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91 Cards in this Set

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Patient with has been trying to get pregnant without success. She asks the nurse, "What should I do?" what does the nurse tell her to do?
Patient with has been trying to get pregnant without success. She asks the nurse, "What should I do?" what does the nurse tell her to do?
- Keep a record of her basal body temp and menstrual cycles for 6 months

- To determine the dates of ovulation, a woman takes her oral temperature before rising each day and records it on a chart for 3-4 months

- Ovulation causes an abrupt fall and then a rise in body temperature (basal body temperature {BBT})
A woman worried about infertility wants to keep a record of her temperature, when should the nurse advise her to take her daily temp?
A woman worried about infertility wants to keep a record of her temperature, when should the nurse advise her to take her daily temp?

- In the morning
- To determine the dates of ovulation, a woman takes her oral temperature before rising each day and records it on a chart for 3-4 months
- Ovulation causes an abrupt fall and then a rise in body temperature (basal body temperature {BBT})
A 18 year old male comes into the clinic with genital herpes, what type of lesions will you see?
A 18 year old male comes into the clinic with genital herpes, what type of lesions will you see?
- genital herpes - has lesions called vesicles

- Pimples progress to papules, vesicles, and finally crusts in 1-3 weeks
When should a male do a TSE?
When should a male do a TSE?

- TSE right after a warm shower
- Every males, from age 13 or 14, is encouraged to perform monthly TSE
- Best performed after a bath or shower because warm water relaxes the scrotal sac
- Do not touch the scrotum with cold hands, that may stimulate the cremasteric reflex, which causes the scrotum to contract
- Testicle should feel rubbery and smooth
- Instruct client to palpate the testicle between the thumb and first finger progressing along the posterior surface of the epididymis
- Check inguinal and femoral areas for bulges which may indicate a hernia
- Epididymis is on top and behind the testicle
- Notify a healthcare provider if any small, painless lumps are palpated or if the testicle is enlarged
What symptoms would a female with fibroid tumor c/o?
What symptoms would a female with fibroid tumor c/o?
- Complaints of heavy menstrual flow (heavy bleeding) (menorrhagia)

- S/S – Abnormal vaginal bleeding, menorrhagia, pelvic heaviness and pressure, urinary retention, constipation

- Most common type of benign uterine tumor is the fibroid tumor (myoma)

- Range in size

- Grow slowly and arise from muscle cells

- Believed to result from hormonal influences due to shrinkage after menopause
What is the position for a cervical exam?
What is the position for a cervical exam?
- Lithotomy position for cervical exam
What would you tell your female patient to do to prevent toxic shock syndrome (TSS)?
What would you tell your female patient to do to prevent toxic shock syndrome (TSS)?

- To prevent toxic shock syndrome - change tampon's frequently (at least every 4 hours)
- If any of the S/S occur, remove the tampon and call the physician immediately
- Change tampons frequently, failure to remove may result in infection
- Use Tampons intermittently
- Insert tampon carefully to avoid abrasions
- Wash hands thoroughly before and after tampon insertion
- A serious condition associated with the use of tampons, particularly those with plastic inserters
- A bacterial toxin, Staphylococcus aureus, is believed to be the cause
- S/S – fever of 102 degrees F or greater, vomiting, diarrhea, drop in B/P, weakness, dizziness, peeling red rash, decreased Hgb, decreased urine output
What are some complications that can arise from a mastectomy post-op that relate to immobility?
What are some complications that can arise from a mastectomy post-op that relate to immobility?

- Bleeding, hoemans sign, pneumonia, lymphedema
- you want them to turn, cough and take deep breaths (to prevent DVT), Incentive Spirometer
- Postoperative exercises to prevent lymphedema if lymph node surgery is done
- Elevate affected arm for several days
What would u tell a patient with Syphilis?
What would u tell a patient with Syphilis?

- With STD's patient's need to be taught about the "ping pong effect" (getting the STD again from the still infected partner)
What do you tell a patient who has come in for a pelvic exam?
What do you tell a patient who has come in for a pelvic exam?

