NUR 2759 MDC3 Exam

NUR 2759 MDC3 Exam 1 Review With NCLEX 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 Risk Factors o At least every 3 years for women in their 20s and 30s and every year for asymptomatic women at least 40 years old • 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*