Rasmussen College: NUR2502 Exam 1 Focused LATEST UPDATED 2021/2022,100% CORRECT

Rasmussen College: NUR2502 Exam 1 Focused LATEST UPDATED 2021/2022 Review Please know labs for all diseases. Name of Lab Range Notes Albumin 3.4-5.4 g/dL • Without enough albumin, the body can't keep fluid from leaking out blood vessels. Not having enough albumin can also make it harder to move important substances throughout the body. • Higher than normal levels of albumin may indicate dehydration or severe diarrhea Blood urea nitrogen (BUN) 10-20 • Indicates the nitrogen portion of urea • Elevated indicates a slowing of glomerular filtration rate • Below normal levels occur when there is a fluid overload, malnutrition, severe liver damage, SIADH Serum Creatinine Male: 0.6-1.2 mg/dL Female: 0.5- 1.1 mg/dL • Specific indicator of renal function • Increased levels indicates a slowing of glomerular filtration. Instruct pt not to eat red meats • Below normal range occurs with decaying muscle GFR 90- 120mL/min • Best indication for kidney function and stage of kidney disease • High means higher rate of fluid going through the kidney • Low means lower rate of fluid going through the kidney Hematocrit (HCT) Men: 39-50% Women: 35- 47% • Percent of blood sample that was red cells Hemoglobin Men: 14-18 grams/dL Women: 12- 16 grams/dL • Amount of protein that carries oxygen Platelets 150,000 to 400,000 mm3 • Clot/coagulation • Elevated can be caused by acute infections, chronic granulocytic leukemia, collagen disorders, polycythemia, postsplenectomy, etc • Below normal values occur in the following: acute leukemia, chemotherapy, disseminated intravascular coagulation, hemorrhage, infection, systemic lupus erythematosus, thrombocytopenic purpura. Prealbumin 16-40 mg/dL • High can be a sign of kidney problem • Low levels is a sign of malnutrition White blood cells 5000-10,000 mm3 • High means infection • Low means susceptible to infection • Normal = :) 1. Therapeutic communication 2. Remember your ABCs 3. Uterine leiomyoma - assessment (fibroid, myoma) • Benign, slow-growing solid tumor that occurs front he overgrowth of smooth muscle and connective tissue in the uterus o Also called fibroids or myomas o Position in uterus determines type • Assess pelvic pressure, abdomen size, elimination patterns, dyspareunia (pain during sex) • Symptoms - range from heavy to no menstrual bleeding, prolonged periods, periods • Risk factors - genetics and no pregnancies • Can be calcified • Classified via layer o Intramural – contained in the uterine wall in the myometrium o Submucosal – protrude into the cavity of the uterus – can cause bleeding and disrupt pregnancy o Subserosal – protrude through the outer surface of the uterine wall – may press on other organs • Assessment o How many tampons are you using in a day (Amanda says hour) ▪ To determine how much blood they are losing ▪ Do they have pelvic pressure ▪ Do they have constipation ▪ Do they have urinary retention • KEY SYMPTOM IS HEAVY VAGINAL BLEEDING! “WINK WINK” • Assess pelvic pressure, elimination patterns, abdomen size, dyspareunia (painful intercourse), infertility ▪ This is due to the fibroid/myoma/leiomyoma pushing on the organs • Pain is not going to kill you, hemorrhaging will 4. Erectile dysfunction- causes, treatment Also called impotence, inability to achieve or maintain erection for sexual intercourse • Organic ED o Is it a problem within? medications? health? spinal injury? • Functional ED o Psychological - what is going on in their lives that is causing this (stress?) • Assessment o History o Serum hormone levels o Doppler ultrasonography test • Treatment o Medications - teach about vasodilation effects (THEY CANT TAKE NITRO) o Vacuum constriction devices o Injections with vasodilatong drugs o Penline implants (prostheses) 5. Education related to treatment for HPV/cervical cancer a. Most cases caused by HPV b. Detected by pap smears c. Begin paps by age 21 d. Watch for signs such as bleeding increasing in frequency and amount, watery pink discharge, flank pain, e. Look at chart 71-4 5. Breast cancer- preventative screenings, risk factors, diagnostic tests, education Most common malignant condition, second leading cause of death in women Prevention screening • Mammography • Breast