NR509 Final Chapter 22 Anus.pdf

o Uerine umors o Cervical cancer (including screening and risk acors) o Human papillomavirus (HPV) (including vaccinaon recommendaons) o HPV oers he opporuniy o preven cervical cancer and pre-cancers o Pap-smears can al...

o Uerine umors o Cervical cancer (including screening and risk acors) o Human papillomavirus (HPV) (including vaccinaon recommendaons) o HPV oers he opporuniy o preven cervical cancer and pre-cancers o Pap-smears can also ideny high-risk precancerous changes or early cancers o Prevens inecon rom HPV subypes 16,18, 6, and 11, which cause 90% o genial wars. o The bivalen vaccine prevens inecon rom subypes 16 and 18 o Recommended or prevenon o cervical, vulvar, and vaginal cancers and precancers emales as well as anal cancer, and genial wars in boh emale and males. o Vaccinaed women should sll ge cervical screening because vaccines do no preven all HPV subypes. o Condoms does no eliminae he risk o cervical HPC inecon o Recommended or hose wih compromised immune sysems including HIV Chapter 22 Anus, Rectum, and Prostate Techniques o examinaon o Pu p. in a side lying posion ▪ Inspec he sacrococcygeal and perianal areas Inspec he anus ▪ A ender purulen reddened mass wih ever or chills suggess an anal abscess. Abscesses unneling o he skin surace rom he anus or recum may orm a clogged or draining ano-recal sula. Fisulas may ooze blood, pus, or eculen mucus. Consider anoscope or sigmoidoscopy or beer visualizaon. ▪ Sphincer ghness may occur wih anxiey, inammaon or scaring ▪ Sphincer laxiy occurs in neurologic disease such as S2-S4 cord lesions and signals possible changes in he urinary sphincer and derusor muscle o Perorm a digial recal examinaon ▪ Assess he anal sphincer one ▪ Palpae he anal canal and recal surace ▪ I a mass is noed wih irregular borders, suspicious o recal cancer ▪ In persons wih prosaes palpae he prosae gland Common concerns o Change in bowel habis ▪ Pencil hin sools may warn o colon cancer o Blood in sool ▪ Dark arry sools i polyps, carcinoma, GI bleeding, mucus in villas adenomas, IBD, or IBS o Pain wih deicaon, recal enderness ▪ Hemorrhoids, procs rom STIs o Anal wars or ssures  ▪ HPV, condylomaa laa in secondary syphilis, ssures in Crohn’s disease, procs rom recepve anal inercourse, ulceraons o herpes simplex, or chancers o primary syphilis. o Weak urinary sream ▪ These sympoms sugges urehral obsrucon rom BPH or prosae cancer, especially men >70 years. The AUA sympoms index helps quany BPH sympom score index ▪ Higher sores (max 35) indicae more severe sympoms, scores