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Med Surge Study Guide Ch 41-44
Terms in this set (100)
If your pt is in the beginning of labor, which layer of the uterus would you focus on?
If your pt is having prostate gland problems, which function of the prostate should you focus on?
Which hormone is responsible for stimulating the release of milk?
In premenopausal females, what is a major effect of decreased secretion of estrogen?
When assessing an older male, what would you identify as a normal part of aging?
GII,PII (G2, P2)
Your pt had 2 pregnancies. The first was a girl, the second were twins. How would you document this history?
Loss of a fetus before it was mature enough to live outside of the mother
What does abortus mean?
Monthly BSE and a mammogram and clinical examination yearly
What would a 50 year old female do to monitor herself for breast cancer?
Avoid deodorant and powder before the exam
What instructions would you give a female who is having a mammogram?
Any pattern that is consistent and covers all breast tissue
What is the appropriate palpation pattern to use when doing breast self-examinations?
Have the patient void
What action should you do prior to assisting a female pt who is having a pelvic exam?
Teach the pt relaxation exercisies
What would be appropriate to do if you are assisting a female with their first pelvic exam?
Explain the procedure and provide support
What is the best action to take when assisting a pt with a pap smear?
Have the pt lie flat for several hours
What care will you provide after your pt has had insufflation with an endoscopic exam?
"Monthly TSE is an important part of cancer screening"
"If you do this every month, you will locate tumors before they metastasize"
When teaching about testicular self-examination what would you include?
The TSE examination is easiest after a warm bath or shower
After teaching about testicular-examinations, how would you know the teaching was effective?
Have a yearly digital rectal exam (DRE)
When teaching a 50 year old about reproductive health, what should you remind him to do for his prostate?
Gynecomastia noted bilaterally, no complaints of tenderness
How would you document enlarged breasts on an older gentleman?
How would you document the urethral opening that is located underside the penis?
"Do you have any allergies?"
What question would you ask a pt who is going for a cystourethroscopy?
"You should report any changes in your usual urination patterns"
If your pt has a cystourethroscopy, what kind of instructions would you give them prior to discharge?
Prostatic hypertrophy or cancer
What does it mean if a pt has an elevated PSA?
How often should females perform breast self exams?
It is a trans-illumination test that determines if the mass is solid or filled with fluid.
Why would you turn off the lights and get a flashlight after finding a scrota mass?
BRCA1 or BRCA2 genetic mutation or strong family history
What are some risk factors of breast cancer?
The chest incision makes the pt hesitant to deep breathe and cough
Why would a mastectomy pt be at risk for pulmonary problems?
pain level of 7 on a scale from 0-10
A pt had a mastectomy, what would be the priority concern for this pt?
Measure and compare the circumferences both arms
If your post mastectomy pt's arm is swollen, how would you verify this?
"How have you coped with other problems in your life?"
"Do you have someone you can talk to?"
Your pt is crying because she has had a mastectomy, how would you respond to this?
How would you document heavy, irregular menses with bad headaches and back pain?
Weigh her perineal pads before and after flow
What instruction would you include when teaching a pt about menstrual flow?
"You should notify your doctor if this is a new experience for you"
Your pt is having bad pains with her period, this is the first time with the bad pain, how do you respond?
Avoidance of alcohol and caffeine may help reduce your discomfort.
What advice would you give a pt who is experiencing PMS symptoms?
"You may still be fertile for several months after your last period. You should consult with your doctor to know when to stop using birth control"
Your 50 year old patient has decided to stop her birth control since she has not had a period in 3 months. How do you respond to this?
A 28 year old woman who sits at a desk 5 days a week
What kind of pt is predisposed to developing a yeast infection?
Take Flagyl as prescribed, even if your symptoms are gone.
What would you instruct a patient about Flagyl for bacterial vaginosis?
she takes bubble baths every night
Your pt has contact vaginitis. What will assist you to teach this pt?
"I should put the suppository in at night after I get into bed"
How would you know your teaching for a daily vaginal suppository was effective?
Determine what the girl knows about risk factors for TSS
A 16 year old has toxic shock syndrome, what is your priority nursing action?
Your pt's bladder is sagging into her vagina, how do you document this?
Starting with the first day of your period, record your temp first thing each morning.
What can you teach a pt about keeping a basal body temp chart?
"A baby must have been very important to you. When you feel ready, we can talk about other alternatives"
Your pt says her life is over because she cant have children. How do you respond?
"Not enough research has been done to prove that OC's can prevent STI's"
A pt requests oral contraceptives because they prevent STI's, how do you respond?
Your pt needs to prevent a pregnancy while receiving chemo, what type of birth control is best?
"You should plan to use birth control, breastfeeding is not a reliable form of contraception"
Your pt is in for a 6 week checkup, what will you teach her about birth control?
"You are going to have your uterus, fallopian tubes, and ovaries removed"
What does hysterectomy with bilateral saplingoophorectomy mean?
Perform a scratch test
Your post hysterectomy pt hasn't voided after surgery, how can you assess for bladder distention?
"Loss of reproductive function may cause grieving"
A 42 year old is crying after a hysterectomy, how would you comfort her?
Rectal pain, pain with erection, low abdominal pain, low back pain
Your pt was diagnosed with prostatitis, what are some symptoms you expect?