self-awareness/examination • Clinical breast examination Risk Factors • non-modifiable o Family history o Early menarche, late menopause o increased age - both men and women • Modifiable o Nulliparity (never been pregnant) or first child born after 30yrs old o Lack of breastfeeding o Postmenopausal obestity o Use of postmenopausal HRT (hormone replacement therapy) o Alcohol consumption o Mutations in BRCA1+2 • Lack of exercise • Diet • Breast implants • Smoking • Medications such as birth control and hormone therapy • No pregnancies Diagnostic tests: • Mammography • Tomosynthesis • Ultrasonography • MRI • Chest x-ray • Breast biopsy Education • Non-invasive breast cancer (confined to the duct or lobule) o Ductal carcinoma in situ (DCIS) ▪ Cancer cells are located within the duct and have not invaded the surrounding tissue. ▪ “early form of breath cancer” • Lobular carcinoma in situ (LCIS) ▪ Cells that are contained in the lobules (mammary glands) appear to be cancer cells but are not. The presence of LCIS indicates a risk of developing breast cancer. ▪ cells look like breast cancer but they are not considered to be a precursors to invasive cancer ▪ these take place where milk is stored • Invasive breast cancer (spread to distant sites such as lymph nodes, lungs, etc…) • Infiltrating ductal carcinoma ▪ The cancer cells originate in the mammary ducts and spread to the surrounding tissue in an irregular pattern ▪ Most common type of invasive breast cancer ▪ Fibrosis develops around the cancer ▪ Peau d’orange - this means that it looks like the rind of an orange “very scary looking”, typical in late stages ▪ Lump will be present, irregular, poorly defined ▪ Skin dimpling may be present • Inflammatory breast cancer ▪ Diffuse erythema (redness of the skin) ▪ Peau d’orange ▪ Often harder to successfully treat ▪ Aggressive ▪ Rapidly growing lumps ▪ Itchy breasts • Start mammograms at 40 • What are you going to feel when you feel breast cancer? • A firm, irregular, poorly defined lump • You can't move it • What if it's a cyst? • Softer, round, defined, • typically painless • Moveable • Gynecomastia • Enlarged breasts in men • If men get breast cancer - large painless lumps are typical • Breast Cancer in young women • Genetic predisposition • younger women often have more aggressive forms • screenings are less effective because younger women have more dense breasts so the mammogram may not detect it 7. Endometrial cancer- symptoms, risk factors, diagnostic testing Endometrial cancer is caused by cancerous cells that originate in the inner lining of the uterus and grows slowly Most common malignancy for GYN • Vaginal bleeding Risk Factors: • Review tabel 71-2*** • Women in reproductive years • Family History • Diabetes mellitus • Hypertension • Obesity • Uterine polyps • Late menopause • Nulliparity (no childbirths) • Smoking Diagnostic tests: • CA-125, AFP, hCG, IVP • Transvaginal ultrasound • Endometrial biopsy • Chest x-ray • Abdominal ultrasound • CT of pelvis • MRI of abdomen and pelvis • Liver & bone scans • Diagnostic criteria o Stage I – confined to the endometrium o Stage II – involves the cervix o Stage III – reaches the vagina or lymph nodes o Stage IV – spreads to bowel and bladder mucosa and/or beyond pelvis o May metastasize outside of the uterus • Review tabel 71-2*** Assessment findings - know the key one • Key - postmenopausal bleeding - ask how many tampons they use • low back, pelvic, abdominal pain • Watery, bloody vaginal discharge • Pelvic exam may reveal palpable uterine mass - uterus is enlarged if cancer is advanced 8. Cervical cancer – post-op care/education, prevention Prevention • Vaccination o HPV Treatment • Chemotherapy • Surgery • Radiation therapy Risk • Multiple sex partners • Smoking • Oral contraceptives • Sexually transmitted disease Signs and symptoms • Pelvic and back pain • Vaginal bleeding • Pain during sex 9. Hysterectomies- what they are, who gets them, post-operative care, education Removal of the uterus Uterine cancer No lifting 10. Vulvovaginitis- s/s, causes, treatment, education Inflammation of the lower genital tract due to an imbalance of hormones and normal flora of the vagina and vulva, which results in vaginal discharge, itching or irritation, painful urination, and pain during