MDC3 Exam 1 Review - With NCLEX questions and extra notes.

MDC3 Exam 1 Review

ABCs
 A - airway
 B - breathing
 C – circulation

Uterine Leiomyoma
 Benign, slow growing solid tumors of the muscle layer of the uterus (fibroids)
 Excessive local growth of smooth muscle tissues
o Growth may be stimulated by estrogen, progesterone, and growth
hormone
Assessment: asymptomatic or symptomatic (heavy prolonged vaginal bleeding)**
 Assess pelvic pressure, elimination pattern, abdomen size, dyspareunia,
infertility
 Painful menses
 Elimination patterns (due to enlarged fibroid pressing on organs)
 Ask how many pads/tampons used in a day
S/S: Heavy periods or periods that last a long time & abd distention, urinary
frequency
Psychosocial assessment:
 Quality of life from dyspareunia
 Fear that symptoms could be cancerous
 Anxiety
 Significance of loss of uterus for patient and partner if want to conceive
Diagnostic assessment:
 CBC – iron deficiency anemia from heavy bleeding
 WBC would be normal
 HGB and HCT – low
 Pregnancy test to rule out uterine enlargement
 Transvaginal US – able to see if fibroid is protruding into uterine cavity
 Biopsy: gold standard
Pelvic exam
Planning and Implementation
 Manage bleeding
o Non-surgical management: oral contraceptive**
o Surgical management:
 MRI focused ultrasound-heat to tumor
 Uterine artery embolization – starves tumor of circulation
allowing it to shrink

,  Myomectomy- laser removal
 Hysterectomy

Erectile Dysfunction: causes & treatment
 Common as one ages: reduced blood flow to penis
Causes
Medical causes: change in blood pressure
Non-organic: increased stressor, illnesses
Treatment
 Medications that increase perfusion to penis (PDE- 5 inhibitors)
 Vacuum pump
 Pineal implant
 Managing stress

Education related to treatment for HPV/Cervical Cancer
 Caused by HPV
s/s of cervical cancer:
o heavy bleeding in later stages
o bleeding after sex
o Most of the time asymptomatic
Bleeding between periods
Preventive screening: PAP smear, surgical biopsy (gold standard) to determine
staging
Treatment:
 Early- ablation, laser
 Late- chemotherapy/radiation
Education:
 No sticking anything up the vagina (tampons, douches)
 May have bleeding
 No sexual intercourse
 No tub baths

Breast cancer- preventative screenings, risk factors, diagnostic tests
Preventative screenings
 Mammography
o Recommended to start screening at 45
o Women over 55 may switch to every 2 years
 Breast self-awareness/self-examinations
o >90% detected by patient
 Clinical breast clinical

, o At least every 3 years for women in their 20s and 30s and every year for
asymptomatic women at least 40 years old
Risk Factors
 Increased age
 Family history
 Early menarche, late menopause
 Lack of breastfeeding
 Postmenopausal obesity
 Alcohol consumption
 Mutations in BRCA1 or BRCA2
Diagnostic tests
 Lab assessment: study of breast mass tissue and lymph nodes, liver enzymes,
calcium, and alkaline phosphatase
 Imaging assessment:
o Mammogram
o Ultrasound
o MRI
o Chest x-ray, CT for metastasis
o Breast biopsy*

Endometrial cancer- symptoms, risk factors, diagnostic testing
 Most common gynecologic malignancy
 Cancer of inner uterine lining
 Grows slowly but vaginal bleeding usually leads to prompt evaluation and
treatment = good prognosis
 Most commonly associated with prolonged exposure to estrogen without its
protective effects of progesterone
Risk Factors:
 Women in reproductive years
 Family History
 Diabetes Mellitus
 HTN
 Obesity
 Uterine polyps
 Late menopause
 Nulliparity (no childbirths)
 Smoking
 Tamoxifen – given for breast cancer

Symptoms: