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Test 4- Community health > test 4 > Flashcards

test 4 Flashcards

1
Q

True or False.
Women with disabilities experience increase risk for abuse.

A

True

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2
Q

When should a woman get her first pelvic exam?

A

Age 21 unless a specific complaint

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3
Q

What is the purpose of the Pap smear?

A

Assess for the abdominal cellular changes that can lead to cervical cancer

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4
Q

Prior to screening, instruct client to avoid?

A

Douche, sex (48 hours), spermicides

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5
Q

The nurse should make the pelvic examination ___ ____.

A

Less threatening

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6
Q

Begin screening for cervical cancer begins at what age?

A

21 years old

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7
Q

Pap test every 3 years if results are normal are during what age range?

A

age 21-30 years

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8
Q

Pap test every 3 years or Pap test + HPV test every 5 years are done during what age range?

A

age 31-64 years old

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9
Q

Stop routine screening if results are normal for the previous 10 years are done during what age range?

A

Age 65 years and older

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10
Q

What is the purpose of a colposcopy?

A

to magnify the tissue being examined

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11
Q

Application of ___ ___ helps to highlight any areas of suspicious cells.

A

acetic acid

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12
Q

They should ___ areas of concern to determine a treatment plan

A

biopsy

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13
Q

The goal of a colposcopy is to prevent ___ ___

A

cervical cancer

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14
Q

A ___ is visualization of the ovaries, Fallopian tubes, uterus, and small intestines via a lighted tube inserted in the vagina via the cul-de-sac.

A

culdoscopy

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15
Q

If a patient is having a culdoscopy, they should avoid ___ and ___ for 2 weeks post procedure.

A

douching, intercourse

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16
Q

A culdoscopy can be used to?

A

-rule out ectopic pregnancy
-evaluate ovarian disorders
-evaluate pelvic masses

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17
Q

What are the treatment options for cervical dysplasia?

A

cryotherapy/laser therapy OR cone bx loop electrosurgical excision procedure (LEEP)

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18
Q

A fine wire loop that has a low-voltage electrical current to remove abnormal layer of cervical cells is known as?

A

Cone Bx Loop Electrosurgical Excision Procedure (LEEP)

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19
Q

Freezing cervical tissue with nitrous oxide is known as?

A

cryotherapy/laser therapy

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20
Q
A
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21
Q

Is cervical cancer often symptomatic or asymptomatic?

A

asymptomatic

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22
Q

What are some S/S of cervical cancer?

A

painless vaginal bleeding, watery-foul odor (Progressively darken), irregular periods, bleeding between periods

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23
Q

What are the treatment options for cervical cancer?

A

LEEP, laser therapy, cryotherapy, cervical conization, hysterectomy

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24
Q

What are the indications for a hysterectomy?

A

uterine fibroids, heavy or unusual vaginal bleeding, uterine prolapse, endometriosis (severe), chronic pelvic inflammatory disease, adenomyosis, cancer

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25
Q

___ ___ is removal of ovaries (with or without the tubes)

A

Bilateral Oophrectomy

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26
Q

A bilateral oophorectomy and salpingectomy is removal of the ovaries ___ the ___.

A

with, tubes

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27
Q

What are the different types of hysterectomies?

A

-total abdominal hysterectomy
-total vaginal hysterectomy
-laparoscopic-assisted vaginal hysterectomy
-bilateral sapling-oophorectomy
-loop electrosurgical excision
-uterine ablation is frequently being used to treat abnormal uterine bleeding

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28
Q

What discharge teaching should be given to a patient after a hysterectomy?

A

-pelvic rest for 4-6 weeks
-no heavy lifting 8 weeks
-frequent bladder emptying
-bowel regimen
-ambulate

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29
Q

What are risks for women that have a hysterectomy at a young age <45?

A
  1. bone loss/osteoporosis
  2. lack of hormone
  3. symptomatic vasomotor symptoms
  4. increased risks for cardiovascular/neurological symptoms or stroke
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30
Q

True or False.
If ovaries are removed before menopause, supplemental estrogen therapy is recommended.

A

true

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31
Q

HPV vaccine is recommended for ages __-__ for both females and males.

A

9-26

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32
Q

True or False.
Preteens have a higher immune response to HPV vaccine than older teens.

A

True

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33
Q

Ovarian ____ are benign tumors that may be associated with pain.

A

Cysts

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34
Q

Ovarian ___ is the leading female cancer death because it rapidly spreads and has non-specific symptoms

A

cancer

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35
Q

S/S of ovarian cancer are?

A

abdominal selling or bloating, pelvic pressure or abdominal pain, difficulty eating

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36
Q

What diagnostics are used for ovarian cancer?

A

imaging or surgery

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37
Q

What are the treatment options for ovarian cancer?

A

surgery (primary)
chemotherapy
hormone therapy
radiation
**often 2 or more different types of treatments are used

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38
Q

Who is at risk for ovarian cancer?

A

increased age, hx of breast cancer, BRCA 1 or BRCA 2 gene mutations, family hx of breast or ovarian cancer

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39
Q

American CA society does not recommend that breast __ __ be presented to women but it does recommend that women be familiar with how their breast normally look and feel.

A

self exam

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40
Q

__-___ condition is the presence of soft, movable, tender lumps (more common at time of menses)

A

Non-cancerous

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41
Q

Are fibrocystic breast a pre-cursor to breast cancer?

A

No they are NOT

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42
Q

What causes fibrocystic breasts?

A

fluctuating hormones made by the ovaries

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43
Q

What are symptoms of fibrocystic breast?

A

swelling, tenderness, pain, thickening of tissue, lumps in one or both breasts

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44
Q

What is a mammogram?

A

Soft tissue x-ray of the breast
*can detect lesions earlier than by using palpation

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45
Q

Annual mammogram and clinical breast examination for all women over the age of __

A

40

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46
Q

What does a trained professional examiner assess for in a clinical breast exam?

A

general appearance & symmetry, appearance of nipples, color of skin, check for lumps and texture

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47
Q

What are predisposing risk factors for breast cancer?

A

-age (older the higher the risk)
-hx of breast cancer
-female gender
-having BRCA 1 or BRCA 2 gene mutation
-family hx of first degree relative
-long term post menopausal combine hormone therapy estrogen/progestin
-alcohol
-no hx of pregnancy or first after 30
-never breast feeding
-long reproductive phase
-hx of high dose radiation to chest
-no physical activity
-smoking
-overweight or obese after menopause

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48
Q

If you have a family history of pre-menopausal breast cancer, when should screening start?

A

10 years prior to youngest family member with breast cancer

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49
Q

____ ____ is a test for hereditary breast and ovarian cancer syndrome

A

BRCA analysis
**it does NOT tell if you have cancer it just tests for the mutation

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50
Q

What are the characteristics of breast cancer?

A

small, immobile, painless lump (unilateral)
Less common: rash, changes in color/dimpling

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51
Q

What are the treatment options of breast cancer?

A

surgery, radiation, chemo

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52
Q

What is the most important finding on a breast exam?

A

A painless mass or lump

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53
Q

What are some worrisome findings on a breast exam?

A

dimpling, new nipple inversion, change in size of breast, change in shape, skin breakdown, lump under arm

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54
Q

What is the clinical therapy for breast cancer?

A
  1. stage of cancer
  2. best treatment for the stage
  3. age
  4. personal preference
  5. risk and benefits
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55
Q

What are the surgical options for breast cancer treatment?

A

Lumpectomy or radical mastectomy

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56
Q

___ destroys cancer cells or shrink large masses before surgery

A

radiation

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57
Q

What are some systemic therapy options for breast cancer treatment?

A

tamoxifen (block estrogen), chemotherapy, ovarian function suppression (prevent estrogen excretion from ovaries)

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58
Q

The goal of surgery is to remove the cancer from the ___ & _______

A

breasts, lymph nodes

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59
Q

____ is a breast-sparing approach that is often used for stage I & II breast cancer

A

Lumpectomy- removal of the cancerous tissue plus a rim of normal tissue

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60
Q

____ drug blocks estrogen receptors in breast cancer cells. It stops estrogen from binding to the cancer cells and telling them to grow and divide,

A

Tamoxifen

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61
Q

Tamoxifen can also be used for ___ ___ by women who are at high risk for developing breast cancer

A

cancer prevention

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62
Q

What is nursing care for a patient after a mastectomy?

