Breast and Female Reproductive System Anatomy and Abnormalities, Exams of Nursing

Download Breast and Female Reproductive System Anatomy and Abnormalities and more Exams Nursing in PDF only on Docsity! NR 304 EXAM 3 STUDY GUIDE LATEST UPDATED 2024. Top Rated Guide for Guaranteed Success. Exam 3 Study Guide Breast and Axillae Structure and Function -Purpose: production of milk and sexual pleasure -Cooper’s Ligaments: “coopers droppers” breast stretch as you age (ligaments lengthen and stretch) -Four quadrants of the breast (face of clock) -Tail of spence: up by the axillary, check for lumps -Where breast cancer is usually found -Palpate all the lymph nodes -Central (axillary) -Pectoral (anterior) -Subscapular (posterior) -Lateral (brachial) Breast History -Is it cyclic? Does it occur around the same time? Example: every time a woman gets her period she gets breast pain. -Caffeine contribute to pain -Skin Rash: where did it start? From the nipple out? Or the skin towards the nipple? Paget’s Disease: nipple is red, scaly, and itchy, spreading off of nipple Galactorrhea: discharge -Yellow discharge: clostridium (normal for pregnant) -Bloody nipple discharge: cancer -Grayish discharge: clogged duct from milk Development: Childhood -Newborns: breasts may be enlarged at birth due to mom’s hormones (witch’s milk) -Adolescence: tanner 2-5 about 3 years -Stage 1) preadolescent stage: before age 10, nipple small, slightly raised -Stage 2) Breast bud stages: after age 10, nipple and breast form small mound -Stage 3) Menarche begins (first period), breast bud will enlarge -Stage 4) Late adolescent stage (14-17 years) Pregnancy Non-pregnant breast -3-4 days before period: full, tight, heavy, sore -4-7 days after period: least full, least nodular Pregnant breast -Ductal system expansion, secretory alveoli NR 304 EXAM 3 STUDY GUIDE LATEST UPDATED 2024. Top Rated Guide for Guaranteed Success. -Nipples/areola large and dark, venous pattern NR 304 EXAM 3 STUDY GUIDE LATEST UPDATED 2024. Top Rated Guide for Guaranteed Success. -Menopause greater than 55 yr -Never breast feed -Nulliparity (never having a child) or first child greater than 30 Breast Abnormalities Fibrocystic: (benign) -20-35 “water balloons” that change size/shape with monthly hormones, can be painful -Wear supportive bra -Decrease caffeine, low fat diet, decrease smoking Fibroadenoma (benign) -Very common “lump” found in younger women 18-25, rapid growing “lump” firm, smooth, painless, moveable-frequent biopsies Mammary Duct Ectasia (benign) -Ducts get wide and full of old cells, dried colostrum-pain, hard lump, with pasty colored discharge, often nipple retraction Mastitis -Infection often after/while breastfeeding, hard, hot, red, lump, pain, fever Cancer -Pucker, pull, skin change, discharge -Can be contained or spreading Intraductal Papilloma -Starts in duct and moves outward -Blood tinged discharge Paget’s -Skin changes with scaling, redness, pain, nipple changes, from inside to out, length of breast, malignant Female Reproductive System External Genitalia -Mons Pubis: adipose tissue covering the symphysis (hair in mature female), protects reproductive structures -Clitoris: small, elongated mound of erectile tissue -Labia: dual set of lip-like structures on either side -Labia Majora: cover external genitalia -Labia Minora: overlie the vaginal and urethral openings Skene’s Gland: paraurethal gland -Located posterior to urethral orifice NR 304 EXAM 3 STUDY GUIDE LATEST UPDATED 2024. Top Rated Guide for Guaranteed Success. -Has higher pH value to decrease bacteria, cleans urethra NR 304 EXAM 3 STUDY GUIDE LATEST UPDATED 2024. Top Rated Guide for Guaranteed Success. Bartholin’s Gland: greater vestibular gland -Produces mucus -Promotes sperm motility and viability Internal Reproductive Organs Vagina: 9-15cm -Covered in transverse rugae, allow for vagina to stretch to accommodate penis/baby Uterus: Pear shaped -Cervix projects 2.5 cm into vagina Fallopian Tubes -Two ducts on either side of the uterine fundus -Serves as a site of fertilization Development Considerations Infant -Maternal hormones may result in the following -Labia Majora: may be enlarged at birth -Blood mucus drainage