XI.
Disorders of the Female and Male Reproductive System
OBJECTIVES:
At the end of this class, the student will be able to:
1. Compare the common benign breast disorders.
2. Describe the diagnostic tests for breast cancer.
3. Develop a plan of care for a woman experiencing breast cancer.
4. Discuss the clinical manifestations and treatment for endometriosis.
5. Describe toxic shock syndrome.
6. Compare the common sexually transmitted diseases with regard to causative
organisms, clinical manifestations, treatment and any residual implications.
7. Develop a plan of care for a woman undergoing gyneocologic surgery
8. Describe the most common gynecological surgical procedures.
9. Compare the various types of reproductive cancers, according to incidence, risk
factors, and treatment.
10. Identify nursing interventions for patients experiencing infections of the male
reproductive system.
11. Describe testicular cancer, including clinical manifestations, risk factors, and
incidence, and management.
OUTLINE
I.
Breast Masses
A. Screening for breast masses
1. Breast self examination
2. Exam by clinician
3. Risk factors
B. Benign Breast Disorders
1. Fibrocystic breast changes
2. Fibroadenoma
3. Intraductal papillomas
4. Ductal ectasia
II.
Gynecologic Disorders
A. Endometriosis
B. Toxic shock syndrome
C. Vaginitis/vulvo vaginitis
D. Vaginosis
III.
Sexually Transmitted Infections
A. Trichomoniasis
B. Chlamydia
C. Gonorrhea
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D. Herpes simplex
E. Condylomata Acuminata
F. AIDS
G. Syphilis
H. Teaching for health promotion
IV.
Pelvic Inflammatory Disease
A. Pathophysiology
B. Clinical manifestations
C. Diagnosis and treatment
D. Risk factors
E. Nursing interventions
V.
Reproductive Cancers
A. Breast cancer
1. Pathophysiology
2. Etiology
3. Incidence
4. Risk factors
5. Clinical manifestations
a. Physical
b. Psychosocial
c. Laboratory assessment
d. Mammography
e. Other
6. Nursing process
a. Nursing diagnoses
b. Planning/interventions
7. Management
a. Surgical management – care of the client undergoing
mastectomy or breast conserving surgery
b. Pre and post op care
c. Nonsurgical management
d. Adjuvant care
8. Discharge planning
a. Teaching
b. Home care
c. Resources
B. Cervical changes
C. Ovarian masses
D. Uterine masses
E. Endometrial cancer
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VI.
Urinary Alterations
A. Cystitis
B. Pyelonephritis
VII.
Male Reproductive Disorders
A. Testicular cancer
B. Other reproductive disorders
1. Assessment – clinical manifestations
2. Management
3. Nursing process
4. Related patient teaching
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149
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151
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XII. SPECIAL REPRODUCTIVE CONCERNS-INFERTILITY, GENETICS
OBJECTIVES:
At the end of this class, the student will be able to:
1. List and define the various diagnostic tests utilized in an infertility workup.
2. Describe the various risk factors and causes for male and female infertility.
3. Identify the nursing role during the diagnostic and treatment phase.
4. Describe the various pharmacological regimes used to treat various aspects of
infertility.
5. Define and give examples of the various chromosomal abnormalities.
6. Describe the diagnostic tests utilized in genetic testing.
7. Apply the nursing process to the care of a family undergoing genetic testing
OUTLINE
I.
The Couple Experiencing Infertility
A. Risk factors
B. Components of fertility
C. Alterations of fertility components
D. Fertility Workup
1. Diagnostic Tests
E. Infertility management
1. Pharmacology
2. Procedures
F. Nursing Process
II.
The family Experiencing a Genetic Disorder
G. Chromosomal Abnormalities
1. Examples of various abnormalities
2. Diagnostic testing
3. Nursing role
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APPENDICES
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ATI Maternal Newborn Nursing Test
Upon completion of Nursing 222, you will take proctored ATI exams online. You must register
with ATI on their website sometime during the course. PLEASE SEE BELOW ON HOW TO ACCOMPLISH
THE REGISTRATION. If you have previously registered to take the TEAS or other ATI exams, then you will
not need to register again. However, it is recommended that you sign on the ATI website and sign in
using your password to ensure there will not be a problem with the registration when you sit for the
exam. If you have any problems with the registration process, call the help number listed on the site.
The ATI exam will be administered in the Computer Lab in Building 19. The date will be announced at a
later time.
Any students registered with the Learning Disability department will be provided with
reasonable time accommodation to take the exam.
This 60‐item test offers an assessment of the student’s basic comprehension and mastery of
maternal‐newborn nursing content. Reference: ATI Maternal Newborn Nursing. (2007). RN Edition 7.1.
How to register for ATI.
1. Navigate to the ATI website at http://www.atitesting.com
2. Click on the SIGN in button in the upper right‐hand corner of the homepage.
3. Enter your login information. If you do not already have an ATI login, click the Register button in
the upper right‐hand corner of the page to create one.
4. Check your user profile to make sure you are associated with College of San Mateo.
5. Once logged‐in into your account, you need to go to “take an assessment” on their main menu
on the left side of the student homepage. Once there you will need to enter the assessment ID,
which is: 855472. After you enter the assessment ID you will be prompted to make your
payment. You will be able to pay by credit or debit card. When you register online, you will be
prompted to pay $18.00 online for the exam. The deadline for payment is two hours before the
exam. Until the payment is made, the system will not allow the student to take any tests.
6. Once you made your payment you will be able to test.
Note: Until the payment is made, the system will not allow the student to take any tests. The
CUSTOMER SERVICE IS 1‐800‐667‐7531, please have your assessment code as noted when calling.
