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Maternal Newborn > Thorpe final exam > Flashcards

Thorpe final exam Flashcards

1
Q

What breast cancer screening measures are recommended

A

Clinical Breast exam ( CBE) and mammography

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2
Q

Do BRCAI 1 and BRCAI 2 increase

A

A woman’s risk for developing breast cancer

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3
Q

What characteristics are considered when determining breast cancer staging

A

Size of tumor
Extent and number of lymph nodes
Distant metastasis

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4
Q

What 2 tests are the best indicator of breast cancer diagnosis

A

MRI
Needle core biopsy
Mammography

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5
Q

What treatment would be most appropriate for a woman newly diagnosed with stages 1or 2 Breast cancer

A

Breast conservation ( lumpectomy) followed by irradiation

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6
Q

What 2 stages of cancer are curable

A

Stages 1&2

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7
Q

What does the SERM ( selective estrogen receptor modulator) tamoxifen do

A

Counteracts the effects of circulating estrogen in the body to reduce the risk for return or spread of cancer

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8
Q

What should the nurse caution about when administering the Aromatase inhibitor (AI) letrozole ( femara)

A

Signs of blood clots in her leg
Joint pain and stiffness
Intermittent chest pain

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9
Q

List risk factors for cancer of the vulva

A

Smoking
HPV infection
HIV infection
Immunosuppression

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10
Q

List risk factors for cancer of the vagina

A 
Previous cervical cancer
In uterine exposure to diethylstilbestrol (DES)
Previous vaginal or  vulvar cancer 
Previous radiation therapy
HX of HPV
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11
Q

What are risk factors for cancer of the cervix

A

Hx of dysphasia. Family hx
Multiple sexual partner Smoking/ exposure to 2nd hand
Sex with uncircumcised men. Coitus less than 16
Early childbearing. Nutritional deficiencies
Exposure to HPV types 16&18. Use of chemotherapy
Overweight. Chronic cervical infection

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12
Q

What are risk factors for cancer of the uterus

A 
Obese
White woman 
Cumulative exposure to estrogen
Infertility 
Diabetes 
Use of tamoxifen
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13
Q

What is tamoxifen used for

A

Treatment and prevention of breast cancer

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14
Q

For cancer of the vulva what are good diagnostic tools

A

VSE vulvar self examination

Ultrasound

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15
Q

For cancer of the vagina, what diagnostic tool can be used

A

Colposcopy
Cervical and vaginal cultures
Pap smear
Ultrasound

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16
Q

For cancer of the cervix, what diagnostics can a nurse use

A 
Colposcopy 
Cervical and vaginal cultures
Endometrial biopsy
Pap smear Cultures
LEEP
D&C
Ultrasound
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17
Q

Name 8 risk factors that predispose a woman to breast cancer

A 
Age
Female
Hx of previous breast cancer
Mutation of BRCAI genes 
Family hx 
Alcohol consumption
Obesity
Nulliparity
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18
Q

What are risk factors for cancer of the ovaries

A 
Family hx
Obesity 
Older than 40
Early menarche
Late menopause
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19
Q

For cancer of the uterus, what are good diagnostic tests

A 
Endobiopsy
Pap smear
LEEP
Ultrasound
D&C
Hysteroscopy
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20
Q

For cancer of the ovary, what are good diagnostic tests

A

BRCA1 and BRCA2 gene Mutation screening
Laparoscopy
Ultrasound

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21
Q

What is a good diagnostic test for the diagnosis of cancers of the Fallopian tubes

A

Hysteroscopy

Ultrasound

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22
Q

Based on the Bethesda system for classifying Pap smears, what ones describe epithelial cell abnormalities of glandular cell type.

A

Atypical glandular cells ( NOS)
Atypical endocervical cells, favor neoplatic
Endocervical adenocarcinoma in situ

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23
Q

What bests describes stage 2 ovarian cancer

A

It is a cancer that is contained within the ovary or ovaries if both are initially infected

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24
Q

List clinical manifestations of cervical cancer

A 
Persistent vaginal discharge 
Abnormal bleeding between menses or post menopause
Abnormal cells on pap smear
Anorexia
Pelvic pain
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25
Q

List clinical manifestations of cancer of the uterus

A 
Irregular bleeding and pain
Prolonged flow
Dysuria
Dyspareunia
Pelvic pain
Enlarged uterus ( rule out fibroids, pregnancy, obesity)
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26
Q

List clinical manifestations of cancer of the vulva

A 
Pruritis/ soreness
Enlarged lymph nodes in groin
Bleeding
 Smelly discharge
Wart like lesions, itching, sores, ulcers, change in skin color/ texture.
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27
Q

List clinical manifestations for cancer of the vagina

A 
Dysuria
Dyspareunia, 
Pelvic pain
Lump or swelling of vagina
Pain 
Discharge
Bleeding after intercourse
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28
Q

What abnormal findings should a woman report upon completion of a vulvar self exam

A

Redness, severe itching, and lump on labia minora
Ulcer of the labia majora that does not heal
Severe pain with vaginal penetration during intercourse

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29
Q

A patient has undergone total abdominal hysterectomy ( TAH) and bilateral salpinoophorectomy for stage 2 ovarian cancer is receiving the prescribed chemotherapy with intravenous Paclitaxelm( Taxol) and Carboplatin ( Paraplatin). She asks the nurse what toxic effects she may experience. The nurse states she may experience the following;

A 
Leukopenia
Alopecia
Anaphylactic shock
Neurotoxicity 
Fever
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30
Q

True or false

Endometriosis is a benign condition characterized by the presence of endometrial tissue outside the uterine cavity….

