TOPIC 8 - female reproductive disorders Flashcards
cervical cancer early vs late symptoms
early : none
late : unusual discharge, AUB or postcoital bleeding (thin and watery, dark and foul smelling as disease advances), vaginal bleeding and spotting that becomes heavier and more frequent, pain is a late symptom and is followed by weight loss, anemia, and cachexia
risk factors for cervical cancer
(1) infection with high-risk strains of human papillomavirus (HPV) 16 and 18
(2) immunosuppression
(3) low socioeconomic status
(4) chlamydia infection
(5) smoking.
diagnostic studies
pap test : identifies changes in cervical cells that may indicate precancerous changes
(for 21-29 years old every 3 years
30-65 years old every 5 years)
HPV testing : identify high risk HPV types 16 and 18
(vaccinate at age 9-12)
treatment options for cervical cancer
surgery (biopsy)
combination of chemo and radiation
terminal cervical cancer manifestations
anemia, cachexia, weight loss
meds to control symptoms of endometriosis
oral contraceptives
early vs late signs of endometrial cancer
early: abnormal uterine bleeding
later: pain during urination or intercourse
risk factors for endometrial cancer
exposure to estrogen
Obesity is a risk factor because adipose cells store estrogen, thus increasing the amount of circulating estrogen
Increasing age
never being pregnant
early menarche
late menopause
Smoking
diabetes mellitus
personal or family history of hereditary nonpolyposis colorectal cancer
primary diagnostic test for endometrial cancer
endometrial biopsy
there is no routine screening test, most cases are diagnosed early because of postmenopausal bleeding
treatment for endometrial cancer
total hysterectomy and bilateral salpingo-oophorectomy with lymph node biopsies
external radiation either to the pelvis or abdomen or internal radiation (brachytherapy) intravaginally if there is local or distant metastasis.
polycystic ovary syndrome
disorder that includes ovulatory dysfunction, polycystic ovaries, and hyperandrogenism.It most commonly occurs in women under 30 years old and is a cause of infertility.
what is the thought to be cause of PCOS
ovaries producing estrogen and excess testosterone but not progesterone.
risk factors for ovarian cancer
Family or personal history of ovarian, breast, or colon cancer
Personal history of hereditary nonpolyposis colorectal cancer
Hormone replacement therapy
Mutant BRCA
Early menarche and late menopause
Increasing age
Never been pregnant or nulliparity
High-fat diet
vague and non specific symptoms of ovarian cancer
pelvic or abdominal pain
bloating
urinary urgency or frequency
late symptoms of ovarian cancer
Difficulty eating or feeling full quickly
Abdominal enlargement with ascites
Unexplained weight loss or gain
Menstrual changes
hysterectomies can be used to treat …
cancers of the uterus, ovaries, and fallopian tubes, endometriosis, and abnormal uterine bleeding
education for post-op hysterectomy patients
intercourse should be avoided for 4-6 weeks
vaginal sensation should return within a few months
bathing in a tub should be avoided for at least 1 month to prevent infection
avoid heavy lifting for 6 weeks
menstruation should immediately stop
risk factors for breast cancer
Female gender
Advancing age
Family history - especially if the involved family member also had ovarian cancer, was premenopausal, had bilateral breast cancer, or is a first-degree relative (i.e., mother, father, sister, brother, daughter).
Genetic link - BRCA1andBRCA2(BRCA stands forBReastCAncer).
Prior breast cancer
Past history of thoracic radiation therapy
Atypical findings on a prior breast biopsy
First period before age 12
Menopause after age 55
Dense breast tissue
Age of 50 or more
Benign breast disease with atypical biopsy
Weight gain and obesity
Alcohol consumption
Exposure to ionizing radiation
manifestations of breast cancer
lump or thickening in breast
abnormal mammography
often in upper, outer quadrant
nipple discharge or retraction
sites of breast cancer recurrence and metastasis
Skin, chest wall
Lymph nodes
Spinal cord
Brain
Pulmonary
Liver
Bone marrow
diagnostic studies for breast cancer
Mammography
Digital mammography
Three-dimensional (3D) mammography
Biopsy of breast tissue
types of breast tissue biopsies
FNA biopsy
Core (core needle) biopsy
Stereotactic mammography
Vacuum-assisted biopsy
Axillary lymph node biopsy
when is there a greater risk for recurrence
when more nodes are involved
primary treatment for breast cancer
surgery
either :
-lumpectomy (early stages : tumors smaller than 5cm)
-mastectomy (total or simple removes the entire breast and axillary lymph nodes but preserves the pectoralis major muscle)
when are clients usually discharged from the hospital
within 24-48 hours
(may have JP drains - teach about dressing and drain care)
what does in situ mean
cancer is currently noninvasive within the duct
lymphedema (complication)
accumulation of lymph within soft tissue
occurs from lymph removal from biopsy, surgery, or radiation
results in tissue no longer being able to drain fluid
client education for lymphedema
Teach measures to prevent and reduce lymphedema
no BP readings, venipuncture, or injections on the affected arm
Affected arm should not be dependent for long periods.
Caution should be used to prevent infection, burns, or compromised circulation on the affected side
use compression sleeves
IF ACUTE : decongestive therapy with a pneumatic sleeve
what is the purpose of post op radiation therapy
to prevent local breast cancer recurrences after breast conserving surgery, prevent local and lymph node recurrences after mastectomy, relieve pain caused by local/regional/or distant spread of cancer
how often is radiation therapy done
for 5 days a week for 5-7 weeks
common side effects of doxorubicin (chemo drug)
involve rapidly dividing cells in the gastrointestinal tract (nausea, anorexia, weight loss), bone marrow (anemia), and hair follicles (alopecia).
monitor cardiotoxicity (SOB, pedal edema, decreased activity, dysrhythmias)
