W&I Test2 (Part8)

  1. What are some managements for ovarian cancer? (2)
    • 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.
  2. Discribe Stage I ovarian cancer.
    Stage ___ovarian cancer: disease limited to ovaries
  3. Discribe Stage II ovarian cancer.
    Stage ___ovarian cancer: disease limited to the true pelvis
  4. Discribe Stage III ovarian cancer.
    Stage ___ovarian cancer: disease limited to the abdominal cavity
  5. Discribe Stage IV ovarian cancer.
    Stage ___ ovarian cancer: distant metastatic disease
  6. How Do they treat Stage I ovarian cancer?
    • 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?
  7. How Do they treat Stage II 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?
  8. How Do they treat Stage III ovarian cancer?
    Treatment as for Stage I and II and additional combination chemotherapy

    These are treatments for what stage of ovarian cancer?
  9. How Do they treat Stage IV 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?
  10. Vaginal cancer is rare, but what is a risk factor for it.
    In-utero exposure to DES (diethylstibestrol) is a causative risk factor for what type of cancer?
  11. Vulvar cancer is also rare but what are some of the symptoms
    These are symptome of what type of rare cancer: itching or burning, pain, bleeding, or discharge
  12. Vulvar cancer has been linked to ____ and diagnosed by _____
    ____ cancer has been linked to HPV and diagnosed by biopsy.
  13. In vulvar cancer, precursor lesions like vulvar intraepithelial neopolasia (VIN) precedes _____ vulvar cancer.
    In vulvar cancer, precursor lesions like ____ _____ _____ precedes invasive vulvar cancer.
  14. In radiation brachytherapy where is the radioactive packet placed.
    In _____ _____the radioactive packet is implanted directly into the area of the tumor, usually it's inserted through the uterus or vagina.
  15. What are two prepatory procedure for radiation brachytherapy?
    • 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 ______ _______.
  16. How long is the packet left in place with radiation brachytherapy?
    The packet left in place for 24-72 hours with radiation brachytherapy

    NOQ
  17. What are some considerations because of the radiation used in radiation bracytherapy.
    • 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?
  18. A patient undergoing radiation brachytherapy should have absolute bedrest allowing for _____ to ____ turning only.
    A patient undergoing _______ _______ should have absolute bedrest allowing for side to side turning only.
  19. What are some potential complications of radiation brachytherapy? (5)
    Fistulas, cystitis, phlebitis, hemorrhage, and vaginal wall fibrosis are all potential complications of _____ ______.
  20. What are some side effects of radiation brachytherapy? (5)
    • 1) Uterine cramping
    • 2) Foul-smelling discharge
    • 3) Nausea and vomiting
    • 4) Diarrhea
    • 5) Malaise

    These are side effects of _______ _______.
  21. What are some preop preperations for GYN surgery?
    • 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
  22. What is a hysterectomy?
    The surgical removal of the uterus is called what?
  23. What three things would be expected in a client who has undergone a hysterectomy?
    • 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 _______.
  24. What would be some nursing interventions for a patient with abdominal distention secondary to having a hysterectomy
    • 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.
  25. What are some DVT preventive measures when dealing with a patient who has undergone a hysterectomy? (4)
    • 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
  26. What are some discharge teaching with a patient who has undergone a hysterectomy? (4)
    • 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 ________.
  27. What is a salpingectomy-oophorectomy?
    The removal of the ovaries and fallopian tubes is called what?
  28. The surgical meopause secondary to a salpingectomy-oophorectomy would be evidenced by what symptoms?
    • 1) Hot flashes
    • 2) Night sweats
    • 3) Mood changes
    • 4) Vaginal dryness

    These are symptoms brought on by surgical ______ secondary to a salpingectomy-oophorectomy
  29. What is usually done if not contraidicated for patients who have undergone a salpingectomy-oophorectomy.
    Hormone replacement is usually done in patients who have undergone a ______-_______if not contraidicated.
  30. Describe a vulvectomy.
    The removal of the vulva, sometimes from anus to a few cm above the pubic symphysis is called a what?
  31. What kind of dressing is usually placed for the 1st 24 hours after a vulvectomy?
    A heavy pressure dressing is usually placed for the 1st ___ hours after a vulvectomy
  32. How would you care for the wound in a vulvectomy? (2)
    • 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 ______.
  33. What kind of considerations should be given to bowel and bladder care in a patient who has had a vulvectomy? (2)
    • 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
  34. By when should the patient ambulate after a vulvectomy?
    The patient should ambulate by the 2nd post op day after a _______.
  35. What would a patient who has undergone a vulvectomy be perscribed to prevent DVTs
    A patient who has undergone a vulvectomy would be perscribed anticoagulation therapy to prevent ____.
  36. What are some discharge teachings for a patient who has undergone a vulvectomy. (4)
    • 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 ________.
  37. What should be discouraged during the healing process after a vulvectomy.
    Sex should be discouraged during the healing process after a _______?
  38. Describe a pelvic exenteration.
    It's the radical hysterectomy, total vaginectomy, removal of bladder with diversion of the urinary system, and resection of bowel with colostomy.
  39. What are some concerns with a pelvic exenteration. (3)
    • 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?
Author
Ted
ID
11325
Card Set
W&I Test2 (Part8)
Description
Breast and GYN problems
Updated