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91 Cards in this Set
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Patient with has been trying to get pregnant without success. She asks the nurse, "What should I do?" what does the nurse tell her to do?
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Patient with has been trying to get pregnant without success. She asks the nurse, "What should I do?" what does the nurse tell her to do?
- Keep a record of her basal body temp and menstrual cycles for 6 months - To determine the dates of ovulation, a woman takes her oral temperature before rising each day and records it on a chart for 3-4 months - Ovulation causes an abrupt fall and then a rise in body temperature (basal body temperature {BBT}) |
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A woman worried about infertility wants to keep a record of her temperature, when should the nurse advise her to take her daily temp?
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A woman worried about infertility wants to keep a record of her temperature, when should the nurse advise her to take her daily temp?
- In the morning - To determine the dates of ovulation, a woman takes her oral temperature before rising each day and records it on a chart for 3-4 months - Ovulation causes an abrupt fall and then a rise in body temperature (basal body temperature {BBT}) |
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A 18 year old male comes into the clinic with genital herpes, what type of lesions will you see?
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A 18 year old male comes into the clinic with genital herpes, what type of lesions will you see?
- genital herpes - has lesions called vesicles - Pimples progress to papules, vesicles, and finally crusts in 1-3 weeks |
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When should a male do a TSE?
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When should a male do a TSE?
- TSE right after a warm shower - Every males, from age 13 or 14, is encouraged to perform monthly TSE - Best performed after a bath or shower because warm water relaxes the scrotal sac - Do not touch the scrotum with cold hands, that may stimulate the cremasteric reflex, which causes the scrotum to contract - Testicle should feel rubbery and smooth - Instruct client to palpate the testicle between the thumb and first finger progressing along the posterior surface of the epididymis - Check inguinal and femoral areas for bulges which may indicate a hernia - Epididymis is on top and behind the testicle - Notify a healthcare provider if any small, painless lumps are palpated or if the testicle is enlarged |
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What symptoms would a female with fibroid tumor c/o?
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What symptoms would a female with fibroid tumor c/o?
- Complaints of heavy menstrual flow (heavy bleeding) (menorrhagia) - S/S – Abnormal vaginal bleeding, menorrhagia, pelvic heaviness and pressure, urinary retention, constipation - Most common type of benign uterine tumor is the fibroid tumor (myoma) - Range in size - Grow slowly and arise from muscle cells - Believed to result from hormonal influences due to shrinkage after menopause |
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What is the position for a cervical exam?
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What is the position for a cervical exam?
- Lithotomy position for cervical exam |
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What would you tell your female patient to do to prevent toxic shock syndrome (TSS)?
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What would you tell your female patient to do to prevent toxic shock syndrome (TSS)?
- To prevent toxic shock syndrome - change tampon's frequently (at least every 4 hours) - If any of the S/S occur, remove the tampon and call the physician immediately - Change tampons frequently, failure to remove may result in infection - Use Tampons intermittently - Insert tampon carefully to avoid abrasions - Wash hands thoroughly before and after tampon insertion - A serious condition associated with the use of tampons, particularly those with plastic inserters - A bacterial toxin, Staphylococcus aureus, is believed to be the cause - S/S – fever of 102 degrees F or greater, vomiting, diarrhea, drop in B/P, weakness, dizziness, peeling red rash, decreased Hgb, decreased urine output |
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What are some complications that can arise from a mastectomy post-op that relate to immobility?
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What are some complications that can arise from a mastectomy post-op that relate to immobility?
- Bleeding, hoemans sign, pneumonia, lymphedema - you want them to turn, cough and take deep breaths (to prevent DVT), Incentive Spirometer - Postoperative exercises to prevent lymphedema if lymph node surgery is done - Elevate affected arm for several days |
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What would u tell a patient with Syphilis?
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What would u tell a patient with Syphilis?
- With STD's patient's need to be taught about the "ping pong effect" (getting the STD again from the still infected partner) |
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What do you tell a patient who has come in for a pelvic exam?
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What do you tell a patient who has come in for a pelvic exam?
