Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Womens Health > Womens Health Across the Lifespan > Flashcards

Womens Health Across the Lifespan Flashcards

1
Q

Screening Tests: Pelvic Exam

A

–Performed for health maintenance or disease diagnosis.
–Many women perceive as uncomfortable and embarrassing.
–Negative feelings may delay this important exam.
–Important to make women feel comfortable.
–Good time for educational moments.
–Performed by nurse practitioners, mid-wives or Dr.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Screening Tests Cont: Pelvic Exam

A
  • inspect of the vulva
  • inspection of the vagina and cervix per speculum
  • Palpation of cervix, uterus, and ovaries per bimanual exam
  • Usually par smear is obtained at this time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Screening tests Cont: Pap Smear

A
  • Screen for cellular abnormalities by obtaining a sample of cells from cervix and endocervical canal
  • Precancerous and cancerous conditions, as well as atypical findings and inflammatory changes can be identified
  • 50 Million womens have yearly and 7% need further work-up
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Screening tests Cont: Pap Smear

A
  • Tradionally performed by placing cells on a slide
  • Slides sent to see if cellular changes taking place
  • Sometimes slides hard to read
  • Newest test: HPV test or liquid based test. The cells are directly transferred to a vial containing preservative fluid. Great tool for HPV screening
  • Pap is just a screening tool, diagnosis of cervical cancer is made with a biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Screening tests Cont: Breast Self- Exam

A
  • Great method for detecting breast masses early
  • Large percentage of women discover their own CA
  • Should be performed monthly
  • Should be taught by health care provider around age 20
  • Dont forget the armpit!
  • Know client teaching plan for Breast self exam in your book! Pg 65-66
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Screening tests Cont: Mammogram

A

–Soft-tissue x-ray of the breast.
–Detects lesions before they can be felt.
–Detects about 90% of breast CA in women who are symptom free.
–All women over 40 should have it done yearly or every other year.
–Some negatives including false-positives and they miss 25% of invasive breast cancers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Benign Breast Conditions: Fibrocystic Breast Change:

A

Most common.
–Prevalent in women 20 to 50.
–Results from fluctuating hormone levels.
–Not a risk factor for breast cancer in most women.
–Some women have hyperplasia of the fibrocystic cells and can cause atypical cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Fibrocystic Breast Change

A

Symptoms:
–Some have asymptomatic mass.
–Often pain and tenderness that is cyclic.
–Some have galactorrhea – nipple discharge.
–Some have large, fluid-filled cyst that are mobile and tender.
•Mammogram, somogram, MRI, palpation and fine-needle aspiration may be used to confirm.
•Decrease of methylxanthines!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Benign Breast Condtion: Fibroademoma

A
  • 2nd most common in all women, most common in women under 25
  • Asymptomatic, mobile, well-defined, painless, palpable mass with a rubbery texture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Benign Breast Condition: Intraductal papillomas:

A
  • Tumors growing in the terminal portion of a duct

- Unilateral mass or a sponatenous bloody discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Benign Breast Condition: Duct ectasia:

A
  • An inflammation of the ducts behind the nipple
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Malignant Breast Disease

A
  • Life time risk 1 in 8
  • 1/3 of female cancers and si the most frequently diagnosed cancer in women
  • Maligant neoplasm originates in duct or epithelium of lobes
  • About 50% originonate in upper outer quadrant and spread to lymph nodes
  • BRCA1 & 2 genes- about 5-10% of breast CA’s are due to these inhereted mutations
  • Common sites of metastasis- lymph nodes, lungs, liver, brain, and bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Predisposing Factors

A
  • Age – increases steadily.
  • Female.
  • History of.
  • Family history of.
  • Long-term HRT.
  • Overweight.
  • Increased alcohol consumption.
  • Jewish descent.
  • No history of pregnancy or first pregnancy over 30.
  • Never breast feeding.
  • Longer reproductive phase.
  • History of high-dose radiation before 30.
  • No exercise.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Prevention of Breast Cancer

A

•Women should be encouraged to take action to reduce risks of breast cancer:
–Avoiding obesity.
–Exercising regularly.
–Reducing dietary fat.
–Limiting alcohol.
–No smoking.
–Women at very high risk, may consider bilateral prophylactic mastectomy, reduces cancer 90%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Malignant Breast Disease Cont:

A 
Worrisome Findings: 
–Painless mass most important physical symptom.
–10% have breast pain with no mass.
–Dimpling of the breast tissue.
–Recent or acute nipple inversion.
–Change in breast size or shape.
–Increase in size in breast mass.
–Skin erosion or ulceration.
–Presence of axillary lump.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Malignant Breast Disease Cont: Diagnosis:

A
  • Routine mammogram detects masses 2 to 3 years before clinical appearance.
  • Fine-needle aspirate.
  • Ultrasound.
  • MRI.
  • Biopsy is essential for diagnosis.
  • Once diagnosed, lymph node involvement is evaluated, staging is determined and treatment is initiated.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Clinical Therapy:

