ONCOLOGY: Ignatavicius Ch 71: Care of Patients with Gynecologic Problems Flashcards
A client has undergone a vaginal hysterectomy with a bilateral salpingo-oophorectomy. She is concerned about a loss of libido. What intervention by the nurse would be best?
a. Suggest increasing vitamins and supplements daily.
b. Discuss the value of a balanced diet and exercise.
c. Reinforce that weight gain may be inevitable.
d. Teach that estrogen cream inserted vaginally may help.
d. Teach that estrogen cream inserted vaginally may help.
Use of vaginal estrogen cream and gentle dilation can help with vaginal changes and loss of libido. Weight gain and masculinization are misperceptions after a vaginal hysterectomy. Vitamins, supplements, a balanced diet, and exercise are helpful for healthy living, but are not necessarily going to increase libido.
The nurse is doing preoperative teaching for a client who is scheduled for removal of cervical polyps in the office. Which statement by the client indicates a correct understanding of the procedure?
a. I hope that I do not have cancer of the cervix.
b. There should be little or no discomfort during the procedure.
c. There may be a lot of bleeding after the polyp is removed.
d. This may prevent me from having any more children.
b. There should be little or no discomfort during the procedure.
Polyp removal is a simple office procedure with the client feeling no pain. The other responses are incorrect. Cervical polyps are the most common benign growth of the cervix. Cautery is used to stop any bleeding, and there is no evidence that cervical polyps have a relationship to childbearing.
A client has scheduled brachytherapy sessions and states that she feels as though she is not safe around her family. What is the best response by the nurse?
a. You are only reactive when the radioactive implant is in place.
b. To be totally safe, it is a good idea to sleep in a separate room.
c. It is best to stay a safe distance from friends or family between treatments.
d. You should use a separate bathroom from the rest of the family.
a. You are only reactive when the radioactive implant is in place.
In brachytherapy, the surgeon inserts an applicator into the uterus. After placement is verified, the radioactive isotope is placed in the applicator for several minutes for a single treatment. There are no restrictions for the woman to stay away from her family or the public between treatments.
A 20-year-old client is interested in protection from the human papilloma virus (HPV) since she may become sexually active. Which response from the nurse is the most accurate?
a. You are too old to receive an HPV vaccine.
b. Either Gardasil or Cervarix can provide protection.
c. You will need to have three injections over a span of 1 year.
d. The most common side effect of the vaccine is itching at the injection site.
b. Either Gardasil or Cervarix can provide protection.
Current HPV vaccines are Gardasil and Cervarix, which should be given before the first sexual contact to protect against the highest risk HPV types associated with cervical cancer. The client is not too old since it is recommended that young women up to 26 years should receive an HPV vaccine. The entire series consists of three injections over 6 months, not 1 year. Local pain and redness surrounding the injection site are very common, but this does not include itching.
The nurse is taking the history of a 24-year-old client diagnosed with cervical cancer. What possible risk factors would the nurse assess? (Select all that apply.)
a. Smoking
b. Multiple sexual partners
c. Poor diet
d. Nulliparity
e. Younger than 18 at first intercourse
a. Smoking
b. Multiple sexual partners
c. Poor diet
e. Younger than 18 at first intercourse
The nurse is teaching a client who is undergoing brachytherapy about what to immediately report to her health care provider. Which signs and symptoms would be included in this teaching? (Select all that apply.)
a. Constipation for 3 days
b. Temperature of 99 F
c. Abdominal pain
d. Visible blood in the urine
e. Heavy vaginal bleeding
c. Abdominal pain
d. Visible blood in the urine
e. Heavy vaginal bleeding
Health teaching for a client having brachytherapy should emphasize reporting abdominal pain, visible blood in the urine, and heavy vaginal bleeding. Severe diarrhea (not constipation), urethral burning, extreme fatigue, and a fever over 100 F should also be reported.
A client who had a hysterectomy has a 200-mg dose of ciprofloxacin (Cipro) ordered to infuse in 30 minutes. At what rate should the nurse infuse the medication if the pharmacy provides 200 mg in a 100-mL bag of normal saline? (Record your answer using a whole number.) ___ mL/hr
ANS: 200 mL/hr
100 mL 2 = 200 mL/hr.
