Reproductive System Disorders Flashcards
Total abdominal hysterectomy
Preferred when there is a need to explore the pelvic cavity. Removal of the entire uterus and cervix, but leaves the fallopian tubes and ovaries.
Bilateral salpingo-oopherectomy
Removal of both fallopian tubes and ovaries. Removal of ovaries induces menopause.
Endometriosis
Condition where endometrial tissue appears outside the endometrial cavity. Ovaries, fallopian tubes, and uterus. Symptoms are acute during menstruation and subside afterwards. Common drugs are Danazol (Danocrine) and Leuprolide (Lupron).
Arm exercises for modified radical mastectomy
Wall climb. Elbow pull in. Back scratch. Rope pull. Hair combing.
Signs and symptoms of Toxic Shock Syndrome
Acute bacterial infection caused by Staph aureus. Flu symptoms, fever, vomiting, dizziness, headache, diarrhea, myalgia, hypotension, sore throat, red macular palmar, diffuse rash, desquamation of skin, decreased urinary output, elevated BUN, disorientation, dehydration, pulmonary edema, and inflammation of mucous membranes.
Correct way to do testicular self exam
Begin at puberty. Perform monthly. After a warm shower. Check color, contour, and skin breaks. Palpate with thumb and index finger. Should be smooth and egg shaped. Firm to touch. Epididymis should feel like soft tube.
How to contract epididymisis?
Infection of the excretory duct of the testicle. Common infection caused by S. aureus, E. coli, N. gonorrhoeae, and streptococci.
Tubal insufflation (Rubin’s test)
Transuterine insufflation of the fallopian tubes with CO2. Evaluates patency of tubes, as gas enters abdominal cavity, and auscultated. May complain of shoulder pain from diaphragmatic irritation due to CO2 presence. If tubes are occluded, no pain is reported, as no gas entered the abdominal cavity.
Familiar w/ pap smear, time frame recommend to have it
Within 3 years of becoming sexually active. No later than 21. Regular pap test every year or thin prep pap ever 2 years. Women over 30 with good results could do every 2-3 years. Women over 70 with 10 years of normal results can stop all together.
Most common cause of female infertility
Tubal insufficiency, ovarian, and uterine conditions such as endometriosis or congenital defects.
Genital herpes
Infectious viral disease characterized by recurrent episodes of acute, painful, erythematous blisters on the genitalia lasting up to 10 days. Fever, malaise, myalgia, dysuria, and leukorrhea can occur. Treated with oral acyclovir. IV administration is reserved for life-threatening infections. Valacyclovir (Valtrex) and famciclovir (Famvir) purine analogs inhibit herpatic viral replication.
Major complications of PID
Sterility and adhesions, purulent vaginal exudate. Dysmenorrhea and vulvar pruritis.
Having a mammogram is most useful method of Dx breast cancer, why?
Differentiate cyst from lesions and detect small tumors before they can be palpated by a physician.
Correct way to do a BSE
After shower. One week after menses. After menopause, same time every month. Palpate the whole breast up to the axially lymph node.
Hydrocele
Accumulation of fluid between the membranes covering the testicles and the membrane enclosing the testicles. Scrotum enlarges as fluid accumulates. Scrotal transillumination. Fluid aspiration or surgical removal of the sac may be indicated.
Things considered abnormal when doing BSE
Change in skin color, feelings of tenderness in breasts, puckering or dimpling of tissue, nipple discharge, retraction of the nipple, and axillary tenderness.
The most common std
Chlamydia
Why is cervical cancer more common in women that smoke?
*use common sense
Purpose of the male ductal system
Stores and releases semen during ejaculation.
Purpose of accessory glands in males
Seminal vesicles, prostate gland, bulbourethral gland.
Pt dx w/ fibrotic cysts in breast, specific thing to eliminate from diet
Methylxanthines (coffee, tea, soda).
Amenorrhea
The absence of menstrual flow. Normal before puberty, after menopause, and during pregnancy or lactation. Frequent vigorous exercise, depression, anorexia or bulimia.
Signs and symptoms of Chlamydia
White or clear exudate, burning or pruritis around the urethral meatus, urinary frequency, mild dysuria. Vaginal pruritis or burning, dull pelvic pain, fever, vaginal discharge, irregular bleeding, PID.
Why treat syphilis with injectable penicillin rather than oral?
Injectable penicillin allows for greater concentration of the drug to delivered to all body tissues.
Rectovaginal fistula
Opening between rectum and vagina.
Reasons for prolapsed uterus
OB trauma, overstretching of the uterine muscle support system, multiple births, coughing, straining, the aging process, and lifting heavy objects.
Dilation and curettage
Scrape material from the wall of a cavity to remove tumor for microscopic study. Used to obtain tissue for biopsy, correct cervical stricture, and treat dysmenorrhea. General anesthesia is used, cervix dilated, and inside of uterus scraped with a curette. Vaginal packing is used to absorb drainage.
Body position for vaginal hysterectomy
Lithotomy
Vaginal condition caused by E. coli
Vaginitis
Drug category would be used for candida
Nystatin and amphotericin B
Med for chlamydia and for trichamonis
Tetracycline, doxycycline, azithromycin, ofloxacin.
Meds to relieve symptoms of menapouse
Hormone replacement therapy, estrogen, progestin.
Dx test for endometriosis
Laproscopy with biopsy of lesion. Also ultrasound and pelvic exams are performed.
Dx test for growths on cervix and vagina
Cancer of the cervix is usually a squamous cell carcinoma. Diagnostic tests are pap smear, physical exam, colposcopy and cervical biopsy, CT scan, radiographic exam, cystoscopy.
Fallopian tubes and ovaries dx tests
Bimanual pelvic examination, rectovaginal examination, CT scan of pelvis and abdomen, laparotomy with biopsy. Ovarian cancer is diagnosed by aspiration of ascitic fluid and detection of cancer cells in the fluid. Blood test for CA-125 antigen is used to determine women with epithelial ovarian cancer. Vaginal ultrasonography is also used.
Dx test for early detection of cervical cancer
Pap smear
Female has fibrotic cysts in breasts, why they become more tender around menstrual cycle
*use common sense
Female is taking the pill, why would they ask them to stop smoking when taking it
Increases risk for DVT.
How the pill prevents pregnancy
Combination birth control pills contain both estrogen and progesterone. The dosage prevents ovulation, causes changes in endometrium, alters cervical mucous and tubal transport. Morning after pill contains ethinyl estradiol and norgestrel. Creates hostile uterine lining and alters tubal transport. Progestin only pills are taken everyday with no breaks and are preferred for women who are breast feeding. Does not suppress lactation but inhibits ovulation, thickens cervical mucous, alters uterine lining, with lower cardiovascular risk than combined pills. DEPO is a progestin only drug given by injection every 3 months. Norplant is another progestin only subdermal implant providing protection for 5 years. Does not suppress lactation.
Cause of Trichamonas
Caused by protozoan Trichomonas vaginalis. Transmitted sexually, dirty douche nozzles, douche containers, and dirty washcloths. Newborns may develop infection from mother. Frequent douching and use of oral contraceptives and antibiotics raise normal pH of the vagina, making the woman more vulnerable to infection.
Colporrhaphy
Surgical suture and repair of the vaginal wall and underlying fascia. Used in conjunction with vaginal hysterectomy for repair of uterine prolapse.
Signs and symptoms of benign prostatic hyperplasia
Prostate enlargement. Elevated PSA levels in the blood stream. Difficulty urinating, and maintaining erections.
Tubal ligation – select all that apply
Permanently prevents sperm and ovum from meeting. Crushing, ligating, clipping, or plugging of the fallopian tubes. Some complications are bowel injury, hemorrhage, or infection.
What is the barrier form of contraceptives.
Diaphragms are dome shaped latex caps with flexible ring that fits over the cervix. Inner surface is coated with a spermicide. Cervical caps are rubber thimble shaped shields covering the cervix and is held in place by suction. Contains spermidcide and acts as a mechanical barrier to sperm.
Jessica is a bitch
This is true.
What age should males start doing TSE?
After puberty.
Right time for post menapousal woman to do a bse
Same time every month, after a shower.
Orchiectomy
Surgical removal of the testicles from the scrotal sac.
Pt is HIV positive, how to teach about safe sex.
HIV is transmitted through blood and sexual contact.
Menarche
The beginning of menses. Designates the first menstrual cycle. Occurs late in puberty and indicates that the body is capable of supporting pregnancy.
Signs and symptoms of gonorrhea and why men that are exposed to it are symptomatic a lot sooner than women are
Caused by gram negative bacterial infection. Incubation takes from 3-5 days. May be asymptomatic otherwise develop urethritis, dysuria, profuse purulent discharge, edema. Women show a green-yellow discharge from the cervix, urinary frequency, purulent discharge from urethra, pruritis, vulvar burning and pain, nausea, vomiting, tachycardia. PID, Bartholin’s abscess, ectopic pregnancy, infertility.
