Beg Med Surg: Female Repro

Front 1

What sloughs off when we have our period?

Back 1

endometrium

Front 2

Bartholin gland

Back 2

secreats mucous, lubricating vagina

Front 3

Ovulation (what and when?)

Back 3

monthly discharge of matured ovum ( 2 weeks prior to next menstrual cycle)

Front 4

matured ovum produce what hormone?

Back 4

progesterone

Front 5

Tubal ligation

Back 5

dissect tube to prevent pregnancy

Front 6

sterilization means

Back 6

you cannot produce a pregnancy
men and women

Front 7

endometriosis

Back 7

lining of uterus is not always inside the uterus- blood can back up the fallopian tube and into the abdominal cavity, scarring can occur, problems happen from that

Front 8

What effect does estrogen have on the ligaments that hold up our uterus?

Back 8

lack of estrogen weaken the muscles and prolapse of the uterus can happen

Front 9

Significant Hormones and Hormone Changes during menstrual cycle?

Back 9

Estrogen
Progesterone
Follicle Stimulating Hormone
Androgens
Luteinizing Hormone

Front 10

Luteinizing Hormone

Back 10

made by pituitary, send msg to oavries telling you to excrete an ova- stimulates progesterone

Front 11

When is ovulation?

Back 11

ovulation is about 13-15 days after beginning of menstrual cycle

Front 12

When do we get pregnant?

Back 12

during ovulation

Front 13

Which hormone stimulates progesterone production?
LH
FSH
Thyroid hormone
Estrogen

Back 13

LH

Front 14

What to assess about sexual hx?

Back 14

Menstrual history and history of pregnancies
History of exposure to medications
Pain with menses or intercourse
Vaginal discharge, odor, or itching- STD, yeast inf, etc
Urinary and bowel function
Sexual history (sexually active?), including sexual or physical abuse
History of STDs, surgeries, or procedures
Chronic illness or disabilities that affect health/self-care
Family and genetic history

Front 15

Birth control put at higher risk for...

Back 15

DVTs

Front 16

Prolonged or heavy menstrual bleeding can lead to

Back 16

anemia

Front 17

Diabetes can affect the flora and can cause

Back 17

higher rate of STIs and UTIs

Front 18

Asking the patient to label herself as married, single, etc. may be interpreted as

Back 18

as inappropriate; asking about current meaningful relationships may be less offensive.

Front 19

Which of the following refers to the partial or total removal of the external genitalia or other injury to the female organs?
Female genital mutilation
Rape
Incest
Battery

Back 19

Female genital mutilation

Front 20

Female genital mutilation

Back 20

Female genital mutilation (FGM), or cutting, refers to partial or total removal of the external female genitalia or other injury to female organs.

Front 21

Pelvic examination

Back 21

manual exam in lithotomy position with on back with stirrups

Front 22

Pap smear

Back 22

to scrape off cells- prophylaxis to rule out cervical cancer- Every 2 years with healthy cells unless possible problems- atypical cells, will be annually

Front 23

pap smear, if under 21 and sexual, start _ years past first sexual encounter.

Back 23

3

Front 24

Cryotherapy and laser therapy-

Back 24

trying to get cervix to slough off outer layer of cells

Front 25

Cone biopsy and loop electrosurgical excision (LEEP)

Back 25

remove cells of cervix

Front 26

Endometrial biopsy

Back 26

through cervix into uterus for tissue sample

Front 27

Dilation and curettage (D & C)

Back 27

dilating cervix and cleaning out inside of uterus- light vaginal bleeding for a few days, come back from surgery with peri-pad.

Front 28

What is the tool used when performing a pap smear?

Back 28

speculum

Front 29

Bimanual Examination of the Pelvis

Back 29

Looking to see the size and position of the uterus, anything abnormal, and can feel the position of bladder

Front 30

If a Pap smear shows atypical cells and no high-risk HPV types are found, when should the next Pap smear be performed?
6 months
1 year
2 years
3 months

Back 30

1 year

Front 31

Menorrhagia

Back 31

abnormally heavy and prolonged bleeding

Front 32

Menopausal

Back 32

someone who has not had their period for at least a year

Front 33

VDRL or an RPR-

Back 33

both blood tests to check for syphilis , in both males and females. Will be pos if have disease, or neg if have not been exposed

Front 34

Mg is a

Back 34

muscle relaxer

Front 35

Postmenopausal bleeding

Back 35

not normal, is a sign of cancer

Front 36

Menopause

Back 36

Permanent physiologic cessation of menses associated with declining ovarian function

Front 37

what age does menopause happen?

Back 37

Somewhere around 50 to mid 50s, early in 40s

Front 38

s/s menopause is coming

Back 38

Changes in menstruation- less and less regular, can still get pregnant

Front 39

s/s of menopause

Back 39

hot flashes, vaginal dryness, low Ca level, palpatations, diaphoresis (sweating), psych changes- irritability, psychosocial changes

Front 40

What are hot flashes attributed to?

Back 40

hormone surges

Front 41

Alternative therapy for hot flashes

Back 41

dress in layers, fan, ice chips.

Front 42

Nutrition post menopause?

Back 42

decrease fat and calories and increase calcium, whole grains, fiber, fruit, and vegetables. Calcium and vitamin D supplementation may be helpful.

Front 43

Menopause dx when

Back 43

mensus ceases (amenorrhea) for at least 12 months

Front 44

Types of vaginal infections?

Back 44

Candidiasis
Gardnerella
Trichomonas vaginalis
Bartholinitis
Cervicitis
Atrophic vaginitis

Front 45

How to treat vaginal infections?