sex Causes • Imbalance of hormones and normal flora • Infection • Reduced estrogen levels after menopause and some skin disorders Treatment: • Good hygiene • Rest & sleep • Good dietary • Exercise • Avoid tight clothing • Do not douche or use feminine sprays • No intercourse until treated • Google - oral antibiotics and antibiotic cream Education • Keep good hygiene of peri area • Urinate with knees spread apart • Do not use vaginal sprays, perfumed soaps, douches 11. Toxic shock syndrome - prevention • Wash hands before inserting tampon • Do not use a tampon if it is dirty • Insert tampon carefully • Change your tampon every 3 to 6 hours • Do not use super absorbent tampons • Use perineal pads at night • Do not use tampons at all if you've had TSS • Can be fatal 12. Prostate cancer- risk factors, s/s, lab tests, screening, metastases, post-op education, interventions, and complications • Second leading cause of cancer in men • if found early, great cure rate • Advanced Age is leading risk factor • African American • Assessment o DRE - digital rectal exam is performed by the healthcare provider • There is a potential for metastasis due to the invasion of cancer cells to the other parts of the body • Almost the same as BPH except prostate cancer produces blood in the urine • Laboratory tests o PSA o Alkaline phosphate • How do we prevent metastases o Keep track of patient o Make sure they comply with treatment, show up to appointments, etc Lab tests: • PSA Screening: • DRE • Transrectal ultrasound • Biopsy Post-op education: • Encourage patient to use patient controlled analgesia as needed • Help the patient get out of bed into a chair on the night or surgery and ambulate by the next day • Maintain the sequential compression device until the patient begins to ambulate • Monitor the patient for DVT and PE • Keep an accurate record of intake and output • Keep the urinary meatus clean using soap and water • Avoid rectal procedures and treatments 13. BPH- s/s, treatment, education Glandular units in the prostate that undergoes nodular tissue hyperplasia, resulting in enlargement of the prostate gland. Older age, hormones, obesity, diabetes, smoking, etc... are factors. Causes BOO - bladder outlet obstruction • Difficulty in starting and continuing urination • Reduced force and size of urinary stream • Sensation of incomplete bladder emptying • Straining to begin urination • Post-void dribbling or leaking • May cause secondary UTI, other bladder problems 14. Testicular cancer - multidimensional interventions & nursing interventions Rare cancer affecting men, usually between 20 and 35 Nursing/mutli interventions • do testicular self exams • consider risk factors o Family history • might be swelling, lump or nodule • Usually no pain • Assess family situation, sexuality, and desire for children • inspect for swelling for lump - the provider will palpate 15. Genital herpes – interventions, treatment Overgrowth of fibrous tissue in the genital area caused by HPV Acute, recurring, incurable viral disease HSV-1 (cold sores), HSV-2 Incubation 2-20 days Primary outbreak may be asymptomatic but patient is still infectious Don’t spread it Treatment 16. Syphilis- s/s, treatment STD caused by Treponema pallidum Can cause serious complications such as heart disease, nervous system disorders, blindness, and even death Can become systemic Primary (kanker) Secondary (Systemic, flu-like symptoms, palmar and secondary lesoins) Latent (early- first ear after infection,lesions can come back and late, more than a year after infection) Tertiary (occurs between 5 and 20 years due to untreated and can mimic other condition - affects the whole system) 17. Genital warts- risk factors, s/s, treatment Most common STD, caused by HPV Incubation period is four days after exposure Risk factor is unprotected sex Usually not painful, they come and go as they please papillary growths look like cauliflower wart biopsy • Treatment o Drug therapy o Cryotherapy, TCA or BCA, podophyllin 18. Chronic renal failure- causes, treatment Causes • Diabetes • Hypertension Treatment • kidney does not recover - you need a new kidney • dialysis is necessary BUN indicates dehydration status 19. Acute kidney injury- causes, electrolyte imbalances, treatment Rapid reduction