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NURS 534 FINALS REVISION MATERIAL. WELL RESEARCHED AND VERIFIED ANSWERS. A+ GRADE STUDY MATERIAL
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NURS 534 FINALS REVISION MATERIAL. WELL RESEARCHED AND VERIFIED ANSWERS. A+ GRADE STUDY MATERIAL
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NURS 534 FINALS REVISION MATERIAL. WELLRESEARCHED AND VERIFIED ANSWERS. A+
GRADE STUDY MATERIAL
1 . What are the medical treatments for hot flashes?: -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%
2. what factors lower the menopause date? smoking, nulliparity,
menstrual regularity and shorter cycle length, family hx of early
menopause, increased galactose intake, type 1 DM,
3. What defines menopause? -amenorrhea for >1 year
4. What are diagnostic tests for menopause? - TSH
_ HCG
- CBC
- pap
-endometrial biopsy
- transvaginal US
_ FSH
-LH
5. What are some perimenopause symptoms? - sleep
disturbances - mood disturbances
- somatic symptoms (fatigue, palpitations, headache, increased
migraine, breast pain and enlargement) -olio- anovulation
,6. What are some ways to manage of menopause symptoms? -
aerobic exercise
-dietary habits- high complex carbs
- stress reduction
-smoking cessation
- herbal therapies- is flavonoid and black cohosh
7. what are the vaginal/urogenital symptoms of menopause and
how are they treated? - decrease in estrogen produce atrophic
changes in bladder and urethra epithelium
- increased risk for atrophic cystitis- urgency, frequency, incontinence,
dysuria
- disappearance of lactobacilli can increase vaginal infections
- loss of support of the ureterovesical junction can lead to stress urinary
incanting-
cense
- treatments- pap smear and u/a- r/o infix
-topical vaginal application of estrogen product- estradiol ring, or
estrogen vat ran
- water soluble vat lubricants
-sitz bath, vinegar douches,
-Kegels exercises
8. What is the menopausal metabolic syndrome? - lipid triad-
hypertriglyceridemia, increased LDL and decreased HDL
- abhors of insulin- insulin resistance, increased insulin secretion-
hyperinsulinemia
- other factors- endothelial dysfunction, increased visceral fat
9. what is the recommendation for HRT? -only for women with moderate
to severe symports
,-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
10. what are the the concerns with HRT? - increased risk for VT
E
-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
1 1. what are contraindications to HRT? undiagnosed vaginal
bleeding,
-acute vascular thrombosis,
-active liver disease with an LFTs
-history of endometrial or breast cancer
-active or recent angina/MLX
-uncontrolled H TN
-pregnancy or breast feeding
12. What are the WHI 5 points of agreement? 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
3/61
, 5. An increased risk of breast CA is seen in 3-5 years of continuous
estrogen/protester-one therapy
2 /40
13. what monitoring is required for HRT? - 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 protest dose or decrease duration to 7-10 days
14. what are alternatives to HRT? - oral
-patches/gels
-topical estrogen
-mirena
-clonidine
15. what are risk factors for vulvar cancer? - smoking
-HPV infections
-Lichen sclerosis
- immunosuppression
- vulvar or cervical neoplasia
-northern European ancestry
16. What are clinical presentations of vulvar cancer? rare,
Squamous cell - vulvar lump with or without associated pruritic
- discharge
- erythema
-dyspareunia
-dysuria
- bleeding
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