Nursing 2Nd Semester: Ob Exam 4: Unit 10 Part 1

Front 1

Mumps in a man may lead to _____.

Back 1

infertility

Front 2

_____ virus in the first 3 months of pregnancy is very dangerous to the baby, can cause congenital anomalies.

Back 2

rubella

Front 3

What is the chandelier sign?

Back 3

jump when cervix is touched

Front 4

What is the preparation for a pelvic exam? When should it begin? What should she avoid before the test?

Back 4

advise pt to make appt 2 wks after menses (no intercourse or douching 48-72 hours before test. Tell pt to empty bladder before exam. Provide privacy, warm blanket, warm speculum for comfort. Explain to patient what to expect.

Front 5

For a breast exam in a female, have her sit up, put hands in hips and then behind head. First look for _____. Then palpate using the ______ and feel for any abnormalities.

Back 5

symmetry

fingertips

Front 6

For a breast exam in the male, have him either stand or lie down for the exam. If over age 50, there may be ____ in breast but make sure there is no _____.

Back 6

swelling
discharge

Front 7

The inguinal area of a man is a common area for a _____.

Back 7

hernia

Front 8

In the testicular exam, we hold the testicles and have him cough to check for a ____.

Back 8

hernia

Front 9

Which is more accurate for pregnancy testing, blood or urine test?

Back 9

Blood

Front 10

In determining the reason for amenorrhea, checking _____ levels can help.

Back 10

prolactin

Front 11

The hormones _______ and ______ check ovarian function and assist in determing fertility.

Back 11

progesterone and estraidol

Front 12

Tumor markers include ____ , ____, and ____.

Back 12

AFP, HCG, PSA

Front 13

VDRL stands for what? What does it test for?

Back 13

Venereal Disease Research Laboratory

tests for syphilis (detects antibodies)

Front 14

PSA is a screening for _____ cancer. It is not ______.

Back 14

prostate
diagnostic
(If elevated, further testing is needed).

Front 15

An ______ can be used to look at IUD placement, an ovarian mass, pelvic cyst, hydatiform mole, ectopic pregnancy, testicular distortion or mass.

Back 15

ultrasound

Front 16

A ______ ultrasound checks for prostate cancer.

Back 16

transrectal

Front 17

A pap smear should be started within 3 years of beginning sexual intercourse. However it is best to begin....

Back 17

at the start of sexual intercourse.

Front 18

A pap smear takes a swab from the ___ for examination. The cells are examined with dye to detect abnormalities. Also, cells can be scraped from the cervix which is known as _____. Which method is better swab or scrape?

Back 18

cervix
cytology
scraping is a better indicator of abnormal cells

Front 19

A very definitive LOOK at the cervix is known as a _______. The woman is placed in _______ position. The cervix is ______ to show detail. _____ vinegar is used to change color and show cancerous cells.

Back 19

colopscopy
lithotomy
magnifies
white

Front 20

In a _____ ______, small tissue samples are taken from the cervix and examined for disease or other problems. The cervix is viewed through speculum with patient in lithotomy position.

Back 20

cervical biopsy

Front 21

In a ____ ____ biopsy, a large area of tissue around the cervix is excised for examination. The cervix is viewed through speculum with patient in lithotomy position. This position usually involves .... What kind of surgery is this?

Back 21

cold cone

cervical block, IV opiates

outpatient surgery

Front 22

In a cold cone biopsy, Postmenopausal women should not have bleeding, if bleeding is present, there may be _____ _____ cells. How is the degrees of abnormality of cervical cells measured?

Back 22

endometrial cancer

CIN 1 to CIN 7 = malignancy

Front 23

________ a method to resection the cervix or remove part of it because of _____ cells, not necessarily cancerous cells.

Back 23

cryosurgery
abnormal

Front 24

An _______ biopsy is done if there is abnormal bleeding of an unknown cause.

Back 24

endometrial

Front 25

In an endometrial biopsy, a _____ is inserted into the ______ through the vagina to remove cells from the uterine ______ for examination.

Back 25

catheter
uterus
lining

Front 26

In an endometrial biopsy, the cervix is dilated, the catheter is advanced in a spinning motion as it suctions samples of endometrium. It is a minor procedure. Advise the woman that the procedure is ______ and there may be some _____ which can be alleviated with NSAIDs

Back 26

uncomfortable
cramping

Front 27

An _______ of progesterone and estrogen can cause a _____ endometrial lining. What can this cause?