in kidney function resulting in failure to maintain fluid and electrolyte Typically asymptomatic, Can result in death, Occurs over hours or days Causes systemic effects and complications Once the waste starts to build up, there’s symptoms Causes • See table 68-4 for causes • Anything that could cause there to be less perfusion to the kidney o blood clots, dehydration, nephritis, calculi, bladder cancer, contrast dye (this can severely damage kidneys) Interventions • Avoid hypotension • fluid restriction and fluid replacement • frequently monitor lab values • closely watch I/O • Kidney replacement therapy • Help with coping mechanisms for increased need to urinate - particularly nocturia • Look edema - ascites (fluid in the abdomen) Treatment • Avoid dehydration by drinking 2 to 3L of water daily • Be aware of urine characteristic changes • avoid nephrotoxic substances 20. Types of dialysis and nursing considerations related to dialysis Hemodialysis • Dialysis settings • procedure - given via a fistula or cath • anticoagulation • vascular access • nursing care • post-dialysis care Peritoneal dialysis • It's in the stomach • you can do it at home • silicone rubber cath placed into the abdominal cavity for infusion of dialysate • Type of peritoneal dialysis (PD) is dependant on patients ability and lifestyle o Continuous ambulatory o multi-bag continuous ambulatory o automated o intermittent o continuous-cycle • Complications such as peritonitis is possible Nursing considerations • DO NOT LET OTHERS TOUCH DIALYSIS CATH • For the arm that has a fistula for dialysis o Do not do blood pressure o Do not do blood draws o Do not touch this arm o Check for a bruit and a thrill to assess functioning ▪ Bruit - hearing a swoosh ▪ Thrill - put hand over it for vibration 21. Chlamydia- s/s, treatment, education Bacterial infection caused by organism C trachomatis resulting in urethritis in males and females, epididymitis in males, and cervicitis in females Must be reported to the health department Can be present without showing symptoms Reportable to local health department Afrian American women between 15 and 24 at highest risk • Assessment o Complete history o GU review o Psychosocial history o sexual history • Signs include o Painful pee o pelvic pain o bleeding • Treatment is azithromycin and doxycycline • Education o Mode of transmission o Asymptomatic infection o need for abstinence 22. STD education STIs that recur and become chronic are STDs These are a worldwide health concern Older adults lack awareness Some are reportable (HIV, ADIS, Chlamydia) CDC provides regular updated guidelines for treatment Women are more easily infected, particularly if they are having sex with men vs women Younger adults have more unprotected sex Post meno women may not use barrier protection 23. Diabetic nephropathy - education Diabetic nephropathy is a complication of both type one and type two diabetes It is the leading cause of ESKD (end stage kidney disease) The severity of diabetic nephropathy is related to the degree of hyperglycemia that the patient generally experiences Management is the same for CKD Education • Have good control over your diabetes to prevent this o Keep sugars in range o Do not have recurrent hyperglycemic episodes 24. Nephrotic syndrome - interventions Condition of increased glomerular permeability • ALlows larger molecules to pass through the membrane into urine • massive loss of protein in urine • Edema formation • decreased plasma albumin levels • Most common cause is altered immunity with inflammation Interventions • ACE inhibitors • heparin • dietary changes • mild diuretic • sodium restrictions 25. Incontinence- types, treatment, education Involuntary loss of urine, not normal consequence of aging or childbirth. Not a disease, rather a symptom of a disease process Types • Stress incontinence o Due to increased abdominal pressure under stress (weak pelvic floor muscles) o most common o Inability to retain urine - anything that jerks their bladder will cause urine output o occurs laughing, sneezing, coughing, jogging o stay away from bladder irritants Treatment • topical estrogen treatment • pelvic floor training - they are doing them correctly if they can stop urine mid stream • surgical sling or bladder suspension