Exam 14: Gynecologic and Obstetric Surgery

When catheterizing the female patient,the nurse must locate the urethra.The correct order of the external organs of the vulva listed anterior to posterior is:

During the preoperative nursing assessment in the ambulatory surgery receiving unit,the nurse notices bruises and abrasions in various stages of healing on her patient's abdomen,arms,and breasts.In a quiet and respectful manner,the nurse says,"The staff at our facility are concerned about your safety.We know that many things can happen in our lives that affect our mental and physical health." This technique is an appropriate method of establishing a sense of __________ with the patient while conveying caring and concern.

Ova travel through the fallopian tubes toward the uterus by which type of action?

A 72-year-old patient with multicentric carcinoma in situ (CIS)of the vulva,without evidence of leukoplakia and pruritus is scheduled for surgery.She has a history of prior papillomavirus infection.Select the most appropriate surgical option.

A significant potential complication of hysteroscopy is the intravasation of the fluid used to distend the uterine cavity.Intravasation with systemic absorption can lead to:

A 55-year-old woman with uterine cancer is undergoing an open panhysterectomy.She is positioned in Trendelenburg position to facilitate exposure of the lower pelvis and displacement of the small bowel from the operative area.The surgical team gently abducted the patient's arms into position on padded arm boards at less than 90 degrees with palms facing up.Extra padding was placed under her elbows,and an arm board strap was secured over her forearm.The arm boards were locked into place to prevent inadvertent abduction.This important maneuver is designed as a risk reduction strategy to prevent:

A 29-year-old woman is in the emergency department (ED)with a ruptured appendix.Before the ED room nurse and surgical resident transported her to the OR,the nurse called to inform them that the patient is 27 weeks' pregnant.What special considerations must the perioperative nurse and anesthesia provider address with this new information?

During cesarean delivery,which is the priority instrument or device needed as soon as the fetal head is delivered?

A 46-year-old gravida 2 para 2 returned to her gynecologist's office for a second Pap smear when her routine exam showed dysplastic cells in her cervical cytology test.She has a family history of cervical cancer and had laser ablation within the last 2 years for vulvar condylomata.She can expect her gynecologist to perform another Pap smear and:

A 55-year-old woman with uterine cancer is undergoing an open panhysterectomy.During the procedure,a moment of light anesthesia causes the patient to move slightly.The perioperative nurse prepared to assist while the anesthesia provider titrated drugs to a deeper anesthetic level.What would be the next priority intervention by the perioperative nurse?

A middle-aged mother of nine children from an orthodox community is seen in the gynecologic clinic for heavy vaginal bleeding.She is anxious and shy and timidly asks the nurse if she may be seen only by a female doctor.An appropriate nursing action by the female nurse would be to:

The American Cancer Society estimated that invasive cervical cancers were diagnosed in over 12,500 women in 2016.Pap test screening provides early detection,aids in cancer treatment,and lowers mortality rates by detecting early changes in cervical cells and enabling prompt treatment.What is the recommended screening for women ages 30 to 65?

An experienced perioperative nurse has recently been hired at the new ambulatory surgery center to lead their endometrial ablation and fibroid embolization program.She has created a teaching tool with relevant postprocedure care information for patients and caregivers and is developing a training module for the nurses to learn techniques for teaching patients before surgery and before discharge.She is teaching the nurses how to encourage patients and caregivers to reflect on what they have just learned in order to elicit a "teach-back" scenario.Select the reflective statements and questions appropriate for a post-endometrial ablation patient,to determine their understanding of her discharge instructions.

A 55-year-old woman with uterine cancer is scheduled for an open panhysterectomy.After the incision is made and primary dissection accomplished,she will be positioned in Trendelenburg position to facilitate exposure of the lower pelvis and displacement of the small bowel from the operative area.The patient is at risk for compromise and injury related to prolonged Trendelenburg tilt,which promotes:

A 67-year-old former competitive track athlete with debilitating osteoarthritis is scheduled for a laparoscopic-assisted vaginal hysterectomy (LAVH).During the preoperative assessment,she tells the perioperative nurse that,while she is in excellent health for her age,her hip and leg joints are tender,and her movement is limited.The nurse explains that during the procedure she will be "up in stirrups" but will be handled gently and protected from further discomfort.An appropriate nursing action,after the patient is transferred to the OR bed and before anesthesia induction,is to:

An example of perineal glands that secrete mucus is:

A 57-year-old patient's assessment and examination has revealed a family history of endometrial cancer.She has never been pregnant and has been taking hormone replacement therapy for 4 years.Her physician has scheduled her for a surgical procedure to obtain visual and pathologic information and provide treatment as indicated.The patient was sure that she would have to have a dilatation and curettage (D&C).Her surgery,on the operative schedule,would most probably be written as:

A 56-year-old postmenopausal obese woman is seen for her routine gynecologic exam.Which statement by the patient might prompt her physician to suspect that she may have endometrial cancer?

What classification of drugs are gynecologic/obstetric-related medications that require monitoring of blood pressure,assessment for continued bleeding,and monitoring of fundal response to the drug?

A 32-year-old woman,gravida 1 para 0,requires an emergency cesarean section as part of the management strategy for severe preeclampsia.Prior to surgery,she received magnesium sulfate 5 g deep IM and has IV magnesium sulfate infusing at 2 g/hr.What perioperative nursing considerations are related to the magnesium sulfate infusion?