is normal due to enlarged labia Children: 8-13 years of age -Clear drainage is normal before a female gets a period, occurs 6 months before menses. Maturation Stages in the Female Stage 3: sparse, dark, visibly pigmented curly pubic hair on labia Stage 6: Further extension laterally and upward Developmental Considerations: Pregnancy Goodell’s Sign: softening of cervix Chadwich’s sign: purple blue color of cervix -Mucus plug forms: if women lose the mucus plug, pregnancy is near -You can dilate for weeks, doesn’t necessarily mean that you are going to have a baby right now Gestational Onset Diabetes: body cannot produce insulin -Get tested around 28 weeks Developmental Considerations: Older Adult Reproductive ability peaks late 20’s Peri-menopausal -Between 46 and 55, menstrual periods become shorter and less frequent -Vasomotor instability, sweating, mood swings, vaginal dryness Menopause: absence of menstrual period for one year -Sex organs atrophy -Vaginal secretions reduce NR 304 EXAM 3 STUDY GUIDE LATEST UPDATED 2024. Top Rated Guide for Guaranteed Success. Herpes Simplex Virus-2 -Pubic region -Once you have herpes you have it for life -Burning, tingling, itching -Painful, especially during urination -Cannot have a vaginal birth Syphilitic Lesion -Nontender papule which converts to draining ulcer Abscess of Bartholin’s Gland -Labial edema, erythema with palpable mass -Purulent drainage Human Papilloma Virus -Cauliflower warts in clusters -More than 40 HPV types -Seen on vulva, inner vagina, cervix, and anal area NR 304 EXAM 3 STUDY GUIDE LATEST UPDATED 2024. Top Rated Guide for Guaranteed Success. Atrophic Vaginitis -Estrogen deficiency -Dryness, itching, dyspareunia -Postmenopausal women Candidiasis (Yeast infection) -Alteration in vaginal pH (douches) predispose to this condition -Vulva and vagina are erythematous -Cheesy, white discharge Bacterial Vaginosus -Smelly vaginal discharge -May look grayish white or yellow -“Fishy” smell, which may be worse after sex -Multiple sex partners, alcohol, and douching NR 304 EXAM 3 STUDY GUIDE LATEST UPDATED 2024. Top Rated Guide for Guaranteed Success. Chlamydia -STD that is often asymptomatic -Purulent drainage -May lead to sterility -Most common STI Gonorrhea -Usually asymptomatic -Vaginal discharge or bleeding -Do not flush or douche Trichomoniasis -Painful urination -Vulvar itching -Yellow, foul discharge -Pain during intercourse NR 304 EXAM 3 STUDY GUIDE LATEST UPDATED 2024. Top Rated Guide for Guaranteed Success. Cowper’s Gland (Bulbourethral gland): will lubricate urethra NR 304 EXAM 3 STUDY GUIDE LATEST UPDATED 2024. Top Rated Guide for Guaranteed Success. -Protects from bacteria Corpus Cavernosum: pair of sponge-like regions of erectile tissue which contain most of the blood in the penis during penile erection Corpus Spongiosum: surround urethra Prostate -Similar to skene’s gland in females -Size of chestnut -Consistency of hardboiled egg without shell -Secretes milky, alkaline solution (aids sperm motility) Scrotum -Loosely hanging pear-shaped pouch -Below surface lie two muscles: Dartos and cremasteric (contract the testes) Testes: left hangs lower than right, both will hang lower than body to maintain a good body temperature to keep sperm healthy Epididymis: comma shaped organ Inguinal Area: groin area -Lots of lymph nodes -Can get inflamed -Testicular cancer can affect groin lymph nodes -Femoral ring Perianal Area: anus -Anus is terminal end of the GI system -Valves of Houston: keep stool supported -Internal Muscles Involuntary: S1, S2, and S3 Male Genitals -Should be evident at birth -Any ambiguity, get genetic counseling Hypospadias: urethral opening on ventral side of the penis Epispadias: urethral opening on the dorsum of the penis Phimosis: cannot retract foreskin (normal occurrence up to 3-years old) Cryptorchidism: one or both testes absent from scrotum -Descend by 2-3 years of age, if not take it out (surgery) NR 304 EXAM 3 STUDY GUIDE LATEST UPDATED 2024. Top Rated Guide for Guaranteed Success. -can increase testicular cancer NR 304 EXAM 3 STUDY GUIDE LATEST UPDATED 2024. Top Rated Guide for Guaranteed Success. -Papular Lesions NR 304 EXAM 3 STUDY GUIDE LATEST