if pelvic floor exercise does work Drug treatment helps the urethra be more resistant to the leaks • Urge incontinence o Due to involuntary contractions of the bladder muscle o Feel it but cant hold it o oab o polyuria o too much urine o Can be caused by stroke, uti, diuretics, o bladder training - pee on schedule Drug - Treatment - purpose is to improve urethral resistance • Ditropan o Used for urge incontinence (OAB) o dry mouth o constipation blurred vision (anticholinergic) • Detrol o Used for urge incontinence o anticholinergic o dry mouth o suck on hard candy o increase water intake o laxative?? • Overflow incontinence o Due to blockage of the urethra o overdistension o • Neurogenic incontinence o due to disturbed function of the nervous system Treatment • Anticholinergics • Alpha blockers • topical estrogen (post menopausal women only) - increases the blood flow and tone of the muscle - improves the patient's ability to contract the muscles • Pelvic floor exercises (PT) - you know they're doing it correctly if they have better control of their bladder - they can stop urine flow midstream • Surgical - sling, suspension Risk factors • Spinal cord injury • Brain disorders • vag delivery after 30 Education • Reduce stress for stress incontinence (most common type) • Stay away from caffeine, smoking, alcohol (anything that could irritate the bladder) 26. Cystitis- s/s, treatment, education - UTI Inflammation of the bladder due to an infection - Inflammatory conditions of the bladder that can be caused by an infection or may be caused by other factors such as drugs (antibiotics), chemicals, radiation, hygiene products, and long-term catheter use, trauma, most common seen in the US, can happen anywhere in the urinary tract Risk factors • obstruction such as a stone • BPH • Tumors • sexual activity • genetics • smoking • cranberry products Signs and symptoms • pain, burning, stinging when peeing • frequent urination • dark, cloudy, smelly urine • lower abdominal pain Treatment • Urinalysis • Culture/sensitivity Education • Clean catch urine specimen - mid stream wipe, front to back • Frequent you see more invasive diagnostic tests • 48 hours after catheter insertion bacteria colonization begins 27. Urolithiasis- s/s, complications, treatment Presence of calculi stones in the urinary tract. Generally, this is symptom free until the calculi pass into the lower urinary tract, which results in excruciating pain. This is a result of dehydration, gout, overuse of vitamins and minerals Symptoms • severe, sharp pain in the side and back below the ribs • Pain that radiates to the lower abdomen and groin • pain that comes in waves and fluctuates in intensity • pain or burning sensation when urinating • blood in urine • males show testicular and scrotal pain • increased vitals Complications • Obstruction and uremia (high urea) • sepsis • chronic pyelonephritis (kidney infection) • acute or chronic renal failure Treatment • Pass the stone • Pain relievers and muscle relaxants such as alpha blockers • Drink lots of water • bring stone to lab • shock wave to break the stone up lithotripsy • stay away purine (contains uric acid) from red meat, red wine, aged meats, alcohol 28. Pyelonephritis- causes, s/s, treatment, complications Bacterial infection of the kidney and renal pelvis; it can be chronic or acute and can interfere with elimination Both can be infected or just one - can be form virus or bacteria Chronic is a result of repeated upper UTIs in patients with anatomic abnormalities of the urinary tract Acute is the result from bacterial infection with or without obstruction Upper urinary tract - ureters, renal pelvic, and papillary tips (can also include nephron) Causes • repeated infection • obstruction • indwelling urinary catheter Risk factors • Ubstruction • Anatomical abnormalities • Diabeteic neuropathy • Spinal cord injury • catheter • urinary calculi Manifestations • flank pain • fever • chills • costovertebral angle pain • bad smelling Do if CT if treatment does not resolve in 48 hours Chronic • Diabetes • spinal cord injury Acute • someone might complain of flank pain, fever, chills, nausea vomiting, disuria Labs and others • CPR (inflammatory marker) • Urinalysis • BUN and creatine , GFR • KUB or CT • Kidney