Back 45

ABX and antifungal meds

Front 46

PID

Back 46

Pelvic inflammatory diesease

Front 47

Pelvic inflammatory diesease leads to

Back 47

leads to scarring of tissue that can lead to sterilization, tx is ABX

Front 48

2 types of genital viral infections

Back 48

Human papillomavirus (HPV) and Herpes type 2

Front 49

Are genital viral infections curable?

Back 49

no just treatable

Front 50

How often are pap smears necessary with HPV?

Back 50

annually

Front 51

Malignant Disorders of the Female Reproductive Tract

Back 51

Cervical, uterine, vaginal, vulvar, and ovarian cancers

Front 52

Treatment of Reproductive Malignancies

Back 52

Surgery- remove cancer area,
chemotherapy,
radiation- to area to kill cells, or a
combination of these

Front 53

Can female repro cancers be cured?

Back 53

yes if caught early

Front 54

Uterine Fibroids or Myomas

Back 54

Very common, like polyps, can be inside or outside the uterus
If inside, herder to get pregnant,
outside of uterus no concern
have possibility of bleeding

Front 55

Treatment of Uterine Fibroids or Myomas

Back 55

Can have them removed, can get to be as big as a baby, can burst with lots of bleeding

Front 56

Hysterectomy

Back 56

Surgical removal of the uterus to treat cancer, dysfunctional uterine bleeding, endometriosis, nonmalignant growths, persistent pain, pelvic relaxation and prolapse, and previous injury to the uterus.

Front 57

Total hysterectomy

Back 57

take out everything, inc ovaries and tubes, lymph nodes

Front 58

Types of approaches to hysterectomy

Back 58

Laparoscopic
Vaginal
Abdominal

Front 59

What type of therapy is preferred to hysterectomy?

Back 59

Hormone therapy

Front 60

Why do all hysterectomy surgeries require a f/c?

Back 60

so close to bladder, we don’t want to nick the bladder during surgery, want the bladder collapsed

Front 61

How many voids to measure after f/c has ben removed?

Back 61

3

Front 62

abdominal hysterectomy

Back 62

suprapubic cut- more pain, complications

Front 63

Salpingo

Back 63

removal of tubes

Front 64

oopherectomy

Back 64

removal of ovaries

Front 65

nsg dx after hysterectomy?

Back 65

Anxiety
Disturbed body image
Acute pain
Deficient knowledge

Front 66

Why do we check vitals and count peri pads post hysterectomy?

Back 66

in case of Hemorrhage

Front 67

DVT- higher risk with ______ surgery

Back 67

pelvic

Front 68

How to promote early diagnosis of vulvular cancer

Back 68

Encourage regular pelvic exams, Pap smears, and self-examination for early diagnosis.

Front 69

Vulvectomy

Back 69

Treatment for vulvar cancer includes wide excision of the vulva: vulvectomy

Front 70

Chemotherapy usually admin via

Back 70

IV

Front 71

s/e chemotherapy

Back 71

neutropenia, thromobocytopenia, nephrotoxicity, neurotoxicity, hair loss, hypersensitivity reactions, nausea, and vomiting.

more susceptible to anemia (decrease RBC), bleeding (Decrease plt), and infection (decrease WBC) d/t decrease of blood cells

Front 72

examples of chemotheraoy drugs?

Back 72

Paclitaxel (Taxol)
Carboplatin (paraplatin)
Liposomal therapy

Front 73

Internal (intracavitary radiation)

Back 73

surgically put in radiation seeds inside a cavity

Front 74

What precautions to take if pt is receiving intracavitary radiation?

Back 74

If pregnant do no take care of a family member or pt that has radiation seeds implanted in them, need a nurse that can get in and out very quickly and efficiently, nurse wont be spending a lot of time with them. Will have a radiation cart outside door and sign on door. Double glove for urine specimens

Front 75

patient prep for pap smear

Back 75

Scheduled between mensus so blood flow does not interfere with the test
Woman should not douche, have vaginal intercourse, or use vaginal medications or deodorants 24 hrs before the test
assist pt into lithotomy position
relaxation techniques

Front 76

patient prep for ultrasound

Back 76

Women should have a full bladder for uterine US
For and, breast, or scrotal scan oil or gel is applied to the fully exposed area
For transvaginal or transrectal, a condom is placed on the transducer along with gel

Front 77

amenorrhea

Back 77

almost any disease that disturbs a woman's metabolism or nutrition can depress ovarian function and cause amenorrhea

Front 78

Failure of ovulation is associated with greater risk for

Back 78

endometrial cancer

Front 79

How long does the intracavitary radiation capsule stay in the uterus?

Back 79

1-3 days

Front 80

Who can visit a pt with intracavitary radiation?

Back 80

noone, they are on strict isolation

Front 81

Activity order for pt with intracavitary radiation?

Back 81

Strict bedrest on back with head of bed flat or slightly elevated. movement in bed is restricted to prevent dislodgement of implant

Front 82

Can pt get up to void with intracavitary radiation?

Back 82

No, they will have a f/c

Front 83

Diet and specific meds for pts with intracavitary radiation?

Back 83

low residue, lots of fluid, and antidiarrheals to prevent BMs

Front 84

Estrogen treatment

Back 84

Used when bleeding is heavy and acute,
Is associated with an increased risk for coronary heart disease and breast cancer

Front 85

If HRT- estrogen with progestin- necessary, what is the recommendation?

Back 85

to maintain quality of life, take HRT at the lowest possible dose to relieve symptoms for the shortest period of time

Front 86

Estrogen given alone can cause

Back 86

endometrial cancer, gallbladder disease, thromboembolic conditions such as DVT and stroke,