Test 1 Flashcards
- GYN procedure Post op client education (Slide 24)
• Hysterectomy:
o With any abdominal surgery increase protein to promote wound healing
o If ovaries removed with stop menses
o Will have menopausal symptoms
o If total hysterectomy client education would include: no sexual intercourse until provider gives release, no baths, no douching, no lifting more than 5lbs
• Mastectomy:
o Will need OT to help with ADLs that require abduction of the effected arm
o Take BP in opposite arm to prevent lymphedema
o Home health nurse to assess drains, pain, sign of infection
- Finasteride K,H,K
• Might decrease libido
• Can take with or without food
- Pessary client ed
• Need to be fitted for it
• Come back for frequent exam
• Clean regularly
- avoid heavy lifting or straining
- Ovarian cancer risks (page 735 and slide 22)
• Other arise from ovarian cysts
• Recent research has shown that the more times a woman ovulates during her lifetime, the greater risk
• Nulliparous woman
• Those who have been diagnosed with other types of cancer such as endometrial, colon or breast cancer
o Best detection yearly pelvic exams
- Breast cancer risks
• Family history-genetic mutations, hormones, obesity, ETOH use
• Women who begin menstruating at early age (before age 12)
• Women who experience late menopause (after age 55)
- Pap smear nursing actions
• Warm and lubricator speculum
• Lithotomy position
• Educate about pressure
• Not during menses
- TURP and informed consent
• Transurethral resections of the prostate
• Can lead to impotence and need to know prior signing the consent form
- Diaphragm client ed (page 728)
• They tell cleint who use a diaphragm, vaginal sponge, or cervical cap for birth control to remove the deceive within 24 hours after use
• The nurse emphasizes hand hygiene and keep vaginal devices clean
- 6-8 hours need to be keep on after having sex (Diaphragm)
- Sildenafil K,H,K
• HYPOTENSIVE priority* do not mix with anytging else that can also cause hypotension
- BSE client ed
• Examine your breasts 3 days after the end of menstruation or anytime if you no longer menstruate
• Begin the examination in the shower when the breasts are wet and soapy and again after the shower when lying down with a folded towel under the shoulder on the side being examined
• Use light, medium, and firm pressure applied with the pads of three fingers when checking each breast
• Move your fingers in circles, spokes of a wheel, or rowa, but follow the same technique eith each BSE
• Feel every part of each breast, including the nipple area and the armpit to the collarbone
• Raise your arms over your head and look at the breasts in a mirror
• Look for changes in breast shape, size and contour; puckering (dimpling) of the skin; or aress the appear red
- FSH, LH. What are they for/what do they mean?(page 711)
• FSH (Follicle-stimulating hormone/anterior pituitary hormone): initiates ovulation monthly.
• LH (Luteinizing hormone/ second pituitary hormone): causes the mature follicle to rupture, thereby releasing an ovum from the ovary
- Priority findings in a post-menopausal woman
• vaginal bleeding
- Menstrual irregularities
• Vasomotor disturbances like sleep disturbances and night sweats
• Vaginal dryness
• Increased risk of heart disease
• Stress incontinence
- Vaginitis assessment findings and risks (Page 725)
Assessment Findings:
• Candidiasis: cottage cheese liked discharge-diabetics at higher risk.
• Trichomonas: yellow white, foamy, and foul
• Gardnerella: Fishy smell
Risk:
• Pregnant woman
• Unregulated diabetes
• Those who take hormonal contraceptives
- Tamoxifen K,H,K
• Causes hot-flashes, drowsiness, n/v common adverse effect
• Abnormal Vaginal bleeding
- risk for DVT/PE
- Best prevention for STIs
Condoms with spermicide
- Prostate cancer diagnosis
• Doing DRE (digital rectal exam) and PSA (Prostate-specific antigen) yearly if a strong family history every year
- Prostatitis manifestations and client ed
Manifestation:
• Glandular swelling, tenderness, perineal pain
• Unusual sensation prior to or after ejaculation
• Low back pain, fever, dysuria, urethral discharge
Client education: avoid substance that have diuretic action like;
• Alcohol
• Coffee
• Tea
• Chocolate
• Cola
• Spices
-sexual partners need to be treated
- HSV client ed (page 775)
• Inform all potential sexual partners of the HSV infection even if asymptomatic.
• Use a condom or dental dam during sexual activity even if the disease seems inactive. Avoid sexual contact if there is any question that the infection is active; condoms and dental dams do not protect skin and mucous membrane that is left exposed.
• Keep lesions dry using alcohol, peroxide, witch hazel, and warm air from a hairdryer.
• Check with the primary provider about taking warm baths with Epsom salts or baking soda to relieve discomfort.
• Wear loose clothing that promotes air circulation about the genitals.
• Perform thorough handwashing after direct contact with lesions, and keep any personal hygiene articles, like a towel, separate to avoid inadvertent use by others.
• Use a separate towel to pat lesions dry and another when drying other body parts to avoid autoinoculation.
• Have annual Papanicolaou (Pap) tests to detect cervical cancer.
• Investigate stress management strategies because reducing stress tends to decrease the frequency of outbreaks.
- Gardnerella manifestations
• Fishy smell
• Grayish white
• Watery
• More discharge after intercourse
- Semen analysis for infertility client ed
• If being testing for semen analysis: Obstain from ejeculation 2-3 days prior to providing the sample
- Transrectal US client ed
• Transrectal ultrasound; instruct is having to give laxatives or edema prior to removing stool because they need good vision of the prostate
- Culdoscopy nurse priority
Look out for shock; low BP & tachycardia
- Ectopic pregnancy manifestations
• Still might have early pregancy sympotoms
• Light spotting
• Colicky pain that progresses to severe abdominal pain
• Might radiate to shoulder if rupture: priority!!!
- Age related changes in reproductive system
• Labial thinning
• Decrease bone formation
• Increased vaginal PH
• Decrease vaginal lubrication
- Diagnostic Tests
• Cytologic test for cervical cancer (Papanicolaou test)
o →Client preparation: empty bladder prior to, no coitus or douche before
• Cervical biopsy: conization
• Endometrial smears and biopsy
• Colposcopy
• BSE: should be performed 3-7 days after menses
• Dilation and curettage
• Endoscopic examinations:
o Culdoscopy
o Laparoscopy
o Colposcopy
• Hysterosalpingogram
• Abdominal ultrasonography (sonogram)
Laboratory tests:
o FSH, LH, progesterone, estrogen
- Benign Prostatic Hyperplasia
• Gradual onset
• Difficulty urinating
• Emptying bladder
• Nocturnal
• Urgency
- Testicular Self-Examination
• Use both hands
• Use index and middle fingers
• Feel small lump or abnormality by gently rolling the testicles
• Locate and feel epidiymis using both hands
• Performed monthly
NTK
Chlamydia is the most common
Herpes (oral, genitals), shingles, chickenpox, mono (Same family )?
Hep B & C can cause liver disease. Hep C is more common with drug use
HIV it’s the virus that causes AIDS. Someone can have HIV but not have AIDS.
HAART: Highly active antiretroviral-therapy; can extend the life’s with people with HIV ; check their viral load
Check the genitals before