A
  • Most women diagnosed with breast CA will have some type of surgery
  • The goal of surgery is to remove cancer
  • Lymphectomy- removal of the cancerous tissue plus a rim of normal tissue
  • Simple of total masectomy- removal of the entire breast.
  • Modified radical masectomy- removal of the entire breast and portions of the lymph nodes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Clinical Therapy: Axillary lymph node dissection (ALND):

A
  • removal of the axillary lymph nodes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Sentinel lymph node Biopsy: SLNB:

A

-the first node is idenfitied, and a biopsy is taken with a probe. Biopsy is sent for patho immediatley and then the physician knows if ALND should be performed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

ALND

A
  • longer operating room time
  • surgical drain
  • General anesthesia
  • Overnight admission
  • infection 10-30%
  • Decreased ROM
  • Neuropathic Sensations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

SLNB

A
  • Shorter operating room time
  • No surgical drain
  • Local anesthesia with moderate sedation
  • Outpatient surgery
  • Infection 0-7%
  • Unlikely decreased ROM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Patient Education POST ALND

A
  • Avoid blood pressures, injections and blood draws in affected arm.
  • Use sunscreen.
  • Apply insect repellent to avoid bug bites.
  • Wear gloves while gardening.
  • Avoid cutting cuticles or pushing back.
  • Avoid lifting objects greater than 5-10 lbs.
  • If break in skin, add OTC antibacterial ointment.
  • If redness, swelling or fever occur, call doctor.
23
Q

Adjunctive Therapy:

A

Radiation: decreases the chance of a local recurrence by eradicating microscopic cancer cells
Chemotherapy: use of anticancer agents in addition to radiation and surgery
Hormones:
—Toxifen- 26% annual reduction in reoccurance and 14% reduction in death
- SERM- clinical trials show more effectiveness

24
Q

Psychologic Adjustment: Shock

A
  • Extends from the discovery of the lump through the process of diagnosis
    ~”Everything is unreal”
    ~ Why is this happening to me?
25
Q

Psychologic Adjustment: Reaction

A
  • occurs in conjunction with the initiation of treatment
  • coping mechanisms become evident
  • Denial is common and protects the woman, making therapy tolerable
26
Q

Recovery:

A
  • Following the completion of medical treatment.
  • Anxiety about her illness diminishes
  • Looks to the future once more
  • Turns outward and resumes her former activities
  • Depression and social isolation occur if unable to negotitate this phase successfully
27
Q

Reorientation

A
  • Follows recovery and is unending
  • Acknowledges breast CA is a part of her life
  • Life has returned to its former fullness and meaning
28
Q

Toxic Shock Syndrome

A
  • Primarily a disease of women in their reproductive years.
  • Responsible organism is a strain of Staphylococcus aureus.
  • The use of superabsorbent tampons has been widely related to an increased incidence.
  • Early diagnosis and treatment are important in preventing a fatal outcome.
29
Q

TSS: Symptoms of TSS

A 
–Fever.
–Rash on trunk initially followed by shedding of the skin of the palms and soles.
–Hypotension.
–Dizziness.
•Systemic signs:
–Vomiting.
–Watery diarrhea.
–Severe muscle pain.
–Inflamed mucous membranes.
•CNS disorders:
–Alterations of consciousness.
–Disorientation.
–Coma.
30
Q

Toxic Shock Syndrome

A 
•Evidence of renal, hepatic and hematologic involvement can be seen in abnormal labs:
–Elevated BUN and creatinine.
–Elevated AST, ALT and total bilirubin.
–Decreased platelets, less than 100,000.
•Women are hospitalized and given:
–IV to maintain BP.
–Antibiotics.
•Severe cases require renal dialysis and intubation along with vasopressors.
31
Q

Toxic Shock Syndrome: Management

A

–Avoid prolonged use of tampons.
–Change tampons every 3 – 6 hours.
–Postpartum women should avoid the use of tampons until after her first normal period.
–Women with a history, should never use tampons.

32
Q

Endometriosis

A
  • Presence of endometrial tissue outside of the uterine cavity
  • Has been found almost everywhere in the body- including lungs, CNS, and GI
  • Most are found in the pelvis
  • The tissue responds to hormonal stiumulation in the same way the uterine lining does
  • This tissue grows and bleeds but cannot exit the body
  • The tissue sheds and forms scar tissue
33
Q

Endometriosis Cont:

A 
•Most common in childbearing years.
•Exact cause is unknown:
–Retrograde menstrual flow.
–Family tendency.
–Autoimmune disorder.
•Diagnosis:
–History.
–MRI and U/S.
–Laparoscopy and biopsy. 
•Symptoms:
–Pelvic pain.
–Dysmenorrhea.
–Dyspareunia.
–Abnormal uterine bleeding.
–Often diagnosed when a women seeks evaluation for infertility
34
Q

Endometriosis Treatment:

A
  • Interrput cyclic ovarian hormone production.
  • If wants a baby, encouraged to get pregnant.
  • Medications that suppress hormones:
  • Progesterone.
  • Continuous birth control pills.
  • Lupron.
  • Danazol.
  • Hysterectomy, laser surgery, or laparoscopy.
  • NSAIDS.
35
Q

Abnormal Uterine Bleeding

A
  • Pregnancy
  • Hormonal Disorders
  • Fibroids
  • Infections
  • Cancer
36
Q

Dysfunctional Uterine Bleeding (DUB):

A

•Characterized by anovulatory cycles with abnormal uterine bleeding that does not have an organic cause.
•Can occur at any age but is most common at either end of the reproductive age span.
•Treatment:
–Control bleeding.
–Prevent or treat anemia.
–Prevent endometrial hyperplasia or cancer.
–Identify any cause, medications, surgery.

37
Q

Associated Menstrual Conditions: Hypomenorrhea

A

Decreased amounts of flow

38
Q

Hypermenorrhea or menorrhagia

A

Long or heavy flow

39
Q

Metrorrhagia

A

Irregular Bleeding

40
Q

Intermenstrual bleeding

A

Bleeding occuring between regular cycles

41
Q

Amenorrhea

A

Absence of menses

42
Q

Benign tumors

A
  • 75% of all ovarian tumors are benign, that makes 25% cancerous!
  • Uterus: Fibroids (also called leiomyomas):
  • most common benign tumors in women
  • Ages 20-50 years of age
  • More common in African descent
  • Rarely cancerous
  • Estrogen dependent
  • Slow Growing
  • Decrease after menopause
43
Q

Treatment of Fibroids:

A

•If small, observe over time.
•If symptoms present but want a child:
–Myomectomy (removal of fibroid only).

–Medications:Lupron will shrink the fibroid for easier removal.
•Hysterectomy if symptoms are a problem and pregnancy is not a goal.

44
Q

Ovarian Benign Cysts

A
  • Peak incidence ages: 20 – 40.
  • No relationship exists between benign ovarian masses and ovarian cancer.
  • Potential for rupture leading to peritonitis or hemorrhage.
  • Menstrual irregularities.
  • Fullness or cramping.
  • Mass felt on routine pelvic exam.
45
Q

Benign Ovarian Cysts:: Types

A

Functional:

  • Most common cysts between ages 20-40
  • Leave them alone, observe for 2-3 menstrual cycles as often resolve on their own
  • May give oral contraceptives to suppresss ovarian function
46
Q

Benign Ovarian Cysts: Demoid

A

-Cartilage, bone, teeth, skin or hair can be observed

47
Q

Endometrial Cancer

A

Most common malignancy of the reproductive system.
Most commonly seen in perimenopausal and postmenopausal women between 50 & 65.
Slow growing and has good prognosis.

48
Q

Ovarian Cancer

A

2nd most common and causes more deaths.

Called silent killer because of symptoms.

49
Q

Cervical Cancer

A

3rd most common.
Begins as neoplastic changes in cervical epithelium – dysplasia, seen on PAP.
Colposcopy – microscope of cervix; looks for areas to biopsy.
LEEP (loop electrosurgical excision procedure) – cone biopsy.

50
Q

GYN surgery: Questions that should be addressed!

A 
–What are indications?
–What are the risks?
–What is the success rate?
–Are there alternatives?
–What are the effects on childbearing?
–What are the effects on sex?
–Should I get a second opinion?
–What are my fears?
51
Q

Hysterectomy

A
  • Removal of the uterus.
  • Total abdominal hysterectomy (TAH).
  • Removal of both fallopian tubes and ovaries is called a bilateral salpingo-oophorectomy (BSO).
  • Total vaginal hysterectomy (TVH).
  • Laparascopic-assisted vaginal hysterectomy (LAVH).
  • Removal of ovaries is controversial.
52
Q

Other Surgeries

A
  • Dilation and curettage (D & C).
  • Uterine ablation – destroying the innermost layer of the endometrium.
  • Salpingectomy – removal of the fallopian tubes.
  • Oophorectomy – removal of the ovary.
  • Vulvectomy – removal of labia and clitoris and possibly the entire vulva.
  • Pelvic exenteration – removal of the pelvis.
53
Q

Surgery Continued:

A 
•Diagnoses:
–Knowledge deficient.
–Fear related to the unknown.
•Plan:
-Preoperative teaching.
–Postoperative care.
–Psychosocial issues.
•Evaluation:
–Woman can discuss the reasons for surgery.
–Woman has an uneventful recovery.
–Woman feels she is able to ask questions.
–Woman participates in decision making.
–Woman is aware of available resources.

Womens Health (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions