CHA2, exam 2 - study guide on the reproductive system and GI PDF

Preview

Summary

study guide on the reproductive system and GI...

Description

Testicular cancer  Risk Factors: Undescended testicles at birth  S/S o Non painful swelling in one testicle  Tx: o Chemo: Causes infertility; Bank sperm before chemo if you want children Through a sperm bank 

Staging of cancer  Ex Question: Cancer is stg 0 o Slow growth  Slow growing cancers o Watchful waiting o Monitor labs, S&S, problems  Norm PSA: o 7 worry prostate cancer Prostate cancer  Man comes in w/ PSA = 10 o Anticipate cares/ Dr will:  Labs  Rectal ultrasound w/ biopsy  If cancer + person: o Prostatectomy o Watchful waiting- depending on age and stage of cancer Watchful waiting  Monitor progression of cancer o Only tx if necessary  Slow growing- may not affect you in long rung TURP- (Prostate removal)  Immediate after procedure irrigation (HUGE amt) o Ex Question: 400mL in 200mL out  First stop infusion/ irrigation  Check kinks in tubing  Bladder scan  May need to manual irrigate w/ obstruction  SE: o Temp urinary incontinence  Limit fluids at night o Bladder Spasms

Admin: B&O suppository if meds not working o Sexual dysfunction  Dr prescribe ED drugViagra  Careful w/ ED drug not okay w/ heart meds o Bleeding Anytime someone has surgery o Encourage cough & deep breath 

BPH NOT CANCER  S/S o BOO (Bladder outlet obstruction s/s) o Urinary symptoms o Dripping, dribbling etc o Hematuria  Come in to test and evaluate for poss UTI  BPH cause bladder & kidney infections Tx: Flomax  Flomax SE: o Check for: o Orthostatic Hypotension  Get up slowly OTC BPH Example Question  Man comes in and says I want to take “Salpemento” for my BPH o As a RN what would you do? o Ask what does your dr say about this med- tlk to dr first o Herbals can interfere w/ other meds Menopause Define: absence of period for 12 months  Cause o ↓ function of ovaries = ↓ estrogen (Biological) o Radiation / Chemo o Hysterectomy w/ oophorectomy (remove ovaries)  Put in immediately by this Perimenopausal S/S:  Hot flashes

   

o ↓ hot spicy foods alcohol Night sweats Irritability Thinning shortening urethra Vag dryness: urethra shorten, atrophy in perineal area o Greater risk for UTI

As a RN how to help w/ S&S  Wear layers  Fan on/ remote control fan- doesn't disrupt sleep  At night have layers to sleep in  Vag dryness o Water based lub Dr Prescribe to tx symptoms  Hormone replacement therapy o Has Uterus  Progesterone o No uterus  Estrogen alone okay o NO ESTROGEN to:  Risk for breast cancers: hx or strong family hx  Some breast cancers thrive off of ESTROGEN Breast Cancer Lymphedema  Immediately after surgery o DON'T raise above shoulder o Elevate arm- okay Mastectomy  YES need mammograms Drains  

After breast removal JP & how to use

Invasive infiltrating ductal carcinoma:  Breast Cancer that spreads into BREAST TISSUE  Infiltrates OUT o (Not just in duct or group but spreads ) o NOT Metastasized!! Ex ?: Pt asks you: What is infiltrating ductal carcinoma?

  

Cancer that spreads into the breast tissue Infiltrate out Not good dx

Breast cancer  BRACA Genes  Genetic counseling Ovarian cancer puts you at risk for breast cancer  Ex Sister breast cancer & mom w/ ovarian cancer o YOU are at ^^ risk for Breast Cancer Abnormal breast tissue  Dimpling  Orange peel skin  ^^ Risk for Breast Cancer  Mammogram right away Pap smears  Detect Cervical cancer  Sample from cervix  No douche/ sex 24hrs before  Not comfortable during pap  When to start? o 21yrs!!!! Self-testicular exam  When: o During or after warm shower o Testes nice and low in sac to feel them o Feel nice smooth not irreg w/ lumps & bumps  Abnorm = call dr  Who is at Greater Risk o Undescended testicle (cryptorchidism) Breast self-exam  

Check 2wks after period Dont check 1wk before

FEEL: 



