MDC 3 Exam 1
NUR2502 Multidimensional Care III Exam 1 study Guide
Uterine leiomyoma
o Also called fibroids or myomas
o Benign, slow growing solid tumors of uterine myometrium (muscle layer)
o Excessive local growth of smooth muscle cells
Caused by hormones
Cause pain for the patient
o 80% of woman are likely to have fibroids
o Symptomatic or asymptomatic
Key symptom is often heavy vaginal bleeding
o Ask how many pads/tampons are used daily
o Assess pelvic pressure, elimination patterns, abdomen size, dyspareunia,
infertility
Uterine leiomyoma Classification
Classified depending on layer of uterus
Intramural- contained in uterine wall
Submucosal-protrude into uterine cavity
subserosal- protrude through outer surface of uterine wall
Uterine leiomyoma Diagnostic
CBC- iron deficiency anemia from heavy bleeding
Pregnancy test to rule out cause of uterine enlargement
Transvaginal ultrasound- able to see if fibroid is protruding into uterine cavity
Uterine leiomyoma Treatment
Managing bleeding
• Nonsurgical management
o Oral contraception- first thing we do
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
o Organic- gradual deterioration
o Functional- whiskey dick or something like that
o Causes (from textbook)
Inflammation of the prostate, urethra, or seminal vesicles
• Surgical procedures such as prostatectomy
• Pelvic fractures
• Lumbosacral injuries
• Vascular disease, including hypertension
• Chronic neurologic conditions, such as Parkinson disease or multiple sclerosis
• Endocrine disorders, such as diabetes mellitus (a major cause) or thyroid
disorders
• Smoking and alcohol consumption
• Drugs, such as antihypertensives
• Poor overall health that prevents sexual intercourse
If the patient has episodes of ED, it usually has a functional (psychological) cause.
Men with functional ED usually have normal nocturnal (nighttime) and morning
erections. Onset is usually sudden and follows a period of high stress.
Erectile Dysfunction: Treatment
The most common intervention for ED is drug therapy. Other interventions
include vacuum devices, intracorporal injections, intraurethral applications, and
prostheses (implants).
First-line oral drugs used to manage ED, phosphodiesterase-5 (PDE-5) inhibitors,
work by relaxing the smooth muscles in the corpora cavernosa so blood flow to
the penis is increased. The veins exiting the corpora are compressed, limiting
outward blood flow and resulting in penile tumescence (swelling). Teach patients
to take the pill 1 hour before sexual intercourse.
Instruct patients taking PDE-5 inhibitors to abstain from alcohol before sexual
intercourse because it may impair the ability to have an erection. Common side
effects of these drugs include dyspepsia (heartburn), headaches, facial flushing,
, and stuffy nose. If more than one pill a day is being taken, leg and back cramps,
nausea, and vomiting also may occur. Teach men who take nitrates to avoid PDE-
5 inhibitors because the vasodilation effects can cause a profound hypotension
and reduce blood flow to vital organ.