- tell them to relax, and to empty bladder
- The client needs to empty the bladder prior to the examination
- Encourage the client to breathe deeply to minimize discomfort
Patient comes into the ER and complains of abnormal bleeding/spotting, what would you suspect?
Patient comes into the ER and complains of abnormal bleeding/spotting, what would you suspect?
- suspect cervical cancer (especially if there is bleeding after intercourse)

- S/S of cervical cancer – Bleeding that does not occur in the early stages such as spotting between periods or after intercourse
If a patient has a vasectomy, how long should he use protection during sex to prevent pregnancy?
If a patient has a vasectomy, how long should he use protection during sex to prevent pregnancy?

- wait 6 weeks post vasectomy to prevent pregnancy chances
- It may take up to 6 weeks after a vasectomy for the semen to be totally free of sperm
- Sperm count is taken 6 weeks to 2 months after the procedure
- Alternative birth control measures must be used until sperm counts remain at zero for 6 weeks
- Sperm counts should be taken after 6 months and then yearly to assess surgical effectiveness
What complication can arise immediately (post-op) after a woman has abdominal surgery?
What complication can arise immediately (post-op) after a woman has abdominal surgery?
- DVT (look to prevent thrombophlebitis post op)
What does a pan hysterectomy include?
What does a pan hysterectomy include?

- Total hysterectomy (pan hysterectomy) – Removal of entire uterus and cervix
What is a subtotal hysterectomy?
What is a subtotal hysterectomy?

- Removal of the uterine body and fundus, leaving the cervix
What is a salpingectomy?
What is a salpingectomy?

- Removal of an oviduct
What is a pan hysterosalpingectomy?
What is a pan hysterosalpingectomy?

- Removal of the uterus, cervix, and oviducts
What is a Pan hysterosalpingo-oopherectomy?
What is a Pan hysterosalpingo-oopherectomy?

- Removal of the uterus, cervix, oviducts, and ovaries
A woman with heavy bleeding with period and complaining of fatigue, why?
A woman with heavy bleeding with period and complaining of fatigue, why?

- Anemia (lack of Iron)
- lack of o2 to the tissues make the patient pale and tired
What is one of the S/S of rectocele?
What is one of the S/S of rectocele?

- S/S of a rectocele - patient would have hemorrhoids
- S/S – Backache, fatigue, heaviness in the pelvic region, bowel difficulties, incontinence, flatus, hemorrhoids, and alternating constipation and diarrhea
What should a female patient avoid to prevent harsher PMS symptoms?
What should a female patient avoid to prevent harsher PMS symptoms?

- PMS - avoid caffeine to prevent exacerbations of symptoms

- Low salt diet for 1-2 weeks during the premenstrual cycle

- Medications to increase excretion of sodium: HCTZ, HydroDiuril, Esidrix

- Increased protein and decreased sugar intake

- Elimination of allergens, omission of caffeine

- Positive stress management, support groups

- Active exercise, anti-anxiety medications if symptoms are severe
Vesicovaginal fistula, what are the s/s?
Vesicovaginal fistula, what are the s/s?

- S/S urine leaking into vaginal area
- Vesicovaginal – Between bladder and vagina
- Ureterovaginal or Vesicovaginal fistulas will leak urine into the vagina
What is Toxic Shock Syndrome (TSS)?
What is Toxic Shock Syndrome (TSS)?

- To prevent toxic shock syndrome - change tampon's frequently (at least every 4 hours)
- If any of the S/S occur, remove the tampon and call the physician immediately

- Change tampons frequently, failure to remove may result in infection

- Use Tampons intermittently

- Insert tampon carefully to avoid abrasions

- Wash hands thoroughly before and after tampon insertion

- A serious condition associated with the use of tampons, particularly those with plastic inserters

- A bacterial toxin, Staphylococcus aureus, is believed to be the cause

- S/S – fever of 102 degrees F or greater, vomiting, diarrhea, drop in B/P, weakness, dizziness, peeling red rash, decreased Hgb, decreased urine output
What can be a long term complication of PID (Pelvic Inflammatory Disease)?
What can be a long term complication of PID (Pelvic Inflammatory Disease)?
- sterility (infertility)