- tell them to relax, and to empty bladder - The client needs to empty the bladder prior to the examination - Encourage the client to breathe deeply to minimize discomfort |
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Patient comes into the ER and complains of abnormal bleeding/spotting, what would you suspect?
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Patient comes into the ER and complains of abnormal bleeding/spotting, what would you suspect?
- suspect cervical cancer (especially if there is bleeding after intercourse) - S/S of cervical cancer – Bleeding that does not occur in the early stages such as spotting between periods or after intercourse |
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If a patient has a vasectomy, how long should he use protection during sex to prevent pregnancy?
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If a patient has a vasectomy, how long should he use protection during sex to prevent pregnancy?
- wait 6 weeks post vasectomy to prevent pregnancy chances - It may take up to 6 weeks after a vasectomy for the semen to be totally free of sperm - Sperm count is taken 6 weeks to 2 months after the procedure - Alternative birth control measures must be used until sperm counts remain at zero for 6 weeks - Sperm counts should be taken after 6 months and then yearly to assess surgical effectiveness |
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What complication can arise immediately (post-op) after a woman has abdominal surgery?
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What complication can arise immediately (post-op) after a woman has abdominal surgery?
- DVT (look to prevent thrombophlebitis post op) |
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What does a pan hysterectomy include?
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What does a pan hysterectomy include?
- Total hysterectomy (pan hysterectomy) – Removal of entire uterus and cervix |
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What is a subtotal hysterectomy?
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What is a subtotal hysterectomy?
- Removal of the uterine body and fundus, leaving the cervix |
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What is a salpingectomy?
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What is a salpingectomy?
- Removal of an oviduct |
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What is a pan hysterosalpingectomy?
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What is a pan hysterosalpingectomy?
- Removal of the uterus, cervix, and oviducts |
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What is a Pan hysterosalpingo-oopherectomy?
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What is a Pan hysterosalpingo-oopherectomy?
- Removal of the uterus, cervix, oviducts, and ovaries |
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A woman with heavy bleeding with period and complaining of fatigue, why?
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A woman with heavy bleeding with period and complaining of fatigue, why?
- Anemia (lack of Iron) - lack of o2 to the tissues make the patient pale and tired |
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What is one of the S/S of rectocele?
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What is one of the S/S of rectocele?
- S/S of a rectocele - patient would have hemorrhoids - S/S – Backache, fatigue, heaviness in the pelvic region, bowel difficulties, incontinence, flatus, hemorrhoids, and alternating constipation and diarrhea |
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What should a female patient avoid to prevent harsher PMS symptoms?
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What should a female patient avoid to prevent harsher PMS symptoms?
- PMS - avoid caffeine to prevent exacerbations of symptoms - Low salt diet for 1-2 weeks during the premenstrual cycle - Medications to increase excretion of sodium: HCTZ, HydroDiuril, Esidrix - Increased protein and decreased sugar intake - Elimination of allergens, omission of caffeine - Positive stress management, support groups - Active exercise, anti-anxiety medications if symptoms are severe |
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Vesicovaginal fistula, what are the s/s?
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Vesicovaginal fistula, what are the s/s?
- S/S urine leaking into vaginal area - Vesicovaginal – Between bladder and vagina - Ureterovaginal or Vesicovaginal fistulas will leak urine into the vagina |
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What is Toxic Shock Syndrome (TSS)?
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What is Toxic Shock Syndrome (TSS)?
- To prevent toxic shock syndrome - change tampon's frequently (at least every 4 hours) - If any of the S/S occur, remove the tampon and call the physician immediately - Change tampons frequently, failure to remove may result in infection - Use Tampons intermittently - Insert tampon carefully to avoid abrasions - Wash hands thoroughly before and after tampon insertion - A serious condition associated with the use of tampons, particularly those with plastic inserters - A bacterial toxin, Staphylococcus aureus, is believed to be the cause - S/S – fever of 102 degrees F or greater, vomiting, diarrhea, drop in B/P, weakness, dizziness, peeling red rash, decreased Hgb, decreased urine output |
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What can be a long term complication of PID (Pelvic Inflammatory Disease)?
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What can be a long term complication of PID (Pelvic Inflammatory Disease)?