A

True, it can arise anywhere

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31
Q

What are risk factors for endometriosis

A

Early onset of menarche

Woman with a menstrual cycle of less than 27 days and flow lasting more than 7 days

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32
Q

Name some pathophysiological factors of endometriosis

A 
Familial predisposition
Shorter menstrual cycle
Outflow obstruction
Younger age at menarche
Misplaced endometrial tissue
Retrograde menstruation
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33
Q

What clinical manifestations are currently assoc with endometriosis

A

Abdominal and pelvic pain
Dysmenorrhea and dyspareunia
Painful defecation during menstruation

34
Q

What test provides a definitive diagnosis of endometriosis

A

Direct visualization of glandular lesions during laparoscopy

35
Q

What med is commonly prescribed for woman who are diagnosed with mild endometriosis and symptoms

A

NSAIDS

36
Q

What is The medication Leuprolide ( Lupron) used for?

A

Moderate to severe endometriosis

37
Q

How does the medication Leuprolide ( Lupron) work

A

It suppresses the menstrual cycle through estrogen antagonism

38
Q

What meds can be used to treat breast cancer

A 
Hormone therapy
Tamoxifen
SERMS
Aromatase inhibitors 
Herceptin
Analgesics
39
Q

List the 4 stages of the Rape Trauma Syndrome and list them in order of occurrence

A 
Acute phase or disorganization
Outward adjustment or denial phase
Reorganization phase
Integration and recovery phase
Silent reaction phase
40
Q

What are diagnostic tests for CHD

A

Lipid profile
EKG
stress test

41
Q

Name 3 problems of menopause that result for the decline in estrogen levels

A

Osteoporosis- loss of bone density and quality
CHD- coronary heart disease
Changes in HDL and LDL ratio because of declining estrogen

42
Q

What tests may be done to confirm the diagnosis of menopause

A

Analysis of FSH and LH

43
Q

What are positive signs of pregnancy

A

Fetal heart beat
Fetal movement
Visualization of the fetus

44
Q

What are sources of folic acid

A

Fresh leafy vegetables
OJ
citrus fruits and juices
Red meats,mush, poultry, legumes

45
Q

What are risk factors for osteoporosis

A

Personal hx of fracture after age 50
Low bone mass, hx of fracture in 1st degree relative
Female, thin ( weighing less than 127 or having a small frame)
Advanced age, family hx of osteoporosis, abnormal absence of menses
Early onset of menopause,anorexia, low lifetime of calcium intake
Vitamin D deficiency, cigarettes smoking, excessive alcohol use
Inactive lifestyle, being Caucasian or Asian
Use of corticosteroids, chemotherapy, or anticonvulsants

46
Q

What are risk factors for CHD in woman

A 
Family hx of heart disease
Advancing age over 55 or postmenopausal
Overweight and obese
Cigarette smoking 
Sedentary lifestyle, HTN, diabetes, elevated cholesterol, African American
47
Q

What meds are available to treat or prevent osteoporosis

A

Biphosphonates-
SERMS ( selective estrogen receptor modulators)
Salmon calcitonin
Parathyroid hormone

48
Q

What are biphosphonates

A

They are an alternative to estrogen, they are the gold standard in alleviating post menopausal osteoporosis
It is taken in the morning on an empty stomach with a large glass of water. Woman should stand or sit upright for 30 min afterward

49
Q

What is zoledronic acid ( Zometa)

A

It is a intravenous biphosphonate approved for the use in txt of metastatic bone cancer

50
Q

What are SERMS

A

Selective estrogen receptor modulators, an alternative to estrogen that has estrogen like properties.

51
Q

What is raloxifene ( evista)

A

It’s a SREM approved for tx in prevention of osteoporosis

52
Q

Whatnots salmon calcitoni

A

A calcium regulator that may inhibit bone loss and is approved for tx I. Woman who are 5 yrs post menopausal. It comes as a nasal spray

53
Q

What is parathyroid hormone

A

A daily subQ injection that activates bone formation

54
Q

What is the recommended calcium intake dosage for postmenopausal woman

A

1200 mg or 1500 if they are not on hormone therapy

55
Q

What are fasting levels for a pregnant woman

A 
Fasting 95
1 hr 180
2 hr  155
3 hr 140
The woman should remain seated and not smoke throughout the test. Gestational diabetes is diagnosed if 2 or more values are met or exceeded.
56
Q

What is glycosulated hemoglobin (HbA1c)

A

It is a lab test that loosely reflects glucose control over the previous 4-8 weeks. It measures the % of glycohemoglobin in the blood.

57
Q

What are complications at delivery for a mother with Candida albicans

A

If the infection is present at birth and the fetus is born vaginally, the fetus may contact thrush

58
Q

What are complications at delivery for a mother who had BV

A

PROM
PTL
Intravenous- amniotic infection
And endometritis postpartally

59
Q

What are complications at delivery for a mother who has trichomonas

A

Increased risk for PROM
preterm birth
Low birth weight

60
Q

What are complications at delivery for a mother who has chlamydia

A

The newborn may develop newborn conjunctivitis, which may be treated with erythromycin eye ointment ( but not silver nitrate)
Infant may also develop chlamydial pneumonia. May be responsible for premature labor and fetal death

61
Q

What complications at birth can arise because of syphillis

A

Syphillis can be passed transplacentally to the fetus.
If untreated one of the following may occur; second trimester abortion, stillborn infant at term, congenitally infected infant, uninfected live infant

62
Q

What may complications of gonorrhea cause at delivery

A

Ophthalmia neonatorum

63
Q

What discomforts are experienced during the first trimester

A

N/V {r/t increased levels of hCG, changes in carbohydrate metabolism,emotional factors, fatigue}
Urinary frequency { r/t pressure of the uterus on bladder in both the 1st & 3rd trimesters}
Fatigue
Breast tenderness { r/t increases in levels of estrogen and progesterone}
Increased vaginal discharge { r/t hyperplasia of vaginally mucosa and increased production of mucus by the endocervical glands due to the increase in estrogen levels}
Nasal stiffness and epitaxis { r/t elevated estrogen levels}
Ptyalism ( excessive, often bitter salivation)

64
Q

What are discomforts that arise in the 2nd and 3rd trimesters

A

Heartburn (pyrosis)

Ankle edema, varicose veins, hemmoriods, constipation, backache, lag cramps

65
Q

How much weight should a pregnant woman gain

A

28-40 pounds for a underweight woman
25-35 pounds for a normal weight woman
15-25 pounds for a overweight woman
11-20 pounds for a obese woman

66
Q

How is nägele’s rule calculated

A

Begin with the FIRST day of LMP, subtract 3 months, add 7 days and 1 yr.

67
Q

What is McDonald’s rule

A

Measure the distance in centimeters from the top of the symphysis pubis over the curve of the abdomen to the top of the uterine fundus

68
Q

What is true of fetal development at 4 weeks of life

A

The fetal heart begins to beat

69
Q

What is true of fetal development at 8 weeks of life

A

All body organs are formed

70
Q

What is true of fetal development at 8-12 weeks of life

A

Fetal heart times can be heard by Doppler device

71
Q

What is true of fetal development at 20 weeks of life

A

Heartbeat can be heard with fetoscope
Quickening, babies develops a regular schedule of sleeping, sucking, and kicking
Hands can grasp, baby assumes a fav position in utero
Vernix and lanugo appear
Head hair, eyebrows, and eye lashes are present

72
Q

What is true of fetal development at 24 weeks of life

A

Weighs 780g (1pound 10 ounces)
Activity is increasing
Fetal respiratory movements begin

73
Q

What is true of fetal development at 28 weeks of life

A

Eyes begin to and close
Baby can breathe
Surfactant needed for breathing is formed
Baby is two thirds its final size

74
Q

What is true of fetal development at 32 weeks of life

A

Baby has fingernails and toenails
Subcutaneous fat is being laid down
Baby appears less red and wrinkled

75
Q

What is true of fetal development at 38+ weeks of life

A

Baby fills total uterus

Baby gets antibodies from mother

76
Q

What tests are done to detect osteoporosis

A

BMD
WAIST TO HIP RATIO want ratio to be under 0.8
Ht
Calcium And phosphate levels to see if their decreased

77
Q

What are side effects of ERT estrogen replacement therapy

A

Headaches
Brown spots on skin
N/V
Swelling, wt. gain,eye problems, risk for thromboembolism

78
Q

Estrogen replacement therapy is contraindicated in who

A

Hypertensive patients, cardiac patients, breast cancer patients, hx of thromboembolism

79
Q

What are the 3 phases of the menstrual cycle

A

Proliferation phase days 7-14
Secretory phase days 15-26
Ischemic phase days 27-28

80
Q

List the 2 hormones produced by the pituitary gland which influences the female reproductive cycle

A

FSH

LH- aids in the final maturation of follicle

81
Q

State the 3 major hormones produced by the ovary and describe there functions

A
  1. Estrogen, increase size of uterus contractions increases
  2. Progesterone, decreases contractility helps maintain pregnancy
  3. Prostaglandins, affect metabolism, play a role in glycolysis,made the smooth muscle contractility, affect ovulation and changes in cervix
    Play a role in inhibition of labor by increasing contractions
82
Q

Describe 3 changes that occur at ovulation

A

Increase in progesterone levels
Increased temp
Change in cervical mucus becoming clear and thin
Slight spotting

Maternal Newborn (26 decks)

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