W&I Test2 (Part8)

• 1) Counseling on option of prophylactic oophorectomy or oral contraceptives if positive genetic mutation
• •Oophorectomy minimizes risk but does not eliminate the possibility of disease onset
• 2) Staging guides treatment decisions and is critical
• •Multiple biopsies

These are managment options with ______ cancer.

Stage ___ovarian cancer: disease limited to ovaries

Stage ___ovarian cancer: disease limited to the true pelvis

Stage ___ovarian cancer: disease limited to the abdominal cavity

Stage ___ ovarian cancer: distant metastatic disease

• 1) Total abdominal hysterectomy and bilateral salpingo-oophorectomy with removal of as much tumor as possible
• 2) Remaining tissues in the abdomen and pelvis are carefully scrutinized
• 3) Ascitic fluid is sent for cytologic study
• 4) Systemic chemotherapy or instillation of intraperitoneal radioisotopes is usually suggested for cancer that is poorly differentiated

These are treatments for what stage of ovarian cancer?

• 1) Treatment as for Stage I and:
• 2) External abdominal and pelvic radiation
• 3) Intraperitoneal radiation
• 4) Systemic combined chemotherapy after surgery
• 5) Second look surgery after treatment to again check for evidence of residual disease

These are treatments for what stage of ovarian cancer?

Treatment as for Stage I and II and additional combination chemotherapy

These are treatments for what stage of ovarian cancer?

• 1) Surgical debulking and more chemo agents
• •Intraperitoneal chemotherapy: Local “wash” of chemotherapeutic agents to the abdomen and peritoneum
• –Controversial, some difficulty with delivery, SEs

These are treatments for what stage of ovarian cancer?

In-utero exposure to DES (diethylstibestrol) is a causative risk factor for what type of cancer?

These are symptome of what type of rare cancer: itching or burning, pain, bleeding, or discharge

____ cancer has been linked to HPV and diagnosed by biopsy.

In vulvar cancer, precursor lesions like ____ _____ _____ precedes invasive vulvar cancer.

In _____ _____the radioactive packet is implanted directly into the area of the tumor, usually it's inserted through the uterus or vagina.

• 1) Cleansing enema to avoid disruption of the implants if straining with stool
• 2) Indwelling catheter to prevent a distended bladder from coming into contact with the radioactive source

These are prepatory procedures for ______ _______.

The packet left in place for 24-72 hours with radiation brachytherapy

NOQ

• 1) Patient is placed in a lead-lined private room
• 2) Nurse should not stay in immediate area any longer than is necessary to give proper care and attention
• 3) No individual nurse should attend the patient for more than 30 minutes per day
• 4) Nurse should stay at foot of the bed or at the entrance to the room to minimize radiation exposure
• 5) Visitors need to stay 6 feet away and limit visits to less than 3 hours per day
• 6) Rationales should be explained to patient and her family

These are considerations used because of radiation used in what radiation therapy?

A patient undergoing _______ _______ should have absolute bedrest allowing for side to side turning only.

Fistulas, cystitis, phlebitis, hemorrhage, and vaginal wall fibrosis are all potential complications of _____ ______.

• 1) Uterine cramping
• 2) Foul-smelling discharge
• 3) Nausea and vomiting
• 4) Diarrhea
• 5) Malaise

These are side effects of _______ _______.

• 1) Perineal or abdominal preparation
• 2) Vaginal douche or enema may be ordered
• 3) Bladder emptied before pt. is sent to the OR
• 4) Indwelling catheter is usually placed during procedure
• 5) Psychological support
• 6) Teaching/anticipatory guidance

These are some preop preperations for ____ surgery

The surgical removal of the uterus is called what?

• 1) Bleeding of moderate serosanguinous fluid
• 2) Post-op urinary retention
• 3) Abdominal distention

These would be expected in a client who has undergone a _______.

• 1) Food and fluid restriction if nauseated
• 2) BS assessment
• 3) Encourage ambulation

These would be some nursing interventions for a patient with ________ _______ secondary to having a hysterectomy.

• 1) Frequent position changes
• 2) Avoidance of high Fowler position
• 3) Avoidance of pressure under the knees
• 4) Leg exercises

These are some____ preventive measures when dealing with a patient who has undergone a hysterectomy

• 1) Menstruation will cease (no uterus!)
• 2) Heavy lifting restrictions for 2 months
• 3) Activities that increase pelvic congestion (dancing, walking swiftly?) should be limited for several months
• 4) Wearing a girdle may provide comfort

These are some discharge teaching with a patient who has undergone a ________.

The removal of the ovaries and fallopian tubes is called what?

• 1) Hot flashes
• 2) Night sweats
• 3) Mood changes
• 4) Vaginal dryness

These are symptoms brought on by surgical ______ secondary to a salpingectomy-oophorectomy

Hormone replacement is usually done in patients who have undergone a ______-_______if not contraidicated.

The removal of the vulva, sometimes from anus to a few cm above the pubic symphysis is called a what?

A heavy pressure dressing is usually placed for the 1st ___ hours after a vulvectomy

• 1) Cleaned with saline or antiseptic applied with a water pik or suction bulb twice daily
• 2) Meticulous wound care to prevent infection

These are the things you would do to care for the wound in a patient who has undergone a ______.

• 1) Low residue diet and stool softeners
• •Prevent straining and wound contamination
• 2) Indwelling catheter used to promote drainage
• •Difficult to insert due to edema

These are both considerations that should be given to _____ and ______ care in a patient who has had a vulvectomy

The patient should ambulate by the 2nd post op day after a _______.

A patient who has undergone a vulvectomy would be perscribed anticoagulation therapy to prevent ____.

• 1) Signs of infection
• 2) Bleeding precautions
• 3) Signs of incisional breakdown
• 4) Perineal care

These would be discharge teachings for a patient who has undergone a ________.

Sex should be discouraged during the healing process after a _______?

It's the radical hysterectomy, total vaginectomy, removal of bladder with diversion of the urinary system, and resection of bowel with colostomy.

• 1) Physical, social, and emotional adjustment needs for patient and family are great
• 2) Long recovery
• 3) Rehabilitative process should keep pace with her acceptance of the situation

These are some concerns with what GYN procedure?