med/surg E4a

- silent killer

• Risk factors:
• ** infection with a certain type of HPV
• -HIV infection
• - chlamydia infection
• - diet/obesity
• - birth control pills

• Health promotion:
• -pep test
• -screening for HPV infection

• Risk Factors:
• - age >63
• - birth controls
• - weight
• - having no pregnancies
• - ERT, composed of estrogen alone
• - family history
• - breast cancer

• Health Promotion:
• - regular pelvic exams
• - family history

- shortening of pelvic muscles to support displaced structures

• ANTERIOR: to repair a Cystocele --> tighter support for the bladder ( sagging of bladder)
• POSTERIOR: to repair a Rectocele --> tighter support for the rectum
• 

removal of the ovaries/ ovaries and fallopian tube

• for: very large, recurring ovarian cysts
• - endometrial cancer
• - ovarian cancer
• (effects your ability to conceive)

surgical removal of the uterus only

Subtotal: removal of uterus, leaves the cervix

Total: removal of uterus, cervix, fallopian tubes and ovaries

• for: dysfunctional uterine bleeding (DUB) (vaginal bleeding
• - uterine prolapse

• removal of organs and pelvic cavity
• (colon, bladder, uterus, ovaries)

for recurrent cervical cancer

• - pt understanding of procedure (sex, child birth..)
• - prevention of "harm" to other stuctures during surg (bowel cleansing)

• 1. DVT (there's a lot of pelvic congestion = vein is compressed = venous coding in the leg
• 2. Alt in elimination
• - Urinary: voiding in suff quantities by bladder scan, kegel exercise, InO, straight cath
• - bowel: stool softer
• 3. Bleeding/ heorrhage (dressing, pad counts, vs, labs, drainage)
• 4. Self concept: (reproductive capability...)
• 5. Discharge teaching (ss to report, no heavy lifting, unusual bl...)

• - mammography ( can detect breast tumors 2yrs b/f they reach palpable size)
• - hard less movable, irregular shape w ill defined boarders
• - skin irritation or dimpling of the skin
• - nipple pain or retraction

• 1. lupectomy= removes the cancerous tissue and some normal tissue surrounding
• 2. -Simple: breast only
• - modified radical: breast and varying # of lymph nodes. leaving the breast skin ava for reconstruction
• - Radical: entire breast, lymph nodes and the heast wall muscles.
• 

• 1. Wound care:
• - monitor dressings
• - TRAM- flap: more extensive surgery, activity restriction, test cap refill

• 2. Arm Care:
• - preventing lymphedema
• - raising arm on a pillow, no IV, BP, needle stick on the effect arm
• - preventing frozen shouder: (progressive arm exercises, range of motion

3. Psychosocial care

1. Risk factors: (major cryptochidism = undescended testicle, occupational, HIV infection)

2. SS (early: painless scotal lump, slight testicular swelling)(late: back pain, SOB, breast enlargement, change in LOC)

3. Treatment: orchiectomy (testes), radicaloctoy (cord, testes, local lymph nodes)

• 4. NC:
• - physical after surgery
• - emotional
• - health promotion (at age 15, men should perform monthly teticular self exam)

• - slow increase number of nonmalignant epithelial cells in the prostate -> show gradual tissue -> enlargement of the gland in urethra.
• - b/c of the retention of male sex hormones, the older the more risk

• Symptoms: (r/t obstruction of urine outflow bc of the location of the gland)
• - steam slows, dec in force
• -diff starting steam
• - dribbling incontience
• - incomplete bladder emptying -> urine retention
• - dysuria, urgency, nocturia

1. drugs (relax smooth muscles: flowmax, hytrin)( suppress androgens: proscar)

• 2. Doesn't involve anesthesia surgeries
• - needle ablations: specialized needle that delivers energy in the form of radiofreq. to kill tissue
• - TUNA (improves the flow of urine thru uretura), Indigo Laser

- Thermotherapies: threading an antennae up and into the urethra, next to the prostate and uses radiant heat to kill cells. TUMT.

• - aim to remove or resact most of the prostatic gland
• 1. TURP ( uses the resedscope to remove obstructing issue one piece at a time
• - pre opt nc (to restore urinary flow, treat any bladder infection, some bowl prep, BUM lab)
• - post opt (encourage men to drink water, maintain antiebolic stocking/compression)
• - maintain traction! to prevent bleeding, do not remove type!
• - CBI - continuous bladder irrigation, use normal saline, it is to irrigate out any clots and bladder disention, dec bladder spasms
• - urine should be clear to light pink
• - no sticking things up the rectum.

• - non reportable
• - Herpes simplex virus
• Type I: lesions on mouth and lips
• tyep II: genital herpes
• ** you can get I from II.
• - genital herpes can be spread when NO lesions are present
• - infection occurs 7-21 days after initial contact
• - no cure...zovirax, valtrex and famvir and dec the outbreak

• - sexual contact
• - chlamydia trachomatis
• - asympotomatic
• - can be cure
• - abn discharge, dysuria, abd and back pain...
• - doxycycline

• - untreated
• - direct contact w lesions or direct bl, having a break in skin that has contact w lesion
• - t. pallidum spirochete
• 1. Primary (chancres, 2wks- 3mo)
• 2. Secondary (RASH on palms and feet, flu like, hair loss)
• 3. Latent ( no symptoms, 5years remined infected, w/out txmnt pt wil progressed to late)
• 4. Late (systemic problem, gummas on skin, CNS (neurosyphilis)

• fnt of the kidney: to maintain the body's homeostasis
• - fromation of urine (excretion of metabolic wastes, balancing of fluid vol)
• - regulation of acid/base balance
• - conservation of nutrients
• - secretion of hormones

• - infection of the renal pelvis, calyces and medulla.
• - usually starts as lower UTI and ascends into renal pelvis

"-liasis" means the formation of concretions of minerals in the body = stone

• -inflammation of the glomerular capillaries (streptococcal infections)
•