary lifestyle, trauma, surgery (prostatectomy)
ED medications
PDE5 -afil
NO Nitrates
Chlamydia treatment
azithromycin 1 dose or doxycycline BID for 7 - 14 days, avoid sex for 7 days after treatment
Syphilis primary stage symptoms
localized at site of infection, round firm painless sores, 10-90 days after inoculation
syphilis secondary or systemic state s/s
Swollen lymph nodes, skin rash, flu-like symptoms, cutaneous lesions or weeping papules, mucous patches, s/s may go unnoticed, and then transfer to latent disease
Syphilis tertiary stage s/s
can affect the heart, brain and other organs, 1-20 years after initial infection, Abx make this less common
syphilis treatment
priority benzathine penicillin G or doxycycline or tetracycline allergy
contact tracing treat 90 days worth of contacts
syphilis education
no sex for 7 days after treatment and until all partners complete Abx too, safe sex practices
urinary incontinence education
kegels, keep a schedule, avoid caffeine, prevent constipation
urolithiasis (kidney stones) s/s
sudden flank pain, dysuria, fever/chills, n/v, diaphoresis
UTI/ cystitis interventions
hydrate, cranberry use should be discussed with urologist, urinate before and after sex, sitz bath, finish antibiotics, phenazopyridine (may turn urine orange)
pyelonephritis s/s
fever, flank pain, nausea, vomiting, foul-smelling/cloudy urine
pyelonephritis causes
acute UTI traveled to kidneys
chronic repeated continued uti can be caused by an anatomic abnormality
acute glomerulonephritis s/s
recent skin or upper respiratory infection, UA bloof and protein, elevated BP, edema
polycystic kidney disease interventions
treat manifestations UTL, HTN, dialysis or kidney transplant for end-stage, pain management, genetic counseling, limit sodium, drink 2L of fluid daily, BP, weight, temp, characteristics of Urine, genetic predisposition
Diabetic nephrothapy
a vascular complication of DM, the leading cause of ESRD, severe hyperglycemia correlates with the severity of kidney disease, educate on glycemic control
nephrotic syndrome interventions
treat the cause, diet restrictions, if GFR is decreased (decrease protein, sodium, and potassium in diet) ACE inhibitors can help decrease protein lost in urine
acute kidney injuries - prerenal
most common cause of AKI, related to perfusion, disrupted flow to kidneys, caused by renal artery stenosis, hypovolemia, dehydration, MI, hypotension, sepsis
acute kidney injuries intrarenal
damage inside of kidney caused by lupus, nephrotoxic drugs, glomerulonephritis, sepsis, diabetes, and hypertension
acute kidney injuries, post-renal
related to outflow causes BPH< obstruction, UTI, bladder cancer, cervical cancer, prostate cancer, and colon cancer
renal cell carcinoma treatment
cryoblation, nephrectomy (monitor bleeding)
Chronic kidney disease intervention
control bp, restrict fluids, adhere to medication, dialysis for ESRD
chronic kidney disease nursing care
AV fistula or graft, ensure proper circulation by checking radial ulnar pulses and cap refill, check bruit and thrill, arm precautions no BP or IV, no meds through port
BUN normal values
10-20
increase in AKI
Creatinine
males 0.6 - 1.2
females 0.5-1.1
increased in AKI
potassium
3.5-5
increased in AKI
Magnesium
1.3-2.1
increased in AKI
phosphorus
3.0-4.5
increased in AKI
calcium
9.0-10.5
decreased in AKI
CO2
25-35
decreased in AKI
pH
7.35-7.45
decreased in AKI
hgb
males 14-18
females 12-16
decreased in AKI
hct
males 42-52
females 37-47
decreased in AKI
specific gravity
1.005-1.030
decreased in AKI
HCO3
21-28
decreased in AKI
polycystic kidney disease s/s
UTI, urinary calculi, HTN, hematuria, back side and abdominal pain
what STIs to notify health department
chlamydia, gonorrhea, and syphilis
kidney stone risk factors
diabetes, genetics, gout, male