Med-Surg Exam 12

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mel26704
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165553
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Med-Surg Exam 12
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2013-09-03 21:23:00
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Reproductive System
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Reproductive System
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  1. What are the s/s of PMS for adolescents?
    • breasts develop
    • redistribution of fat
    • hair growth
    • mood swings
    • menarche- usually 10-14 yrs old
  2. What are the s/s of PMS for adults and when do they occur?
    • wt gain
    • h/a
    • nervoisness
    • irritability
    • anxiety
    • confustion
    • depression
    • bloating
    • breat enlargement and tenderness
    • swelling of hands and feet
    • anger
    • social withdrawal
    • *They occur 1-10 days prior to menses
  3. How can you dx PMS?
    • hx
    • s/s
    • journaling
    • eliminate other causes
  4. What are some things that can treat PMS?
    • diet
    • pain control
    • relaxation
    • treat anxiety/dpression
    • OTC meds
  5. What is the menstrual cycle?

    My mnemonic: (yea, I know, a little random lol)
    If
    Ollie
    Opens
    The
    Door
    Later,
    Olivia's
    Pretty
    Little
    Orange
    Dog
    Escapes
    • Increased FSH
    • Ovarian follicle releases estrogen
    • Ovum begins to mature
    • Thickening of endometrium
    • Decreased FSH
    • LH increased
    • Ovulation occurs and corpus luteum forms
    • Progesterone released by corpus luteum
    • Lining of uterus thickens and proliferates
    • Ovum dies, corpus luteum degenerates (if no fertilation occurs)
    • Decreased estrogen and decreased progesterone
    • Endometrium degenerates and menses begins
  6. What is the menstrual disorder that is described as difficult or painful menstruation?
    dysmenorrhea
  7. What are the s/s of dysmenorrhea?
    • low abd cramping
    • aching in lower back/pelvic region
    • n/v
    • diarrhea
    • h/a
    • dizziness
    • fatigue
    • emotional instability
  8. How would you diagnose dysmenorrhea?
    pelvic exam to eliminate secondary cause
  9. What is the tx for dysmenorrhea?
    • treat symptoms
    • heat
    • exercise
    • NSAIDS
    • if secondary, treat cause/disease
  10. What is the menstrual disorder that is described as an absence of menstrual flow?
    amenorrhea
  11. What are some causes of amenorrhea?
    • endocrine dysfuntion
    • tumor
    • anorexia
    • decreased body fat
    • emotional problems/stress
  12. How would you diagnose amenorrhea?
    • s/s
    • hx
    • pelvic
    • exam
    • hormone levels
  13. When is amenorrhea a normal occurence?
    • pregnancy
    • menopause
  14. What is described as a cessation of menses?  How long should it be absent?
    menopause
  15. What age does menopause usually occur?
    40-55; may happen as early as 35, avg 52 years old
  16. What are some s/s of menopause?
    • decreased/irregular menses
    • nervousness
    • sweating
    • palpitation
    • h/a
    • hot flashes
  17. What is the menstrual disorder that is described as irregular bleeding at a time other than menses?
    metrorrhagia
  18. What are the s/s of metrorrhagia?
    pink to brown spotting to frank bleeding
  19. When is the best time to perform a self-breast exam?
    monthly 1 week after menses
  20. Prior to a pap smear or pelvic exam, what should you teach the patient?
    do not douche, no sex, no tampons, do not apply vaginal prep for at least 48 hours before the exam
  21. What is the common postition for gynocological procedures?
    lithotomy
  22. What is the procedure called that is used to sterilize a male?
    vasectomy
  23. What should you teach a pt who has had a vasectomy?
    • impotency may occur
    • sperm may be present in ejaculatory fluid for 6 weeks, so use another form of birth control until sperm count is zero.
  24. When should a woman should have a mammogram?
    • at age 40 as a baseline, then every 1-2 years
    • at age 50, every year
  25. What is the exam that allows visual inspection of the vagina and cervix, as well as sampling of mucous, discharge, cells, and exudates?
    pelvic exam
  26. How would you establish a rappor with a pt?
    • explain the procedure
    • provide privacy for changing into gown
    • remain with pt
    • acknowledge embarrassment and allow pt to verbalize, explore feelings
  27. What is the implantation of the fertilized ovum anywhere outside of the uterine cavity?  Where does this most commonly happen?
    ectopic pregnancy; fallopian tube
  28. What is a complication of an ectopic pregnancy?
    peritonitis
  29. What are the nursing interventions for a woman with an ectopic pregnancy?
    • monitor s/s
    • emotional support
    • explanations
    • answer questions
  30. What gland are the male and female hormones influenced by?
    anterior pituitary gland
  31. What is the common recommended for treating cancer of the female reproductive system that?
    hysterectomy
  32. Which hysterectomy involves removing the ovaries, oviducts, lymph nodes and lymph channels along with the uterus and cervix?
    radical hysterectomy
  33. Which hysterectomy involves removing the uterus and the cervix?
    total hysterectomy
  34. What type of mastectomy removes the entire breast and axillary nodes?
    simple or total mastectomy
  35. Which type of mastectomy removes the breast, axillary lymph nodes, and lining over the chest wall muscle?