- sterility (infertility) - Untreated PID can lead to: chronicity and sterility due to blockage of the oviducts with scar tissue |
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What is the test for Benign prostatic hyperplasia (BPH)?
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What is the test for Benign prostatic hyperplasia (BPH)?
- BPH test = PSA with DRE - Prostate specific antigen (PSA) – a glycoprotein found in prostate gland tissue that is elevated in prostatitis, BPH, and adenocarcinoma (0-4 ng/mL) - DX – DRE, urodynamic testing, endoscopy, PSA, ultrasound |
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What is the position for a DRE exam?
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What is the position for a DRE exam?
- modified standing |
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What is the cause of Orchitis?
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What is the cause of Orchitis?
- post puberty mumps - Orchitis – inflammation of the testes that may result from infection or injury - Causes – Mumps after puberty (may result in sterility) - S/S – Pain and swelling in the scrotum, sometimes urethral irritation - Tx – Scrotal support, ice bag to the scrotum (do not apply heat) |
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If patient has painful swollen scrotum (possible caused from orchitis), what would you suggest they wear?
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If patient has painful swollen scrotum (possible caused from orchitis), what would you suggest they wear?
- Patient with orchitis - wear underwear that supports the scrotum |
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What is the most important thing to look for when doing a cone biopsy (Coniztion)?
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What is the most important thing to look for when doing a cone biopsy (Coniztion)?
- Post cone biopsy - watch for excessive bleeding - There may be some bleeding during and delayed bleeding after the procedure |
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What causes fibrocystic breasts (Chronic Cystic Mastitis)?
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What causes fibrocystic breasts (Chronic Cystic Mastitis)?
- caffine adds to fibrocystic breasts - Caffeine aggravates cyst formation: coffee, tea, chocolate, and cola drinks |
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What would a patient complain of after laparoscopic surgery?
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What would a patient complain of after laparoscopic surgery?
- shoulder pain from abdominal laparoscopy - Shoulder pain may occur due to gas trapped in the abdomen under the diaphragm - Severe pain may indicate hemorrhage |
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Post uterine surgery, what do we watch for?
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Post uterine surgery, what do we watch for?
- Post uterine surgery to watch I & O's - Document I&O’s - Watch Urine output |
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Post mastectomy, what is one of the treatments to prevent swelling (Lymphedema) for the arm on the operative side?
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Post mastectomy, what is one of the treatments to prevent swelling (Lymphedema) for the arm on the operative side?
- Post mastectomy - to prevent swelling on operative side – elevate affected arm - Elevate affected arm for several days - Lymphedema – most common cause is infection; monitor and report signs of infection - Avoid taking blood pressure, giving injections, or drawing blood on the operative side |
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What is the most important question to ask when screening for breast cancer?
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What is the most important question to ask when screening for breast cancer?
- Family history important in breast cancer screening - Menarche prior to age 12 - Late menopause (after 50) - Long or irregular menstrual cycles - Women older than 40 - Hx of fibrocystic breast disease - Hx of cancer of the other breast - Hx of endometrial or ovarian cancer - Women who have never had a baby (nulliparous) - Women who had their first baby after the age of 30 - Women who have not breast fed - Women on Antihypertensive therapy - Radiation exposure before age 30 - Diet high in fat - Obesity - Alcohol and tobacco use - Previous breast surgery (biopsy, implants) - Estrogen replacement therapy for longer than 8 years |
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For an ABDominal ultrasound, how would you want the bladder - Full or Empty?
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For an ABDominal ultrasound, how would you want the bladder - Full or Empty?
- ABDominal ultrasound need bladder full - Do not void for several hours prior to a pelvic ultrasound |
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What is the best way to prevent pregnancy?
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What is the best way to prevent pregnancy?
- Abstinence and then second is condoms to prevent pregnancy |
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What is the most important aspect for care with a sexual assault patient?
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What is the most important aspect for care with a sexual assault patient?
- Rape patient - crisis intervention, emotional support and preserve DNA evidence - Provide emotional support (priority) |
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What are the S/S for gonorrhea?
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What are the S/S for gonorrhea?
