Female GYN Cancer Med Surg – Flashcards

decreased level of estrogen -starts at age 35

Process is done, post babies -age 45-52 or later

Inflammation of tissues from inner lining of uterus Sxs: pain, hemorrhage, anemia

-Empty bladder before exam -Supine Laparotomy position, Upright Laparotomy, Left Sims Position -should not hurt unless infected or inflamed

Detects cervical cancer/STDs -do not do during period or douching -Atypical squamous cells w/ HPV (do biopsy, pt will have watery discharge) -Atypical cells w/ no HPV (check pt again in a year) -Pain = Pos. Chandler Sign (infection) -Uterine Inspection (1 hand in vj & 1 pushing on abdominal wall) -Cancer looks like califlower, bleeds easily

For pt who had multiple pregnancies, will have lacerations, dilated 2-3 cm

-more extensive -packing left in vj -no sex until after healing

women with midlife irregular bleeding, will have some pain

diagnostic for cause of bleeding & therapeutic treatment -obtains endometrial tissue

Direct visual of uterine cavity -Adjacent to D&C -Treats infertility, fibroids, implants IUDs, detects early pregnancy

Myomatous or Fibroid Tumors -Can be intracavity (in lining), intramural (in wall), or outside of the uterus -Develop slowly

Infertility Meno/Metorraghia Backache Bleeding urinary problems Asymptomatic Pain

Disappears after menopause -Myomectomy (removal of large tumors) -Hysteroscopic Resection (resection w/ laser, no overnight stay or incision) -Hysterecctomy (for meno/metorraghia. Sxs- severe chills) -Meds (Lurpine-temp menopause, shrinks size of tumors before surgery)

Early intercourse HPV Unsafe sex Smoking

Asymptomatic in beginning Thin watery discharge after sex/douching, irregular bleeding/discharge, pain after sex Advanced: spotting, irregular bleeding between periods, back/leg pain, dysmenorrhea, painful urination, rectal bleeding, edema, dysrua, fever, anemia, abscesses, fistulas

Screening: Pap Smear -biopsy, x-ray, lab tests Diagnosis: Colposcopy

Radical Hysterectomy (large lesion) Radical Trachelectomy (alternative to hysterectomy, for young women who want kids, removes cervix) Pelvic Extenteration (reocurrent cancer, increased risk for surgical complications)

Corpus & Fundus

Increased Estrogen Early period & late menopause Afertile, Infertility, Nulliparity Diabetes, HTN, Gallbladder disease, Obesity Hermoxicine (drug for breast cancer)

Annual check up, ultrasound, biopsu Diagnostic: Biopsy Aspiration

Total hysterectomy, oophorectomy Whole pelvis radiation (temporary) Pre-op radiation (stage 2 cancer) Surgery & radiation (reocurrent cancer) Chemo & hormone therapy (cancer extended beyond vj)

Smoking HPV HIV Immunosuppressant therapy Chronic vulva irritation Early sexual activity

Long-standing pruritus & soreness Presents as chronic dermatitis/lumps/ulcer/mass Late signs: bleeding, foul-smelling discharge, pain

Surgical, Chemo, Creams, Cryosurgery Vulvectomy (wide excision of the vulva) -w/ or w/out lymph node dissection -Additional therapy: chemo or radiation -complications (infection, sepsis, DVT, hemorrhage, vj scarring)

Rare, takes years to develop Risk Factors (previous female cancer, use of vaginal pessaries, DEF drug) Treatment (laser/radical vaginectomy- reconstructive surgery)

Rare, least common, any age SxS (abdominal pain, distention, bleeding) Diagnosis (Sonogram) Treatment (Surgery first, than radiation)

*causes the most death Nulliparity Infertility Talcum powder

*there is no screening tool* Nonspecific, increased abdominal girth, pelvic pressure, bloating, constipation, abdominal pain, flatulence, urinary urgency, indigestion, leg/pelvic pain

Removal of uterus & cervix

Removal of uterus, surrounding tissues, including lymph nodes

Remove fungus & leave cervix

Under anesthesia, applicators placed, x-ray done after, radiologist loads predetermined amount, decreases exposure for others & makes sure its the exact amount. Pt in isolated room or room w/ lead wall, adjacent room must be dislocated

Foley Catheter **Bed Rest: 24-72 hours* Diet: low residue Hygiene: don't clean perineal area No prego visitors or visitors under 18 S/E: fatigue, spasms *Leg exercises for circulation

Staff: wear film badges, decrease time around pt If device becomes dislodged do not touch & call radiation safety Wear: rubber gloves, no latex

-progressive ambulation -allowed to shower, no douching -Radiation S/E (fatigue, enteritis (diarrhea & cramping), cystitis (urinary frequency)

4.) "I need to have my first Pap test when I turn 21 or earlier if I become sexually active." (Screening should begin within 3 years of the initiation of sexual intercourse or at 21 years of age. Pap smear is a painless and relatively inexpensive method of early detection. Preventive measures for cervical cancer include regular pelvic examinations and Pap tests for all women, especially older women past childbearing age.)

3.) Provide emotional support to the patient and her family (Emotional support is an integral part of nursing care at this point in the disease progression. It is not normally appropriate for the nurse to inform the family of the patient's diagnosis. It may be inappropriate and simplistic to focus on distraction, relaxation, and positive thinking.)

1.) Douching (Risk factors for vulvovaginal infections include frequent douching, allergies, oral contraceptive use, use of broad-spectrum antibiotics (for bacterial infections), and low estrogen levels)

2.) WBC count (The patient's white blood cell count is low, revealing leukopenia and placing the patient at an increased risk for infection. The other results are within normal parameters and would not be a cause for concern)

4.) 45-year-old woman who has never been pregnant (The incidence of ovarian cancer increases in women who have never been pregnant, are older than age 40, are infertile, or have menstrual irregularities. Other risk factors include a family history of breast, bowel, or endometrial cancer. The risk of ovarian cancer is reduced in women who have taken hormonal contraceptives, have had multiple births, or have had a first child at a young age.)

1.) Tumors present with nonspecific symptoms 2.) There is no effective screening test. 3.) Tumors are typically far advanced and inoperable by the time they are diagnosed 4.) They are the leady cause of gynocological cancer deaths (Although other types of female reproductive system cancers occur with greater incidence, ovarian tumors are the leading cause of death from gynecologic malignancies. Tumors of the ovary have been lethal largely because they present with nonspecific symptoms; there is no effective screening test, and therefore tumors frequently are far advanced and inoperable by the time they are diagnosed. Ovarian tumors are the leading cause of death from gynecologic malignancies partly because they present with nonspecific symptoms. Ovarian tumors are the leading cause of death from gynecologic malignancies partly because there is no effective screening test. Ovarian tumors are the leading cause of death from gynecologic malignancies partly because tumors are typically far advanced and inoperable by the time they are diagnosed.)

2.) Vaginal invasion

2.) It grows within the wall of the uterine muscle.

2.) "The cancer has not spread" (carcinoma in situ means the cancer has not left the original site and therefore has not invaded other tissues. Further treatment is required, which usually consists of cryosurgery or hysterectomy. Surgery with adjuvant chemotherapy is usually reserved for cancers that are more advanced. Even though cervical cancers tend to be slower growing, treatment should not be delayed)

2.) Scheduled analgesia should be administered around-the-clock to prevent pain (Because of the wide excision, the patient may experience severe pain and discomfort even with minimal movement. Therefore, analgesic agents are administered preventively (i.e., around the clock at designated times) to relieve pain, increase the patient's comfort level, and allow mobility. Opioids are usually required)