lOMoAR cPSD| 36357603
FINAL EXAM STUDY GUIDE
FUNDAMENTALS NURSING SKILLS GYNECOLOGY
IMPORTANCE OF HEALTH HX FOR GYN CARE TYPES
OF QUESTIONS OPEN-ENDED ESTABLISHED RAPPORT
WITH PATIENT
Gynecology
» Importance of health Hx for GYN care
o Types of questions
▪ open-ended
o *establish rapport with patient first
» Menstrual Terms
o Heavy or prolonged bleeding often controlled with NSAIDS or by
regulating the periods with different types of birth control
o Intermenstrual bleeding may occur as result of birth control,
usually improves with time
o Post menopausal bleeding is NEVER a good thing
▪ Often associated with fibroids, polyps, or cancer
» Prevention
o Mammograms (when, how often)
▪ Age = 40 – 50
▪ How often = every 1 – 2 years
o PAPs
▪ Age 21
▪ Every 3 years until age 30
• If everything stays negative then every 5 years
• Stop at age 65
▪ Abnormal PAP
• Depends
▪ PAPs are used to detect cervical cancer
• HPV = number one cause of cervical cancer
o STI testing
▪ Until age of 24
» Menopause
o Climacteric
▪ Phase during which ovarian function and hormone
production
o Perimenopause
▪ Before menopause = lasts about 4 years
▪ Symptoms
• infrequent periods
• heat flashes
, lOMoAR cPSD| 36357603
• night sweats
• decrease sex change, increase mood swings, still
have to worry about pregnancy
▪ Concerns
o why do we see those symptoms
▪ decrease in estrogen
o menopause = periods stop for a year
▪ average age 51.4
o Treatment for menopause
▪ Dress in layers, use fan, avoid alcohol
» Breast Cancer
o Risk factors
▪ Family history – first degree relative
▪ Gene – BRAC1/2
▪ Didn’t breastfeed
▪ Early menarche late menopause
▪ Never had a child
▪ Diet
▪ obesity
o how to determine
▪ mammogram, needle biopsy
▪ 50% originate in upper outer quadrant
o warning S&S
▪ lump (immobile, more fixed)
▪ breast drainage
▪ dimpling of the skin – orange peel
o Prevention
▪ Exercise, good diet, breastfeeding, having babies
o Breast self exam
▪ Best to do 1 week after period
» Osteoporosis
o Decrease in bone strength due to diminished bone density and
bone quality
o Prevention
▪ Calcium supplements
• 1200mg or 1500mg
▪ Vitamin D – 30 minutes of sun or 1000-2000mu/day
▪ Diet/exercise
o Causes
▪ More prone as we age and go through menopause
▪ Lack of exercise – especially strengthening exercise
» Differences between
, lOMoAR cPSD| 36357603
o prolapsed uterus
▪ generalized pressure in the vagina, irritated
o rectocele
▪ rectum into the vaginal
▪ constipation
▪ severe rectal pressure
o cystocele
▪ bladder prolapsed in the vagina
▪ more urinary freq
▪ downward displacement of bladder
▪ treatment
• kegals, estrogen, physical therapy
» Fibrocystic disease
o S&S
▪ Pain, tenderness, sometimes nipple discharge
▪ Occurring week before period, improving 1 – 2 days into
cycle
▪ Dense, irregular, nodularity cysts
▪ What can help?
• OCP, Primrose Oil
o what means
▪ very benign
• if cancer = fixed, painless, retraction noted
▪ more dense breasts = more mammograms/ UC
» Polycystic ovarian disease
o S&S
▪ Painful periods????
▪ Extra facial hair - hirsutism
▪ Irregular/no periods**** = not ovulating
o reasons for
▪ can lead to DM, metabolic syndrome, HTN, cardiovascular
disease, cancer
o treatment
▪ birth control
▪ metformin
▪ weight loss
» Hysterectomy
o Types (abdominal, vaginal, robotic)
o Nurses role after surgery
▪ monitor vitals – pulse and BP, O2 saturation
▪ pain control
» Ovarian Cancer
, lOMoAR cPSD| 36357603
o S&S
▪ Bloating***
▪ General malaise/ discomfort
▪ Cannot eat as much
o who’s at risk
» Endometriosis
o Signs and symptoms
▪ Lining of the uterine wall gets out in other places and
causes pain and discomfort especially during periods
▪ Debilitating
▪ Painful sex
o Treatment
▪ Birth control where they do not get a period
• Progestins (Depo Provera), Hormonal IUD
▪ Laproscopy diagnosis it
o *endometrial cancer
▪ Most often post menopause, must suspect if any bleeding
post menopause
» Abuse/Sexual assault in Women
o Phases
▪ Tension building, abusive incident, honeymoon period
o Identifying victims
o how to best help
o how to ask about
» Sexually transmitted infections
o Chlamydia
▪ Facts
• Most frequently reported STI
• Difficult to diagnosed
• Can lead to PID, infertility, ectopic pregnancy
• Increased risk of HIV
▪ Signs and symptoms
• Thin, mucopurulent discharge
• Cervical changes, friable cervix
• Burning/frequency of urination
• Lower abdominal pain and 50% asymptomatic
▪ Testing
• PAP, urine, cultures
▪ TREATMENT
• No sex for 7 days after both treated
• Medications
o Doxycycline 100mg PO BID 7 days