UPDATED 2024. Top Rated Guide for Guaranteed Success. Gonorrhea -Caused by Neisseria Gonorrhea -Symptoms of urethritis, dysuria, penile discharge Penile Cancer -Rare cancer -Redness on penis, foul discharge, pain in the penis -Factors HIV, HPV, tobacco use Abnormal Findings Phimosis: cannot retract foreskin Paraphimosis: foreskin becomes trapped, emergency NR 304 EXAM 3 STUDY GUIDE LATEST UPDATED 2024. Top Rated Guide for Guaranteed Success. Peyronie’s Disease: curvature, diabetes -J or C shaped -Sugar wrap around ligatures Abnormal Findings in the Scrotum -Hydrocele: fluid-filled mass in tunica vaginalis -Transillumination Varicocele -Enlargement of the veins within the scrotum -Feels like a bag of worms -Can be treated Spermatocele -Cyst that develops in the epididymis -Painless and noncancerous -May contain sperm Scrotal Edema -Seen in conditions causing edema of the lower body: CHF, renal failure -Ascities NR 304 EXAM 3 STUDY GUIDE LATEST UPDATED 2024. Top Rated Guide for Guaranteed Success. Femoral Hernia -Characteristics: Bulge occurs over the femoral artery -Lowest incidence of all inguinal hernias -Signs/Symptoms: May not be painful -Risk of strangulation Urinary System Subjective Data -Nocturia: getting up during the night to urinate -Dysurina: burning when you pee -Hematuria: blood in urine -Amber: concentrated urine and blood can be present due to filtration -Foamy urine: protein spill, bad kidney damage (beer color urine) Infants and Children -Renal blood flow and glomerular filtration rate, increase at birth compared to fetal filtration -Enuresis: bedwetting -Concerning after 5 years of age, may be social and family issues, infection, and diabetes Pregnancy: -1st trimester: pressure on bladder from uterus -2nd trimester: frequency decreases -3rd trimester: frequency returns -Urine production increase -May retain urine (UTI) -Edema in ankles, legs Older Adult -Decrease in renal blood flow and perfusion -Decrease ability to concentrate and dilute urine -Prostate enlargement -Kidneys are not functioning as well as they use to Important Labs Blood Urea Nitrogen (BUN)-excreted by kidney after metabolism Creatinine: cleared by kidney as normal product of muscle contraction Serum Potassium: monitored closely since if K+ not cleared by kidney, then it builds up in body causing cardiac arrhythmias Percussion/Palpation -Do not percuss or palpate if there is a tumor, polycystic kidney disease, or discomfort in pelvis region -Palpate over costovertebral angel, right and left Bladder Palpation NR 304 EXAM 3 STUDY GUIDE LATEST UPDATED 2024. Top Rated Guide for Guaranteed Success. -Palpate the bladder 2-2.5 inches below the umbilicus NR 304 EXAM 3 STUDY GUIDE LATEST UPDATED 2024. Top Rated Guide for Guaranteed Success. -Percuss bladder -Dull indicated full bladder Changes in Urinary Elimination -Dysreflexia: neurological dysfunction of bladder-may retain or be incontinent (Parkinson, MS, DM) Incontinence -Functional: continent but cannot get to the bathroom, disabled, line waiting -Reflex: incontinent with full bladder or at predictable intervals -Stress: with laugh, cry, sneeze -Urge: sudden need and urgency-often bladder spasms -Total: no control of bladder/urine often due to neurologic injury Urinary Retention: not able to fully empty bladder-leads to urinary stasis and infection Renal Calculi: stones -Form accumulation of magnesium, ammonium, phosphate, and uric acid -Urinary frequency, urgency, hematuria -Obese and weight gain increase risk for kidney stones -Not drinking enough fluids increase risk Abnormal Findings Pyelonephritis (inflammation of renal pelvis of kidney) -Usually due to reflux of bacteria from bladder up to infect kidneys fever, N/V, CVA tenderness, hematuria Glomerulonephritis (inflammation of glomerulus) -Usually due to antibody/antigen reaction to a bacterial infection (strep) -Tea color, frothy urine -Glomerulus becomes leaky -Often hypertensive Tumors Renal Tumors: benign or malignant -Malignant more common -Hematuria, flank pain, weight loss, palpable mass Bladder Cancer -Related to smoking, multiple sex -Aging -Painless hematuria, flank pain, frequent urination UTI -Inflammation of bladder-cystitis