Pelvic Inflammatory Disease (PID), pg 4490

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Questions and Answers

What is the most common cause of Pelvic Inflammatory Disease (PID)?

Fungal infections

Viral infections

Chlamydia (correct)

Bacterial vaginosis

Which of the following clinical manifestations is most specifically associated with PID?

Rash

Chest pain

Dysuria (correct)

Shoulder pain

What risk factor is considered significant for the development of PID?

Gynecological surgeries

Use of hormonal contraceptives

Early age at first intercourse (correct)

Having a single sexual partner

Which physical examination finding suggests the presence of PID?

Cervical motion tenderness Signup and view all the answers

What complication can arise from untreated Pelvic Inflammatory Disease?

Ectopic pregnancy Signup and view all the answers

What is a potential serious complication of a tubo-ovarian abscess if it ruptures?

Septic shock due to infectious pus Signup and view all the answers

Which antibiotic combination is recommended for treatment?

Doxycycline, Azithromycin, and Ceftriaxone Signup and view all the answers

What is NOT a reason for admitting patients for hospitalization?

Improvement from therapy Signup and view all the answers

Which nursing management strategy is crucial for infection control?

Teach proper perineal care Signup and view all the answers

What should patients be advised to do regarding their antibiotic regimen?

Finish the full course of antibiotics Signup and view all the answers

What should nursing staff emphasize regarding patient symptoms to report?

Delayed menses and dizziness Signup and view all the answers

Which condition could warrant the use of an NG tube for suction?

Abdominal distention due to GI involvement Signup and view all the answers

What is the first diagnostic method used for suspected infections?

Ultrasound and culture of vaginal discharge Signup and view all the answers

What is a vesicovaginal fistula?

An abnormal opening between the bladder and the vagina Signup and view all the answers

Which of the following is a recommendation for managing rectovaginal fistula?

Low fiber and low-residue diet Signup and view all the answers

What clinical manifestation is associated with a cystocele?

Frequent urination Signup and view all the answers

What is the main goal of medical management for vaginal fistulas?

Prevent infection and manage symptoms Signup and view all the answers

What test can help diagnose a vesicovaginal fistula?

Tampon test with methylene blue dye Signup and view all the answers

At what age should cervical cancer screening begin?

21 Signup and view all the answers

What symptom indicates the presence of vulvar cancer?

Non-healing ulceration Signup and view all the answers

What is a common practice for strengthening pelvic floor muscles?

Kegel exercises Signup and view all the answers

What condition is characterized by the downward displacement of the bladder?

Cystocele Signup and view all the answers

Which symptom is NOT associated with rectocele?

Urinary urgency Signup and view all the answers

What is the typical characteristic of Grade 1 tumors?

They contain cells that resemble normal tissue. Signup and view all the answers

Which symptom is most commonly associated with ovarian cancer?

Increased abdominal girth Signup and view all the answers

What is the primary risk factor for developing ovarian cancer?

Family history of the disease Signup and view all the answers

Which treatment is commonly used for advanced ovarian cancer?

Paclitaxel and carboplatin chemotherapy Signup and view all the answers

What is true about a radical hysterectomy?

It includes the removal of the uterus and surrounding tissues. Signup and view all the answers

Which of the following symptoms best describes ascites management for patients?

Encourage small frequent meals and limit fluid intake Signup and view all the answers

What is a common preoperative nursing measure for total abdominal hysterectomy?

Performing a pregnancy test Signup and view all the answers

What kind of symptoms are typically seen in women with ovarian cancer?

They usually have vague and nonspecific symptoms. Signup and view all the answers

Which genetic mutation is associated with an increased risk of ovarian cancer?

BRCA1 and BRCA2 Signup and view all the answers

What nursing diagnosis is commonly applicable for a postoperative patient after a hysterectomy?

Acute pain Signup and view all the answers

What is the recommended cervical cancer screening frequency for women aged 21 to 29?

Every 3 years Signup and view all the answers

Which of the following statements about HPV testing for women aged 21 to 29 is true?

HPV testing should only be performed after an abnormal Pap test result Signup and view all the answers

What is the most common symptom of cervical cancer?

Irregular bleeding Signup and view all the answers

At what age should women stop cervical cancer testing if they have had regular testing with normal results?

Age 65 Signup and view all the answers

What is the primary treatment option for a tumor less than 3 mm in invasive cervical cancer?

Hysterectomy Signup and view all the answers

Which type of cancer begins in the mucus-producing glands and is often associated with HPV infection?

Adenocarcinoma Signup and view all the answers

What procedure is used to obtain a sample of abnormal cervical tissue for analysis?

Colposcopy Signup and view all the answers

What is the significance of HPV types 16 and 18 in cervical cancer risk?

They are the primary cause of cervical cancer Signup and view all the answers

What is the biggest sign of endometrial cancer?

Menopausal bleeding Signup and view all the answers

Which risk factor is associated with endometrial cancer?

Obesity Signup and view all the answers

What method is used to diagnose cervical cancer?

Pap smear Signup and view all the answers

What is the primary purpose of LEEP in cervical cancer treatment?

To cut away abnormal cervical cells Signup and view all the answers

Which of the following is a potential complication after cervical cancer surgery?

Cramps and vaginal bleeding Signup and view all the answers

What is a typical intervention if a tubo-ovarian abscess develops?

Perform an incision and drainage Signup and view all the answers

What is the primary diagnostic method used for suspected pelvic infections?

Ultrasound Signup and view all the answers

Which combination of antibiotics is recommended for treatment?

Doxycycline, Azithromycin, and Ceftriaxone Signup and view all the answers

When should a patient with pelvic inflammatory disease be hospitalized?

If there is no improvement from therapy Signup and view all the answers

What position should patients maintain for effective drainage during nursing management?

Semi-fowler's position Signup and view all the answers

Which symptom should patients be educated to report to their healthcare provider?

Shoulder pain Signup and view all the answers

What is a potential complication of untreated pelvic inflammatory disease?

Tubo-ovarian abscess Signup and view all the answers

What strategy is essential for infection control in nursing management?

Maintaining strict medical sepsis Signup and view all the answers

What is a common clinical manifestation of a rectovaginal fistula?

Fecal incontinence Signup and view all the answers

Which of the following dietary recommendations is most appropriate for a patient recovering from a rectovaginal fistula?

Low fiber diet Signup and view all the answers

What is the primary goal of the medical management for a patient with a fistula?

To prevent infection and promote healing Signup and view all the answers

Which statement about pelvic organ prolapse is true?

It can result from weakened pelvic floor muscles due to childbirth. Signup and view all the answers

Which test is used to diagnose the presence of a vesicovaginal fistula?

Tampon test with methylene blue dye Signup and view all the answers

What is a typical characteristic symptom of a cystocele?

Pelvic pressure and urgency Signup and view all the answers

Which intervention is most effective for strengthening the pelvic floor muscles?

Kegel exercises Signup and view all the answers

What is a key nursing responsibility when a patient undergoes a pelvic exam?

To provide a non-stressful environment and education Signup and view all the answers

What is an important feature in diagnosing pelvic organ prolapse?

Symptoms can vary based on the degree and location of prolapse Signup and view all the answers

What is the general management approach for vulvar cancer?

Early detection through screenings like pelvic exams and pap smears Signup and view all the answers

What is a significant risk factor for developing Pelvic Inflammatory Disease (PID)?

Having multiple sexual partners Signup and view all the answers

Which of the following symptoms is characteristic of an ectopic pregnancy associated with Pelvic Inflammatory Disease (PID)?

Severe shoulder pain Signup and view all the answers

What type of infection is primarily responsible for the development of Pelvic Inflammatory Disease (PID)?

Bacterial infections, primarily Chlamydia and Gonorrhea Signup and view all the answers

What physical exam finding is classically associated with Pelvic Inflammatory Disease (PID)?

Cervical motion tenderness or 'chandelier sign' Signup and view all the answers

Which of the following is a potential complication of untreated Pelvic Inflammatory Disease (PID)?

Ectopic pregnancy Signup and view all the answers

What characterizes Grade 1 tumors?

Tumor cells and organization appear close to normal Signup and view all the answers

Which of the following risk factors is considered the most significant for ovarian cancer?

Family history Signup and view all the answers

What symptom is most commonly associated with ovarian cancer?

Increased abdominal girth Signup and view all the answers

Which type of treatment is typically used in conjunction with chemotherapy for ovarian cancer management?

Adjuvant radiation Signup and view all the answers

What is the focus of nursing management for a patient undergoing ovary removal and other affected organs?

Providing emotional and educational support Signup and view all the answers

Which surgical method involves the removal of the uterus through the vagina?

Vaginal hysterectomy Signup and view all the answers

Which of the following symptoms is NOT typically associated with the early detection of ovarian cancer?

Severe weight loss Signup and view all the answers

What preoperative nursing intervention is essential before a total abdominal hysterectomy?

Administer prophylactic antibiotics Signup and view all the answers

What does the grading of a tumor indicate in relation to its growth?

Higher grades indicate rapid growth and less differentiation Signup and view all the answers

Which of the following describes a radical hysterectomy procedure?

Removal of the uterus with surrounding tissue and cervix Signup and view all the answers

What is the recommended frequency for Pap tests for women aged 30 to 65?