FINAL EXAM STUDY GUIDE
FUNDAMENTALS NURSING SKILLS GYNECOLOGY
IMPORTANCE OF HEALTH HX FOR GYN CARE TYPES
OF QUESTIONS OPEN-ENDED ESTABLISHED RAPPORT
WITH PATIENT
Gynecology
» Importance of health Hx for GYN care
o Types of questions
▪ open-ended
o *establish rapport with patient first
» Menstrual Terms
o Heavy or prolonged bleeding often controlled with NSAIDS or by
regulating the periods with different types of birth control
o Intermenstrual bleeding may occur as result of birth control,
usually improves with time
o Post menopausal bleeding is NEVER a good thing
▪ Often associated with fibroids, polyps, or cancer
» Prevention
o Mammograms (when, how often)
▪ Age = 40 – 50
▪ How often = every 1 – 2 years
o PAPs
▪ Age 21
▪ Every 3 years until age 30
• If everything stays negative then every 5 years
• Stop at age 65
▪ Abnormal PAP
• Depends
▪ PAPs are used to detect cervical cancer
• HPV = number one cause of cervical cancer
o STI testing
▪ Until age of 24
» Menopause
o Climacteric
▪ Phase during which ovarian function and hormone
production
o Perimenopause
▪ Before menopause = lasts about 4 years
▪ Symptoms
• infrequent periods
• heat flashes
, lOMoAR cPSD| 36357603
• night sweats
• decrease sex change, increase mood swings, still
have to worry about pregnancy
▪ Concerns
o why do we see those symptoms
▪ decrease in estrogen
o menopause = periods stop for a year
▪ average age 51.4
o Treatment for menopause
▪ Dress in layers, use fan, avoid alcohol
» Breast Cancer
o Risk factors
▪ Family history – first degree relative
▪ Gene – BRAC1/2
▪ Didn’t breastfeed
▪ Early menarche late menopause
▪ Never had a child
▪ Diet
▪ obesity
o how to determine
▪ mammogram, needle biopsy
▪ 50% originate in upper outer quadrant
o warning S&S
▪ lump (immobile, more fixed)
▪ breast drainage
▪ dimpling of the skin – orange peel
o Prevention
▪ Exercise, good diet, breastfeeding, having babies
o Breast self exam
▪ Best to do 1 week after period
» Osteoporosis
o Decrease in bone strength due to diminished bone density and
bone quality
o Prevention
▪ Calcium supplements
• 1200mg or 1500mg
▪ Vitamin D – 30 minutes of sun or 1000-2000mu/day
▪ Diet/exercise
o Causes
▪ More prone as we age and go through menopause
▪ Lack of exercise – especially strengthening exercise
» Differences between
, lOMoAR cPSD| 36357603
o prolapsed uterus
▪ generalized pressure in the vagina, irritated
o rectocele
▪ rectum into the vaginal
▪ constipation
▪ severe rectal pressure
o cystocele
▪ bladder prolapsed in the vagina
▪ more urinary freq
▪ downward displacement of bladder
▪ treatment
• kegals, estrogen, physical therapy
» Fibrocystic disease
o S&S
▪ Pain, tenderness, sometimes nipple discharge
▪ Occurring week before period, improving 1 – 2 days into
cycle
▪ Dense, irregular, nodularity cysts
▪ What can help?
• OCP, Primrose Oil
o what means
▪ very benign
• if cancer = fixed, painless, retraction noted
▪ more dense breasts = more mammograms/ UC
» Polycystic ovarian disease
o S&S
▪ Painful periods????
▪ Extra facial hair - hirsutism
▪ Irregular/no periods**** = not ovulating
o reasons for
▪ can lead to DM, metabolic syndrome, HTN, cardiovascular
disease, cancer
o treatment
▪ birth control
▪ metformin
▪ weight loss
» Hysterectomy
o Types (abdominal, vaginal, robotic)
o Nurses role after surgery
▪ monitor vitals – pulse and BP, O2 saturation
▪ pain control
» Ovarian Cancer
, lOMoAR cPSD| 36357603
o S&S
▪ Bloating***
▪ General malaise/ discomfort
▪ Cannot eat as much
o who’s at risk
» Endometriosis
o Signs and symptoms
▪ Lining of the uterine wall gets out in other places and
causes pain and discomfort especially during periods
▪ Debilitating
▪ Painful sex
o Treatment
▪ Birth control where they do not get a period
• Progestins (Depo Provera), Hormonal IUD
▪ Laproscopy diagnosis it
o *endometrial cancer
▪ Most often post menopause, must suspect if any bleeding
post menopause
» Abuse/Sexual assault in Women
o Phases
▪ Tension building, abusive incident, honeymoon period
o Identifying victims
o how to best help
o how to ask about
» Sexually transmitted infections
o Chlamydia
▪ Facts
• Most frequently reported STI
• Difficult to diagnosed
• Can lead to PID, infertility, ectopic pregnancy
• Increased risk of HIV
▪ Signs and symptoms
• Thin, mucopurulent discharge
• Cervical changes, friable cervix
• Burning/frequency of urination
• Lower abdominal pain and 50% asymptomatic
▪ Testing
• PAP, urine, cultures
▪ TREATMENT
• No sex for 7 days after both treated
• Medications
o Doxycycline 100mg PO BID 7 days
