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NURS 534 FINAL EXAM WITH LATEST 100% VERIFIED QUESTIONS AND CORRECT ANSWERS GRADED A+
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NURS 534 FINAL EXAM WITH LATEST 100% VERIFIED QUESTIONS AND CORRECT ANSWERS GRADED A+
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NURS 534 FINAL EXAM 2024-2025 WITHLATEST 100% VERIFIED QUESTIONS AND
CORRECT ANSWERS GRADED A+
What are the medical treatments for hot flashes? - ANS--Estrogen- principal treatment
-progestins- can be used if contraindicated for estrogen BUT increased RISK for BREAST CA
- Clonidine- centrally acting alpha agonist
- SSRI and SNRI
-Gabapentin- decrease HF b 50-80%
what are symptoms of cervical cancer? - ANS-- brownish discharge
-abn vaginal bleeding
- abnormal cytology
what are the guidelines for pap smears? - ANS-- screening begins at age 21
-21-29, PAP Q3 years
- >30-65, PAP and HPV Q 5 years, or pap Q 3 years
- immunosuppresion= more frequent
- >65 with no precancers in 20 years can stop testing
,- hysterectomy with cervix removal do not need pap smears
What is the cervical cancer follow-up? - ANS-- cytology repeated 4-6 months for 2 years
- high risk disease should be followed q 3 months for 1st 2 years, every 6 months for years 3-5, then
annually
- lower risk patients- followed q 6 months for 1st 2 years then annually?
what factors lower the menopause date? - ANS-smoking, nulliparity, menstrual regularity and shorter
cycle length, family hx of early menopause, increased galactose intake, type 1 DM,
What defines menopause? - ANS--amenorrhea for >1 year
-
What are diagnostic tests for menopause? - ANS-- TSH
- HCG
- CBC
- pap
-endometrial biopsy
- transvaginal US
-FSH >40
-LH
What are some perimenopause symptoms? - ANS-- sleep disturbances
- mood disturbances
- somatic symptoms (fatigue, palpitations, headache, increased migraine, breast pain and enlargement)
-oligio- anovulation
What are some ways to manage of menopause symptoms? - ANS-- aerobic exercise
-dietary habits- high complex carbs
- stress reduction
,-smoking cessation
- herbal therapies- isoflavonoid and black cohosh
what are the vaginal/urogenital symptoms of menopause and how are they treated? - ANS-- decrease in
estrogen produce atrophic changes in bladder and urethra epithelium
- increased risk for atrophic cystitis- urgency, frequency, incontinence, dyuria
- disappearance of lactobacilli can increase vaginal infections
- loss of support of the urethrovescical junction can lead to stress urinary incontincence
- treatments- pap smearand u/a- r/o infx
-topical vaginal application of estrogen product- estradiol ring, or estrogen vag rin
- water soluble vag lubricants
-sitz bath, vinegear douches,
-kegels exercises
What is the menopausal metabolic syndrome? - ANS-- lipid triad- hypertriglyceridemia, increased LDL
and decreased HDL
- abnorms of insulin- insulin resistance, increased insulin secretion- hyperinsulinemia
- other factors- endothelial dysfunction, increased visceral fat
what is the recommendation for HRT? - ANS--only for women with moderate to severe symptoms
-not for prevention of heart disease or stroke, dementia
-used for vasomotor symptoms- hot flashes, night sweats disturbed sleep patterns, concentration,
memory
-prevent/treat osteoporosis- hip and vertebrae
- GU atrophy- bladder irritability, vaginal dryness, dyspareunia
-MINIMUM dose for shortest time required
what are the the concerns with HRT? - ANS-- increased risk for VTE
-increased risk for breast CA with prolonged use
-increased risk for endometrial cancer with ET
, -increase risk for cardiac events for older women with EPT
-probable increase in strokes
what are contraindications to HRT? - ANS-undiagnosed vaginal bleeding,
-acute vascular thrombosis,
-active liver disease with abn LFTs
-history of endometrial or breast cancer
-active or recent angina/MI
-uncontrolled HTN
-pregnancy or breast feeding
What are the WHI 5 poits of agreement? - ANS-1. for younger women, HRT is acceptable for mod/severe
menopausal young women 59yo
2. women with a uterus need to take progesterone along with estrogen to prevent cancer of the uterus
3. Women who have vaginal symptoms only preferred treatment is low doses of vaginal estrogen
4. Both estrogen and progesterone increase the risk of blood clots
5. An increased risk of breast CA is seen in 3-5 years of continuous estrogen/progesterone therapy
what monitoring is required for HRT? - ANS-- follow-up in 3 months- BP, wight, symptoms, bleeding
-erratic bleeding common in 3-6 months- any longer needs further w/u
- progesterone side effects (fluid retention, weight gain, mood swings) can half progest dose or decrease
duration to 7-10 days
what are alternatives to HRT? - ANS-- oral
-patches/gels
-topical estrogen
-mirena
-clonidine
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