Back 27

imbalance
thick
irregular or prolonged periods

Front 28

In a D & C (dilation and curettage) the cervix is widened with a dilator, the uterine walls are scraped with a curette. Biopsy forceps are used to sample the cervix and a colposcope illuminates the cervix for biopsy. This can be done to scrape the endometrial lining when it is too _____. What should be the patient be told?

Back 28

thick

There may be some bleeding & discharge for a few days


(D & C is also used in extracting products of conception after an abortion.)

Front 29

True or False: endometrial growth can be affected by a hormone imbalance at any age.

Back 29

True

Front 30

Biopsies can be done on the prostate and the testes. ____ _is the most reliable test to identify an enlarged prostate. It detects the abnormal “feel of prostate”. A biopsy is also done if there is an ↑ in ____. An ___ guides the needle.

Back 30

Digital Rectal Exam (DRE)
PSA
US

Front 31

The menstruation cycle averages ____ to ____ days. The stage of the menses is the menstrual phase which usually lasts ____ to ____ days.

Back 31

28 to 32

3 to 7

Front 32

The proliferative or _______ phase is day ____ to _________. During this phase, the egg is released into the fallopian tube.

Back 32

follicular
5 to ovulation (usually day 13-16)

Front 33

The luteal or ______ phase is from ovulation to ____ days before the menses and is when the _______ _____ is building up. This phaase helps support the fertilized egg for ______.

Back 33

secretory
3
endometrial lining

implantation

Front 34

The final stage of the menstruation cycle, the ______ phase is __ days before the menses.

Back 34

ischemic
3

Front 35

How do you figure out the exact day of ovulation?

Back 35

count back 14 days from 1st day of menses

Front 36

The hormones ____ and ____ act on ovarian function.

Back 36

FSH and LH

Front 37

The menstrual cycle is dependent on the hypothalmus, which stimulates the ______ gland to produce hormones.

Back 37

pituitary

Front 38

Which HPV types are known to cause cervical cancer?

Back 38

6, 11, 16, 18

Front 39

_______ is a series of 3 vaccines against some types of HPV which can cause cervical cancer. When is each of the vaccines given? At what age are they recommended for?

Back 39

Gardasil
1st dose: any time pt. & HCP choose
2nd dose: 2 months later
3rd dose: 6 months after 1st dose.
Recommended for ages 9-26

Front 40

True or false: Gardasil can treat HPV.

Back 40

False. It can help prevent HPV.

Front 41

A _________ is the surgical removal of all or part of the prostate. What are the 3 approaches to this procedure?

Back 41

retropubic
perianal
suprapubic

Front 42

________ is a broad term for all conditions causing inflammation of the prostate.

Back 42

prostatitis

Front 43

What are some causes of prostatitis?

Back 43

acute or chronic bacterial infection (bacteria ascends from urethra or descends from bladder, bacteria could be in bloodstream or lympathic channels).

Front 44

What are some s/s of prostatitis? (6)

Back 44

fever, chills
dysuria
urethral discharge
UTI like s/s
lower back, pelvic, perineal pain
tender, swollen, painful area

Front 45

Diagnostic studies for prostatitis include....(6)

Back 45

UA
CBC
PSA
Transabdominal US
MRI (rule out abscess)
DRE (will be painful)

Front 46

If untreated, prostatitis can lead to ______ or ______.

Back 46

epididymitis
cystitis (bladder infection)

Front 47

Treatment for prostatitis includes ___ to _____ weeks on antibiotics, especially ____ and _____.

Back 47

3 to 4
Cipro & Bactrim

Front 48

________is the inflammation of the epiditimis. It is very _____. What is the function of the epiditimis?

Back 48

Epididymitis
painful
transfers sperm as it matures

Front 49

What can cause Epididymitis ? (4)

Back 49

STD
UTI
trauma
urinary reflux

Front 50

What are some s/s of Epididymitis ?

Back 50

pain and swelling in scrotal area (to the point where testes and epidytimis are indistinguishable)

Front 51

What is the treatment for Epididymitis ? Patient teaching?

Back 51

antibiotics, especially if STD
Pain / swelling should decrease within one week of proper use of meds, but sometimes can last weeks to months.
If there's an STD, it needs to be treated too.
Refrain from intercourse during acute phase.
Elevate legs (not in dep. position) when resting to decrease swelling to scrotum.
Ice packs
analgesics

Front 52

The _____ and seminal vesicle make seminal fluid.

Back 52

prostate

Front 53

Benign Prostatic Hypertrophy is the growth and _______ of the prostate. There is no known cause but it is associated with an increase in _____.

Back 53

enlargement
age
(90% of men over 80 have it)

Front 54

True or False: A high sodium diet and obesity are linked with Benign Prostatic Hypertrophy.

Back 54

False
a high fat diet and obesity

Front 55

True or False: African Americans are at high risk of Benign Prostatic Hypertrophy.

Back 55

True

Front 56

What are some s/s of Benign Prostatic Hypertrophy?

Back 56

dysuria
incomplete emptying of bladder
dribbling
decreased force of stream of urine
nocturia

Front 57

If Benign Prostatic Hypertrophy restricts the ______ this is a medical emergency because he can't ____!

Back 57

urethra
pee!

Front 58

Some complications associated with Benign Prostatic Hypertrophy are an increased risk of _____ and it can decrease _____.

Back 58

UTI
libido

Front 59

What is a diagnostic test to detect Benign Prostatic Hypertrophy?

Back 59

PSA levels
transrectal exam w/ biopsy

Front 60

What are some things a man with Benign Prostatic Hypertrophy should avoid?

Back 60

Abstain from or decrease caffeine, spicy food, alcohol, decongestants, anticholinergics, and artificial sweeteners

Front 61

An increase in s/s of Benign Prostatic Hypertrophy may indicate ________, so further testing and treatment is necessary.

Back 61

obstruction

Front 62

The medication Flomax promotes smooth muscle relaxation and promotes urinary flow through the urethra. It is nice to let the patient know and can also decrease episodes of ________ and ________.

Back 62

syncopy and hypotension

Front 63

What are some treatments for Benign Prostatic Hypertrophy?

Back 63

medications like proscar,
saw almetto, flomax

foley catheter inserted for drainage, bypasses obstruction and forces urethra open

stents or coils placed
laser ablasion

Or invasive procedures like:
TURP
TUIP
TULIP

Front 64

What is TURP

Back 64

transurethral resection of prostate
An invasive procedure
cytoscopy (go through bladder)

it is performed by visualising the prostate through the urethra and removing tissue by electrocautery or sharp dissection. This procedure is done with spinal or general anesthetic. A large triple lumen catheter is inserted through the urethra to irrigate and drain the bladder after the surgical procedure is complete.

Front 65

What is TUIP?

Back 65

A treatment for Benign Prostatic Hypertrophy
TERP: Transurethral Incision of Prostate
splits into tissue to relieve obstruction....
Prostate tissue is not removed, the doctor cuts one or two small grooves in the area where the prostate and the bladder are connected in order to open up the urinary flow.

Front 66

What is TULIP?

Back 66

A treatment for Benign Prostatic Hypertrophy

transurethral US guided laser induced prostatectomy (removal of prostate)

Front 67

What is the best (most successful) treatment of Benign Prostatic Hypertrophy ?

Back 67

TURP

Front 68

If a patient is being treated for Benign Prostatic Hypertrophy, he needs to be educated about the reasons for the procedure, which should alleviate his symptoms with time. Why must he have a catheter in place for a while?

Back 68

drainage of bladder
continuous irrigation to keep clots from obstructing urinary flow

Front 69

Patient with Benign Prostatic Hypertrophy is usually sent home with antibiotics, especially if he has a ____. This patient usually has some degree of ______ dysfunction.

Back 69

UTI

sexual

Front 70

There may be pain associated with bladder spasms when being treated for Benign Prostatic Hypertrophy. What can be prescribed?

Back 70

antispasmatic suppositories such as beladona and opium, also ditrapan

Front 71

How long is the foley catheter left in place during tx for Benign Prostatic Hypertrophy?

Back 71

2-4 days

Front 72

Teach the patient being treated for Benign Prostatic Hypertrophy about the foley catheter. Encourage him to drink plenty of fluids and avoid irritants to the bladder such as..... Also teach him about the s/s of ______ and how to avoid constipation, such as avoiding lifting more than ____ lbs.

Back 72

citrus juices,
alcohol,
caffeine

infection
10

Front 73

Orchitis is an infection of the ______.

Back 73

testes

Front 74

Orchitis occurs after bacterial or viral infections such as ...... (4)

Back 74

mumps, TB, pneumonia, and syphilis

Front 75

Orchitis is diagnosed by doing a culture. What are some s/s?

Back 75

pain, tender, swollen testes

Front 76

Causes of orchitis

Back 76

can occur with prostatectomy
trauma
infection (i.e. mononucleosis)
flu
complications from UTI

Front 77

True or False: the treatment for orchitis is the same as that for epiditmytis.

Back 77

True
(antibiotics, elevate legs, ice packs, analgesics. Treat primary infection or STD if there is one.)

Front 78

______ is a nontender, fluid filled mass of the testes and it sometimes can interfere with ______ drainage in scrotum, which leads to swelling.

