NR 602 Final Exam with complete solution
Colposcopy exam- Correct answer- procedure that visualizes vaginal, vulvar, or cervical
epithelium w/ magnification to id abnormal area to be bx
painful menstruation that prevents normal activity and requires medication
3 types: primary (no organic cause), secondary (pathologic cause) and membranous - causes intense cramping pain due to passage of a cast of endometrium through undilated cervix Correct answer- Dysmenorrhea
Dysmenorrhea treatment Correct answer- Tx- NSAIDs/tyelnol, heat, antiprostaglandins, OCP w/ increased estrogen- pain relief r/t absence of ovulation, decreased prostaglandin production; surgery
Dysmenorrhea mechanism Correct answer- prostaglandin activity
-vaginal wall weakens and stretches and allows the bladder to bulge into the vagina Correct answer- Cystocele
Sx-felling of fullness or pressure in vagina, increased discomfort when you strain/cough/bear down, feeling of incomplete empty, repeated bladder infection, pain or
urinary leak during sex, bulge of tissue into vaginal opening Correct answer- Cystocele
Cystocele prevention Correct answer- kegels, prevent constipation, avoid heavy lifting, avoid wt gain
Rectocele Correct answer- -When thin tissue of vagina separates the vaginal and rectum allowing vaginal wall to bulge
Sx- soft bulge of tissue in vaginal, difficult BM, sensation of rectal pressure, incomplete emptying after BM, sexual concerns Correct answer- Rectocele
Causes of rectocele Correct answer- Causes- constipation/strain, chronic cough, heavy lifting, overweight, childbirth, age
Retocele prevention Correct answer- Prevention- kegels, prevent constipation, avoid heavy lifting, cough, avoid wt gain
-pelvic floor muscles and ligaments stretch and weaken and no longer provide support for uterus and protrude into vagina. Correct answer- Uterine Prolapse Uterine Prolapse causes Correct answer- Causes- pregnancy, large baby delivery, lower estrogen level after menopause, obesity Common in postmenopausal and one or more childbirth
Uterine Prolapse symptom Correct answer- Sx- heaviness or pulling into pelvis, tissue protruding from vagina, urinary probs (leakage, retention), trouble having BM, feeling of sitting on small ball, sexual concerns
Uterine Prolapse prevention Correct answer- Prevention- kegels, treat constipation, correct lifting, avoid wt gain
uterine prolapse treatment Correct answer- Tx- pessary
chronic viral infection caused by HSV1 or HSV2, relapsing Correct answer- Herpes Simplex
Herpes Simplex prevention Correct answer- Prevention: consistent condom use b/c viral
shedding can occur in asymptomatic periods and can lead to transmission. W/ symptoms- Valacyclovir 500 mg daily
Herpes Simplex sign and symptoms Correct answer- Sx-multiple painful vesicular or ulcerative lesion on genitals, can be absent. Virus lays dormant and can be reactivated
Herpes Simplex diagnosis Correct answer- lays dormant and can be reactivated
Dx-cell culture and PCR
Herpes Simplex treatment Correct answer- Tx- systemic antiviral. Acyclovir 7-10 days for 1st episode, suppressive 200 mg daily BID
Chancroid Correct answer- -Transmitted via sexual contact or on hands that have touched lesion. Caused by Haemophillus ducreyi
-Reportable disease
Chancroid symptoms Correct answer- -Sx- erythematous papule that evolves into pustule and degenerates into saucer shaped ragged ulcer that is circumscribed by inflammatory wheal. Tender, heavy foul discharge that is contagious
Chancroid diagnosis Correct answer- Dx-culture that grows H ducreyi
Chancroid treatment Correct answer- Tx- Abx azithromycin 1 g PO one time, ceftriaxone 250 mg IM 1 x, cipro 500 mg PO BID x3 days erythromycin 500 mg PO TID x7 days. Personal hygiene, clean w/ soap and water, sitz bath