Education related to treatment for HPV/cervical cancer
o Gardisil
o Safe sex
o Annual pap smears after the age of 21
Breast Cancer: Risk Factors
Teach to use multiple methods for early detection
Mammography
Breast self-awareness/self-examination
More than 90% are detected by patient
Clinical breast examination
Options for high-risk women
• Close surveillance, annual MRIs, prophylactic mastectomy
Breast Cancer: Prevention
Teach to use multiple methods for early detection
• Mammography
• Breast self-awareness/self-examination
o More than 90% are detected by patient
o One a month, a few days after the onset of period (breast swell) do standing up
and laying down, use pad of fingertips
• Clinical breast examination
Options for high-risk women
• Close surveillance, annual MRIs, prophylactic mastectomy
Breast Cancer: Diagnostic Tests
Laboratory assessment
• Pathologic study of breast mass tissue and lymph nodes
• Liver enzymes, serum calcium, alkaline phosphatase
Imaging assessment
NUR2502 Multidimensional Care III Exam 1 study Guide
Uterine leiomyoma
o Also called fibroids or myomas
o Benign, slow growing solid tumors of uterine myometrium (muscle layer)
o Excessive local growth of smooth muscle cells
Caused by hormones
Cause pain for the patient
o 80% of woman are likely to have fibroids
o Symptomatic or asymptomatic
Key symptom is often heavy vaginal bleeding
o Ask how many pads/tampons are used daily
o Assess pelvic pressure, elimination patterns, abdomen size, dyspareunia,
infertility
Uterine leiomyoma Classification
Classified depending on layer of uterus
Intramural- contained in uterine wall
Submucosal-protrude into uterine cavity
subserosal- protrude through outer surface of uterine wall
Uterine leiomyoma Diagnostic
CBC- iron deficiency anemia from heavy bleeding
Pregnancy test to rule out cause of uterine enlargement
Transvaginal ultrasound- able to see if fibroid is protruding into uterine cavity
Uterine leiomyoma Treatment
Managing bleeding
• Nonsurgical management
o Oral contraception- first thing we do
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
o Organic- gradual deterioration
o Functional- whiskey dick or something like that
o Causes (from textbook)
Inflammation of the prostate, urethra, or seminal vesicles
• Surgical procedures such as prostatectomy
• Pelvic fractures
• Lumbosacral injuries
• Vascular disease, including hypertension
• Chronic neurologic conditions, such as Parkinson disease or multiple sclerosis
• Endocrine disorders, such as diabetes mellitus (a major cause) or thyroid
disorders
• Smoking and alcohol consumption
• Drugs, such as antihypertensives
• Poor overall health that prevents sexual intercourse
If the patient has episodes of ED, it usually has a functional (psychological) cause.
Men with functional ED usually have normal nocturnal (nighttime) and morning
erections. Onset is usually sudden and follows a period of high stress.
Erectile Dysfunction: Treatment
The most common intervention for ED is drug therapy. Other interventions
include vacuum devices, intracorporal injections, intraurethral applications, and
prostheses (implants).
First-line oral drugs used to manage ED, phosphodiesterase-5 (PDE-5) inhibitors,
work by relaxing the smooth muscles in the corpora cavernosa so blood flow to
the penis is increased. The veins exiting the corpora are compressed, limiting
outward blood flow and resulting in penile tumescence (swelling). Teach patients
to take the pill 1 hour before sexual intercourse.
Instruct patients taking PDE-5 inhibitors to abstain from alcohol before sexual
intercourse because it may impair the ability to have an erection. Common side
effects of these drugs include dyspepsia (heartburn), headaches, facial flushing,
, and stuffy nose. If more than one pill a day is being taken, leg and back cramps,
nausea, and vomiting also may occur. Teach men who take nitrates to avoid PDE-
5 inhibitors because the vasodilation effects can cause a profound hypotension
and reduce blood flow to vital organ.
Education related to treatment for HPV/cervical cancer
o Gardisil
o Safe sex
o Annual pap smears after the age of 21
Breast Cancer: Risk Factors
Teach to use multiple methods for early detection
Mammography
Breast self-awareness/self-examination
More than 90% are detected by patient
Clinical breast examination
Options for high-risk women
• Close surveillance, annual MRIs, prophylactic mastectomy
Breast Cancer: Prevention
Teach to use multiple methods for early detection
• Mammography
• Breast self-awareness/self-examination
o More than 90% are detected by patient
o One a month, a few days after the onset of period (breast swell) do standing up
and laying down, use pad of fingertips
• Clinical breast examination
Options for high-risk women
• Close surveillance, annual MRIs, prophylactic mastectomy
Breast Cancer: Diagnostic Tests
Laboratory assessment
• Pathologic study of breast mass tissue and lymph nodes
• Liver enzymes, serum calcium, alkaline phosphatase
Imaging assessment
