Study sets, textbooks, questions
Upgrade to remove ads
MS II Exam 9 Ch 49 & 50
Terms in this set (49)
Androgenic steroid therapy: Danazol & Side Effects
"Turns Dana into Daniel"
Inhibits production of pituitary gonadotropins.
Used to treat endometriosis and fibrocystic breast cancer.
SE: Acne, Oily skin and hair, hirsutism, edema, weight gain, nervousness
Culdoscopy: Post procedure
Nothing should be put into the vagina - no intercourse, no tampon use, no douching until MD says it's okay.
Laparoscopy: Postop period
Encourage pt to ambulate as soon as possible to reduce pain in shoulder and below the rib caused by the injected gas. These symptoms of discomfort are expected and temporary.
Care of pts with reproductive tract infections: Deficient Knowledge
Instruct pt about perineal hygiene:
Wiping perineal-anal area from front to back; one stroke per tissue.
-Frequent washing with neutral soap
Constriction of pelvic structures by endometriosis-related adhesions. Constriction of the bowel, ureters, or both may cause partial or complete obstruction within the affected structure, creating a medical emergency.
Pt may present with signs of fluid retention or bowel restriction
Mastectomy Post-Op Care: Lymphedema-Risk for injury
Elevate the arm above ht of the heart
-Measure BP on unaffected arm
-Encourage frequent and progressive exercise of the arm on affected side
-Encourage pt to use the arm for as many ADLs as possible.
Grows slowly; Increased incidence in women with HPV, HIV, smokers, those that had sexual intercourse in early adolescence, compromised immune system, and multiple sex partners. Early detection is key to survival. Because pts may be asymptomatic -
regular paps are used for early detection/screening
Should be done at the same time each month, at the END OF PERIOD (for those who have periods). Women should start self-examining at the age of 20.
Drugs used for breast cancer treatment: Tamoxifen Citrate (SERM)
Block circulating estrogen from reaching the receptor cells. Prevents initial malignancy in selected women who are high risk for development of breast cancer.
Drugs used to treat menopause: Premarin - Side effects
Breast tenderness, breakthrough bleeding, and vaginal candidiasis
Used as replacement of natural hormones after menopause.
Trichomonas vaginalis (Protozoal Infection)
Causes vaginal discharge: frothy, yellow-gray in color, with fishy odor
Can't be treated with ABX (use antiprotozoa)
No sex until medication is finished by BOTH partners.
Infertility diagnostic date tests: Medical Dx
Inability to conceive within one year of regular unprotected sex.
For females, this could be caused by many health factors including low progesterone levels.
Hysterectomy: Risk for Deficient Fluid Volume r/t post-op bleeding
Check abdominal and perineal pads for bleeding every hour for the first 12 hours for excessive bleeding (hemorrhages)
Not recommended for regular hygiene
because it washes away the "good" bacteria and elements within vagina that are needed to maintain normal pH.
Only use if MD has ordered
Candida albicans (fungus, or yeast infection)
Often associated with use of ABX therapy or DM.
Discharge described as cottage cheese-like appearance and distinctive odor.
Breast Cancer: Types & malignancy
Nearly 1/2 of malignant breast tumors are located in the upper outer quadrant
and nearly 1/4 are located in the nipple-areolar complex.
Infertility: Ineffective Coping
Give pt the opportunity to discuss her thoughts of feelings about infertility and to explore coping strategies.
Woman who has never conceived or a man who has never impregnated a woman
-Has highest mortality rate of all reproductive system
-Probably inoperable/in advanced stages by the time pt is diagnosed.
-Asymptomatic until it is advanced. (TOO LATE!)
Nursing Care of patient with breast cancer
To many women, loss of breasts = loss of femininity. (Disturbed body image)
Teach pt how to avoid lymphedema: elevate affected arm above the heart, encourage frequent use/exercise of effected arm... (Risk for injury)
Pt is at risk of contractures unless proper positioning is maintained and exercises are begun as soon as permitted. (Impaired Physical Mobility)
Ovulatory Stimulant drugs: Clomid - Use & Action
Stimulates action of natural pituitary gonadotropins
May cause hot flashes, breast tenderness, N/V, fatigue, depression, multiple births...
Staging of a breast tumor
Stage 1-tumor <2 cm with 0 lymph nodes CA+
Stage 2-tumor 2-5cm with 0-1 lymph nodes CA+
Stage 3-tumor >5cm with 0 lymph nodes CA+, tumor <2cm with axillary lymph nodes CA+, tumor 2-5cm with axillary lymph nodes CA+
Stage 4-tumor of any size with or without lymph nodes CA+ and DISTANT METASTASES present
Menorrhagia: Oral Contraceptive Use - Medical Treatment
Make sure pts take meds at same time daily
-Estrogenic potency of oral contraceptive is increased
-Progestational potency of oral contraceptive is increased.