- gonorrhea - foul smelling discharge - A yellow-green purulent vaginal discharge |
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Patient has gonorrhea, what else will you check for?
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Patient has gonorrhea, what else will you check for?
- check for other STD's, REPORTABLE STD - Individuals with gonorrhea should also be tested for other STD’s, including HIV |
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At what age does a woman start getting mammograms?
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At what age does a woman start getting mammograms?
- Mammograms start baseline at age 40 for people not deemed to be at familial risk - Women > 40 years should have annual mammogram |
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What do you assess for post TURP?
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What do you assess for post TURP?
- Monitor I&O (make sure the TURP is patent and make sure there are no blood clots) - Monitor for catheter obstruction: bladder spasms and pain |
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What is a patient with HPV (Genital Human Papillomavirus or Condylomata acumate) higher risk for?
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What is a patient with HPV (Genital Human Papillomavirus or Condylomata acumate) higher risk for?
- higher risk of cervical cancer - At least 10 of the HPV virus types can lead to development of cervical cancer |
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What presents candida?
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What presents candida?
- Presents with cottage cheese look - Symptoms include: intense vulvar itching, inflammation and irritation, burning after urination, and a white, cottage cheese-like discharge |
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What is the most prevalent surgery used for prostate enlargement?
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What is the most prevalent surgery used for prostate enlargement?
- TURP - most common prostate surgery - Transurethral resection of the prostate - Most common procedure, particularly for older men or those who are a poof surgical risk - Surgeon removes prostate tissue through the urethra using a resectoscope - No incision is necessary - Recovery is shorter than other approaches - Complications: hemorrhage, urinary incontinence, and ED |
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Q1. What childhood infectious disease most significantly affects male fertility?
Q2. Couple trying to have a baby, what child hood disorder would you ask about? |
Q1. What childhood infectious disease most significantly affects male fertility?
- Mumps can cause infertility Q2. Couple trying to have a baby, what child hood disorder would you ask about? - Mumps - Cryptorchidism, orchitis after mumps |
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Is Gonorrhea a reportable disease?
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Is Gonorrhea a reportable disease?
- Yes |
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What can you teach a man with gonorrhea to do?
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What can you teach a man with gonorrhea to do?
Wear a condom and tell other sexual contacts to get treated |
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Pt having a TURP and c/o pain, what do you do?
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Pt having a TURP and c/o pain, what do you do?
- Assess the catheter for kinks |
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Pt with a swollen scrotum, what can you do for him?
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Pt with a swollen scrotum, what can you do for him? Ice packs and scrotal support
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How often does a man do a TSE (Testicular Self Exam)?
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How often does a man do a TSE (Testicular Self Exam)? Monthly after a warm shower
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Gonorrhea is state mandated reporting
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Gonorrhea is state mandated reporting
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Vaccinate for mumps!!
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Vaccinate for mumps!!
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What STD is highest risk to develop cervical cancer?
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What STD is highest risk to develop cervical cancer? HPV
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What is used to monitor for prostate cancer?
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What is used to monitor for prostate cancer?
- PSA (normal levels are 0-4) |
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What can you teach a pt with a vasectomy?
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What can you teach a pt with a vasectomy? Come back for check up because it will be six weeks before all sperm is gone out of system
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What is a panhysterectomy?
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What is a panhysterectomy? Same thing as a total hysterectomy (removal of entire uterus and cervix)
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What might bleeding after sex indicate?
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What might bleeding after sex indicate? Cancer
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S/S of toxic shock syndrome?
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S/S of toxic shock syndrome?
- Fever of 102 and greater. - Vomiting, diarrhea, drop in B/P, weakness, dizziness, peeling red rash, decreased Hgb, decreased urine output |
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What do you teach a pt with a total mastectomy?
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What do you teach a pt with a total mastectomy?
- Elevate arm and assess lung sounds |
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What is basal body temp?
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What is basal body temp?
- Fertility Awareness Method. Take temp each morning for many months before rising to acquire your ovulation days (rhythm method) |
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Pt comes in with smelly discharge, how do you test for gonorrhea or chlamydia?