biopsy • You will see an increase in WBCs, nitrates Check neuro status, maintain hydration, foley possible, meet nutritional needs, prevent chronic kidney disease Treatment • Tylenol (NOT NSAIDS) • antibiotics • blood pressure control 29. Acute glomerulonephritis- s/s, diagnosis, complications Disease that injures the glomerulus of the kidney, impacting the ability of the kidney to rid the body of waste and fluid. Acute occurs suddenly and results from an infection within the body often caused by strep infections that originate in the upper respiratory tract, middle ear, and strep throat Quick treatment is necessary early SS • Blood/brown urine • urinating less than usual • Retaining fluid - puffy face • high blood pressure - check for third heart sound if there is extra fluid • short of breath, cough - ASSESS ASK about infection history, new piercing and tatts Interventions • manage infection • why is it happening • prevent complications o look for fluid overload o check bp o look for edema o signs of getting worse • education • get on the antibiotic - check allergy • sodium and water restriction possible • infection control 30. Polycystic kidney disease- pathophysiology, diagnosis, interventions and treatment Polycystic kidney disease (PKD) is a genetic disorder in which fluid-filled cysts form on the nephrons. These cysts divide abnormally and result in kidney enlargement and a reduction in blood flow. There are two main types of inheritance for PKD: autosomal dominant, which usually appears between the ages of 30 to 50 (you can pass this on to your kids), and autosomal recessive, which has a childhood onset and progresses rapidly to end-stage kidney disease. Kidney enlargement Associated with • high blood pressure abdominal fullness and pain, cyst bleeding, hematuria, kidney stone formation, infections, systemic disease Assess • Family history • pain, constipation, urine changes, hypertension, headaches, dysuria, noturia 31. Renal cell carcinoma- s/s, treatment options, post-op interventions, education Renal cell carcinoma, or adenocarcinoma of the kidney, is the most common type of kidney cancer and results in an alteration in cellular regulation. Due to changes in cellular regulation, the kidney tissues become damaged, which affect urine elimination. Renal Cell Carcinoma usually metastasizes to the adrenal gland. liver, long bones, and other kidney Assessment • Ask about age, known risk factors, weight loss, urinary changes, pain, fever • May have flank pain, obvious blood in urine, kidney mass • Urinalysis, hematological studies, BUN and creatinine, CT, MRI, kidney biopsy Interventions • nephrectomy aka taking the kidney out (most common treatment) o If they have a nephrectomy and their abdomen is distended ▪ Assessment ▪ check vital signs constantly (Post OP) • Preventing metastasis Education • If you have a nephrectomy, the other kidney will pick up the slack Extra Easter eggs that she added to her lectures • Review anatomy for third module • Radiation is only for local “zapping” of the cancer • Client is radioactive until radiation source is out of their breast tissue so they need to stay away from pregnant women and children • fibroadenomas o Benign breast discovery - o most common benign breast tumor during reproductive years, unattached to breast tissue • Review table 70-4*** • Fibrocystic breast conditions o changes including lobules, ducts, stromal tisxsue of breast o 40-50ish years old • KNOW THE KEY FACTOR FOR EACH CONDITION FOR GYN o Do not choose vaginal bleedign or pelvic pain because they are too vague o There are italicized symptoms in our book that we “NEED TO KNOW” o Pain is not going to kill you, hemorrhaging will • Review tabel 71-2*** • Review tavel 71-2*** • Review tabel 68-4*** • There are 5 stages of breast cancer: stage 0 (zero), which is non-invasive ductal carcinoma in situ (DCIS), and stages I through IV (1 through 4), which are used for invasive breast cancer. The stage provides a common way of describing the cancer, so doctors can work together to plan the best treatments. • Nocturia - peeing at night • PID is the leading cause of infertility and causes ectopic pregnancies o Painful sexual intercourse o Lower abdominal or pelvic pain o Friable cervix (weak, thin, easy to damage) • It