Exam 13: Gynecologic and Obstetric Surgery

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

During the procedure,a moment of light anesthesia caused Matilda 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?

Select the congenital anomaly that best reflects indications for fetal surgery.

The surgical team gently abducted Matilda's arms into position on padded armboards at less than 90 degrees with palms facing up.Extra padding was placed under her elbows and an armboard strap was secured over her forearm.The armboards were locked into place to prevent inadvertent abduction.This important maneuver is designed as a risk reduction strategy to prevent:

During the skin preparation for a gynecologic procedure that requires both an abdominal and a vaginal prep,the perioperative nurse must ensure that cross-contamination does not occur.Select two nursing interventions that support cross-contamination prevention.

Matilda Gunderson,a 55-year-old woman with uterine cancer,is scheduled for an open panhysterectomy.She is positioned in low lithotomy with her legs symmetrically arranged in padded cradle stirrups.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.Matilda is at risk for compromise and injury related to prolonged Trendelenburg tilt,which promotes:

An example of perineal glands that secrete mucus is:

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

Many gynecologic conditions and diseases cause chronic pelvic pain.Both surgical and nonsurgical therapies include invasive manipulations.Select the least invasive treatment option for chronic pelvic pain that is recommended by the Agency for Healthcare Research and Quality (AHRQ).

Evelyn Pettigrew is a 67-year-old former competitive track athlete with debilitating osteoarthritis;she is scheduled for a laparoscopic-assisted vaginal hysterectomy (LAVH).During the preoperative assessment,Evelyn 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 to Evelyn 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 Evelyn is transferred to the OR bed and before anesthesia induction,is:

Matilda Gunderson,a 55-year-old woman with a possible latex sensitivity,is scheduled for a panhysterectomy.She is at risk for postoperative urinary retention related to edema,anesthesia,opioids,or pain.An appropriate intraoperative nursing action would be:

Marla Moriarity,a 32-year-old recently unemployed and uninsured college professor,is diagnosed with an early ectopic pregnancy.Her obstetrician has given her the option of surgical or medical therapy.She is well-informed about the details of each medical and surgical option,but her primary concern about her condition is that her decision will be based upon her strong cultural belief system that will not sanction the destruction of the fetus.Marla's treatment decision will most likely be:

From the list below,select the statement that is true about fallopian tube cancer.

Margie Donaldson,a 56-year-old postmenopausal obese woman,is seen for her routine gynecologic exam.What statement by Margie might prompt her physician to suspect that Margie may have endometrial cancer?

Tui Nyguen,a 32-year-old gravida 2 para 2,is scheduled for a hysteroscopy for heavy bleeding of 2 weeks' duration,and possible retrieval of a displaced IUD.She is tired and weak from blood loss and has marked anemia.During the vaginal prep the perioperative nurse noted several large blood clots.She communicated an estimated blood loss amount to the anesthesia provider and surgeon.After Tui was draped,the circulating nurse connected the hysteroscopic insufflator,pressure-infusion pump,and a video camera,light source,and monitor.The uterine cavity was distended with 32% dextran 70 in dextrose (Hyskon)at a continuous pressure through the hysteroscopic pump into the irrigating channel of the hysteroscope.The circulating nurse was relieved for lunch after she gave a hand-off report to her relief nurse.What patient safety information relevant to the hysteroscopy should be given to the receiving relief nurse before the circulating nurse leaves for lunch? Select all that apply.

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

Margie Donaldson's 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.Margie was sure that she would have to have a D&C (dilatation and curettage).Margie's surgery,on the operative schedule,would most probably be written as:

Surgical and nonsurgical options exist for endometriosis.Select the triad that best reflects nonsurgical and nonhormonal options.

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:

Shoshana Rokem,a middle-aged mother of 9 children from the orthodox community,is seen in the GYN 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: