ATI cancers of the reproductive systems – Flashcards
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objective data of breast cancer
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physical findings and skin changes (peau d'orange) dimpling breast tumor- irregular, firm, contender, nonmobile increased vascularity nipple discharge nipple retraction or ulceration enlarged lymph nodes
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screening and diagnostic procedures for breast cancer
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biopsy - open or fine needle genetic testing- BRCA1 and BRCA2.. HER2- incates need for target therapy MRI- better visualization nuclear imaging Position emission mammogram Ultrasound x-ray self breast exam
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instruct clients over __ to schedule an annual mammogram
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40
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___ therapy for breast cancer is most effective in cancer cells with estrogen and progesterone receptors.
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hormone
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inhibits estrogen synthesis may be used in premenopausal women to stop or prevent the growth of breast tumors
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Gonadotropin- releasing hormone (lupron)
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used in women who are at high risk for breast cancer or who have advanced breast cancer suppress the growth of remaining cancer cells postmastrerectomy or lumpectomy
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selective estrogen receptor modulators (SERMs)- tamoxifen (Nolvadex and raloxifene (Evista)
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___ has been found to increase the risk of endometrial cancer, deep vein thrombosis, and PE
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Tamoxifen *Nolvadex*
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radiation therapy is usually reserved for clients who had a ___ or breast- conserving procedures
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radiation
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___ care is a priority with radiation due to radiation damage as well as fatigue
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skin
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client who have there HER2 gene may receive ____
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heceptin
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clients who have mestastic cancer way receive a vascular endothelial growth factor inhibitor such as_____
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avastin
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breast conserving surgery
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lumpectomy
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modified radical mastectomy is
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lymph nodes removed
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radical mastectomy is
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lymph nodes and muscles are removed
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nursing action following mastectomy
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sit client 30 degrees arms on pillows wear a sling avoid affected arm provide emotion support, allow them to express feelings
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client education following a mastectomy
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care for incision and drained- left in for 1-3 weeks avoid dependent arm position arm and hand exercises no constitive clothing teach self brest exam report pain and numbness
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nipple reconstruction may be done using tissue from the __,__ or __
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labia, abdomen or inner thigh
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Genetic counseling for clients who test positive for the ___ genetic mutations in crude recommendation of bilateral mastectomy and oophorectomy to prevent cancer
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BRCA 1 and 2
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the more times a women ovulates in her lifetime seems to be a risk factor for ___ because it is more prevalent in women with early menarche, late onset menopause, nulliparity
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ovarian cancer
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__ and ___ may offer protection against ovarian cancer because the reduce estrogen exposure
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birth control pills and pregnancy
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risk factors of ovarian cancer
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over 40 Nulliparity of first pregnancy after 30 family history history of dysmenorrhea or heavy bleeding endometriosis high-fat diet hormone replacement therapy use of infertility meds older adults following surgery
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subjective data of ovarian cancer
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abdominal pain or swelling abdominal discomfort abdominal mass urinary frequency
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physical findings of ovarian cancer
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enlarged ovary - tumor is atleast 4 inches
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screening and diagnostics for ovarian cancer
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Biopsy - pressance of cancer cells Genetic testing- BRCA 1 and 2- breast cancer risk and ovarian Tumor markers - Alpha fetoprotien is high .. Ca-125 is high
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what tumor markers are high with ovarian cancer
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AFP and CA-125
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staging of __ is determined at the time of the hystectomy or laparotomy when the tumor is removed
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ovarian cancer
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__ is always given for ovarian cancer, even if surgery is performed.
