Med Surg Final Exam

  1. what position will a pt having a vaginal hysterectomy be placed in during surgery
  2. post surgery, pt has c/o gas and distention. no bm in 2 days. what intervention will you do
    • small up and down flush enema
    • ambulation QID
  3. coping stategies for a pt that has inoperable cancer. how would you assist them to recognize and clarify fears and develop coping stategies
    • encourage discussion
    • be an active listener
  4. TAHBSO-will they still have hot flashes
  5. how would a pt fell after having modified radical mastectomy? give a dx
    • disturbed body image
    • fear r/t the cancer dx and surgical intervention
  6. arm exercises should be given for discharge instructions with a
  7. s/s of TSS
    flulike symptoms for 1st 24 hrs- increase temp, vomiting, dizziness, headache, myalgia, hypotension, sore throat, rash, decrease urine output, increase BUN
  8. TSE should be taught to males at what age
    monthly beginning at puberty
  9. describe how to perform a TSE
    once a month, after bath/shower, grab testis with both hands and palpate gently between thumb and index finger
  10. what causes epididymitis
    • s. aureus
    • e. coli
    • strep
    • n. gonorrhoeae
  11. what is rubin's test? what might pt c/o post test
    • insufflation of the fallopian tubes with co2
    • shoulder pain
  12. d/c teaching for a pt recovering form a modified radical mastectomy
    • no procedures on the arm
    • guard against infections
    • no sleeping on that side
  13. what is a papanicolaou smear
    • simple smear method of examining stained exfoliative peeling and sloughed off tissue or cells
    • early detection of cervical cancer
  14. baseline mammogram is done
    between ages 35-39
  15. female infertility is most often r/t
    tubal insufficiency and ovarian and uterine conditions such as endometriosis or congential defects
  16. give instructions for gential herpes virus
    • keep lesions clean and dry
    • wash hands
    • loose absorbant clothing
    • sitz bath
    • no sex during outbreak
    • use condoms when no symptoms occur
  17. severe chronic pelvic inflammatory disease complications are
    adhesions and strictures of the fallopian tubes, infertility, and increase risk of ectopic pregnancy
  18. s/s of gonorrhoeae
    • urethritis
    • dysuria
    • infection with discharge
    • edema
  19. a/p repair of colporrhapy repair of cystocele and rectocele would return to the PACU with a
    retention cath
  20. why is a mammogram the most useful tool for dx of breast cancer
    can detect tumors that cannot be palpated
  21. position of arm postop modified radical mastectomy with rationale
    • in sling or elevated on a pillow with wrist higher than elbow, elbow higher than shoulder
    • to facilitate the flow of fluids to prevent lymphodema
  22. postop nursing interventions for abdominal hysterectomy would be
    • monitor vs
    • prevent urinary retention, intestional distention, and venous thrombosis
    • meticulous cath care
    • incentive spirometer
  23. BSE in postmenopausal women should be performed when
  24. teaching for abdominal hysterectomy
    • no sex for 4-6 weeks after surgery
    • no heavy lifting
    • no walking stairs
    • no prolonged car rides
    • no tight clothing
  25. nursing interventions for hydrocele
    • maintain bed rest
    • scrotal support with elevation
    • ice to edematous areas
    • change dressings frequently
  26. withdrawn and non interacting pt fixing to get a unilateral orchiectomy for tx of testicular cancer. what action to take
    provide emotional support
  27. breast abnormalities
    • fibrocystic breast condition
    • acute mastitis
    • chronic mastitis
    • breast cancer
  28. what information do you need to collect when you pt has profuse, purulent urethral discharge and painful urination
    history of sexual contact
  29. teaching about HPV
    • verbal reassurance
    • position pt comfortably
    • change position slowly
    • maintain body alignment
    • provide pain relief
    • change dressings often
    • teach yearly pap smear
  30. why is a foley inserted prior to a laparoscopy
    to maintain bladder decompression for an open view
  31. why are older women more reluctant to seek medical care for reproductive problems
    • cultural factors
    • embarrassment
    • lack of knowledge
  32. baseline mammograms need to be performed on women
    between ages 35-39
  33. why are false negative results in mammography occuring in specific age groups
    less sensitive in younger women
  34. what causes vaginal fistulas
    an ulcerating process resulting from cancer, radiation, weakening of tissues by pregnancies and surgical interventions
  35. dc instructions for modified radical mastectomy
    no procedures on affected arm side, guard against infections, referral to physical therapy, avoid lifting objects, no sleeping on affected side, no constriciting clothing or bracelets or watches, diuretics and low sodium diet, isometric exercises
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Med Surg Final Exam