Every 5 years with HPV testing or every 3 years with Pap test alone Signup and view all the answers

Which symptom is most commonly associated with advanced cervical cancer?

Dark, foul-smelling discharge Signup and view all the answers

What factor significantly increases the risk of developing cervical cancer?

HPV types 16 and 18 Signup and view all the answers

Which diagnostic method is primarily used to identify cervical cancer?

Pap smear Signup and view all the answers

What is the primary purpose of LEEP in cervical cancer management?

Excision of abnormal cervical tissue Signup and view all the answers

At what age should women cease cervical cancer testing if they have consistent normal results?

Age 65 Signup and view all the answers

Which procedure allows visualization of the cervix and sampling of abnormal tissue?

Colposcopy Signup and view all the answers

Which of the following is considered a significant risk factor for endometrial cancer?

Obesity Signup and view all the answers

What is the most significant clinical manifestation of endometrial cancer?

Menopausal bleeding Signup and view all the answers

Which treatment is recommended for invasive cervical cancer with a tumor less than 3 mm?

Hysterectomy Signup and view all the answers

What is the usual method of diagnosing endometrial cancer?

Endometrial aspiration/biopsy Signup and view all the answers

What is the expected complication after cervical cancer surgery?

Fertility complications Signup and view all the answers

Which hormonal factor significantly contributes to the risk of endometrial cancer?

Unopposed estrogen therapy Signup and view all the answers

Study Notes

Pelvic Inflammatory Disease (PID)

PID is an inflammatory condition of the pelvic cavity, often arising from cervicitis, leading to reproductive organ infections.
It can present as acute, subacute, recurrent, or chronic and varies from localized to widespread.
PID significantly jeopardizes female fertility.
Most cases are bacterial, primarily caused by Chlamydia and Gonorrhea; viral, fungal, or parasitic infections may also occur.
Risk factors include use of IUDs, multiple sexual partners, early sexual debut, unsafe sex, history of STDs, and bacterial vaginosis.

Clinical Manifestations

Key symptoms include dysuria, dyspareunia, lower abdominal pain (referred to as "PID shuffle"), abnormal bleeding, and vaginal discharge.
Increased pain during urination or defecation is common.
Progressive symptoms may include high fever, fatigue, and malaise.
Cervical motion tenderness, termed "chandelier sign," indicates significant discomfort during pelvic examination.

Complications

Inflammation may cause ectopic pregnancy, infertility, abscess formation, and adhesions affecting various organs.
Ectopic pregnancy symptoms include unilateral pain, shoulder pain, and abnormal bleeding.
Serious complications can arise such as bacteremia, septic shock, and tubo-ovarian abscesses requiring incision and drainage.

Diagnosis and Treatment

Diagnosis usually involves ultrasound and cultures of vaginal discharge.
Treatment includes broad-spectrum antibiotics: Doxycycline, Azithromycin, and Ceftriaxone, often known collectively as "DAC."
Hospitalization may be necessary for those with severe illness or complications.

Nursing Management

Education on maintaining semi-Fowler's position for drainage and proper infection control is vital.
Emphasize safe health practices and completing antibiotic courses.
Patients should be informed about symptoms requiring medical consultation.

Fistulas of the Vagina

A fistula represents an abnormal opening between two internal organs or between an internal organ and the exterior.
Types include:
- Vesicovaginal fistula: leads to urine leakage from the bladder into the vagina.
- Rectovaginal fistula: results in fecal incontinence with pressure sensation and fecal matter in the vagina.

Diagnosis and Management

Diagnosis includes symptom assessment, methylene blue dye tests, cystoscopy, or IV pyelography.
Management focuses on symptom relief, including cleansing enemas and skin care, and may require surgical intervention if severe.

Pelvic Organ Prolapse

Caused by weakened pelvic floor muscles, often due to age and childbirth.
Types of prolapse include cystocele (bladder displacement), rectocele (rectal pouching), and enterocele (intestinal protrusion).
Common symptoms are pelvic pressure, urinary urgency, fecal incontinence, and dyspareunia.

Treatment

Kegel exercises help strengthen pelvic muscles.
A pessary can provide vaginal support; check for latex allergies.

Female Reproductive Cancer

Includes malignant conditions such as cervical, uterine, ovarian, vaginal, and vulvar cancers.
Early detection through annual pelvic exams and Pap smears is crucial, as early-stage cancers have higher survival rates.

Cervical Cancer

Predominantly squamous cell carcinoma; risk factors include HPV types 16 and 18 and low socioeconomic status.
Symptoms often manifest as irregular bleeding and discomfort during intercourse.
Diagnosis involves Pap smears, biopsies, and colposcopies.

