NUR 2502 / NUR2502 Exam 1, Multidimensional Care III / MDC 3 - Rasmussen College

NUR 2502 / NUR2502 Exam 1, Multidimensional Care III / MDC 3 - Rasmussen College. Which stage of syphilis is this? ▪ Ulcer called chancre develop at the site of entry and can occur anywhere. ▪ Highly infectious stage, begins as a small papule, then breaks down to a painless, indurated, smooth weeping lesion Correct Answer: Primary syphilis Which stage of syphilis is this? ▪ Develops 6 weeks to 6 months, becomes systemic circulating in the blood. ▪ Commonly mistaken for the flu. Rash appears on the palmar surfaces of hands and feet. Patchy alopecia Correct Answer: Secondary syphilis Treatment: *Syphilis* Correct Answer: ▪ Penicillin G ▪ What do you ask before giving? "Do you have any allergies?" Treatment: *Chlamydia* Correct Answer: Azithromycin single dose 1 g IM Patient Education: *Chlamydia* Correct Answer: ▪ *Abstinence* (7 days) until treatment is completed ▪ *Expedited Partner Therapy (EPT)* - Educate the patient on the importance of contacting their sexual partners to enable them to seek testing and possible treatment. Prevention: *Vulvovaginitis* (SATA?) Correct Answer: • Wear cotton underwear. • Always wipe front to back after having a bowel movement or urinating. • Do not douche or use feminine hygiene sprays. • Do not use scented products. • Use ice packs to help inflammation Patient has heavy vaginal bleeding - What are you checking and what manifestations do you expect? (SATA?) Correct Answer: ▪ iron levels ▪ CBC (H&H) ▪ hormone levels ▪ low blood pressure S/S: ▪ dizziness ▪ weakness ▪ fatigue ▪ SOB Patient Education: *Urinary Incontinence* (SATA?) Correct Answer: ▪ Kegel exercises ▪ Bladder training ▪ No drinking after 5pm or 6pm ▪ Avoid foods or drinks with caffeine ▪ Skin care ▪ Proper hygiene S/S: *BPH* Correct Answer: ▪ distended bladder ▪ visible mass above the symphysis pubis ▪ **difficulty initiating urination** ▪ decreased urine stream ▪ diminished force of urinary stream ▪ urinary hesitancy ▪ urinary frequency ▪ urinary urgency ▪ urinary retention ▪ incontinence ▪ incomplete emptying of the bladder ▪ **dribbling post-voiding** ▪ nocturia ▪ hematuria ▪ straining with urination ▪ obstruction of urine flow **presents as a uniform, elastic non-tender enlargement** Pharmaceutical Treatment: *BPH* Correct Answer: alpha-1 blockers (doxazosin) - better for patients with hypertension too What medications should patients with BPH avoid? Correct Answer: anticholinergics Pharmaceutical Treatment: *Erectile Dysfunction* Correct Answer: ▪ phosphodiesterase - 5 (PDE-5) inhibitors (ex: sildenafil, vardenafil, tadalafil) Risk factors for ED (SATA?) Correct Answer: ▪ **Stress** ▪ **Increasing age** ▪ **Smoking** ▪ Obesity ▪ **Hypertension** ▪ **Medications such as antihypertensives** ▪ **Endocrine disorders (Diabetes mellitus, thyroid)** ▪ Chemotherapy ▪ **Alcohol and drug abuse** ▪ **Trauma or surgery to the pelvic area** ▪ Lumbosacral injuries ▪ Pelvic fractures ▪ Neurological diseases (Parkinson's and multiple sclerosis) ▪ Inflammation of seminal vesicles, urethra, and prostate ▪ **Prostatectomy, TURP** ▪ Poor overall health that prevents sexual intercourse ▪ **DVT, PE** ▪ **Cardiac issues** Therapeutic communication... Correct Answer: ▪ respect to privacy ▪ nonjudgmental ▪ open ended Qs "Tell me more..." "It sounds like..." Prostate Cancer - Where is the most common site for metastasis? Correct Answer: bone Blood levels that might be elevated if prostate CA has metastasized to the bone (SATA?) Correct Answer: Phosphorus (>4.5) Potassium (> 5.0) Magnesium (> 2.5) Calcium (>10.5) Creatinine (> 1.2) BUN (> 20) Liver enzymes What do we use to screen prostate CA? And when should this start? Correct Answer: ▪ PSA ▪ age 40 (risk), 50 (non risk) + prostate exam S/S: *Prostate Cancer* Correct Answer: ▪ often asymptomatic - if you're not getting screened you won't know! late: hematuria, bone pain, scrotal edema Patient Education: *Testicular Cancer* Correct Answer: ▪ sperm banking ▪ self checking Risk Factors: *Breast CA* Correct Answer: *Non-modifiable* ▪ Increased age - primary risk factor for both men and women ▪ **Genetics (mutations in BRCA1 and BRCA2)**