*NURSING > QUESTIONS & ANSWERS > MDC 3 Exam 1 Study Guide With Complete Solution (All)
MDC3 Exam 1 Review ABCs A - airway B - breathing C – circulation Uterine Leiomyoma Benign, slow growing solid tumors of the muscle layer of the uterus (fibroids) Excessive... local growth of smooth muscle tissues o Growth may be stimulated by estrogen, progesterone, and growth hormone Assessment: asymptomatic or symptomatic (heavy prolonged vaginal bleeding)** Assess pelvic pressure, elimination pattern, abdomen size, dyspareunia, infertility Painful menses Elimination patterns (due to enlarged fibroid pressing on organs) Ask how many pads/tampons used in a day S/S: Heavy periods or periods that last a long time & abd distention, urinary frequency Psychosocial assessment: Quality of life from dyspareunia Fear that symptoms could be cancerous Anxiety Significance of loss of uterus for patient and partner if want to conceive Diagnostic assessment: CBC – iron deficiency anemia from heavy bleeding WBC would be normal HGB and HCT – low Pregnancy test to rule out uterine enlargement Transvaginal US – able to see if fibroid is protruding into uterine cavity Biopsy: gold standard Pelvic exam Planning and Implementation Manage bleeding o Non-surgical management: oral contraceptive** o Surgical management: MRI focused ultrasound-heat to tumor Uterine artery embolization – starves tumor of circulation allowing it to shrink Myomectomy- laser removal Hysterectomy Erectile Dysfunction: causes & treatment Common as one ages: reduced blood flow to penis Causes Medical causes: change in blood pressure Non-organic: increased stressor, illnesses Treatment Medications that increase perfusion to penis (PDE- 5 inhibitors) Vacuum pump Pineal implant Managing stress Education related to treatment for HPV/Cervical Cancer Caused by HPV s/s of cervical cancer: o heavy bleeding in later stages o bleeding after sex o Most of the time asymptomatic Bleeding between periods Preventive screening: PAP smear, surgical biopsy (gold standard) to determine staging Treatment: Early- ablation, laser Late- chemotherapy/radiation Education: No sticking anything up the vagina (tampons, douches) May have bleeding No sexual intercourse No tub baths Breast cancer- preventative screenings, risk factors, diagnostic tests Preventative screenings Mammography o Recommended to start screening at 45 o Women over 55 may switch to every 2 years Breast self-awareness/self-examinations o >90% detected by patient Clinical breast clinical o At least every 3 years for women in their 20s and 30s and every year for asymptomatic women at least 40 years old Risk Factors Increased age Family history Early menarche, late menopause Lack of breastfeeding Postmenopausal obesity Alcohol consumption Mutations in BRCA1 or BRCA2 Diagnostic tests Lab assessment: study of breast mass tissue and lymph nodes, liver enzymes, calcium, and alkaline phosphatase Imaging assessment: o Mammogram o Ultrasound o MRI o Chest x-ray, CT for metastasis o Breast biopsy* Endometrial cancer- symptoms, risk factors, diagnostic testing Most common gynecologic malignancy Cancer of inner uterine lining Grows slowly but vaginal bleeding usually leads to prompt evaluation and treatment = good prognosis Most commonly associated with prolonged exposure to estrogen without its protective effects of progesterone Risk Factors: Women in reproductive years Family History Diabetes Mellitus HTN Obesity Uterine polyps Late menopause Nulliparity (no childbirths) Smoking Tamoxifen – given for breast cancer Symptoms: Postmenopausal bleeding (how many pads/tampons a day)** Watery, bloody vaginal discharge Low back or abdominal pain Low pelvic impaired comfort (describe exact location and intensity) Pelvic exam may reveal palpable uterine mass** Diagnostic testing: o Transvaginal ultrasound* o Endometrial biopsy – gold standard “determine presence of endometrial thickening/cancer”** Interventions o Pelvic exam Hysterectomies- what they are, who gets th [Show More]
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