NUR 114 Partial Focus Notes Final Fall 2019/2020_complete, A+ guide

NUR 114 Partial Focus Notes Final Fall 2019 This does not include any of Ms. Jordans lectures only for McLean and Ms. Pizzotti’s Conversions, medication math for PO, IV rates mcg/min, ml/min, gtts/min, mcg/kg/min CONCEPT OF SEXUALITY • Recommendations for testing and assessment for PAP smears, Breast cancer, Prostate CA, Testicular CA. HPV ◦ PAP SMEAR: ▪ a cytological study that is effective in detecting precancerous and cancerous cells within the female patient’s cervix. ▪ When to get tested: • Not recommended for women under 21 (unless SEXUALLY ACTIVE) • 21-29 every 3 years • 30-65 every 5 years + HPV test • 65+ whom has had normal Pap’s in the past should not receive pap test. • Other’s suggest 60+ every 3 years • Those who have had a Hx of cervical cancer should get tested yearly for at least 20 years after the diagnoses regardless of age. ◦ HPV test: can identify many high-risk types of HPV infections associated with the development of cervical cancer. ▪ When to get tested: • At the time of a pap for women 30+ • for any woman of any age who have had an abnormal pap result. ◦ PSA test: ▪ a prostate-specific antigen test is used to screen for prostate cancer and to monitor the disease after treatment. ▪ Normal lab value: 0-2.5 ▪ An elevated PSA should decrease a few days after a prostatectomy. If it has not it shows that it has reoccurred. ▪ Elevated numbers are associated with prostate cancer. ▪ Older men (Esp. AA men) often have a higher PSA. ▪ Should be drawn before a digital rectal exam because the exam can cause an increase in PSA due to prostate irritation. ◦ Mammogram: ** 40 is the magic number ▪ A mammogram is a x-ray of the soft tissue of the breast. Mammograms assess differences in the density of breast tissue. ▪ Helpful in evaluating poorly defined masses, multiple masses or nodules, nipple discharge or changes, skin changes, or pain. ▪ AGE INFORMATION: • Women ages 40 to 44 should have the choice to start annual breast cancer if they wish – Women age 45 to 54 should get mammograms every year. • Women aged 40 years and older be offered screening mammography annually • Women age 55 and older should switch to mammograms every 2 years, or have the choice to continue yearly screening. S - The Marketplace to Buy and Sell your Study Material • American College of Obstetricians and Gynecologists recommends annual screening mammography for women age 40 and over • Yearly screening is recommended at age 40 because younger women have higher density in breast tissue and the test is less effective. ▪ In older women, the amount of fatty tissue is higher. Therefore, fatty tissues appear lighter than cancer ▪ Cancer and cysts usually have the same density. However, cysts are smooth borders and cancers are usually star-burst shape ◦ Testicular Cancer: ▪ Rare form of cancer that most often effects men between ages of 20-35 years of age. ▪ With early detection there is a 95% cure rate ▪ Most common type is germ cell tumors arising from sperm-producing cells • Seminoma tumors are usually localized, metastasize late, and respond to treatment. ▪ Least common type is non-germ cell tumors in stromal, interstitial, or Leydig cells • Most do not metastasize • Adroblastomas sometimes secrete estrogen, which causes feminization and gynecomastia ▪ Men with cryptocordism or HIV have higher risk of testicular tumors. ▪ Common tumor markers that confirm testicular cancer are alfa-fetoprotein, hCG, and LDH • What are the types and s/s of benign breast disorders? Benign Breast disorders 1. Fibroadenoma o Most common benign tumor in women during reproductive years o Mass of connective tissue unattached to surrounding breast tissue o Tumors are oval, freely movable, rubbery 2. Fibrocystic Breast Condition (FBC) o Fibrocystic changes of breast (may involve lobules, ducts, stromal tissues) o Common in pre-menopausal women between 20 and 50 years of age o Thought to be caused by imbalance in normal estrogen-to-progesterone ratio o Symptoms: Breast pain, tender lumps, swelling (often before menstrual period) o Two main features of FBC: fibrosis and cysts  Fibrosis made up of connective tissue and are hard and firm  Cysts are fluid filled and glandular cells – Breast US is used to confirm presence of cysts. o Postmenopausal women taking hormonal replacement may develop FBC or have worsening symptoms. o This does not increase her chances of Breast CANCER; however, if a firm mass arises a mammogram may be done to rule out cancer o A needle biopsy may be done to rule out cancer IF:  No fluid is aspirated S - The Marketplace to Buy and Sell your Study Material  Mammogram is positive  Mass remains palpable after aspiration  Aspirated fluid reveals cancer cells o Management of FBC:  Analgesics  Limit salt intake before menses  Wear supportive bra at all times  Ice or heat may help  Reduce or eliminate caffeine, dairy product  Needle aspiration may be necessary