Test #1 - Malignancy and Womens Health Flashcards

1
Q

Just some tidbits about Cervical Cancer…..

A

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%

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2
Q

What are some risk factors for Cervical Cancer?

A
  • Early age of sexual activity.
  • Multiple partners
  • Untreated chronic cervicitis
  • Human Papilloma Virus (HPV)
  • Smoking
  • Uncircumcised partner
  • Venereal disease
  • Low socioeconomic status
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3
Q

What are some assessments for Cervical Cancer?

A

• 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
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4
Q

What are 2 diagnostics/labs for cervical cancer?

A

Pap Smear

Schiller test - Cervical Biopsy

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5
Q

What are some treatments for cervical cancer?

A
  • 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.
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6
Q

What are the stages of Malignancy?

A

• 0 = cancer in situ

■ 1 = localized tissue growth

• 11= limited local spread

■ 111= extensive local and regional spread

• IV= metastasis

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7
Q

What do you need to do Pre-Op for cervical cancer?

A
  • Consents explained and signed consent.
  • Surgical preparation, bowel/shave
  • Diagnostic tests
  • Foley catheter
  • Encourage questions and feelings
  • Administration of medication before procedure
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8
Q

what do you need to do post-op cervical cancer?

A
  • TCDB, IS, SCD’s
  • Importance of early ambulatior
  • Pain relief
  • Foley catheter/ l/O’s
  • Peri-care/ sitz baths
  • Assess for complications
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9
Q

What are some post-op assessments after cervical cancer surgery?

A

• Assess vaginal bleeding-(<lpad></lpad>

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<p><span>• Care of incisions or drains</span></p>

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10
Q

What do you need to teach post-op cervical cancer surgery?

A
  • 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
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11
Q

What is endometrial cancer?

A

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

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12
Q

What is ovarian cancer?

A
  • 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

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13
Q

What are risk factors for breast cancer?

A
  • 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.
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14
Q

What are some assessments for breast cancer?

A

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

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15
Q

What are some diagnostics/labs for breast cancer?

A

• 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.

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16
Q

What is FNA?

A

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.

17
Q

What is CNB?

A

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;

18
Q

What is Vacuum assisted biopsy?

A

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.

19
Q

What is large core biopsy?

A

Provides large sample without heavy sedation. Removes large amount of normal tissue before reaching lesion; may not remove adequate margin of lesion; stitches/scar

20
Q

What is open surgical biopsy?

A

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

21
Q

Where are the most common places breat cancer metastases to?

A

Bone

Lung

Liver

22
Q

If breast cancer is left untreatedhow long til death?

A

2-3 years

23
Q

What are some treatments for breast cancer?

A
  • Surgical
  • Local excision
  • Modified radical mastectomy
  • Radical mastectomy
  • Radiation
  • Hormonal therapy
  • Chemotherapy
24
Q

What is a mastectomy?

A

• 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).

25
Q

What are some alternative therapies for Breast Cancer?

A

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

26
Q

What are some spirituality/culture considerations for a mastectomy?

A

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

27
Q

What are some post-op surgical interventions for a mastectomy?

A
  • 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
28
Q

What are some post op teachings for a mastectomy?

A

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

29
Q

What do you want to teach post-op mastectomy?

A
  • 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.
30
Q

When do you want to get breast cancer screenings?

A
  • 18-40: BSE Monthly

— 20-40: professional yearly exam

— 35-40: baseline mammogram

— >50: yearly mammogram

31
Q

When do you want to get colon/anal/prostate cancer screenings?

A
  • 40-digital exam yearly

— >50-stool blood test yearly

  • >50-colonoscopy every 3-5 yrs
32
Q

When do you want to do uterine & cervical cancer screenings?

A
  • 20 or earlier if sexually active yearly pap*

— >40 yearly exam

33
Q

When do you want to get testicular cancer screenings?

A
  • Monthly SE
  • Annually after 50