Test #1 - Malignancy and Womens Health Flashcards
Just some tidbits about Cervical Cancer…..
This disease is 100% curable when it is diagnosed in its early stages and treated promptly.
Pap tests are the single most effective method for identifying irregularities in cervical cells that could develop into cancer. Since 1940’s when Papanicolaou smears were first introduced, the death rate for cervical cancer has declined by nearly 75%
What are some risk factors for Cervical Cancer?
- Early age of sexual activity.
- Multiple partners
- Untreated chronic cervicitis
- Human Papilloma Virus (HPV)
- Smoking
- Uncircumcised partner
- Venereal disease
- Low socioeconomic status
What are some assessments for Cervical Cancer?
• Abnormal bleeding including but not limited to
between periods or after intercourse, increased
menstrual bleeding.
- Watery or bloody vaginal discharge.
- Dyspareunia
- Lower back pain
- Dysuria, kidney problems
- Vaginal bleeding after menopause
- Hematuria
What are 2 diagnostics/labs for cervical cancer?
Pap Smear
Schiller test - Cervical Biopsy
What are some treatments for cervical cancer?
- Conization-Cone biopsy
- LEEP- Loop electrosurgical excisicion procedure
- Invasive cervical cancer (stage 2 or above) vaginal
hysterectomy- removal of uterus and fallopian tubes.
- Usually not able to cure stage 4
- TAH-BSO- may also remove related lymph nodes.
- Radical hysterectomy- above plus partial vaginectomy and removal of lymph nodes.
What are the stages of Malignancy?
• 0 = cancer in situ
■ 1 = localized tissue growth
• 11= limited local spread
■ 111= extensive local and regional spread
• IV= metastasis
What do you need to do Pre-Op for cervical cancer?
- Consents explained and signed consent.
- Surgical preparation, bowel/shave
- Diagnostic tests
- Foley catheter
- Encourage questions and feelings
- Administration of medication before procedure
what do you need to do post-op cervical cancer?
- TCDB, IS, SCD’s
- Importance of early ambulatior
- Pain relief
- Foley catheter/ l/O’s
- Peri-care/ sitz baths
- Assess for complications
What are some post-op assessments after cervical cancer surgery?
• Assess vaginal bleeding-(<lpad></lpad>
<p></p>
<p>• Assess incision for bleeding and i<span>ntactness</span></p>
<p>• Foley catheter care, close attention after<span>discontinued for ability to void</span></p>
<p><span>• Pain management</span></p>
<p><span>• Ambulation</span></p>
<p><span>• Resp and Gl system</span></p>
<p><span>• Care of incisions or drains</span></p>
<p></p>
<p></p>
</lpad>
What do you need to teach post-op cervical cancer surgery?
- Showers not baths
- Pelvic rest- NOTHING vaginally for 6 weeks Of
until PCP says so!
- Sexual activity
- Douching
- Tampons
- Heavy lifting or straining
- No driving until cleared by PCP and while on pain medication.
- Annual check ups if not sooner depending on prognosis
- Signs and symptoms to report
- Incision care
- Medication regime and side effects
What is endometrial cancer?
Most common malignancy of the women’s reproductive system.
Most often women between the ages of 60-70.
- Slow growing and most women are
- Asymptomatic in early stages. Because it’s slow growing
- Dyspareunia -
Weight loss -
Abnormal bleeding
What is ovarian cancer?
- 2nd most frequently occurring reproductive cancer but causes more deaths
- Symptoms vague and nonspecific- weight
gain, pelvic & back pain, urinary problems
- “Silent Killer”- rapidly growing
- CA-125, transvaginal ultrasoun
d for diagnosis
What are risk factors for breast cancer?
- Increased incidence in women over 50
- Family history
- Nulliparous women or women whose first pregnancy occurred after age 30
- Early menses (=12)
- Goal: to promote early detection of breast cancer through public education and SBE.
What are some assessments for breast cancer?
Any new hard lump or thickening in the breast or under the arm
Change in size-asymmetry or the breast, shape or color of the breast, skin thickening, large pores
Dimpling or puckering of the breast tissue or nipple
Swelling, redness or warmth that doesn’t go away
Pain in one spot that doesn’t correlate c menses
Sudden nipple discharge or bleeding in one breast
Itchy, sore or scaling area on one nipple
What are some diagnostics/labs for breast cancer?
