med/surg E4a

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Author:
Anonymous
ID:
7386
Filename:
med/surg E4a
Updated:
2010-02-19 03:32:00
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reproductive and urinary
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Description:
reproductive, stds and urinary
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  1. Cervical Cancer
    risk factors
    health promotion
    - silent killer

    • Risk factors:
    • ** infection with a certain type of HPV
    • -HIV infection
    • - chlamydia infection
    • - diet/obesity
    • - birth control pills

    • Health promotion:
    • -pep test
    • -screening for HPV infection
  2. Ovarian Cancer
    • Risk Factors:
    • - age >63
    • - birth controls
    • - weight
    • - having no pregnancies
    • - ERT, composed of estrogen alone
    • - family history
    • - breast cancer

    • Health Promotion:
    • - regular pelvic exams
    • - family history
  3. Colporrhaphy (pelvic surgery)
    - shortening of pelvic muscles to support displaced structures

    • ANTERIOR: to repair a Cystocele --> tighter support for the bladder ( sagging of bladder)
    • POSTERIOR: to repair a Rectocele --> tighter support for the rectum
  4. Oopherectomy/ salipingo-Oopherectomy (pelvic surgery)
    removal of the ovaries/ ovaries and fallopian tube

    • for: very large, recurring ovarian cysts
    • - endometrial cancer
    • - ovarian cancer
    • (effects your ability to conceive)
  5. Hysterectomy (pelvic surgery):
    Subtotal and Total
    surgical removal of the uterus only

    Subtotal: removal of uterus, leaves the cervix

    Total: removal of uterus, cervix, fallopian tubes and ovaries

    • for: dysfunctional uterine bleeding (DUB) (vaginal bleeding
    • - uterine prolapse

  6. Pelvic exteneration (pelvic surgery)
    • removal of organs and pelvic cavity
    • (colon, bladder, uterus, ovaries)

    for recurrent cervical cancer
  7. What are Pre-Operative NC for Female pt w pelvic surgery?
    • - pt understanding of procedure (sex, child birth..)
    • - prevention of "harm" to other stuctures during surg (bowel cleansing)
  8. Post opt nursing care for pelvic surgery?
    • 1. DVT (there's a lot of pelvic congestion = vein is compressed = venous coding in the leg
    • 2. Alt in elimination
    • - Urinary: voiding in suff quantities by bladder scan, kegel exercise, InO, straight cath
    • - bowel: stool softer
    • 3. Bleeding/ heorrhage (dressing, pad counts, vs, labs, drainage)
    • 4. Self concept: (reproductive capability...)
    • 5. Discharge teaching (ss to report, no heavy lifting, unusual bl...)
  9. early detection for breast cancer
    • - mammography ( can detect breast tumors 2yrs b/f they reach palpable size)
    • - hard less movable, irregular shape w ill defined boarders
    • - skin irritation or dimpling of the skin
    • - nipple pain or retraction
  10. Treatment for breast cancer:
    Surgery

    - Breast sparing
    - Mastectomy (3)
    • 1. lupectomy= removes the cancerous tissue and some normal tissue surrounding
    • 2. -Simple: breast only
    • - modified radical: breast and varying # of lymph nodes. leaving the breast skin ava for reconstruction
    • - Radical: entire breast, lymph nodes and the heast wall muscles.
  11. NC for pt having modified radical or radical mastectomy?
    • 1. Wound care:
    • - monitor dressings
    • - TRAM- flap: more extensive surgery, activity restriction, test cap refill

    • 2. Arm Care:
    • - preventing lymphedema
    • - raising arm on a pillow, no IV, BP, needle stick on the effect arm
    • - preventing frozen shouder: (progressive arm exercises, range of motion

    3. Psychosocial care
  12. Male reproductive pic
  13. Testicular Cancer
    1. Risk factors: (major cryptochidism = undescended testicle, occupational, HIV infection)