Medication for PID
ATB – cefoxitin (mefoxin).
Doxycycline.
Corticosteroids.
What is a vasectomy?
Bilateral ligation and resection of ductus deferens. Complications include hematoma, edema, psychological adjustment. Outpatient procedure takes about 30 minutes. Must use backup method of birth control until no sperm is found in examination.
Dx test for visualizing the prostate.
Cystoscopy.
America!
All day everyday.
Increased abdominal girth and dyspnea from pressure on diaphragm. Diagnosed with ovarian cancer. These clinical manifestations result from what condition?
Development of ascites.
Premenopausal woman appropriate time to perform BSE.
7 to 8 days after conclusion of the menstrual period.
52 year old patient with ductal cell carcinoma of the left breast has a modified radical mastectomy. A Davol drain is in place in the left axillary region. What is the main purpose of this drain?
Facilitate drainage and prevent formation of a hematoma.
Patient teaching for vasectomy.
Return to the physician at regular intervals for sperm count.
How long will a Foley catheter be in place postoperatively following an abdominal hysterectomy?
The indwelling catheter will be in place for 1 to 2 days following surgery.
Postoperative interventions to prevent what conditions following a vaginal hysterectomy for a prolapsed uterus as susceptibility has increased?
Venous stasis and thrombophlebitis.
Obese diabetic patient has had a total abdominal hysterectomy. On the second postoperative day the patient complains of increased pain in the operative site, states feeling like something suddenly popped. Removal of the abdominal dressing would reveal what condition?
Dehiscence has occurred.
Patient presents with vaginal pruritus, burning, dull pelvic pain, purulent vaginal discharge. Diagnostic test reveals Chlamydia. Nurse reviews medication schedule in addition to what other nursing intervention (patient teaching)?
Encourage patient to have her sexual partners seek medical care to avoid reinfection of the patient.
40 year old patient with right modified radical mastectomy with wide resection of the axillary lymph nodes. Which interventions are encouraged in the postoperative care for the client?
Encourage turning, coughing, deep breathing, and use of incentive spirometry.
Assess for excessive exudates on the dressing.
Administer an oral analgesic every 4 hours as needed for pain.
23 year old man is diagnosed with gonorrhea and a nursing diagnosis of non-compliance. What is the best way to overcome this non-compliant issue?
Single-dose treatment of ceftriaxone (Rocephin) IM injection.
The most prevalent STI.
Chlamydia infections.
Patient complains of constant seepage of feces from vagina, causing embarrassment due to soilage and odor. These are signs of what condition?
Rectovaginal fistula.
The ACS recommends that women have an annual screening mammography beginning at age:
40 years old.
The first lymph node most likely to drain the cancerous site in a breast cancer patient.
Sentinal node.
The greatest risk for breast cancer is:
Being a woman over the age of 50.
A lumpectomy with radiation has:
About the same 10 year survival rate as the modified radical mastectomy.
Patient teaching with a modified radical mastectomy to prevent lymphedema.
Avoiding unnecessary trauma to the arm on the operative site (venipuncture, blood pressure).
Ambulation for a patient postoperative abdominal hysterectomy to:
Prevent DVT.
Relieve abdominal distention.
Nursing intervention to relieve abdominal distention and to best stimulate peristalsis:
Encourage ambulation at least qid.
Cystocele presents with symptoms of:
Urinary retention.
The Pap smear is done as a diagnostic test for:
Cervical cancer.
The first significant sign of TSS that the patient will exhibit is:
Sudden high fever.
Lower abdominal and lower back pain that increases in severity during menstruation is a sign of what disorder:
Endometriosis.
Dietary supplement recommended to slow osteoporosis:
Calcium and Vitamin D.
History of PID will seek medical care for:
Infertility.
Highest risk for TSS are women who:
Insert tampons using their fingers.
Why do you empty the bladder before a pelvic examination when suspicious of gonorrhea?
Aid in assessment of the pelvic organs.
Patient teaching before having a Pap smear:
Abstain from intercourse for 24 hours.
Nursing response for patient talking about death and dying:
“It is perfectly normal. Be helpful and supportive by listening.”
ACS recommends that the HPV vaccine be routinely given at what age to reduce the incidence of cervical cancer:
11 to 12 years.
13 to 18 years to catch up on mixed vaccine.