    modified radical mastectomy
  36. Which type of mastectomy removes the breast, axillary lymph nodes, lining over the chest wall muscle AND chest wall muscle under the breast?
    radical mastectomy
  37. STI:  bacterial infection, AKA "GC" or "the clap"
    s/s: men/women
    tx:
    • Gonorrhea
    • s/s:  men-  urethritis, dysuria, purulent d/c from urethra, swelling of penis, proctitis
    • s/s:  women-  often mild/none, slight purulent vaginal d/c, vague feeling of fullness in pelvis, discomfort or aching of abdomen, if bladder involved- burning, frequency/urgency
    • tx:  
  38. STI:  gains entry into the body through the mucous membranes or skin during sexual intercourse;  called "the great imitator" because many of s/s are indistinguishable from other diseases.
    s/s:
    tx:
    • syphilis
    • s/s:  primary stage-  a single sore called a chancre; may last 3-6 weeks and heals w/o tx, but w/o tx, it will advance to the secondary stage; skin rash/mucous membrane lesions.  Late stage- organ damage
    • tx:  easy to cure in early stages; (Penicillin)
  39. STI:  most frequently reported of all STIs caused by bacterium; damages reproductive organs; can happen silently.
    • chlamydia
    • s/s:  painful/difficult urination, vaginal d/c,...
  40. STI:  AKA condylomata acuminata; caused by HPV and can lead to cervical cancer
    s/s:
    tx:
    • genital warts
    • s/s:  soft, moist, flesh colored bumps on the genitals that may appear weeks to months after infection
    • tx:  creams, acids, laser, cryotherapy...
  41. STI:  caused by protozoa; can be transferred by toilet seats and towels
    s/s:
    tx:
    • trichomoniasis
    • s/s:  malodorous, copious, frothy thick or thin, white to yellow-green/gray d/c, inflamed vagina, cervical erosions, cervical bleeding, prostatitis, urethritis, reversible sterility
    • tx:  metronidazole
  42. STI:  most often found on the labia, anus, clitoris, vagina, cervix, prepuce, glans penis, or shaft of the penis
    s/s:
    tx:
    • chancroid
    • s/s:  tender genital ulcers, lymphadenopathy and tender buboes after primary lesion, dysprunia, dysuria, pain
    • tx:  abstain from sex until all lesions healed, antibiotics
  43. What are some s/s of HBV?
    jaundice, anorexia, fever, GI upset, inflamed liver
  44. What is described as itching of the perineum?  What can it be caused by?
    • perineal pruritus
    • deficiency of vitamin A or irritating vaginal d/c, ...
  45. What is an opening or passageway between two organs or structures?
    fistula
  46. What can a vaginal fistula be caused by?
    breakdown of tissue by CA, radiation, and damage from delivery
  47. What occures when support between the vagina and bladder is weakened?  What can it cause/lead to?
    • cystocele
    • complete emptying of the bladder difficult; UTI
    • stress incontinence
  48. What occurs when a muscular weakness occurs between the rectum and vagina and can result in not being able to completely empty the rectum?
    rectoocele
  49. What part of the male anatomy secretes an alkaline substance into the semen to counteract vaginal and urethral acidity?
    cowper's glands
  50. What is the term for "undescended testes"?
    cryptochidism
  51. Med:  
    treats herpes
    can cause renal failure and thrombocytopenia
    valacyclovir
  52. Med:
    treats yeast, vaginal infection
    s/e:  hepatotoxicity, decreased potassium
    fluconazole
  53. Med:
    contraceptive
    c/e:  hx of MI, clots, embolisms
    s/e:  migraines, Raynaud's, cerebral hemorrhage, pulmonary embolism
    norgestimate
  54. Med:
    contraceptive
    c/i:  breast/genital cancer
    s/e:  pumonary embolism, cervical erosions...
    withdrawl bleeding 3-7 days after d/c
    medroxyprogesterone
  55. Med:
    treats prostate cancer, endometriosis, uterine fibroids
    s/e:  stroke, personality disorder, mood swings, decreased testicle size, body odor
    leuprolide
  56. Med:
    treats gonorrhea/syphilis
    stains baby's teeth
    doxycycline
  57. Med:
    treats benign prostatic hyperplasia and male baldness
    do not use in women
    s/e:  decreased libido, erectile disfunction, decreased volume of ejaculate
    *risk to male fetuses, females should avoid male's semen
    finasteride
  58. Med:
    c/i:  nitrates
    don't use in women
    s/e:  h/a, sudden death, MI, priapism
    notify MD about vision/hearing loss
    1 hr before activity
    sildenafil
  59. Med:
    needed for normal fetal development
    s/e:  rash, difficulty sleeping, seizures, more yellow urine
    folic acid
  60. Med:
    treats erectile dysfunction
    c/i:  stroke, nitrates, heart failure within 6 months, MI within 90 days
    not for women
    concurrent use:  life-threatening HTN
    administer 30 min before activity
    tadalafil
  61. What is a fluid filled cyst between the testes and tunica vaginalis?
    hydrocele
  62. What is the term for varicosity of the spermatic vein?
    varicocele
  63. What is the term for a persistent irritation of the glans penis, usually secondary to bacterial infecction?
    balanitis
  64. The _____ pelvis is the narrow part below the pelvic brim; it has an inlet and outlet.
    true pelvis
  65. The _____ pelvis is the broad, expanded portion above the pelvic brim.
    false pelvis
  66. What is the triangular pubic hair pattern from the upper portion of the pubic bone to the lateral areas of the labia majora?
    escutcheon
  67. What is described as the presence of normal endometrial tissue in sites outside the endometrial cavity?
    endometriosis

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