Uterine Cancer

Primarily endometrioid, linked to obesity, late menopause, and unopposed estrogen therapy; common symptom is menopausal bleeding.
Diagnosis entails endometrial aspiration biopsies.

Ovarian Cancer

Often presents asymptomatically; vague symptoms may include increased abdominal girth and pelvic discomfort.
Diagnosis typically involves biopsies and imaging as needed.

Hysterectomy Types

Various types include total, vaginal, supracervical, abdominal, and radical hysterectomy, depending on disease extent and patient situation.

Nursing Management for Hysterectomy

Preoperative care includes ensuring no NSAIDs usage and pregnancy testing.
Postoperative monitoring focuses on bleeding, infection, and voiding issues, with knowledge of potential complications such as DVT and bladder dysfunction.

Pelvic Inflammatory Disease (PID)

Inflammatory condition in the pelvic cavity, possibly starting with cervicitis; may infect reproductive organs.
Can be acute, subacute, recurrent, or chronic, with variable localization.
Major threat to female fertility.
Predominantly bacterial causes; most common organisms are Chlamydia and Gonorrhea; viral, fungal, or parasitic origins are possible.
Risk factors: IUDs, multiple sexual partners, early sexual debut, unsafe sexual practices, STDs history, bacterial vaginosis.
Common symptoms include dysuria, dyspareunia, lower abdominal pain (often termed "PID shuffle"), abnormal bleeding, vaginal discharge, and worsened pain with urination or defecation.
Severe manifestations could include high fever, fatigue, and nausea; significant pain during cervical movement (chandelier sign) is a clinical indicator.
Complications may involve ectopic pregnancy due to scarring of fallopian tubes, infertility, abscess formation, and chronic pelvic pain.
Diagnosis via ultrasound and discharge cultures.
Treatment involves broad-spectrum antibiotics (Doxycycline, Azithromycin, and Ceftriaxone) and may require hospitalization if severe.
Nursing management includes patient education, infection control, proper perineal care, and monitoring for symptoms indicating complications.

Fistulas of the Vagina

Abnormal openings between internal organs or between an organ and the body surface.
Types include vesicovaginal (bladder to vagina) causing urine leakage and rectovaginal (rectum to vagina) causing fecal incontinence.
Diagnosis includes symptom evaluation, methylene blue dye tests, and cystoscopy.
Management focuses on symptom relief, hygiene, and sometimes surgical correction.

Pelvic Organ Prolapse

Caused by weakened pelvic floor muscles due to age or childbirth.
Types include cystocele (bladder descent), rectocele (rectal pouching), and enterocele (intestinal wall protrusion).
Symptoms often feature pelvic pressure and dyspareunia.
Treatment includes Kegel exercises, pessary insertion, or surgery for severe cases.

Female Reproductive Cancer

Types: Cervical, Uterine, Ovarian, Vaginal, Vulvar.
Regular pelvic exams and Pap smears are crucial for early detection.
Cervical cancer is primarily squamous cell carcinoma and associated with HPV (types 16 and 18).
Symptoms of cervical cancer include irregular bleeding and discharge, especially after intercourse.
Diagnosis includes Pap tests and colposcopy, leading to biopsy for verification.
Medical management for precancerous conditions may involve LEEP or hysterectomy; invasive cancer treatment varies based on staging.

Cancer of the Cervix

Squamous cell cancer and adenocarcinoma are predominant forms.
Risk factors include HPV, low socioeconomic status, and early marriage/childbearing.
Symptoms in early stages are often absent but may progress to vaginal discharge and bleeding.
Diagnosed via Pap smear and biopsy, with colposcopy as a critical examination tool.
Treatment options include hysterectomy, radiation, and regular follow-ups to monitor for recurrence.

Cancer of the Uterus (Endometrial Cancer)

Most cases are endometrioid; risk factors include obesity, family history, and prolonged estrogen exposure.
Clinical manifestation prominently features menopausal bleeding.
Diagnosis through endometrial biopsy and transvaginal ultrasound.
Management includes hysterectomy and potential chemotherapy.

Cancer of the Ovary

Commonly originates from epithelial tissues; risk factors include family history and BRCA mutations.
Symptoms are often vague; abdominal girth increase is a significant indicator.
Diagnosis involves biopsy and imaging studies.
Treatment typically requires surgical removal and chemotherapy.

Hysterectomy

Types include total, vaginal, supracervical, abdominal, and radical hysterectomies.
Postoperative management includes monitoring for complications, providing education on restrictions, and assessing for pain control and infection risk.

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Description

This quiz covers Pelvic Inflammatory Disease (PID), its causes, and its effects on women's reproductive health. You will learn about the different forms of PID, including acute and chronic, as well as the leading infectious agents responsible for this condition. Understanding PID is essential for recognizing its impact on fertility and overall health.