- Untreated PID can lead to: chronicity and sterility due to blockage of the oviducts with scar tissue
What is the test for Benign prostatic hyperplasia (BPH)?
What is the test for Benign prostatic hyperplasia (BPH)?
- BPH test = PSA with DRE

- Prostate specific antigen (PSA) – a glycoprotein found in prostate gland tissue that is elevated in prostatitis, BPH, and adenocarcinoma (0-4 ng/mL)

- DX – DRE, urodynamic testing, endoscopy, PSA, ultrasound
What is the position for a DRE exam?
What is the position for a DRE exam?
- modified standing
What is the cause of Orchitis?
What is the cause of Orchitis?

- post puberty mumps
- Orchitis – inflammation of the testes that may result from infection or injury
- Causes – Mumps after puberty (may result in sterility)
- S/S – Pain and swelling in the scrotum, sometimes urethral irritation
- Tx – Scrotal support, ice bag to the scrotum (do not apply heat)
If patient has painful swollen scrotum (possible caused from orchitis), what would you suggest they wear?
If patient has painful swollen scrotum (possible caused from orchitis), what would you suggest they wear?
- Patient with orchitis - wear underwear that supports the scrotum
What is the most important thing to look for when doing a cone biopsy (Coniztion)?
What is the most important thing to look for when doing a cone biopsy (Coniztion)?

- Post cone biopsy - watch for excessive bleeding
- There may be some bleeding during and delayed bleeding after the procedure
What causes fibrocystic breasts (Chronic Cystic Mastitis)?
What causes fibrocystic breasts (Chronic Cystic Mastitis)?
- caffine adds to fibrocystic breasts

- Caffeine aggravates cyst formation: coffee, tea, chocolate, and cola drinks
What would a patient complain of after laparoscopic surgery?
What would a patient complain of after laparoscopic surgery?
- shoulder pain from abdominal laparoscopy

- Shoulder pain may occur due to gas trapped in the abdomen under the diaphragm

- Severe pain may indicate hemorrhage
Post uterine surgery, what do we watch for?
Post uterine surgery, what do we watch for?

- Post uterine surgery to watch I & O's
- Document I&O’s
- Watch Urine output
Post mastectomy, what is one of the treatments to prevent swelling (Lymphedema) for the arm on the operative side?
Post mastectomy, what is one of the treatments to prevent swelling (Lymphedema) for the arm on the operative side?

- Post mastectomy - to prevent swelling on operative side – elevate affected arm
- Elevate affected arm for several days
- Lymphedema – most common cause is infection; monitor and report signs of infection
- Avoid taking blood pressure, giving injections, or drawing blood on the operative side
What is the most important question to ask when screening for breast cancer?
What is the most important question to ask when screening for breast cancer?
- Family history important in breast cancer screening

- Menarche prior to age 12

- Late menopause (after 50)

- Long or irregular menstrual cycles

- Women older than 40

- Hx of fibrocystic breast disease

- Hx of cancer of the other breast

- Hx of endometrial or ovarian cancer

- Women who have never had a baby (nulliparous)

- Women who had their first baby after the age of 30

- Women who have not breast fed

- Women on Antihypertensive therapy

- Radiation exposure before age 30

- Diet high in fat

- Obesity

- Alcohol and tobacco use

- Previous breast surgery (biopsy, implants)

- Estrogen replacement therapy for longer than 8 years
For an ABDominal ultrasound, how would you want the bladder - Full or Empty?
For an ABDominal ultrasound, how would you want the bladder - Full or Empty?

- ABDominal ultrasound need bladder full
- Do not void for several hours prior to a pelvic ultrasound
What is the best way to prevent pregnancy?
What is the best way to prevent pregnancy?

- Abstinence and then second is condoms to prevent pregnancy
What is the most important aspect for care with a sexual assault patient?
What is the most important aspect for care with a sexual assault patient?
- Rape patient - crisis intervention, emotional support and preserve DNA evidence

- Provide emotional support (priority)
What are the S/S for gonorrhea?
What are the S/S for gonorrhea?

- gonorrhea - foul smelling discharge
- A yellow-green purulent vaginal discharge
Patient has gonorrhea, what else will you check for?
Patient has gonorrhea, what else will you check for?
- check for other STD's, REPORTABLE STD

- Individuals with gonorrhea should also be tested for other STD’s, including HIV
At what age does a woman start getting mammograms?
At what age does a woman start getting mammograms?
- Mammograms start baseline at age 40 for people not deemed to be at familial risk

- Women > 40 years should have annual mammogram
What do you assess for post TURP?
What do you assess for post TURP?

- Monitor I&O (make sure the TURP is patent and make sure there are no blood clots)

- Monitor for catheter obstruction: bladder spasms and pain
What is a patient with HPV (Genital Human Papillomavirus or Condylomata acumate) higher risk for?
What is a patient with HPV (Genital Human Papillomavirus or Condylomata acumate) higher risk for?
- higher risk of cervical cancer

- At least 10 of the HPV virus types can lead to development of cervical cancer
What presents candida?
What presents candida?

- Presents with cottage cheese look
- Symptoms include: intense vulvar itching, inflammation and irritation, burning after urination, and a white, cottage cheese-like discharge
What is the most prevalent surgery used for prostate enlargement?
What is the most prevalent surgery used for prostate enlargement?
- TURP - most common prostate surgery

- Transurethral resection of the prostate

- Most common procedure, particularly for older men or those who are a poof surgical risk

- Surgeon removes prostate tissue through the urethra using a resectoscope

- No incision is necessary

- Recovery is shorter than other approaches

- Complications: hemorrhage, urinary incontinence, and ED
Q1. What childhood infectious disease most significantly affects male fertility?

Q2. Couple trying to have a baby, what child hood disorder would you ask about?
Q1. What childhood infectious disease most significantly affects male fertility?
- Mumps can cause infertility

Q2. Couple trying to have a baby, what child hood disorder would you ask about?

- Mumps

- Cryptorchidism, orchitis after mumps
Is Gonorrhea a reportable disease?
Is Gonorrhea a reportable disease?

- Yes
What can you teach a man with gonorrhea to do?
What can you teach a man with gonorrhea to do?

Wear a condom and tell other sexual contacts to get treated
Pt having a TURP and c/o pain, what do you do?
Pt having a TURP and c/o pain, what do you do?

- Assess the catheter for kinks
Pt with a swollen scrotum, what can you do for him?
Pt with a swollen scrotum, what can you do for him? Ice packs and scrotal support
How often does a man do a TSE (Testicular Self Exam)?
How often does a man do a TSE (Testicular Self Exam)? Monthly after a warm shower
Gonorrhea is state mandated reporting
Gonorrhea is state mandated reporting
Vaccinate for mumps!!
Vaccinate for mumps!!
What STD is highest risk to develop cervical cancer?
What STD is highest risk to develop cervical cancer? HPV
What is used to monitor for prostate cancer?
What is used to monitor for prostate cancer?

- PSA (normal levels are 0-4)
What can you teach a pt with a vasectomy?
What can you teach a pt with a vasectomy? Come back for check up because it will be six weeks before all sperm is gone out of system
What is a panhysterectomy?
What is a panhysterectomy? Same thing as a total hysterectomy (removal of entire uterus and cervix)
What might bleeding after sex indicate?
What might bleeding after sex indicate? Cancer
S/S of toxic shock syndrome?
S/S of toxic shock syndrome?

- Fever of 102 and greater.
- Vomiting, diarrhea, drop in B/P, weakness, dizziness, peeling red rash, decreased Hgb, decreased urine output
What do you teach a pt with a total mastectomy?
What do you teach a pt with a total mastectomy?

- Elevate arm and assess lung sounds
What is basal body temp?
What is basal body temp?