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Pt comes in with smelly discharge, how do you test for gonorrhea or chlamydia?
- Stained smear test and/or culture and sensitivity |
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What is the long term effect of PID (Pelvic Inflammatory Disease)?
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What is the long term effect of PID (Pelvic Inflammatory Disease)? Infertility/Sterility
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What do you tell a pt who is about to get a uterus ultrasound?
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What do you do for a pt about to get a uterus ultrasound?
- Dont void |
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What is important to teach a pt who has genital herpes?
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What is important to teach a pt who has genital herpes?
- Tell partners |
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How often does a woman do a SBE?
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How often does a woman do a SBE?
- Monthly, usually a week after menstruation |
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What age does a woman start to get mammograms?
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What age does a woman start to get mammograms?
- At age 40, earlier if hereditary |
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What should u avoid with fibrous breasts?
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What should u avoid with fibrous breasts?
- Avoid caffeine with fibrous breasts |
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First sign of gonorrhea?
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First sign of gonorrhea?
- smell |
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What is a colposcopy?
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What is a colposcopy?
- A lighted, magnifying speculum that is inserted into the vagina to view the vagina and cervix, pt will have slight bleeding and cramping |
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Post op for D&C (Dilatation and Curettage)?
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Post op for D&C (Dilatation and Curettage)? Monitor voiding and urinary retention
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What is menorrhagia?
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What is menorrhagia? excessive bleeding
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What is metrorrhagia?
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What is metrorrhagia?
- bleeding between menstrual periods - Metrorrhagia is uterine bleeding at irregular intervals, particularly between the expected menstrual periods |
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S/E of menorrhagia?
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S/E of Menorrhagia?
- may result in anemia - Menorrhagia: Excessive uterine bleeding occurring at the expected intervals of the menstrual periods. |
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S/E of metorrhagia?
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S/E of metorrhagia?
- May indicate cancer or retained placental tissue - metorrhagia: Uterine bleeding at irregular intervals |
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Expectations of menopause?
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Expectations of menopause?
- Hot flashes, perspiration, fatigue, vaginal dryness and atrophy, weight gain, skin dryness, sagging breasts and osteoporosis |
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A fistula is an opening between two organs that normally do not open into one another
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A fistula is an opening between two organs that normally do not open into one another
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Ureterovaginal =
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Ureterovaginal = between ureter and vagina
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Vesicovaginal =
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Vesicovaginal = between bladder and vagina
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Rectovaginal =
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Rectovaginal = between rectum and vagina
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Sign of rectocele?
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Sign of rectocele? Hemorrhoids
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Why does infertility happen with long term PID?
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Why does infertility happen with long term PID?
- Scarring of the fallopian tubes (oviducts) |
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What is a major symptom of a benign uteran tumor?
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What is a major symptom of a benign uteran tumor?
- abnormal heavy bleeding |
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What is important post op hysterectomy?
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What is important post op hysterectomy? DVT, use ted hose
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What is the fastest growing group to acquire HIV/AIDS?
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What is the fastest growing group to acquire HIV/AIDS?
- WOMEN of color and heterosexual |
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Dx of HIV/AIDS?
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Dx of HIV/AIDS?
- EIA and Western Blot |
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S/S of chlamydia?
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S/S of chlamydia?
- Gray white discharge with itching and burning |
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Gonorrhea is a bacterial infection
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Gonorrhea is a bacterial infection
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Young adults have the highest incidence of gonorrhea
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Young adults have the highest incidence of gonorrhea
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What type of antibiotic for gonorrhea?
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What type of antibiotic for gonorrhea? Broad spectrum (Rocephin)
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FYI = Syphilis is a bacteria infection that is reportable to the public health dept. Lesions. Can be spread to a fetus. Many types of blood test to dx
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Syphilis is a bacteria infection that is reportable to the public health dept. Lesions. Can be spread to a fetus. Many types of blood test to dx
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Sentinel Node Biopsy?
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Sentinel Node Biopsy?
- The node that drains the area of the breast affected by the tumor is identified and removed - If the node is cancer free, it is assumed that no cancer cells exist in the other nodes |