1. Aspects of nursing care for medical interruption of pregnancy
    • -scientifically based information
    • -risks
    • -alternatives, non-judgmental attitude
    • -support
    • -monitoring verbal clues
    • -monitoring physical clues
    • -importance of post-abortion care
  2. Papanicolaou smear (pap smear)
    screen for cellular abnormalities of cervix and endometrial canal.
  3. when to start getting pap smears?
    at age 18 or once sexually active; once a year
  4. - frequency of pelvic examination
    - what does the examination consist of?
    • - yearly at the time of pap smear
    • - vulva, vaginal and cervical ispection, bimanual
  5. gynecologic screenings
    • breast examination
    • clinical breast examination
    • mammography
    • pap smear
    • pelvic exam
    • rectal examinations
  6. should have vaginal rest for how long with pap smear
    24 hrs
  7. nursing considerations with pelvic exam
    - doctor will need?
    • privacy and comfort
    • - speculum, gloves, lubricant, pap slide, light source, cultures
  8. nursing care for pap smear
    • - assessment of risks, early screening and recommendations, diagnostic procedures
    • - bethesda system of reporting results
    • - squamnocolumnar junction rises with age
    • - anxiety, preparation
    • - do not give abnormal reassurance
    • - give pre surgery counseling
  9. diagnostic procedures following an abnormal pap smear
    repeat pap, colposcopy, endocervical biopsy, cryotherapy, laster, coinzation, alrge loop excisions of t-zone
  10. at risk for abnormal pap smear
    early first coitus, multiple partners, STD exposure, smoking, long term oral contaceptive use, immunosuppressive therapy, DES exposure in utera, and 98% of the time it is HPV
  11. -Cystocele
    • - bladder displacement down into vaginal wall. weakness of fascia. urinary stress incontinence, vaginal fullness, sitting on a ball.
    • - kegel's mildly helpful; pessaries until surgery
  12. rectocele
    lower posterior vaginal wall prolapse
  13. enterocele
    upper posterior vaginal wall prolapse usually contains loops of bowel
  14. uterine prolapse
    varying degrees depends on how far prolapse extends
  15. nursing care: pelvic relaxation
    • - instruction of kegel exercises to restore tone. involves contracting and relaxing pubococcygeal muscles
    • - before and after childbirth
    • - pessaries: urethral plug: surgery
    • - urinary incontinence 10% women ages 15-64
    • - eliminate caffeine, alcohol, artificial sweetner
  16. fibrocystic breast disease
    most common benign disorder in women 20-50. rare in postmenopausal women not taking HRT. only atypical hyperplastic changes are risk of cancer.
  17. intraductal papillomas
    tumors in terminal portion of duct of breast. unilateral mass and or nipple discharge (usually bloody) benign by may become malignant
  18. fibroadenoma
    benign tumor in teens and 20's. freely movable, solid tumor, sharply delineated, rubbery texture, asymptomatic and non-tender
  19. galactorrhea
    nipple discharge. physiologic, drug induced, idiopathic, pathologic
  20. duct ectasia
    comedomastitis, inflammation of duct behind nipple. occurs around menopause. thick sticky nipple discharge of various colors. may have nipple retraction.
  21. nursing care for breast disease
    • assess risk, discharge, pain, timing, knowledge deficit, anxiety;
    • will be extremly anxious;
    • give treatment options
    • clarify misconceptions
    • screenings
  22. how many in US have malignant breast disease
    one in eight
  23. breast cancer has a higher mortality rate than any other cancer except
  24. risk factors for breast cancer
    • -over 40
    • -history of previous cancer
    • - family history of 1st degree relative with bilateral pre-menopausal breast CA
    • - overweight or obese after menopause
    • - alcohol consumption
    • - no pregnancy history
    • - never breastfed
    • - longer reporductive phase
    • -physical inactivity
    • - geographic location
    • -US
    • -europe
    • -north urban areas
  25. low risk geographical areas for breast cancer
    rural south, asia and africa
  26. symptoms of breast cancer
    • -mass
    • -change in size or shape
    • -nodularity
    • -dimpling
    • -retraction
    • -erosion or ulceration
  27. endometriosis
    endometrial tissue outside uterine cavity
Card Set
Test 1