• Noninvasive techniques
- Mammography- >40 every 1-2 years
- Ultrasound
- Yearly breast exam done by provider
- Monthly breast exam by patient
• Invasive techniques
- Breast biopsy- Several methods of breast biopsy now exist.
The most appropriate method of biopsy for a client
depends upon factors including size, location, appearance
and characteristics of the breast abnormality.
What is FNA?
Fine Needle Aspiration
FNA-Fastest and easiest method; results rapidly available; no stitches or scar, excellent for cysts. Small sample size may cause incomplete assessment or misdiagnosis, multiple needle insertions.
What is CNB?
Core Needle Biopsy
CNB- larger sample can lead to more accurate diagnosis; no stitches or scar. Removes large amount of normal tissue before reaching lesion, may not remove adequate margin of tissue around lesion;
What is Vacuum assisted biopsy?
great for calcium deposits; removes several large samples with one needle insertion, no stitches, min. scar. May be less accurate than surgical biopsy which removes entire lesion; not recommended for hard to reach lesions.
What is large core biopsy?
Provides large sample without heavy sedation. Removes large amount of normal tissue before reaching lesion; may not remove adequate margin of lesion; stitches/scar
What is open surgical biopsy?
Yields largest tissue sample; most accurate method of diagnosis
Causes permanent scar that may make future mammograms difficult to read; possible breast disfigurement; requires stitches and longer
Where are the most common places breat cancer metastases to?
Bone
Lung
Liver
If breast cancer is left untreatedhow long til death?
2-3 years
What are some treatments for breast cancer?
- Surgical
- Local excision
- Modified radical mastectomy
- Radical mastectomy
- Radiation
- Hormonal therapy
- Chemotherapy
What is a mastectomy?
• Mastectomy involves the removal of the whole breast. This is usually accompanied by the removal of lymph nodes in the fat pad under the arm on the same side as the breast (modified radical mastectomy). Occasionally one of the muscles of the chest wall is also removed (radical mastectomy).
What are some alternative therapies for Breast Cancer?
Visits to chiropractors and acupuncturists, the use of vitamins, herbal remedies, and massage, are becoming increasingly common options to breast cancer patients, according to a new survey.
But the survey’s researchers stress that such complementary and alternative medicine should remain just that, an option, and should not be used at the expense of conventional treatment
What are some spirituality/culture considerations for a mastectomy?
Prepare client physiologically & psychologically for surgery.
Assist client to decrease emotional stress
Providaemotional support promote a positive self-image,\Reach for Recovery/
Anticipate concerns related to sexuality and fear of rejection
Promote clients return to homeostasis and understand implications of modified life style;
Discuss symptoms of recurrence
Discuss plans for temporary/permanent prosthesis
What are some post-op surgical interventions for a mastectomy?
- v/s
- Wound care/ pressure dressing
- Monitor drainage from wound and drains
- Ambulation
- Elevate arm on affected side-to level of heart’-^
- Assess emotional stability for discharge
- Contact of referral services
What are some post op teachings for a mastectomy?
Arm may be placed in sling to decrease chances of client trying to use affected side
Passive arm exercises are usually started 24 hours after surgery
Active exercises are started after the wound healing is well developed.
NO B/P, injections, or venipunctures on the are of the effected side- FOREVER
What do you want to teach post-op mastectomy?
- Wound care
- Referrals -Coordination of care
- Delegation of home care and responsibilities
- Narcotic pain medicine is necessary for 5-7 days after discharge
- No lifting over lOlbs for 7 days
- Specific arm exercises will be given at your first post-op visit.
When do you want to get breast cancer screenings?
- 18-40: BSE Monthly
— 20-40: professional yearly exam
— 35-40: baseline mammogram
— >50: yearly mammogram
When do you want to get colon/anal/prostate cancer screenings?
- 40-digital exam yearly
— >50-stool blood test yearly
- >50-colonoscopy every 3-5 yrs
When do you want to do uterine & cervical cancer screenings?
- 20 or earlier if sexually active yearly pap*
— >40 yearly exam
When do you want to get testicular cancer screenings?
- Monthly SE
- Annually after 50