takes 48 hours for bacterial colonization to start after catheterization • Urethritis is different than UTI because it is just urethra o You see pus in the urine • What is normal during a cystoscopy? o A LITTLE bit of blood in the urine • Early signs and symptoms of chronic glomerulonephritis include o hematuria o proteinuria o high bp o swelling of ankles face o foamy or bubbly urine o fatigue o shortness of breath - check lung sounds, this might be fluid overload • What is the normal range of urine output per hour o 30mL-50mL per hour • What is the difference between oliguria and anuria o Oliguria - less than 400mL in 24 hours o Anuria is 50mL in 24 hours • SIRS Criteria o Fulfilling at least two of the following four criteria: fever 38.0°C (104 F) or hypothermia 36.0°C (96.8F), tachycardia 90 beats/minute, tachypnea 20 breaths/minute, leucocytosis 1,200,000,000 or leucopoenia 400,000,000 Kahoot Questions Week One • What is the second leading cause of death in women o Breast Cancer • As long as cancer remains in the mammary duct, it is referred to as o Non-invasive • What is the most common type of invasive breast cancer o Infiltrating ductal carcinoma • A benign condition of breast enlargement in men is called what o Gynecomastia • Which is not a risk of breast cancer? o Breastfeeding • Nurses play a key role in early detection by education women about all except o Mortality rates - dont want to tell them about mortality rates • As a woman learns about her disease and faces numerous treatment decision psychological distress is not o Elation • ACS recommends mammograms annually after what age o 50 • Which is not a diagnostic assessment for breast cancer o mammography o MRI o Ultrasonography o Pap test (this is for cervical cancer, it’s a vaginal exam) • The only definitive way to diagnose breast cancer is what o Biopsy • Breast-conserving surgery is used primarily for this stage of breast cancer o Two, stage 3 and 4 and towards the end and they wouldn’t save/reconstruct the breast, stage five does not exist • Lymphedema is not caused by o injury o radiation o infection o necrosis • Which is not a type of benign breast disorder o fibroadenomas o fibrocystic breast condition o cysts o mastitis • Women with very large breasts often have health problems with are all except o Difficulty finding well-fitting clothes o Fungal infections under the breast o having back aches o difficulty breastfeeding • Which is not a method of breast examination o Vertical strip o nipple compression o circles o cough Kahoot Week Two - I used talk-to-text for these because there are so many so they might have an error or two • Which male patient will the nurse conduct prostate screening and education about prostate cancer? o young adult with a history of urinary tract infection. o A client who has sustained an injury to the external genitalia. o A sexually active client. o adult male who is older than 50 years • A patient with prostate cancer asks why he must have surgery instead of radiation. What is the best response? o Surgery is most common intervention for a cure. o This is because your cancer growth is large. o The surgery is to promote urination. o Surgery slows the spread of the cancer. • A nurse is educating men about testicular self-examinations. Which statement is correct? o I will squeeze each testicle in my hand to feel any lumps. o I will look and feel for any lumps or changes to my testicles. o I will examine my testicles right before taking a shower. o I will only report any large lumps to my primary health care provider • The potential problem of grief is most relevant to a client after which procedure? o Trans urethral microwave therapy. o Sperm banking. o Radical prostatectomy. o Cystoscopy • Which assessment finding causes the nurse to suspect that a client may have testicular cancer? o Painless testicular lump. o Hematuria. o Penile discharge. o Sudden increase in libido. • Open radical prostatectomy surgery to overcome urinary incontinence education o Practice Kegel exercises to improve muscle control. o Practice routine self catheterization and bladder retraining. o Ask provider about prescribing Viagra. o Use pain medication is needed to maintain comfort • Hormone treatment for prostate cancer works by which