Chapter 21 Gynecologic Emergencies

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Chapter 21 Gynecologic Emergencies
2014-05-07 17:47:17
Chapter 21 Gynecologic Emergencies

Chapter 21 Gynecologic Emergencies
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  1. -Infection of the upper organs of reproduction such as the uterus, ovaries, fallopian tubes.
    -Occurs almost exclusively in sexually active women.
    -Disease-causing organisms enter the vagina and migrate into the uterine cavity.
    -If infection expands to fallopian tubes, it will cause scarring.
    -Can result in ectopic pregnancy or sterility.
    -If infection expands to ovaries, it can lead to the development of a life-threatening abscess.
    Pelvic inflammatory disease (PID)
  2. -Most common presenting sign of this disease is generalized lower abdominal pain.
    -Other signs include abnormal or foul-smelling vaginal discharge, increased pain with intercourse, fever, general malaise, and nausea and vomiting.
    Pelvic inflammatory disease (PID)
  3. STDs can lead to more serious conditions, such as:
    Pelvic inflammatory disease (PID)
  4. -Common STD - Affects an estimated 2.8 million Americans each year
    -Caused by bacteria
    -Usually mild or absent symptoms
    -Infection of the cervix can spread to the rectum and can progress to PID
  5. -One of the most common conditions to afflict women
    -Normal bacteria in the vagina are replaced by an overgrowth of other bacteria
    -Symptoms include itching, burning, pain, and a fishy, foul-smelling discharge
    -Untreated, it can progress to premature birth or low birth weight in case of pregnancy, make the patient more susceptible to other serious infections, and cause PID.
    Bacterial vaginosis
  6. -Caused by a bacterium
    -Grows and multiplies rapidly in warm, moist areas of reproductive tract such as the cervix, uterus, fallopian tubes in women and urethra in men and women
    -Bacterium can also grow in the mouth, throat, eyes, and anus
    -Symptoms are more severe in men than women
    -Severe infections present with cramping and abdominal pain, nausea, vomiting, and bleeding between periods indicating it has progressed to PID
    -Untreated, it can enter the bloodstream and spread to other parts of the body, including the brain
  7. An old medical axiom states, “Anyone who neglects to consider a gynecologic cause in a woman of childbearing age who complains of abdominal pain will miss the diagnosis at least __% of the time.”
  8. Determining the cause of bleeding is of less importance than treating the patient for ____ and transporting her.
  9. Most women will use sanitary pads to control bleeding before you arrive.  If the woman has a tampon in place, is it necessary for it to be removed?
  10. The external genitals have a rich nerve supply.  This makes injuries to the area very painful.  Treat external lacerations, abrasions, or tears with moist, sterile compresses.  Use local pressure to control bleeding.  Use a ____-type bandage to hold dressings in place.  Under no circumstances should you pack or place dressings in the vagina.
  11. A patient with PID will complain of abdominal pain.  Pain usually starts during or after normal ____.  Inquiring about the date of last ____ is important.
  12. ____ pain may be made worse by walking. Patients often present with a distinctive gait when they walk (“____ shuffle”).
  13. ____ itself is seldom a threat to life but it is serious enough to require transport and evaluation in the hospital.
  14. Sexual assault and rape are common in the United States.
    -One of ____ women will be raped in her lifetime.
    -One of every ____ women will be sexually molested, often before the age of 12 years.
    • three
    • four
  15. Attempts to immediately gather a detailed report from a ____ assault victim may cause her to “shut down.”
  16. With a sexual assault victim, offer to call the local ____ ____ center for the patient.
    rape crisis
  17. Bear in mind that rape is a ____ diagnosis, not a medical diagnosis.
  18. In rare cases, ____ causes arthritis that may be accompanied by skin lesions and inflammation of eyes and urethra.
  19. If left untreated, ____ ____ can lead to premature birth or low birth weight in pregnant women.
    bacterial vaginosis
  20. If a patient with vaginal bleeding presents with a rapid pulse and cool or pale skin, you should:
    place the patient in a supine position with her legs elevated.
  21. The clothes of a sexual assault victim should be placed into a ____ bag.
  22. Your ____ is the best tool to convince a sexual assault victim to get help.
  23. When treating a female patient with abdominal pain who has recently entered menopause, it is important to remember that:
    A. menstrual periods may be irregular.
    B. the patient may be pregnant.
    C. the patient may be imagining the pain.
    D. the patient may be emotional.
    B. the patient may be pregnant.
    (this multiple choice question has been scrambled)
  24. Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up.  You should:
    A. provide emotional support and visually assess her for obvious trauma.
    B. advise her that she cannot clean herself up because this will destroy evidence.
    C. ask her if there is anyone you can contact, such as a friend or relative.
    D. perform a limited hands-on assessment to detect life-threatening injuries.
    A. provide emotional support and visually assess her for obvious trauma.
    (this multiple choice question has been scrambled)