Therapeutic communication • Remember your ABCs • Uterine leiomyoma - assessment, benign, slow-growing solid tumor that occurs from the overgrowth of smooth muscle and connective tissue in the uterus. It is also called fibroids or myomas. Heavy vaginal bleeding. • Erectile dysfunction- causes, treatment “impotence” Causes Inflammation of the prostate, urethra, or seminal vesicles Prostatectomy surgery Pelvic fracture Lumbosacral injury Vascular disease like hypertension Chronic neurological condition (Parkinson’s, MS) Endocrine disorder like DM or thyroid disorder Smoking and alcohol Drugs – antihypertensive Poor health Tx. Medication—teach about vasodilation effects Vacuum constriction device Injections with vasodilating drugs Penile implants (prostheses) • Education related to treatment for HPV/cervical cancer HPV vaccine • Breast cancer- preventative screenings, risk factors, diagnostic tests, education Risk factors Genetic Hx of previous breast cancer Dense breast tissue Early age at dx. Female sex. Age over 65. First relative with breast cancer. Late menopause. Nulliparity after 30 (not having kids), early period starts Male (testicular disorder) Use or oral contraceptive. High fat diet & Low fiber diet Alcohol & Smoking Exposure to low level radiation Hormone replacement therapy Obesity African American, Puerto Ricans female Diagnostic tests • Biopsy the only definitive way to detect BC MRI, ultrasounds (better view of clients with dense breasts), CT and X-ray Breast self-exam (palpable tumor or lesion) Biopsy Genetic testing (BRCA2 and 2), HER2 (excess normal genes that cause cell replication). Mammography, tomosynthesis (3D mammography)-visualization of lesion. Nuclear imaging- breast specific gamma imaging Positron emission mamo. Serum testing (liver enzymes, serum Calcium, alkaline phosphatase) • Increased lifts can indicate liver metastasis, calcium and phosphatase – bone metastasize. • Mammogram – masses too small to palpate, small dose of radiation exposure • Tomosynthesis – 3D images mammography • Ultrasound – clarify mammogram, differentiates fluid filled cyst or mass • Mri for high risk women and suspicious mammograms Education Preventative screening Genetic testing Self-breast examination. • Endometrial cancer- symptoms, risk factors, diagnostic testing S/S vaginal bleeding, grows slowly, common type is adenocarcinoma tumor. low back, pelvic, or abdominal pain Watery, bloody vaginal discharge Pelvic examination may reveal palpable uterine mass –uterus is enlarged if cancer is advanced Risk factors Women in reproductive years Diabetes mellitus Family hx. Hypertension Obesity Uterine polyps Late menopause Nulliparity Smoking Tamoxifen given for breast cancer Diagnostic testing ➢ CA-125 tumor marker assesses for metastasis. ➢ alpha-fetoprotein (AFP) ➢ hCG to rule out pregnancy before treatment ➢ Transvaginal ultrasound- determine endometrial thickening and cancer. ➢ Endometrial biopsy ➢ Chest x-ray ➢ IVP (Intravenous pyelography to assess renal function and renal metastasis) ➢ Abdominal US ➢ CT of pelvis; MRI of abdomen and pelvis ➢ Liver, bone scans assess for distant metastasis. • Cervical cancer – post-op care/education, prevention Cause HPV Prevention HPV vaccine—must get entire series girls 9-26 b4 first sex Pelvic examinations and Pap tests at 21 yrs. Old 21-29 yr. – pap every 3 years 30-65 yr. – pap plus HPV test every 5 years Post op care/education Radiation ----brachytherapy (internal radiation) to prevent recurrence of vaginal cancer and improve survival. • Hysterectomies- what they are, who gets them, post-operative care, education Removal of the uterus. Women with leiomyomas Post op care Monitor urine output Assess VS Assess heart, lung, and bowel sounds Temp and skin color RBC, hemoglobin, and hematocrit levels activity intolerance avoid heavy lifting adequate hydration ambulation cough and deep breath assess for vaginal bleeding • Vulvovaginitis- s/s, causes, treatment, education Inflammation of lower genital tract resulting from disturbance of the balance of hormones and flora in vagina and vulva. Causes Fungus (yeast), candida albicans