ATI N222 Test Instructions.doc
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ATI Tips / Guidelines for Students the Day of the Test
All N222 course, nursing program and college testing policies apply to ATI testing.
1. Do not arrive late. Get to class with plenty of time to spare before the test begins; Arrive 1445
and wait outside Multimedia Lab, Building 27. Test begins at 1500.
2. No pens, paper, coffee/drinks, or backpacks/purses at your computer station. Please turn off
cell phones and place inside backpacks.
3. Pace yourself so you are able to complete the test within the allotted time. If you cannot
decide, make an educated guess. Trust your knowledge.
4. Avoid reading into question. Deal only with the information in the test question.
5. Earplugs may be of help. Students may leave quietly when the completed the test.
6. Sign on to ATI testing site. Use your password you created when you registered on the site. You
will be using this password for the rest of your “ATI life.” (Bring the information with you.)
7. There’s a “drop down” calculator for math problems but be careful not to use it “too fast” – it
won’t work.
8. When using the cursor for the test, do not move outside your “page.” It will indicate to the
proctor that you are “cheating.”
9. If you need to take a break, there is a “pause” button at the top of the screen. It will pause your
time for 5 minutes only, then your test clock starts to tick again.
10. Please log off when done.
11. There is no printing available at the computer lab.
12. To access the ATI testing site, go to atitesting.com
13. The course points for the ATI Fundamental Predictor test will be allocated by the following
percentage points.
Percentage
0‐25
26‐50
51‐75
76‐100
Points
0
1
2
3
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CSM PATIENT CARE WORKSHEET
N222 - Postpartum Patient
Student: ________________________________
Date: ___________________________
Patient’s Initials: ___________ RM#: _________ Age: ________ Religion: ________________________
Admission Date: ___________ Family Role: __________________ Occupation: ______________________
Type of Delivery: ____________________________
Gravida/Para: _______________________________
Complications: _____________________________
Newborn Gestational Age: ____________________
Newborn Sex: ______________________________
Priority Identified Teaching Needs:
Newborn Apgar Score:
Patient Teaching Plan & Goal:
Ethnic/Cultural Implications:
Referrals:
Safety Issues (Mom/Newborn):
IV Fluids: Type: ______________ IV Balance: _________ ________ Rate of Flow: ________ ________
(Beginning)
(Ending)
(cc/hr)
(gtts/min)
Epidural Catheter in place:_______
IV Medications: ___________________________
IV Site Assessment: ____________________________ Protocols in Progress: _______________________
Allergies:
Treatments/Therapy
Time
Significant Diagnostic Data
(lab, radiology, special procedures, etc.)
MOM
Date
Order
Date
Medications
Time
Test
Results
Significance
Results
Significance
Stop
Date
NEWBORN
Date
Test
LABOR HISTORY:
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N222PTWRKSH.DOC
ASSESSMENT
CRITERIA
T
MOM
ASSESSMENTS/OBSERVATIONS
INTEG: color, temp, moisture,
turgor, integrity, episiotomy,
laceration, c/s incision
NEURO: A&O x 4, PERRLA,
T=
symmetry, facial expressions, EOMs,
fine/gross motor fxn, MAE, grips,
sensation, speech, strength
*RESP: rate rhythm, depth, effort, R=
breath sounds, incentive spirometry,
m. membranes
*CV: pulses, capillary refill, edema, B/P=
CSM, Homan's sign
*GU: amount, urine characteristics,
bladder distention, lochia, breasts,
nipples, fundus
GI: intake, appetite, BM, bowel
sounds, distention, hemorrhoids
*MS: ROM, spine, MAE, Strength
EENT: vision, glasses
EMOT/PSYCH: affect, mood,
cooperation, family support systems,
bonding
PAIN: location, intensity,
characteristics, pharmacological and
nonpharmacological interventions
*Include any accessory equipment used on patient (monitor, 02, foley)
TIME
TIME MANAGEMENT PLAN *If “couplet” care include Mom & Baby
Primary Patient Goal:
PLAN
ANALYSIS OF DAY
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CSM PATIENT CARE WORKSHEET
N222 - Newborn Patient
Student: ___________________________________ Date: ______________________________
Newborn Initials: ______________
Sex: ____
Date & Time of Birth: __________________
Type of Birth: _____________________________
Apgar Score: ________________________
Complications: _____________________________
Birth Weight: ________________________
Type of Feeding: ___________________________
Gestational Age: _____________________
Safety Issues: _____________________________
Referrals: ___________________________
ASSESSMENT CRITERIA
ASSESSMENTS/OBSERVATIONS
INTEG: color, temp, turgor, integrity, rashes,
lanugo, vernix, lesions, cord, birthmarks, , other
variations
NEURO: symmetry, cry, MAE, reflexes (list),
T=
fontanels
RESP: rate, rhythm, depth, effort, breath
sounds, O2 sat, mucous membranes
R=
CV: apical pulse, murmur, peripheral pulses,
capillary refill, CSM
AP=
GU: number of voids, color, discharge, external
genitalia, circumcision site, meatus
placement
GI: intake, feeding reflexes, BM, bowel sounds,
patent anus, cord vessels/status
MS: MAE, spine, symmetry, posture,
extremities
EENT: discharge, nares, response to sounds,
red reflex, palate, ears
EMOT/PSYCH: bonding, response to touch,
eye contact, parental support
PAIN: cry, vital sign changes, consolability,
interventions
5/00
N222PtWrksh.doc
159
PATIENT CARE PLAN
DATA
Subjective &
Objective
NURSING
DIAGNOSIS
PATIENT GOAL
OUTCOME
CRITERIA
160
NURSING
INTERVENTION
S
RATIONALE
WITH
REFERENCES
EVALUATIONS