Assessment and Management of Female Physiologic Processes
1. Margie Smith, 32 years of age, presents to the emergency department after a fall. She stated that she fell down some steps and hit her face. The patient has two black eyes, a nasal fracture, and her ear lobe is torn. She has bruises on the inside of her arms shaped as ?ngers. There are bruises on her back in the shape of a shoe. Her boyfriend is with her at the bedside. (Learning Objective 2)

a. What steps should the nurse take to assess for abuse and what interventions should the nurse provide to deal with the suspected abuse?

2. Joyce Reynolds is a 52-year-old woman being seen by her family practitioner for her annual physical. Over the past 8 months, Joyce has noticed that her menstrual periods are very infrequent and last only 2 to 3 days. During the initial assessment, Joyce asks the nurse if her change in menstruation might be a sign of menopause. (Learning Objective 3)

a. What questions should the nurse ask to assess for other signs of menopause?

b. Joyce admits that she has also been experiencing hot ashes, and asks about hormonal therapy to treat them. How should the nurse answer this question?

c. What medical conditions or diseases would contraindicate the administration of hormonal therapy in postmenopausal women?

d. Joyce does not think she Wants to take hormonal therapy, and asks how she can minimize her hot ?ashes and decrease her chances of osteoporosis.

Case Study, Chapter 57, Management of Patients With Female Reproductive Disorders

1. June Brite, 35 years of age, is admitted to the medical-surgical unit after a Vaginal
hysterectomy with bilateral salpingo-oophorectomy for the treatment of uterine cancer.
(Learning Objective 7)

a. What will occur as a result of this type of surgery and what are the treatment options?

b. What nursing care should be provided for the patient as she arrives on the
medical-surgical unit?

c. What discharge instructions should the nurse provide the patient?

2. The Health Promotion nurse at a state university plans a series of educational programs focusing on female reproductive health issues for incoming ?rst-year female students. Because cervical cancer is the third most common female reproductive cancer and affects over 10,000 women annually in the United States, the nurse has planned the first session to focus on cervical cancer screening and prevention. (Learning Objective 6)

a. What information should the nurse include about Pap smears?

b. What clinical manifestations should the nurse include about cervical cancer?

c. The nurse discusses other diagnostic tests used to diagnose/stage cervical cancer. What information should she include in this portion of the educational program?

Case Study, Chapter 59, Assessment and Management of Problems Related to Male Reproductive Processes

1. Joe Smith, a 55-year-old patient, is admitted to the surgical unit after robotic-assisted laparoscopic radical prostatectomy with nerve sparring for early stage cancerous tumor confined to the prostate. The client has six small incisions in the abdomen with small 4X4 dressings with clear dressing dry and intact. The client has a JP drain in place with clear, red-colored drainage with 50 mL present and an indwelling urinary catheter draining clear, red-colored urine. The surgeon ordered ketorolac (Toradol) for pain management and belladonna and opiate (B&O) suppository every 8 hours, as needed, for bladder spasms. (Learning Objective #5)

a. What nursing care should be provided to the patient in the immediate postoperative period?

b. For what potential complications should the nurse observe, and what actions should the nurse take if the complication develops?

c. The surgeon removes the JP drain the next day and discharges the patient with the indwelling urinary catheter to a leg bag. What discharge instructions should the nurse provide the patient? What follow-up care is anticipated for him?

2. Joe Smith, a 67-year-old man, is admitted with the diagnosis of adenocarcinoma of the penis. He presents with painless wartlike growth on the skin of the glans of the penis.
(Learning Objective #7)

a. Explain the pathophysiology of cancer of the penis.

b. What are the early and late manifestations of cancer of the penis?

c. What are the management goals for cancer of the penis?