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Chemo
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__ and __ are the most common chemo meds used for ovarian cancer
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cisplatin and carboplatin
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a total abdominal hysterectomy with bilateral salpingectomy and oophorectomy is the usual treatment for ___ cancer
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ovarian
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the nurse should observe for what with ovarian cancer
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urinary retention and difficulty voiding assess bowel sounds- paralytic ileum is common
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complications of ovarian cancer
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abdmonial ascites and instestional obstruction
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__ is the 4th most common cancer in women
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Uterine (endometrial cancer)
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endometrial cancer is more common is ___ related to prolonged exposure to estrogen
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older adult women
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Estrogen therapy in postmenopausal women who have a uterus should include ___ to decrease the risk of endometrial cancer
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progesterone
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risk factors of endometrial cancer
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genetic mutation for heredity nonpolyposis colon cancer over 55 obesity uopposed estrogen homone replacement nulliparity use of tamoxifen to treat breast cancer late menopause
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subjective data of endometrial cancer
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irregular and or postmenopausal bleeding
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screening and diagnostics for endometrial cancer
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biopsy pathology testing of staging genetic testing - HNPCC Tumor markers- AFP and CA-125
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for Endometrial cancer __ therapy is usually given after a hysterectomy
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radiation
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__ is useful in palliative care of endometrial cancer
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chemo
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standard treatment for endometrial cancer
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total hysterectomy with bilateral salpingectomy
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__ is a slow growing cancer. it is increasing and affecting a younger population . manifestation do not occur until the cancer has become invasive
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cervical cancer
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prevention of cervical cancer
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vaccinations with HPV vaccine limit numer of sex partners and use condoms
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biggest risk factor of cervial cancer
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infection with HPV others cervial inflammation sex transmitted diseases early sex multiple partnes smoking poor african american
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subjective data of cervical cancer
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painless vaginal bleeding between menses watery, blood tinged vaginal discharge weight loss pelvic pain pain after sex
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screening and diagnostic tests for cerival cancer
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biopsy and HPV typing pap test
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if a patient is at risk for cerival cancer teach them
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report heavy bleeding, foul smells, fever avoid heavy lifting , tampons
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radiation may be used for cervial cancer
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monitory skin damage chemo may be used also
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clients with early stage of cervical cancer may require a
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hysterectomy
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clients with a more extensive cerival cancer may require a more extensive pelvic surgery called ____
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exenteration
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___ involves removal of the uterus, cervix, fallopian tubes, vagina, ovaries, bladder, erethra, and lymph nodes. an ideal conduit is established
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anterior exenteration
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___involves removal of the uterus, cervix, fallopian tubes, vagina, ovaries,anal canal, rectum, and colon. colostomy is used
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posterior exenteration
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__ can develop after a pelvic exenteration
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fistula
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two types of testicular cancer are
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Germ cell (sperm producing) or non germ cell
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classified as summons or nonseminomas. summons are more common type of tesicular cancer and have the better prognosis
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germ cell
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___ testicular cancer is usually unilateral. bilateral tumors typically indicate metastasis from another site
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primary
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___ options should be disscussed with the client soon after diagnosis on testicular cancer
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sperm banking
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risk factors of Testicular cancer
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HIV infection undescended testis (cyroptorchidism) genetic disposition metastases ages 20 to 54
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subjective data of testicular cancer
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lumps and or swelling of testes feeling of heaviness in the testicules evidence of metastasis (abdominal masses, gyro, back pain)
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objective findings of Testicular cancer
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enlarged testes without pain palpable lump welling of lymph nodes in groin
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screening and diagnostics for testicular cancer
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biopsy ultrasound- visual of tumor Tumor markers- AFP, HCG**, LHD testicular self exam testostrone levels increased low sperm count
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treatments for testicular cancer
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chemo or radiation
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removal of the affected testis with placemnt of prosthesis. treatment of choice for testicular cancer
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orthiectomy
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__ is a slow-growing cancer. it is usually slow growing in response to adrogen
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prostate
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the __ and __ are the sites of origin for most prostate cancers
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posterior lobe and outer gland epithelium
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prevention of Prostate cancer
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diet low in fats and high in omega 3 exercise
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risk factors of prostate cancer
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history of vasectomy age greater than 65 family history african AM high fat diet BCRA2 mutation rapid growth od prostate
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subjective data of prostate cancer
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urinary hesitancy and weak stream bladder infection urinary retention blood in urine and seem painful ejaculation
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objective findings of prostate cancer
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residual urine after voiding
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screening and diagnosis for prostate cancer
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DRE biopsy genetic testing- BRCA2 PSA- greater than 4 early prostate cancer antigen BUN, creatinine- renal damage TRUS- visual of lesions Urinalysis- infections
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screening for prostate cancer should begin at age __
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40
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used in advantaged prostate cancer to produce chemical castration
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Lupron -gonadotropin releasing homone
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when taking lupron, clients may experience
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hot flashes decreased libido osteroporosis due to low T
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used in conjunction with a gonadotropin releasing homone, it is a androgen receptor blocker used in prostate patients
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Flutamide (Eulexin)
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when taking Flutamide (Eulexin for prostate problems, what can occur
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gyno liver issues
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usually used to treat breast cancer but can be used to treat prostate cancer as well
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Docetaxel (Taxotere) watch for anemia
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___ is the treatment of choice for prostate cancer
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Radical prostatectomy
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involves the removal of the prostate, along with seminal vesicles, the cuff at the bladder neck and lymph nodes
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radial prostatectomy
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after prostate surgery
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avoid baths for 3 weeks kegel exercises to reduce urinary incontinence
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