Back 78

hydrocele
lymphatic

Front 79

What is the treatment for hydrocele?

Back 79

No treatment really...
If swelling is large or uncomfortable can do aspiration or drainage, especially if a fluid filled cyst.

Front 80

A ________ is a firm, sperm containing cyst in the epiditimis and is usually removed surgically.

Back 80

spermatocele

Front 81

A _______ is the dilation of the veins that drain the testes, it feels "wormlike" when palpated, resembling varicose veins. If it is ______, it may need to be surgically repaired.

Back 81

varicocele

sclerosed

Front 82

True or False: A varicocele is very common among men of all ages.

Back 82

False, it's rare.

Front 83

Torsion of the testes is when a twisted spermatic cuts off the ____ supply to testes. Ischemia can cause tissue ______ if not treated quickly.

Back 83

blood
necrosis

Front 84

True or False: If not resolved spontaneously, torsion of the testes is a medical emergency.

Back 84

True

Front 85

Who is susceptible to torsion of the testes? Why?

Back 85

athletes/ teens
due to hard body and blunt force contact

Front 86

Torsion of the testes can cause _____ dysfunction.

Back 86

erectile

When treating ED, rule this out first.

Front 87

Priaprism is a painful ______ lasting greater than ___ hours.

Back 87

erection
6

Front 88

Causes of Priaprism

Back 88

secondary to thrombosis/blood clots, leukemia
sickle cell anemia
Diabetes
spinal/brain tumor
cocaine use
over use of viagra or lavitra

Front 89

If priaprism doesn't resolve or relax, what can occur due to lack of blood flow in penis?

Back 89

Tissue necrosis

Front 90

What is used to treat priaprism?

Back 90

sedatives and injection of smooth muscle relaxants
surgery can aspirate/irrigate
(very painful procedure)

Front 91

Some causes linked with Erectile Dysfunction (ED): (3)

Back 91

cardiac problems (esp. post surgical)
disease related
psychological issues related

Front 92

True or False; Vitamin E can decrease the risk of prostate cancer.

Back 92

False
Too much Vitamin E increases the risk of prostate cancer.

Front 93

Neoplasms are cancers of the ______. They are rare, but usually occur between the ages of ____ and ___.

Back 93

testes
15-35

Front 94

What can cause neoplasms?

Back 94

undescended testicle
HIV
maternal exposure to DES
(previously prescribed drug to dry up mom's milk)

Front 95

What are some s/s of neoplasms?

Back 95

hard/firm lump in scrotum
scrotal swelling
heaviness
NOT tender or painful

Front 96

If neoplasm spreads, can cause dull ache in _____, _____ and _____.

Back 96

abdomen, perineal area, scrotum

Front 97

How is a neoplasm diagnosed?

Back 97

TSE- testicular self exam
US
Biopsies
Tumor Markers

Front 98

How is a neoplasm treated?

Back 98

orchiectomy
chemo
radiation

Front 99

True or False: A neoplasm is malignant and aggressive.

Back 99

True

Front 100

Prostate cancer is ______ dependent.

Back 100

androgen

Front 101

True or False: It is important to determine a patient's life expectancy when treating prostate cancer because this cancer develops slowly.

Back 101

True
(but up to patient if he wants treatment even if he is 90 etc)

Front 102

Prostate cancer is slow growing by direct ________ to the bladder wall, external sphincter, seminal vesicles, and urethral mucosa. It is a leading cause of cancer death.

Back 102

extension

Front 103

What are some s/s of prostate cancer?

Back 103

Asymptomatic

then in later stages--
dysuria,
dribbling

Front 104

How is prostate cancer diagnosed? (4)

Back 104

PSA
DRE
TRUS
UA

Front 105

What is the treatment for prostate cancer?

Back 105

Sometimes just wait and watch...
do patient education
If life expectancy is <10 y may not do surgery (not causing s/s and is slow growing)
Surgery
Radiation therapy if over 70 or not a candidate for surgery
Hormone therapy- decreased androgen
Non steroidal androgen blockers
Drug Therapy

Front 106

Cancer of the penis is rare except when there is ____, which greatly increases the risk.

Back 106

HPV

Front 107

What are the s/s of cancer of the penis? What is the treatment?

Back 107

superficial ulceration or pimple like nodule

surgical removal of growth
Chemo/Radiation

Front 108

What medications are given for ED in what order? When is the medication taken? What are some other options?

Back 108

1. viagra
2. cialis
3. lavitra

30 min - 4 h before intercourse

vacuum constriction device
implants