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Med Surg 2 > Unit 5 - Female Repro Disorders > Flashcards

Unit 5 - Female Repro Disorders Flashcards

1
Q

Malignant Breast Conditions Prevention

A

Exercise and breastfeeding

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2
Q

Malignant Breast Conditions Risk Factors

A 
Gender: female
Increased age: >60
Genetics: BRCA 1/2
Hormones: Contraceptive use, early period, late menopause, no pregnancies/no full term pregnancies, geriatric pregnancy, long term estrogen/progesterone use
Hx of breast cancer
Obesity
Alcohol
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3
Q

Malignant Breast Conditions S/S

A 
Lump
Skin dimpling
Change in skin color/texture
Change in nipple appearance
Clear/bloody d/c from nipple
Atypical: redness, swelling, pain, warmth
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4
Q

Dx of breast cancer: Mammogram

A

Avg risk: q 1-2y at 40yo

High risk: HCP preference

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5
Q

Dx of breast cancer: Breast exams

A

q 3 y age 20-39

q y after age 40

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6
Q

Dx of breast cancer: MRI

A

Implants

Dense breast tissue

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7
Q

Dx of breast cancer: breast bx

A

Preferred method for dx

Needle or surgical

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8
Q

Dx of breast cancer: labs

A

Estrogen (ER) and progesterone receptor (PR) assays

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9
Q

Malignant breast conditions: protective factors

A 
Maintain normal weight
Physical activity
Avoid/limit alcohol
Breastfeeding for a year or longer
Medications: Chemo prevention for high risk
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10
Q

Ducts carcinoma in situ (DCIS)

A

Cancer cells on milk ducts without spread into tissues
Best cure rate
Localized

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11
Q

Lobular carcinoma in situ (LCIS)

A

Marker with tissue changes that show increased risk for cancer

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12
Q

Invasive ductal cancer

A

Mist common and deadly
Spreads rapidly
Invasive

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13
Q

Invasive lobular breast cancer

A

About 10-15% of breast cancers dx

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14
Q

Breast cancer prognosis/tx

A

Depends on tumor size and lymph node involvement

TMN - tumor, metastasis, nodes

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15
Q

Breast cancer sx: lumpectomy

A

Removal of lump

Bx sentinel node

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16
Q

Breast cancer sx: total/simple mastectomy

A

Removal of breast, bx sentinel node

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17
Q

Breast cancer sx: modified radical mastectomy with sentinel node bx/lymph node dissection

A

Removal of breast and lymph nodes

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18
Q

Breast cancer sx: radical mastectomy

A

Removal of breast, lymph nodes, muscle

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19
Q

Breast cancer: radiation types

A

External beam: skin changes, radiation to outside only, not radioactive
Internal: radioactive, bed rest, limit visitors

20
Q

Breast cancer: systemic therapy

A

Neoadjuvant: shrinks tumors
Adjuvant: destroy all cells, immunocompromised

21
Q

Breast cancer: biologic therapy

A

growth promoting protein that targets specific cell (HER2/neu)

22
Q

Breast cancer: hormonal therapy

A

hormone receptor positive cancer: tamoxifen and anastrozole (postmenopausal)

23
Q

Breast cancer: chemotherapy

A

Depends on size of tumor, lymph node involvement, amount of HER2/neu present

24
Q

Internal radiation considerations

A

Time - direct care (w/in 3 foot distance) no more than 30 min in 8h
Distance - stay 6 ft away from pt when not providing direct care (pain assess. Or admission ?s)
Shielding - wear lead apron and dosimeter
Use forceps and lead container if dislodged
Limit visitors

25
Q

External radiation care

A

Patient is not radioactive

26
Q

Care of skin after radiation

A 
Mild soap and minimal rubbing
Avoid perfumed soaps/deodorant 
Use hydrophilic lotions for dry skin
Use Aveeno soap if pruitis occurs
Avoid tight clothes, underwire bras, excessive temps
Minimize sun exposure and use sunblock
27
Q

Hand and arm care after axillary lymph node dissection

A 
Prevent lymphedema/lymphangitis
No BP/sticks on affected side
No heavy lifting with affect arm
No tight clothing, jewelry 
Elevate affected arm
Don’t sleep on arm
Sunscreen and insect repellant
Gloves for gardening
Cooking kit when removing objects from oven
Electric razor for armpit, avoid chemical hair remover
No cutting cuticles - push them back
If break in skin, wash with soap and water then apply antibacterial ointment
Observe for 24h
28
Q

Reconstruction sx: tissue expander or external breast prosthesis

A

Used for implant to be inserted later

29
Q

TRAM flap

A

Uses fat, skin, blood vessels, and muscle from abdomen

Increased risk of hernia

30
Q

DIEP Flap

A

Uses fat, skin and blood vessels from abdomen

No muscle removed, decreased risk of hernia

31
Q

Types of pelvic organ prolapse (POP)

A

Cystocele: s/s UTI or incontinence
Recticele/enterocele: constipation, fecal incontinence, bloating
Uterine prolapse: dyspareunia, backache, bulge

32
Q

Management of POP

A

Pelvic floor rehab: Kegel exercises
Pessary (push up and hold in place) - must be fitted and cleaned
Reconstructive pelvic sx: A-P repair (make everything tighter)

33
Q

Cervical cancer: risk factors

A 
Intercourse with uncircumcised male
Early age of first coitus
Multiple sex partners
High parity
STIs
Cigarette smoking
Exposure to HPV
34
Q

Cervical cancer screening

A

Q 2-3y depending on age/risk

High risk per HCP

35
Q

Cervical cancer S/S (3)

A

Vaginal bleeding
Pelvic pain
Dyspareunia

36
Q

Cervical cancer management (3)

A

Colposcopy with bx
Cervical conization/LEEP: more precise, can be tx if found early enough
Hysterectomy - has spread to uterus

37
Q

Endometrial cancer: FUNDL

A 
Family hx
Unopposed estrogen use
Nulliparous
Diabetes, PCOS, obesity
Late menopause (>50) or early onset menarche (<12)
38
Q

Endometrial cancer S/S (1)

A

Abnormal vaginal bleeding

39
Q

Endometrial cancer Management (4)

A

Chemo
Radiation
Hysterectomy - additional procedures of metastasis (fallopian tubes, cervix, vagina)
Hormone therapy - progesterone (slow growth of endometrial tissues), tamoxifen (prevents estrogen and cancer from growing)

40
Q

Ovarian cancer risk factors: BONAFIDE

A 
Breast cancer
Obesity
Nulliparous
Age over 40 or post-menopause
Family hx
Infertility meds
Descent northern American/European
Endometrial cancer
41
Q

Ovarian cancer: vague symptoms

A

Bloating
General abdominal discomfort
Change in bowel/bladder habits

42
Q

Ovarian cancer tx (3)

A

Sx (depends on metastasis)
Chemo
Radiation

43
Q

Types of hysterectomy

A

Partial/Supra cervical - removal of uterus, cervix left intact
Total hysterectomy - uterus and cervix
Total with salpingo-oophorectomy - uterus, ovary, Fallopian tubes
Radical- used for gyn cancer; all reproductive organs (uterus, cervix, upper third of vagina, parametrium)

44
Q

Hysterectomy management

A

Monitor for bleeding, atelectasis. DVT, ileus, infection
Encourage ambulation (pain med prior)
Pain mgmt

45
Q

Hysterectomy discharge education

A

Pelvic rest 4-6wks
Avoid heavy lifting
Wear pad for vaginal d/c
Monitor for s/s infection, malaise, drainage

Med Surg 2 (2 decks)

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