Download Nurs 302 Reproductive Questions: Breast Cancer and more Exams Nursing in PDF only on Docsity!
Nurs 302 Reproductive Questions
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Chapters 51, 53, 54 - don't read. 51 is anatomy, 53 is not on the test, and 54 has a chart for it. tumors chart is highly testable KNOW ALL OF THIS MATERIAL!!! -Uterine Fibroids -Cervical polyps -Benign ovarian cyst -Cervical cancer - know the Pap Smear classes I-V -Endometrial cancer -Ovarian cancer -Prostate Cancer etiology of fibroadenoma (common ages, d/t)? correct answer: common cause of benign masses in young females (ages 15-40) due to increased sensitivity in a localized area of the breast what are the 3 benign breast masses? correct answer: 1. fibroadenoma
- intraductal papilloma
- ductal ectasia what is the presentation of a fibroadenoma? correct answer: 1- small, painless mass 2- well delineated 3- very mobile
4- usually solid, firm and rubbery 5- slow growth and stops at 2-3 cm 6- dramatic growth with pregnancy how do you diagnose a fibroadenoma? correct answer: biopsy with tissue examination what is the treatment for fibroadenoma? correct answer: 1. surgical excision - remove the mass
- cryoablation (insert cryoprobe - freeze mass) PT education related to a fibroadenoma? correct answer: 1. teach PT to decrease caffeine
- increase herbal compounds
- they tend to recur fibrocystic vs fibroadenomic correct answer: fibrocystic - pull back fluid (fluid filled cyst) fibroadenoma - solid tissue mass presentation of an intraductal papilloma? correct answer: benign wart-like growths in the mammary ducts - usually near the nipple area can a fibroadenoma be linked to cancer? intraductal papilloma? correct answer: fibroadenom - no intraductal papilloma - yes presentation of intraductal papilloma correct answer: 1. bloody nipple discharge
- palpable mass
skin CA is first breast CA is __ leading cause of death from CA in women. what is first? correct answer: 2nd lung CA is first how many women develop breast CA over a lifetime correct answer: 1/7 or 1/8 or women how are malignant breast tumors classified correct answer: invasive or noninvasive characteristic of invasive tumors correct answer: tend to be more aggressive/eat into tissue what is the greatest risk factor for breast CA? but it is always ___ correct answer: age it is always multifactorial, cumulative interacting factors risk factors for breast CA correct answer: 1. heredity
- hormonal involvement
- inactivity
- obesity
- dietary fat intake (higher in western culture)
- environmental - chemical/radiation exposure
- first full term pregnancy, >30 y/o or nulliparous
- long menstrual history
50 years of age
- women have 99% of breast CA/men 1%
- alcohol only 1 drink per day/average how does heredity relate to breast CA correct answer: history of breast CA (1st degree relative with a pre-menopausal mass) defect in BRCA 1 and BRCA 2 genes how does hormone involvement relate to breast CA correct answer: tumor is hormone sensitive (use of hormone therapy, especially in post menopausal women) how does obesity relate to breast CA correct answer: adipose tissue raises endogenous estrogen what culture has higher intake of dietary fats correct answer: western cultures how does menstrual history relate to breast CA correct answer: higher chance of breast CA if you started puberty early and went through menopause late (<12/>55) how is age relate to breast CA correct answer: higher change in people > how does gender relate to breast CA correct answer: women make up 99% of all breast CA, men only make up 1% what is the tail of spence (aka ___). correct answer: aka axillary tail at least 50% of masses found here
DCIS is larger risk for invasive treatment for noninvasive breast CA correct answer: 1. lumpectomy if possible
- traditional tx was prophylatic bilateral mastectomy for these to prevent invasive spread. what is paget's disease? correct answer: inflammatory process leading to intraductal carcinoma what are the characteristics of pagets disease correct answer: 1. rare
- persistent nipple and areola lesion
- may or may not feel a mass - excoriation won't heal
- itching, burning, bloody discharge
- erosion progressing to ulceration what is the treatment for pagets correct answer: mastectomy what is the prognosis like for pagets disease correct answer: if not invasive, prognosis is good characteristics of inflammatory breast CA correct answer: 1. rare
- aggressive and fast growing
- skin looks red, feels warm, orange-peel skin (p'eau de orange) ( hair follicles enlarge/skin thickens with hive-like humps). treatment for inflammatory breast CA correct answer: early mets so surgery unlikely
radiation and chemo instead Surgical Intervention: Modified radical mastectomy- (can read in your text p 1249) correct answer: procedure for Modified radical mastectomy correct answer: (a) remove tissue, preserve pectoralis muscle (b) axillary node dissection (c) hospital stay of 1-2 days what are the consequences of Modified radical mastectomy to explain preop correct answer: a) Chest wall tightness b) Phantom breast sensation c) arm swelling (lymphedema) d) sensory loss teach PT postop exercised after Modified radical mastectomy to... correct answer: strengthen arm, chest and decrease lymphedema (see exercised in text book p. 1254) what procedure do you do to preserve the breast? correct answer: lumpectomy with radiation how is lumpectomy with radiation done? (how long is hospitalization) correct answer: A) wide excision of tumor, axillary node dissection, RT (radiation therapy) B) hospitalized 1-2 days, RT 5-6 weeks
