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NURSING MANAGEMENT OF COMMON MEDICAL-SURGICAL CONDITIONS AND PROCEDURES ►

CLICK HERE TO ATTEMPT QUESTION CASE 3 FEMALE REPRODUCTIVE SYSTEM

Started on Tuesday, 4 January 2022, 1:58 PM

State Finished
Completed on Tuesday, 4 January 2022, 2:32 PM
Time taken 33 mins 52 secs
Grade Not yet graded
Question 1 What are the risk factors for cervical cancer ?
Complete
Infection by the Human Papillomavirus (HPV) is the most important risk factor for
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cervical cancer.

Other things can increase your risk of cervical cancer—

Having HIV (the virus that causes AIDS) or another condition that makes it hard for
your body to fight off health problems.
Smoking
Using birth control pills for a long time (five or more years).
Having given birth to three or more children.
Women who were younger than 20 years when they had their first full-term
pregnancy are more likely to get cervical cancer later in life than women who waited
to get pregnant until they were 25 years or older.
Having several sexual partners.
Smoking
Women whose diets don’t include enough fruits and vegetables

Almost all cervical cancers are caused by human papillomavirus (HPV). HPV is a group
of more than 150 related viruses.. Some HPV types can cause changes on a woman’s
cervix that can lead to cervical cancer over time, while other types can cause genital or
skin warts.
HPV can infect cells on the surface of the skin, and those lining the genitals, anus,
mouth and throat, but not the blood or internal organs such as the heart or lungs.
HPV can spread from one person to another during skin-to-skin contact. One way
HPV spreads is through sexual activity, including vaginal, anal, and even oral sex.
Different types of HPV cause warts on different parts of the body. Some cause
common warts on the hands and feet; others tend to cause warts on the lips or
tongue.

Other things can increase your risk of cervical cancer—

Having HIV
Smoking.
Using birth control pills for a long time (five or more years).
Having given birth to three or more children.(multiple full term pregnancies)
Women who were younger than 20 years when they had their first full-term
pregnancy are more likely to get cervical cancer later in life than women who waited
to get pregnant until they were 25 years or older.
Having several sexual partners.
Becoming sexually active at a young age (especially younger than 18 years old)
Having one partner who is considered high risk (someone with HPV infection or who
has many sexual partners)
Chlamydia infections
Many low-income women do not have easy access to adequate health care
services, including cervical cancer screening with Pap tests and HPV tests
Women whose diets don’t include enough fruits and vegetables may be at increased
risk for cervical cancer.
DES is a hormonal drug that was given to some women between 1938 and 1971 to
prevent miscarriage. Women whose mothers took DES (when pregnant with them)
develop clear-cell adenocarcinoma of the vagina or cervix more often than would
normally be expected.
Question 2 In preparation for the radium implant, what information should the nurse give?
Not answered

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Radiation therapy (also called radiotherapy) is a cancer treatment that uses

high doses of radiation to kill cancer cells and shrink tumors. At low doses, radiation is
used in x-rays to see inside your body, as with x-rays of your teeth or broken bones.
There are two main types
External Beam Radiation Therapy
External beam radiation therapy comes from a machine that aims radiation at the
cancer. External beam radiation therapy is a local treatment, which means it treats a
specific part of your body. For example, if prson has cancer of the lung, radiation will
only be to your chest
Learn more about external beam radiation therapy.
For this type nurses should:
(1) Put on shoe covers and protective gloves before entering the patient's room.
(2) Work quickly, but effectively and courteously. Minimize time in the room. Remember,
no matter how long you are in the room, you will not receive a radiation exposure large
enough to cause adverse health effects.
(3) Maintain the greatest distance possible from the patient consistent with effective
care. Radiation exposure drops off drastically with increasing distance.
(4) Observe Universal Precautions while handling blood and other body fluids,
especially urine.
(5) Leave all trash, linens and food trays in the room. Upon leaving the room, remove
gloves and shoe covers and place them in the trash box inside the room.
(6) After leaving the room, wash your hands.
(7) In the event of a medical emergency (Code 5) involving the patient, the patient's
well-being is the primary consideration. All initial measures necessary to sustain the
patient should be undertaken, regardless of radiation considerations.
The nurse is also to
Monitor for adverse effects: skin changes, such as blanching, erythema,
desquamation, sloughing, or hemorrhage; ulcerations of mucous membranes;
nausea and vomiting, diarrhea, or gastrointestinal bleeding
Assess lungs for rales, which may indicate interstitial exudate. Observe for any
dyspnea or changes in respiratory pattern.
Identify and record any medications that the client will be taking during the radiation
treatment
Monitor white blood cell counts and platelet counts for significant decreases.

Client Teaching
Wash the skin that is marke d as the radiation site only with plain water, no soap; do
not apply deodorant, lotions, medications, perfume, or talcum powder to the site
during the treatment period. Take care not to wash off the treatment marks
Do not rub, scratch, or scrub treated skin areas. If necessary, use only an electric
razor to shave the treated area
Apply neither heat nor cold (e.g., heating pad or ice pack) to the treatment site.
 Inspect the skin for damage or serious changes, and report these to the radiologist
or physician
Wear loose, soft clothing over the treated area
Protect skin from sun exposure during treatment and for at least 1 year after
radiation therapy is discontinued. Cover skin with protective clothing during
treatment; once radiation is discontinued, use sun-blocking agents with a sun
protection factor (SPF) of at least 15
External radiation poses no risk to other people for radiation exposure, even with
intimate physical contact
Be sure to get plenty of rest and eat a balanced diet.

Internal Radiation Therapy

Internal radiation therapy is a treatment in which a source of radiation is put inside the
body. The radiation source can be solid or liquid.
Internal radiation therapy with a solid source is called brachytherapy. In this type of
treatment, seeds, ribbons, or capsules that contain a radiation source are placed in your
body, in or near the tumor. Like external beam radiation therapy, brachytherapy is a local
treatment and treats only a specific part of your body.
With brachytherapy, the radiation source in the body will give off radiation for a while.
Learn more about brachytherapy.
Internal radiation therapy with a liquid source is called systemic therapy. Systemic
means that the treatment travels in the blood to tissues throughout your body, seeking
out and killing cancer cells. Systemic radiation therapy is given by swallowing, through
an IV line, or through an injection.
With systemic radiation, the body fluids, such as urine, sweat, and saliva, will give off
radiation for a while.
For this type nurses should:
(1) Put on protective gloves before entering the patient's room. Although breakage of a
sealed source is an unlikely occurrence, ingestion of radioactivity is easily prevented by
wearing gloves.
(2) Work quickly, but effectively and courteously. Minimize your time in the room.
(3) Maintain the greatest distance possible from the patient consistent with effective
care. Radiation exposure drops off drastically with increasing distance.
(4) Leave all trash, linens and food trays in the room. Upon leaving the room, remove
gloves and place them in the trash receptacles inside the room. Radiation Safety
surveys all materials before they leave the room.
(5) After leaving the room, wash your hands.
In the event a source becomes dislodged, notify the Radiation Oncology resident on call
immediately. Do not permit others to enter the room until the source is secured. Do not
attempt to handle a dislodged implant or applicator, unless you are specially trained to
do so.
The nurse is also to
Place the client in a private room
Limit visits to 10 to 30 minutes, and have visitors sit at least 6 feet from the client
Monitor for side effects such as burning sensations, excessive perspiration, chills
and fever, nausea and vomiting, or diarrhea
Assess for fistulas or necrosis of adjacent tissues.

Client Teaching
 While a temporary implant is in place, stay in bed and rest quietly to avoid
dislodging the implant
Avoid close contact with others until treatment has been discontinued
If the radiologist indicates the need for such measures, dispose of excretory
materials in special containers or in a toilet not used by others
Carry out daily activities as able; get extra rest if feeling fatigued.
Eat a balanced diet; frequent, small meals often are better tolerated
Contact the nurse or physician for any concerns or questions after discharge

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