Male sexual dysfunction: Medication Side Effects
Drugs most likely to interfere with erection are antihypertensive agents.
Digoxin can decrease levels of testosterone.
Medications for stomach ulcers and anticancer drugs may cause libido to decrease, anticholinergic and antihistamines may block neurotransmitters that cause relaxation of smooth muscle.
Transurethral Resection of the prostate: Catheter
A triple lumen urinary catheter commonly used to maintain continuous irrigation and bladder drainage, clears the bladder or blood and debris.
Inflammation of the epididymis usually caused by infection, trauma, or reflux of urine.
S/S: painful scrotal edema, nausea, vomiting, chills, and fever.
Evaluates for volume, thickness, color, pH, and microscopic evaluation of the sperm count, motility, shape, and ability to penetrate cervical mucus.
Prostatitis: Drug treatment & constipation
Often times pts are prescribed opioids for pain - encourage pt to increase fluids and take stool softeners to avoid constipation
Diagnostic tests: Urethral smear & Stains
Microscopic study to detect STIs and identify pathogens.
To collect, sterile swab is inserted into urethra to obtain specimen. Assess pt for hypotension, bradycardia, and pallor before allowing to rise.
Drug therapy for Prostate CA: DES (Diethylstilbestrol) SE's
Increased risk of reproductive system cancers in offspring that were exposed to the drug.
Gynocomastia could be a common side effect.
Testicular CA: Self-examination
Men should do a monthly self-exam of the penis, scrotum, and perineal area - best done after a warm bath or shower, when he is warm and the scrotum is relaxed.
Vasectomy: Post-Op outcomes
Pain and swelling can be managed with ice and mild analgesics.
Pt can resume intercourse as soon as he feels comfortable - use condom until sperm is evaluated
Can be reversible but should be considered permanent.
Health Assessment: Hydrocele
A mass filled with serous fluid.
To assess, hold scrotum over light and check for red spots to glow
Cryptorchidism: Medical tx
Unknown cause - must be corrected within the first 18 months of life to give best chances of fertility
Drug Therapy: Nilndron- Side Effects & Nursing Intervention
Decreases testosterone level.
Medication must be taken with LHRH. Monitor liver function. Do not double up if a dose is missed.
Drug Therapy: Flutamide - Side effects
Decreases testosterone level.
SE- GI distress, hepatotoxicity (Monitor liver functions before and during treatment), gynecomastia, ED, hot flashes.
Common (10-15%) - usually subsides within 6 months in 85-90% or those affected
Occurs when the spermatic cord twists, cutting off the blood supply to the testicles.
Emergency surgery is required to restore blood flow.
Can cause infertility.
Testicular CA: Interventions - Anxiety
Be sensitive to the pt's fears of altered sexual function, loss of fertility, stressful treatments, and threat of potentially fatal disease - ask open ended questions, provide information, and refer to counselors/support groups
Acute Prostatitis: Drug treatment
Pt should take ABX for 4 weeks for acute prostatitis and for 16 weeks for chronic.
Incontinence should subside within 6 months of treatment.
Erectile Dysfunction: Neurologic Disorders
Usually caused by spinal cord injury or other neurological disorders- pt is unable to initiate; treatable with penile implant
Mumps may result in acute orchitis and epididymitis, accompanied by fever and debilitating pain, bilateral swelling, and redness of testicles.
PSA - Prostate specific androgens
This test often used as a screening
Normal: 0-4ng/mL - if increased, usually indicates prostate CA
Lab tests: Serum Alkaline phosphate & calcium levels
If alkaline phosphate levels are increased (>90mU/mL), it is a sign of cancer of the bone, bone metastases, or liver cancer
If calcium levels are increased (>11.0mg/dL), it is a sign of metastasis.
Drug therapy: Viagra & Cialis nursing interventions
Teach pt to take 1 hour prior to intercourse.
Do not take with nitrates.
Only one tablet daily.
Health History: Present Illness
If pt reports any pain - use pain scale to provide objective data
Signs of breast cancer
Late symptoms: dimpling of the skin, nipple discharge, nipple or skin retraction, edema, dilated blood vessles, ulceration, and hemorrhage - all signs associated with tumors invasion of surrounding tissues
Menorrhagia: Cause & Risk factors
Hormonal dysfunction, benign and malignant tumors, coagulation disorders, systemic diseases, use of some contraceptives, endometrial hyperplasia, and inflammatory process.
Advise pt to abstain from sex for 3-5 days and then collect specimen in clean container. Discourage pts from prolonged abstinence, no collecting specimen in rubber condoms, keep specimen at room temp, no lubricant use, and bring to lab within 1 hour of collection.
Sets with similar terms
Inter. Med Surg Exam 1
HONDROS - MED SURG II - QUIZ #4
Other sets by this creator