what are the 2 meds for breast CA correct answer: 1. tamoxifen
- block estrogen for estrogen fed tumors
- Herceptin - a med that works like antibody against cancer antigens on tumor) what type of CA has a high likelihood of metasteses correct answer: pre-menopausal what kind of response do PTs usually have to chemo correct answer: good what are the types of chemo correct answer: 5FU, cytoxan, methotrexate, vincristine, taxol Navelbine (vinorelbine)- for metastatic disease, fewer side effects what are the side effects of chemo correct answer: 1. GI (anorexia, N/V, wt loss)
- hair follicles- transient hair loss w/therapy
- bone marrow suppression - fatigue, anemia what is hormone therapy for breast CA aimed at correct answer: remove estrogen source - can remove the ovaries to decrease estrogen and shrink the tumor. who are more likely to have hormone-dependent tumors correct answer: post menopausal women MOA of tamoxifen correct answer: blocks estrogen receptors
decreases the growth stimulation of estrogen s/e of tamoxifen correct answer: side effects similar to menopause - Side effects: N/V, hot flashes, vaginal bleeding who do you do bone marrow/stem cell transplant in for breast CA correct answer: PTs with advanced metastatic disease when can bone marrow/stem cell transplant be done correct answer: following massive chemo what is autologous bone marrow/stem cell transplant correct answer: patient donates her own bone marrow or peripheral stem cells- then get the chemo, then do the transplant. definition of PID (pelvic inflammatory disease) correct answer: infection of the pelvis involving fallopian tubes, ovaries and peritoneum. 3 part etiology of PID correct answer: 1) begins as cervicitis that moves upward
- common organism - chylamydia and gonorrhea
- Females < age 24, multiple sex partners, new sex partners what are the common organisms of PID correct answer: chylamydia and gonorrhea who is PID most common in? correct answer: Females < age 24, multiple sex partners, new sex partners
6- infertility what is the education that needs to be done with PID PT correct answer: ed regarding decreasing STD risk nursing care for PID: allow... correct answer: expression of feelings (fear, regret, shame, etc.) nursing care for PID: take regular... correct answer: VS nursing care for PID: document... correct answer: color, amount, odor of vaginal discharge nursing care for PID: increase... correct answer: fluids what position should you put the PID PT in (why)? correct answer: semi-fowlers - facilitates drainage nursing care for PID: assess __ to ___ correct answer: assess abdomen to evaluate drug therapy nursing care for PID: heat to abdomen and ___ if ordered (if no __) correct answer: sitz bath (if no abscess) how long after PID diagnosis should PT not have sex? correct answer: 3 weeks treatment for PID correct answer: 1. ABX therapy
- corticosteroids
- no intercourse for 3 weeks
- test partner for chlamydia/gonorrhea etiology of benign prostatic hyperplasia? correct answer: 1. slow process, cell changes over time
- endocrine - changes in hormonal levels over time (increased androgens/local growth hormone) what are the EARLY clinical manifestations of BPH correct answer: 1. narrowed stream
- hesitancy initiating a stream
- dribbling after voiding (urinary retention)
- feel as if not emptied
- nocturia
- urgency what are the LATE manifestations of BPH correct answer: 1. bladder dysfunction
- destruction of kidney tissue
- abdominal distended ureters
- pyelonephritis how do you diagnose BPH correct answer: 1. abnormal physical findings (feels nodular, hard, or boggy on DRE)
- sx of infection (WBC, hematuria, bacteria in urine)
- may see elevated BUN and serum creatinine if long standing problem
at a time, total of 3-20 treatments. (no tissue necrosis, just decrease in size of prostate) Keep temp 110 or less ( don't want to destroy rectal tissue) what are the 4 surgical options for BPH correct answer: 1. lasar ablation - TULIP (transurethral ultrasound guided laser induced ablation or prostate tissue
- TURP - transurethral resection of prostate
- TUI - transurethral cutting/incision of prostate
- suprapubic resection how is a TURP done? correct answer: 1. no incision - excise and cauterize prostatic tissue
- 18-22 French 3-way catheter with a 30 cc balloon containing 30-60 cc sterile water inserted to apply pressure
- bladder irrigation for first 24 hours (strict I&Os) can have __ after surgical procedures for BPH correct answer: recurrence how is bladder irrigation done for TURP? what are the two ways of doing this? p. 1313 post op care, CBI correct answer: you are putting liter after liter into the bladder and it's draining right out to get all the clots and junk out from the procedure then eventually when it's been irrigated enough, the urine will turn clear.
could be continuous bladder irrigation (CBI) or intermittent bladder irrigation (IBI) when you do it every hour-ish nursing care post TURP correct answer: 1. For bladder spasms - opiate suppositories
- push fluids to 2-3 liters per day
- assess for hyponatremia and fluid excess
- maintain patency of catheter
- pain management
- mobilize pt - roll side to side - worry about clots in bladder...
- may have order for continuous bladder irrigation (CBI) to prevent clot formation (p. 1313 post op care, CBI) who is TUI used for? correct answer: 1. younger PTs
- mild obstructions
- high risk PTs (cardiac history, valve replaced and on lifetime Coumadin, etc.) how is a TUI done? correct answer: make incision or slits on one side or bilaterally on the prostate when is a suprapubic resection done? correct answer: for LARGE mass obstructing urethra