Drinking 3 to 4 martinis each night after work
What would increase your pt's risk for developing prostatitis?
Inability to urinate
Your pt has prostatitis, which manifestation will you attend to immediately?
Your pt was prescribed Hytrin, which side effect will you monitor the pt for?
STAT insertion of an indwelling catheter
A 70 year old hasn't urinated in 24 hrs, he feels the urge but cant go. What should you anticipate will be done?
"Some prostate surgery can cause erectile dysfunction. Ill ask your surgeon to explain the risks to you"
An 80 year old is concerned with becoming impotent after prostate surgery, how do you respond to him?
"The catheter is keeping pressure on the area to prevent bleeding. We will remove it when the risk for bleeding has passed"
Your pt just had a TURP, he wants to know why he needs a catheter. How do you respond?
10 mL urine output in an hour
You are caring for a pt post TURP, which assessment finding would give you pause?
Collect serial samples of urine to monitor for color
After removing a catheter from a pt who had a TURP, what would be the most imp action?
Raking leaves in the yard
Your pt had a prostatectomy. 2 days later he has increased bleeding, what kinds of activity would contribute to the increased bleeding?
"Applying antibiotic ointment to the meatus twice a day will prevent skin breakdown"
You are teaching your pt about being discharged with catheter after a prostatectomy. How would you know your pt needs further teaching?
How would you document a painful prolonged erection?
Retract the foreskin, wash with soap and water, and replace the foreskin to its original position.
Your older pt has never been circumcised, how do you care for his penis?
How would you document excessive fluid from the scrotal sac?
Elevation of the scrotum
What is the most important intervention for a pt with epididymitis?
Tell the pt that it may be possible to deposit sperm in a sperm bank before treatment has begun.
Your pt was diagnosed with testicular cancer, he is upset about not being able to have children. How do you respond to him?
Small painless lump on the testicle
What are the early warning signs of testicular cancer?
Your pt is having erectile dysfunction. which medication classification do you think he has been prescribed?
Urinate before you insert the suppository into your urethra
What instruction would you give to a pt who is prescribed a trans-urethral suppository?
Remove the ring within 15 to 20 minutes of putting it on
Your pt is using a suction device and penile ring for erectile dysfunction, how would they prevent tissue damage?
Powerlessness related to inability to fulfill role functions
What is a priority nursing diagnosis for a patient who reports erectile dysfunction with no success with treatments?
Your pt has infertility due to an endocrine problem, what type of problem does he have?
"Tight jeans hold your scrotum too close to your body, where the heat can inhibit sperm production"
A young man thinks he has to stop wearing tight jeans due to infertility. How would you respond?
How long does a couple try to conceive unsuccessfully before considering infertility as a problem?
If your pt has a chancre on his penis, which STI does he have?
Your pt has a parasitic infection due to close contact with another person's genitals, what infection is this?
If a pt has gummas, what STI does he have?
Condoms can reduce the risk of STI's, but they are not foolproof
Your pt has an STI, she says her BF always uses condoms and she isn't understanding how she got the infection. How should you respond?
How do you describe a vesicular lesion to a pt
What term would you use to describe HPV to a pt?
Sharp pain at the base of the ribs
If your pt has chlamydia, what assessment would you immediately report to the RN of physician?
What type of specimen would you obtain to diagnose Trichomonas?
"Papanicolaou smears should be done more frequently because results may be altered by Trichomonas."
How does Trichomonas affect the risk for cervical cancer?
Interferon therapy can attack warts all over the body at the same time
Why would a physician recommend systemic interferon for genital warts?
HBV-immune globulin less than 12 hrs after birth and the HBV vaccine series.
Your pt with HBV just delivered a healthy baby boy. What action would you anticipate is needed for the infant?
Practice standard preautions
When bathing a pt with herpes, how do you protect yourself against contracting the infection?
Which STD can cause blindness in infants?
"Yes, some STI's have been linked to cancer, so adequate treatment is very important"
A young woman who has genital warts believes she can get cancer from the STI, how do you respond to her?
Alcohol may reduce inhibitions
What is the relationship between consuming alcohol and contracting and STI?
"Before I use a condom, I should inflate it and check it for holes and leaks"
How would you know your pt needs more teaching on ways to prevent condom breakage?
Other than drug use, whats a disorder in a pt's history that would be consistent with a diagnosis of hepatitis?
people may be asymptomatic and still transmit the infection
Why is it imp to teach a pt about completing treatment for gonorrhea?
Sharing intravenous drug equipment
What is a non-sexual activity that may transmit an STI?
What is the best way to prevent contracting and STI?
Human Papillomavirus (HPV)
What causes genital warts?
History of syphilis
Your 76 year old pt has dementia, what would be imp in his history to report to the physician?
Which condition requires a pt to undergo treatment that involves burning lesions with heat?
What can you do to prevent the development of opthalmia neonatorum
Which structures are part of the vulva?
*Wash hands before handling the breast
*NSAIDS may be used to control pain
*Wear a bra to support swollen painful breast
*Change the infants feeding position on the breast often
What would you include in teaching a breastfeeding pt about mastitis?
*Empty bladder often
*increase fluid intake to 3000mL/day
What instructions would you give a pt who is being treated for prostatitis?
*Muscle or joint pain
What are some symptoms that may occur before jaundice appears?
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