- Fertility Awareness Method. Take temp each morning for many months before rising to acquire your ovulation days (rhythm method)
Pt comes in with smelly discharge, how do you test for gonorrhea or chlamydia?
Pt comes in with smelly discharge, how do you test for gonorrhea or chlamydia?

- Stained smear test and/or culture and sensitivity
What is the long term effect of PID (Pelvic Inflammatory Disease)?
What is the long term effect of PID (Pelvic Inflammatory Disease)? Infertility/Sterility
What do you tell a pt who is about to get a uterus ultrasound?
What do you do for a pt about to get a uterus ultrasound?

- Dont void
What is important to teach a pt who has genital herpes?
What is important to teach a pt who has genital herpes?
- Tell partners
How often does a woman do a SBE?
How often does a woman do a SBE?

- Monthly, usually a week after menstruation
What age does a woman start to get mammograms?
What age does a woman start to get mammograms?

- At age 40, earlier if hereditary
What should u avoid with fibrous breasts?
What should u avoid with fibrous breasts?

- Avoid caffeine with fibrous breasts
First sign of gonorrhea?
First sign of gonorrhea?

- smell
What is a colposcopy?
What is a colposcopy?

- A lighted, magnifying speculum that is inserted into the vagina to view the vagina and cervix, pt will have slight bleeding and cramping
Post op for D&C (Dilatation and Curettage)?
Post op for D&C (Dilatation and Curettage)? Monitor voiding and urinary retention
What is menorrhagia?
What is menorrhagia? excessive bleeding
What is metrorrhagia?
What is metrorrhagia?

- bleeding between menstrual periods
- Metrorrhagia is uterine bleeding at irregular intervals, particularly between the expected menstrual periods
S/E of menorrhagia?
S/E of Menorrhagia?

- may result in anemia
- Menorrhagia: Excessive uterine bleeding occurring at the expected intervals of the menstrual periods.
S/E of metorrhagia?
S/E of metorrhagia?

- May indicate cancer or retained placental tissue
- metorrhagia: Uterine bleeding at irregular intervals
Expectations of menopause?
Expectations of menopause?

- Hot flashes, perspiration, fatigue, vaginal dryness and atrophy, weight gain, skin dryness, sagging breasts and osteoporosis
A fistula is an opening between two organs that normally do not open into one another
A fistula is an opening between two organs that normally do not open into one another
Ureterovaginal =
Ureterovaginal = between ureter and vagina
Vesicovaginal =
Vesicovaginal = between bladder and vagina
Rectovaginal =
Rectovaginal = between rectum and vagina
Sign of rectocele?
Sign of rectocele? Hemorrhoids
Why does infertility happen with long term PID?
Why does infertility happen with long term PID?

- Scarring of the fallopian tubes (oviducts)
What is a major symptom of a benign uteran tumor?
What is a major symptom of a benign uteran tumor?
- abnormal heavy bleeding
What is important post op hysterectomy?
What is important post op hysterectomy? DVT, use ted hose
What is the fastest growing group to acquire HIV/AIDS?
What is the fastest growing group to acquire HIV/AIDS?

- WOMEN of color and heterosexual
Dx of HIV/AIDS?
Dx of HIV/AIDS?

- EIA and Western Blot
S/S of chlamydia?
S/S of chlamydia?

- Gray white discharge with itching and burning
Gonorrhea is a bacterial infection
Gonorrhea is a bacterial infection
Young adults have the highest incidence of gonorrhea
Young adults have the highest incidence of gonorrhea
What type of antibiotic for gonorrhea?
What type of antibiotic for gonorrhea? Broad spectrum (Rocephin)
FYI = Syphilis is a bacteria infection that is reportable to the public health dept. Lesions. Can be spread to a fetus. Many types of blood test to dx
Syphilis is a bacteria infection that is reportable to the public health dept. Lesions. Can be spread to a fetus. Many types of blood test to dx
Sentinel Node Biopsy?
Sentinel Node Biopsy?

- The node that drains the area of the breast affected by the tumor is identified and removed
- If the node is cancer free, it is assumed that no cancer cells exist in the other nodes