ONCOLOGY: Lewis Ch 53: Female Reproductive Problems Flashcards
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A patient is considering the use of combined estrogen-progesterone hormone replacement therapy (HRT) during menopause. Which information will the nurse include during their discussion?
a. Use of estrogen-containing vaginal creams provides the same benefits as oral HRT
b. Increased risk of colon cancer in women taking HRT requires frequent colonoscopy.
c. HRT decreases osteoporosis risk and increases the risk for cardiovascular disease and breast cancer.
d. Use of HRT for up to 10 years to prevent symptoms such as hot flashes is generally considered safe.
c. HRT decreases osteoporosis risk and increases the risk for cardiovascular disease and breast cancer.
Data from the Women’s Health Initiative indicate an increased risk for cardiovascular disease and breast cancer in women taking combination HRT but a decrease in hip fractures. Vaginal creams decrease symptoms related to vaginal atrophy and dryness, but they do not offer the other benefits of HRT, such as decreased hot flashes. Most women who use HRT are placed on short-term treatment and are not treated for up to 10 years. The incidence of colon cancer decreases in women taking HRT.
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What action will the nurse take when caring for a patient who has a radium implant for treatment of cervical cancer?
a. Assist the patient to ambulate every 2 to 3 hours.
b. Use gloves and gown when changing the patient’s bed.
c. Flush the toilet several times right after the patient voids.
d. Encourage the patient to discuss any concerns by telephone.
d. Encourage the patient to discuss any concerns by telephone.
The nurse should spend minimal time in the patient’s room to avoid exposure to radiation. The patient and nurse can have longer conversations by telephone between the patient room and nursing station. To prevent displacement of the implant, absolute bed rest is required. Wearing of gloves and gown when changing linens and flushing the toilet several times are not necessary because the isotope is confined to the implant.
** What topic should the nurse plan to discuss with a patient who has been diagnosed with stage 0 cervical cancer? a. Radiation b. Conization c. Chemotherapy d. Radical hysterectomy
b. Conization
Because the carcinoma is in situ, conization can be used for treatment. Radical hysterectomy, chemotherapy, or radiation will not be needed.
** A 31-yr-old patient who has been diagnosed with human papillomavirus (HPV) infection gives a health history that includes smoking tobacco, taking oral contraceptives, and having been treated twice for vaginal candidiasis. Which topic will the nurse include in patient teaching? a. Use of water-soluble lubricants b. Risk factors for cervical cancer c. Antifungal cream administration d. Possible difficulties with conception
b. Risk factors for cervical cancer
Because HPV infection and smoking are both associated with increased cervical cancer risk, the nurse should emphasize the importance of avoiding smoking. An HPV infection does not decrease vaginal lubrication, decrease the ability to conceive, or require the use of antifungal creams.
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A 19-yr-old patient visits the health clinic for a routine checkup. Which question should the nurse ask to determine whether a Pap test is needed?
a. “Have you had sexual intercourse?”
b. “Do you use any illegal substances?”
c. “Do you have cramping with your periods?”
d. “At what age did your menstrual periods start?”
a. “Have you had sexual intercourse?”
The current American Cancer Society recommendation is that a Pap test be done every 3 years, starting 3 years after the first sexual intercourse and no later than age 21 years. The information about menstrual periods and substance abuse will not help determine whether the patient requires a Pap test.
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Which action should the nurse take when a 35-yr-old patient whose repeat cervical Pap test was abnormal?
a. Teach the patient about colposcopy.
b. Teach the patient about endometrial biopsy.
c. Prepare the patient for a dilatation and curettage (D&C).
d. Administer 3 doses of human papillomavirus (HPV) vaccine.
a. Teach the patient about colposcopy.
Patients with an abnormal Pap test will typically be referred for colposcopy. Endometrial biopsy is not the next step in evaluation of abnormal Pap results. The HPV vaccine may reduce the risk for cervical cancer, but it is recommended only for ages 9 through 26 years.
** Which nursing assessment finding in a patient who recently started taking hormone replacement therapy (HRT) requires discussion with the health care provider about a possible change in therapy? a. Breast tenderness b. Left calf swelling c. Weight gain of 3 lb d. Intermittent spotting
b. Left calf swelling
Unilateral calf swelling may indicate deep vein thrombosis caused by the changes in
coagulation associated with HRT and would indicate that the HRT should be discontinued. Breast tenderness, weight gain, and intermittent spotting are common side effects of HRT and do not indicate a need for a change in therapy.
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A healthy 24-yr-old patient who has been vaccinated against human papillomavirus (HPV) has a normal Pap test result. Which information will the nurse include in patient teaching when calling the patient with the results of the Pap test?
a. You can wait until after age 30 before having another Pap test.
b. Pap testing is recommended every 3 years for women your age.
c. No further Pap testing is needed until you decide to become pregnant.
d. Yearly Pap testing is suggested for women with multiple sexual partners
b. Pap testing is recommended every 3 years for women your age.
Women ages 21 to 29 years should get a Pap test every 3 years.
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Which actions can the nurse working in a women’s health clinic delegate to experienced unlicensed assistive personnel (UAP)? (Select all that apply.)
a. Call a patient with the results of an endometrial biopsy.
b. Assist the health care provider with performing a Pap test.
c. Draw blood for CA-125 levels for a patient with ovarian cancer.
d. Question a patient about use of medications that may cause amenorrhea.
e. Teach the parent of a teenager about human papilloma virus (HPV) vaccine
(Gardasil).
b. Assist the health care provider with performing a Pap test.
c. Draw blood for CA-125 levels for a patient with ovarian cancer.
Assisting with a Pap test and drawing blood (if trained) are skills that require minimal critical thinking and judgment and can be safely delegated to UAP. Patient teaching, calling a patient who may have questions about results of diagnostic testing, and risk-factor screening all require more education and critical thinking and should be done by the registered nurse (RN).