actions? o Decrease blood flow to the tumor. o Deconstruction of the tumor. o Suppression of the growth of the tumor. o Shrinkage of the tumor. • When is the best time for the nurse to begin discharge planning for a patient with prostate cancer o two days before being discharged o Day of discharge o after surgery o before surgery • Patient is taking transdermal estrogen therapy what is indication of Need for Additional teaching o I will need to change out the patch once a month. o I will monitor my blood pressure while I'm taking this medicine. o My blood work will be checked regularly. o This medicine will increase my risk of blood clots. • What is the correct way to refer to a client who self-identifies as the opposite gender o transvestite o transgendered o a transgender o transgender • Patient on finasteride reports dizziness, cold sweats, and chills what is the RN's response? o These facts are not related to the finasteride o these are common side effects that usually diminish time o you need to stop taking this medication immediately o schedule an appointment to discuss the symptoms with your provider • Patient is on goserelin. Which statement needs further teaching o I must call 911 right away if i have chest pain o I will be careful when i dispose my needles o This goes into my deep muscle o I want to watch my HR and follow up with my provider • A female-to-male pt wishes to have biological kids after transitioning. What is the nurse’s suggestion? o Oocyte reezing occurs before hormone therapy or transgender surgery. o oocyte freezing occurs after hormone therapy and before menstruation ends. o Oocyte freezing can occur anytime before transgender reassignment surgery. o The options are available to a client with gender dysmorphia • 12 months before surgery, a patient having a vaginoplasty or a phalloplasty is required to have o Hormone therapy o Monthly vocal coaching o Continuously living in the role of the desired gender identity o Therapy sessions with a licensed psychotherapist as needed • Post-op vaginoplasty - which assessment would concern the nurse o Request for pain meds every four hours o edema of the perineum o numbness in the right leg o drainage in the jackson-pratt drain • Education for gonorrhea - what does the nurse tell the client about the disease o Do not engage in sexual activity until your flood tests are negative. o Close follow-up is required Because treatment failure is common. o You are contagious even if you have no outwards symptoms. o You are only infectious while the lesions are draining • Expedited partner treatment (EPT) to a patient diagnosis was chlamydia nurse does what first o Give the drugs and directions to the client for the partner. o Make an appointment at the clinic for the partner. o Provide condoms for the client and partner to use. o Confirm the diagnosis of the partner through appropriate testing • Nurse includes what when talking about STDs o Female condoms are not effective in preventing the transmission STDS o The risk of STDs increases with the number of sexual partners o Spermicidal agents, when used with condoms,will prevent STDs. o Using latex condoms always keep STDs from spreading and infecting others • A nurse tells a group of men to look for what in the primary stage of syphilis o painless chancre o scrotal swelling o rash in genital area o weeping discharge from the urethra • Which shows the antibiotic treatment for pelvic inflammatory disease is effective? o Decrease vaginal discharge. o Increased appetite. o Increased libido. o Decrease pelvic tenderness • A nurse is inspecting a male pt with chlamydia trachomatis. Which is an expected clinical manifestation? o Dysuria (painful urination) o Pustules of the glands of the penis o Painless maculopapular rash in the peri area o Testicular edema • Rn teaching a female about genital warts - which statement requires further education from the RN o There is no treatment o The warts may resolve without treatment o genital warts my reappear at the same site o Wart remover treatment from the drug store will help • Which STD is a vaginal infection o Chlamydia o Syphilis o Gonorrhea o All of the Above • Methods of preventing STDs for sexually active clients o Absence o condoms o mutual monogamy o all of the above