    2. SS (early: painless scotal lump, slight testicular swelling)(late: back pain, SOB, breast enlargement, change in LOC)

    3. Treatment: orchiectomy (testes), radicaloctoy (cord, testes, local lymph nodes)

    • 4. NC:
    • - physical after surgery
    • - emotional
    • - health promotion (at age 15, men should perform monthly teticular self exam)
  14. BPH: benign prostatic hyertrophy
    symptoms
    • - slow increase number of nonmalignant epithelial cells in the prostate -> show gradual tissue -> enlargement of the gland in urethra.
    • - b/c of the retention of male sex hormones, the older the more risk

    • Symptoms: (r/t obstruction of urine outflow bc of the location of the gland)
    • - steam slows, dec in force
    • -diff starting steam
    • - dribbling incontience
    • - incomplete bladder emptying -> urine retention
    • - dysuria, urgency, nocturia

  15. Non surgical management for BPH
    1. drugs (relax smooth muscles: flowmax, hytrin)( suppress androgens: proscar)

    • 2. Doesn't involve anesthesia surgeries
    • - needle ablations: specialized needle that delivers energy in the form of radiofreq. to kill tissue
    • - TUNA (improves the flow of urine thru uretura), Indigo Laser

    - Thermotherapies: threading an antennae up and into the urethra, next to the prostate and uses radiant heat to kill cells. TUMT.
  16. Surgical management for BPH
    TURP
    • - aim to remove or resact most of the prostatic gland
    • 1. TURP ( uses the resedscope to remove obstructing issue one piece at a time
    • - pre opt nc (to restore urinary flow, treat any bladder infection, some bowl prep, BUM lab)
    • - post opt (encourage men to drink water, maintain antiebolic stocking/compression)
    • - maintain traction! to prevent bleeding, do not remove type!
    • - CBI - continuous bladder irrigation, use normal saline, it is to irrigate out any clots and bladder disention, dec bladder spasms
    • - urine should be clear to light pink
    • - no sticking things up the rectum.

  17. 1. suprapubic prostatectomy (front)
    2. retropubic (back)
    3. perineal (middle)
  18. Genital Herpes
    • - non reportable
    • - Herpes simplex virus
    • Type I: lesions on mouth and lips
    • tyep II: genital herpes
    • ** you can get I from II.
    • - genital herpes can be spread when NO lesions are present
    • - infection occurs 7-21 days after initial contact
    • - no cure...zovirax, valtrex and famvir and dec the outbreak

  19. Chlamydia
    • - sexual contact
    • - chlamydia trachomatis
    • - asympotomatic
    • - can be cure
    • - abn discharge, dysuria, abd and back pain...
    • - doxycycline

  20. Syphilis
    • - untreated
    • - direct contact w lesions or direct bl, having a break in skin that has contact w lesion
    • - t. pallidum spirochete
    • 1. Primary (chancres, 2wks- 3mo)
    • 2. Secondary (RASH on palms and feet, flu like, hair loss)
    • 3. Latent ( no symptoms, 5years remined infected, w/out txmnt pt wil progressed to late)
    • 4. Late (systemic problem, gummas on skin, CNS (neurosyphilis)

  21. Gonorrhea
    • fnt of the kidney: to maintain the body's homeostasis
    • - fromation of urine (excretion of metabolic wastes, balancing of fluid vol)
    • - regulation of acid/base balance
    • - conservation of nutrients
    • - secretion of hormones
  22. Pyelonephritis
    • - infection of the renal pelvis, calyces and medulla.
    • - usually starts as lower UTI and ascends into renal pelvis
  23. Urolithiasis (urinary tract)
    Pyelolithiasis (renal pelvis)
    Nephrolithiasis (renal parenchyma)
    "-liasis" means the formation of concretions of minerals in the body = stone
  24. Glomerulonephritis
    • -inflammation of the glomerular capillaries (streptococcal infections)

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