Lumps & bumps o Some are normal - fibrocystic breasts Non-Mobile mas: CONCERNING



o Connected to chest wall Mobile mass not as concerning

LOOK :  Dimplining o See dimpling on breast  RN AnticipateMammogram today!  Orange skin peel appearance o Look at book DX  Mammogram  Ultrasound  Bipsy Gynecological cancer prevention  Safe Sex  HPV Vaxxx o MEN & WOMEN  Reg pap smears  HEALTHY Diet Meds: Cardura For: BPH  Check BP  Get ortho hypo & syncope Proscar-finasteride Admin for: BPH  Does not work immediately o Take several months to work Example Question:  May get phone call: Dr put me on proscar 2 mo ago I’m still having issues starting stream o NORMAL- Reassure it can take several months Gardasil vaccine For Genital Warts!!! HPV  Admin o BEFORE sexually active o CDC 9-11yrs o 2-3 injections over 6 months

 

Tx for 9 strains HPV Hundreds of strains o Not all cause cervical cancer

Example Question:  “I've had genital warts I don't need vax” o NOT TRUE YOU NEED THAT VAX BRO Tamoxifen Admin for Cancer  RISK/ Monitor For o DVT’s!!!!!!! HIGH RISK FOR CLOTS! Colonoscopy  Prep till bowels are running clear  Pt on Blood thinners o Can not take day of or day before! o Stop several days before Liver disease, cirrhosis, labs  Check OTC use of meds o Herbs? o Tylenol? o Is this causing or adding to the issue? Cirrhosis  Monitor for Esophageal varices  Cause o LOTS OF ALCOHOL Labs:    

Check PT w/ liver dx! o Better then PTT AST/ALT Serum ammonia BILI o S/S high bili  ITCHY SKIN!!  Jaundice- sclera of eyes

NG: nasogastric tube What does it do for us/ purpose  Bowel Rest o Pancreas, GB & liver Colon cancer: Colorectal cancer  Screening o Age: 50yrs  Possible early sign o Rectal bleeding

Crohn’s disease  Risk for: o Cancer o Impaired nutrition  Diet changes to decrease exabsterations  Dx through colonoscopy  Doesn't go away o Can get better and worse Pancreatitis S/S  ABD pain on LUQ (L side)  Stools: o Doesn’t release digestive enzymes that break down fat o FATTY STOOLS Steatorrhea  Insulin!! o ^^ BS o Diabetes  ARDS o L pleural effusions  Amylase & Lipase labs (acute) o Normal:  0-160 Lipase  30-220- Amylase Ulcerative colitis  Malabsorption Bloody Stools!! o Labs: Monitor Hgb o Normal hgb:  M: 13.5-17.5  F: 12.0-15.5 Ileostomy  Stools o o

Liquid normal Monitor electrolytes

Stoma assessment  Should look o Beefy red, Moist, pink  Swollen & bloody after surgery normal Esophageal varices Risk  Alcoholic: Greater risk for cirrhosis NO NG TUBE!!!! Cholecystitis



S/S RUQ pain to shoulder blade!!! Gallbladder in RUQ o After fatty meal! o o



High risk o 4 f’s o Fair, female, fat 40 o Pregnant women!! (Female)

Hepatic encephalopathy  Ammonia ^ in brain o Liver doesn't break down  S/S o Confusion Occurs w/ cirrhosis of liver Low protein diet MED: Lactulose- cause diarrhea Pulling through stools Hepatitis Hep A  Cause: Fecal oral route- Food you eat Person W/ HEP A NO FOOD PREP Prevent with hand washing o Easiest & most economic Self limiting o Rest, it will go away o

  

Pancreatitis S & S Cullen’s sign o Pancreatitis s/s o Bruising around umbilicus Turner’s sign o Pancreatitis s/s o Bruising on flank!! Peritonitis  Distended board like abdomen  Acute abdomen  RISK: o BOWEL PERFORATION o Ruptured bowel,  Peritoneum is sterile!! o Anything that ruptures will cause it to be unsterile  MEDICAL EMERGENCY

Meds: Pancreatic enzymes  When do we get them? o Meals & snacks  Pancreatitis- inflammation o Give this med b/c cannot excrete enzymes Sulfasalazine  Tx exacerbation of UC

Lactulose (cirrhosis)  Help excrete ammonia through stools  Cause o Loose stools DVT:  

ISSUES AROUND DVT BUT NOT DIRECTLY ON DVT (Some of issues around like rupture, peritonitis, ostomies)...