Nokea
The nurse is teaching a client about the use of a pessary. Which statement by the client indicates the need for additional instruction?
- A. A white or yellow vaginal discharge is expected and normal.
- B. I need to apply a sterile lubricant to the pessary before reinserting it.
- C. After removal, I should wash the pessary with warm soapy, water, rinse, and dry it.
- D. I should call the physician if I notice any discomfort with the pessary.
Correct Answer: A
Rationale: A white or yellow discharge from the vagina is not a normal finding and should be reported to the physician because it may indicate an infection. A sterile lubricant is applied to the pessary before it is reinserted. After removal, the pessary should be washed thoroughly with warm soapy water, followed by rinsing and drying. Discomfort may indicate that a pessary has been inserted incorrectly, it has moved, or that it is causing irritation. These problems should be reported to the physician.
You may also like to solve these questions
A client is being admitted for suspected toxic shock syndrome (TSS). Which of the following would be most important for the nurse to determine?
- A. Existence of menorrhagia
- B. Psychological trauma
- C. Use of superabsorbent tampons
- D. Use of oral contraceptives
Correct Answer: C
Rationale: TSS is commonly associated with the use of superabsorbent tampons that are not changed frequently and internal contraceptives that remain in place longer than necessary. Assessing the use of oral contraceptives, psychological trauma, or menorrhagia is not required for diagnosing the cause of TSS.
Following a radical vulvectomy, the nurse is preparing the client for discharge to home. Which care intervention would be considered the priority for this client?
- A. Relieving edema to lower extremities
- B. Alterations for sexual function
- C. Prevention of wound complications
- D. Care of colostomy site
Correct Answer: C
Rationale: Prevention of complications and infection is paramount due to the location of the wound. The perineal area provides a warm, dark environment that supports the growth of microorganisms that can be introduced into the wound. With a radical vulvectomy, is is likely to find surgical drains and urinary catheter that can also interfere with the maintenance of the wound. Relieving edema to the lower extremities may be a necessary part of care if the lymph nodes and blood vessels are disturbed. The client may have a colostomy and care instructions should be provided. Alteration in sexual function needs to be addressed but is not a priority for the initial stage of healing.
Following a colopsopsy, the confirmation of in situ carcinoma of the cervix has been determined. Which comment by the client indicates an appropriate understanding of the diagnosis?
- A. I will not need any further treatment.
- B. The cancer has not spread.
- C. I will need surgery and chemotherapy to increase my odds, for survival.
- D. I can wait until I have finished having babies to seek treatment.
Correct Answer: B
Rationale: Carcinoma in situ means the cancer has not left the original site and therefore has not invaded other tissues. Further treatment is required, which usually consists of cryossurgery or hysterectomy. Surgery with adjuvant chemotherapy is usually reserved for cancers that are more advanced. Even though cervical cancers tend to be slower growing, treatment should not be delayed.
A client with vaginitis complains of itching and burning of the perineum. Which suggestion by the nurse would be most appropriate to relieve the client's symptoms?
- A. Use a pure vinegar douche daily.
- B. Use skin protectants containing zinc oxide.
- C. Take sitz baths frequently.
- D. Avoid yogurt with active lactobacilli cultures.
Correct Answer: C
Rationale: Sitz baths are recommended to relieve the client's itching and burning as well as relieve swelling of the vulva and perineum. Skin protectants containing zinc oxide promote healing. Routine douching should be avoided. Taking Lactobacillus acidophilus in capsule form or eating yogurt containing active cultures of lactobacilli can help restore normal vaginal microoorganisms.
Which of the following is an early symptom of vulvar cancer?
- A. Pruritus with genital burning
- B. Fever accompanied by chills
- C. Severe abdominal pain
- D. Dyspareunia
Correct Answer: A
Rationale: Pruritus and genital burning are the most frequent early symptoms of vulvar cancer, followed by a bloody discharge from the vagina. Abdominal pain can be a result of formation of cysts in the ovary. Dyspareunia and fever accompanied by chills are not the early symptoms of vulvar cancer.