A

-inspect the incision and dressing for bleeding
-May have JP drains in place-measure & empty
-encourage arm exercises to prevent contracture
-prevent lymphedema

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63
Q

___ is too much protein rich lymph fluid that collects in the interstitial space due to the removal of lymph nodes

A

Lymphedema

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64
Q

Where does lymphedema usually occur?

A

arm & hand, breast, underarm, chest, trunk, and/or back

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65
Q

Ways to prevent lymphedema:
Elevate affected _____
Turn to _____ side
Avoid _____ clothes
Avoid ___, IVs, ___ ___

A

extremity
unaffected
constricting
BP, blood draws

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66
Q

Why should the nurse avoid poking the affected arm in a patient with lymphedema?

A

it reduces the risk of injury or inflammation to that arm

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67
Q

True or False.
If it is an emergency, it is okay to place an IV in the affected arm in a patient with lymphedema because the benefit outweighs the risk.

A

True

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68
Q

____ scan generally start at age 50 or at onset of menopause, whichever is first

A

DXA

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69
Q

What does a DXA scan measure?

A

how many grams of calcium and other bone minerals are packed into a segment of bone

70
Q

True or False.
Higher calcium content usually does not mean increased bone strength

A

False, it does mean increased bone strength

71
Q

Who is at high risk for osteoporosis?

A

Older women, tobacco use, adult fractures, petite thin women

72
Q

Any ___ ___ = diagnosis of osteoporosis and t should be treated as such even if the DXA result is normal

A

fragility fracture

73
Q

What is a fragility fracture?

A

any broken bone from standing height (excluding fingers/toes/face/nose) or any low trauma fracture

74
Q

Where are the common sites of fragility fractures?

A

hip, spine, wrist

75
Q

Approximenately ___% of patients who have a fragility fracture of the hip will die within 1 year

A

25%

76
Q

When does colorectal cancer screening begin?

A

age 45 for those with average risk

77
Q

The recommended screening for colorectal cancer is?

A

Colonoscopy every 10 years until age 75

78
Q

What are preventative measures for colorectal cancer?

A

-limit red meat
-increased fruit/veggies in diet
-regular exercise
-get screened
-avoid smoking
-get adequate vitamin D and calcium

79
Q

Those born in ___ have ___ the risk of colon cancer and quadruple the risk of rectal cancer compare to people born around 1950

A

1990, double

80
Q

Are adolescent patients considered a diverse population group?

A

yes

81
Q

Based on Virginia law, Minor may exercise independent consent for:
____ services
____ services
STD/HIV services
alcohol/____ treatment
___ ___ services

A

contraceptive
prenatal
drug
mental health

82
Q

____ is the transition to menopause that can last 10 years, when the ovaries begin to make less estrogen

A

Perimenopause

83
Q

_____ is cessation of menses for 12 months and requires a clinical diagnosis

A

Menopause

84
Q

What are some S/S of menopause?

A

irregular menses, breast tenderness, mood changes, hot/warm flashes, night sweats, sleep disturbances

85
Q

What is the treatment plan for a patient going through menopause?

A

Hormone therapy

86
Q

What is the leading post-menopausal cancer?

A

endometrial (lining of uterus)

87
Q

What are risk factors for endometrial cancer?

A

age >55, obesity, irregular periods, use of estrogen after menopause, type 2 diabetes, hypertension

88
Q

What are some S/S of endometrial cancer?

A

vaginal bleeding after menopause
bleeding between menses, abnormal discharge, pain

89
Q

What diagnostics can be used for endometrial cancer?

A

endometrial biopsy, ultrasound, surgical on pathology

90
Q

What is the treatment plan for a patient with endometrial cancer?

A

surgery (recommended), radiation, chemotherapy

91
Q

When does atrophic vaginitis occur?

A

after menopause

92
Q

What are S/S of atrophic vaginitis?

A

thin, pale, dry vaginal mucosa, itching, dyspareunia (painful sex)

93
Q

What is the treatment for atrophic vaginitis?

A

topical estrogen, water-based lubricants

94
Q

Why are smokers at higher risk of atrophic vaginitis?

A

impairs blood circulation to the vaginal tissue which leads to thinning

95
Q

___ ___ are the only method to prevent STI

A

barrier methods

96
Q

What are the barrier method options?

A

external male condom or female condom

97
Q

What is a possible side effect of using a barrier method?

A

contact irritation

98
Q

What is the failure rate for barrier methods ALONE?

A

18%
it is more effective with spermicides

99
Q

Should female condoms be used with a male condom at the same time?

A

NO
they also have a high failure rate of 21%

100
Q

___ kills or disables sperm

A

Spermicides
ex: nonoxynol-9

101
Q

When should one use spermicide?

A

before each sexual encounter
*can cause contact irritation

102
Q

What is the failure rate of spermicides without condoms?
With condoms?

A

W/O- 28%
WITH- 2.5%

103
Q

____ block ovarian stimulation by inhibiting ovulation by blocking FSH release

A

oral contraceptives

104
Q

What is the failure rate for oral contraceptives?

A

9%

105
Q

What are some patient education topics for oral contraceptives?

A

-take at the same time everyday
-use back-up method is miss 2 more more pills
-doesn’t protect against STIs

106
Q

A ___ oral contraceptive pill contains both estrogen and progestin.

A

combined

107
Q

The “minimill” contains only ___

A

progestin

108
Q

What are some contraindications of oral contraceptives?

A

hx of DVT, HTN, hypercoag disorders, age >35 and heavy smoker

109
Q

What are the risks of oral contraceptive pills?
HINT- ACHES

A

A-abdominal/pelvic pain (severe)
C- chest pain
H- headaches (sudden & severe)
E- eye changes
S- sudden leg pain and/or swelling
**PT SHOULD STOP USE due to risk for DVT, PE, and STROKE

110
Q

_____ is an injection of a hormone preventing pregnancy that is given every 3 months

A

Depo-Provera

111
Q

The Depo-Provera injection prevents ____

A

ovulation

112
Q

What are some side effects of the depo shot?

A

irregular bleeding, weight gain, may delay return of periods/fertility for up to 1 year

113
Q

What is the depo failure rate?

A

0.3%

114
Q

____ is a matchstick-sized rod that is inserted in the arm that inhibits ovulation and thickens cervical mucus

A

Nexplanon

115
Q

What is the most common side effect of a Nexplanon?

A

irregular bleeding

116
Q

How long is a Nexplanon effective for?

A

3 years

117
Q

What is the failure rate for a Nexplanon?

A

0.05%

118
Q

A hormonal IUD provides protection for up to __ years & is progesterone only

A

5

119
Q

How does a hormonal IUD work?

A

it thickens the mucus which traps sperm and stops ovulation

120
Q

What are some side effects of a hormonal IUD?

A

menstrual cycle changes, ovarian cysts

121
Q

A non-hormonal (_____) is good for __ years and has NO hormones

A

copper IUD
10

122
Q

Who is a good candidate for a non-hormonal IUD?

A

-women who can’t have hormones
-preference for no hormones

123
Q

What is the failure rate of a copper IUD?

A

0.8%

124
Q

What is a side effect of a copper IUD?

A

heavier or more painful menses

125
Q

___ is a flexible rubber ring with latex that is inserted in the vagina and tucked behind the pubic bone and covers the cervix

A

Diaphragm

126
Q

A diaphragm should not be inserted more than ___ hours before intercourse

A

6

127
Q

What are permanent sterilization options for both male and female patients?

A

Female- bilateral tubal ligation (0.5% fail)
Male- vasectomy (0.15% fail)

128
Q

What are the future (new options) of contraceptives?

A

-hormones
-microchips
-gels
-pills sharing

129
Q

What should be documented in an abusive situation?

A
  1. extent of injuries
  2. the woman exact words
  3. describe the incidence
  4. take pictures for evidence
  5. do not refer to DV on any discharge papers

MOST IMP: safety plan

130
Q

What is considered sexual assault?

A

-touching or penetration without consent
-unwanted sexual contact
-unwanted touching of an intimate partner
-forced anal, oral, or genital penetration

131
Q

What are S/S of toxic shock syndrome?

A

fever, vomiting, diarrhea, drop in BP, sunburn type of rash on palms of hands and doles of feet

132
Q

____ ____ is an imbalance of or overgrowth of normal vaginal flora

A

bacterial vaginosis (BV)

133
Q

What organisms commonly cause BV?

A

Gardnerella & mycoplasma hominis

134
Q

What are S/S of BV?

A

thin, white milk-like discharge, fishy odor, spilled milk look, burning

135
Q

What is the treatment of BV?

A

Metronidazole (Flagyl)
**Avoid alcohol with Flagyl

136
Q

Is BV considered an STD?

A

No

137
Q

What symptoms will a patient experience if they drink alcohol while taking Flagyl?

A

Severe GI symptoms, N/V, flushing, intense abdominal cramping

138
Q

___ ____ is a fungal or year infection due to Candida albicans

A

Vulvovaginal Candidiasis (VVC)

139
Q

What are S/S of VVC?

A

thick, curdy discharge, intense itching, inflammation, odorless

140
Q

What is the treatment for VVC?

A

anti fungal medication (oral or vaginal)

141
Q

Is VVC considered an STD?

A

No

142
Q

What are the most common sexually transmitted infections?

A

-trichomonas vaginalis
-chlamydia trachomatis
-gonorrhea
-herpes
-syphilis
-HPV

143
Q

___ ___ is a protozoan parasite infection

A

trichomonas vaginalis

144
Q

what are S/S of trichomonas vaginalis?

A

yellow-green, frothy/foamy doors discharge, vulvar itching, strawberry cervix

**About 70% of ppl infected do not have S/S

145
Q

What is the treatment of trichomonas vaginalis?

A

Flagyl for both partners
*abstinence until both are treated

146
Q

What are the S/S of chlamydia?

A

thin or purulent discharge, burning and frequency go urination, abdominal/pelvic pain

147
Q

What is the treatment of chlamydia?

A

Doxycycline x7 days OR Zithromax
*abstain for 7 days after tx

148
Q

What are some untreated risks of chlamydia?

A

pelvic inflammatory disease, ectopic pregnancy due to scarring, chronic pelvic pain, infertility

149
Q

Chlamydia is known as the ___ ___ because 75% of people are asymptomatic

A

silent infection

150
Q

What are the different modes of transmission of Gonorrhea?

A

vaginal, anal, oral, or maternal-child during delivery

151
Q

What are S/S of gonorrhea?

A

dysuria, pelvic pain, bleeding between periods or after intercourse, yellow/green discharge

152
Q

What is the treatment of chlamydia?

A

Ceftriaxone (Rocephin) with Azithromycin
*abstain for 7 days after tx

153
Q

What are newborn risks associated with gonorrhea?

A

blindness, joint infections, sepsis

154
Q

What is the 2nd most common STI?

A

Gonorrhea

155
Q

Is there a cure for herpes?

A

No

156
Q

HSV-1:
1. ___ sore
2. can transmit to the ____
3. can be transmitted giving/receiving ___ sex

A

cold
genitals
oral

157
Q

HSV-2:
1. ____ infections
2. very rare for it to be transmitted ___
3. typical appearance of ___ on or around the genitals or rectum
4. reoccurs during times of stress, ___, or menses

A

genital
orally
vesicles
infection

158
Q

What is the treatment options for symptoms of herpes?

A

antivirals *supportive only

159
Q

What is the nickname of syphilis?

A

great prentender

160
Q

How is syphilis transmitted?

A

direct contact with a syphilitic sure or maternal-child via the placenta

161
Q

What is the treatment of syphilis?

A

Penicillin G IM

162
Q

How many stages of syphilis are there?

A

4

163
Q

Syphilis primary stage:
Appearance of a ___ chancre
*firm, round, and painless lesion on genitals that disappears in 4 weeks

A

single

164
Q

Syphilis secondary stage:
___ colored rash on palms/soles and a low grade fever

A

copper

165
Q

Latent and late stages of syphilis:
can appear ___-___ years after initial infection
____ and CNS dysfunction

A

10-20
cardiac

166
Q

Neurosyphilis (final stage):
invasion of the ___ system
headache, altered behavior, movement problems

A

nervous

167
Q

Condylomata acuminata is also called?

A

genital warts

168
Q

What are genital warts caused by?

A

HPV
types 16&18 cause most cervical cancer
types 6&11 cause genital warts

169
Q

How is condylomata acuminate transmitted?

A

vaginal, oral, or anal sex

170
Q

What is the treatment of genital warts?

A

cryotherapy, laser removal, TCA, Podophyllin resin

Test 4- Community health (1 decks)

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