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Registered Nurse (RN)
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HESI®
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HESI®-RN Comprehensive Review
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Reproductive System

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HESI®-RN Comprehensive Review | Registered Nurse (RN) School Study Aid

Reproductive System
39 Picmonics to Learn | 1 hr 23 mins
Dysfunctional Uterine Bleeding
Assessment
Bimodal Age Distribution
Painless Vaginal Bleeding
Amenorrhea
Menorrhagia (Heavy Menstrual Bleeding)
Metrorrhagia (Bleeding Between Menses)
Interventions
Balloon Thermotherapy
Hormone Medications
Dilation and Curettage (DandC)
Considerations
Monitor for Anemia
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3 mins
Menopause Lab Findings
Decreased Estrogen
Lack of Negative Feedback
Increased FSH
Increased LH
Increased GnRH
Small Amount of Estrogen From Androgen Conversion
Increased Androgens = Hirsutism
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1 min
Leuprolide
Mechanism
GnRH Agonist (Pulsatile Use)
GnRH Antagonist (Continuous Use)
Upregulates FSH And LH
Downregulates FSH And LH
Indications Pulsatile
Infertility
Indications Continuous
Prostate Cancer
Precocious Puberty
Uterine Fibroids
Endometriosis
Side Effects
Anti-androgenic Effects
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2 mins
Endometriosis
Cause
Endometrial Tissue Outside Uterus
Retrograde Menstrual Flow
Assessment
Dysmenorrhea
Cyclic Pelvic Pain
Irregular Vaginal Bleeding
Pain with Defecation
Dyspareunia
Interventions
Medications to Decrease Ovulation
NSAIDs
Surgery
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2 mins
Stress Incontinence
Symptoms
Urine Leak with Movement
Cough or Sneeze
Increased Intra-abdominal pressure
Pathophysiology
Laxity of Pelvic Floor Muscles
Urethral Sphincter Insufficiency
Treatment
Kegel Exercises
Pessaries
Alpha-adrenergic Agonists
Surgery
Associations
History of Vaginal Birth
Cystocele
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2 mins
Female Reproductive System Assessment
HEALTH HISTORY
Past Genitourinary and Gynecological History
Current and Past Medication Use
Urine Collection and Characteristics
EXTERNAL GENITALIA EXAM
Inspect External Genitalia
Palpate External Genitalia
INTERNAL GENITALIA EXAM
Inspect Internal Genitalia Using Lubricated Speculum
Examine Vaginal Wall for Color, Texture, and Integrity
Examine Cervix for Color, Position, Size, Shape, Mucosal Integrity and Discharge
Palpate Internal Genitalia
Note Abnormal Findings
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4 mins
Enema Administration
Types
Tap Water/Soapsuds
Normal Saline
Hypertonic Solution
Medication
Oil Retention
Administration
Procedure Education
Wear PPE
Put Patient in Sims Position
Insert Tip
Start Flow Slowly
Stop With Discomfort
Potential for Vagus Response
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2 mins
Cervical Cancer Assessment
Cause/Mechanism
Human Papillomavirus (HPV)
Assessment
Metrorrhagia
Leukorrhea
Pain
Abnormal Pap Test
May Be Asymptomatic
Considerations
HPV Vaccine
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2 mins
Human Papillomavirus (HPV)
Characteristics
Non-enveloped
Circular
Double Stranded DNA
Disease
Warts 1, 2, 6, 11
Condyloma acuminata
Type 16, 18
Cervical Carcinoma
Penile Carcinoma
AIDS/Immunocompromised
Worsened by Smoking
Diagnosis
Koilocytic change in squamous epithelium
Pyknotic Nuclei Surrounded by Clear Halo
Treatment
Vaccine Available
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4 mins
Cervical Cancer Screening
Women Aged 21-65 Years
Pap Smear Every 3 Years
Women Aged 30-65 Years
Can Opt for Co-testing (Pap Smear + HPV Testing) Every 5 Years
Identify Lesions
High grade lesions
Cryotherapy
Loop Excision
Cold Knife Conization
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2 mins
Breast Cancer Diagnosis
Mammography
Ultrasound
MRI for High Risk Patients
Confirmed with Biopsy
Considerations
Lymph Node Involvement
Receptor Positivity
Estrogen and Progesterone Receptors
HER-2
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2 mins
Breast Cancer Interventions
Radiation or Chemotherapy
Hormonal Therapy
Tamoxifen
Lumpectomy
Mastectomy
Avoid BP and Injections Affected Arm
Hand Exercises
Considerations
Grief Related to Body Image
Prosthetics
Reconstruction
Lymphedema
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3 mins
Tamoxifen
Mechanism of Action
Selective Estrogen Receptor Modulator (SERM)
Antagonist on Breast Tissue
Indications
ER-positive Breast Cancer
Side Effects
Decreased Risk of Osteoporosis
Increased Risk of Endometrial Cancer
Increased Risk of Venous Thromboembolism (VTE)
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1 min
Testicular Carcinoma Assessment
Cause/Mechanism
Seminoma Germ Cells
Non-Seminoma Germ Cells
Assessment
Painless Scrotal Mass
Testicular Swelling
Acute Pain Rare
Elevated Serum Tumor Markers
Considerations
Males Between 15-35 Years Old
Cryptorchidism
Testicular Self Exam
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2 mins
Prostate Cancer Assessment
Most Common Cancer in Men
Assessment
Mimics BPH
Metastasis to Back
Low Back Pain
Fatigue
Considerations
Prostate Specific Antigen (PSA)
Digital Rectal Examination (DRE)
Transrectal Ultrasound (TRUS)
Biopsy
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2 mins
Prostate Adenocarcinoma Characteristics and Presentation
Characteristics
Most Common Cancer in Men
Screening Test if Suspicious
Prostate Specific Antigen (PSA)
Peripheral Zone
Risk Factors
African American
Advanced Age
Presentation
Usually Asymptomatic
Terminal Hematuria
Urinary Retention or Incontinence
Lower Back Pain
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2 mins
Neomycin Sulfate
Mechanism
Aminoglycoside Antibiotic
Indications
Topical Infection
Intestinal Surgery Prophylaxis
Side Effects
Ototoxicity
Nephrotoxicity
Rash
Blood Dyscrasias
Considerations
GI Superinfection
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2 mins
Chlamydia trachomatis
Characteristics
A to C
Trachoma
Follicular Conjunctivitis
Blindness
Africa
L1 to 3
Lymphogranuloma venereum
Buboes
Genital Ulcer
D to K
Urethritis and PID
Neonatal Pneumonia
Staccato Cough
Neonatal Conjunctivitis
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2 mins
Chlamydia
Mechanism
Chlamydia trachomatis
Assessment
May Be Asymptomatic
Dysuria
Epididymitis
Discharge
Dyspareunia
Interventions
Doxycycline
Azithromycin
No Intercourse for 1 Week
Treat Partners
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2 mins
Chlamydia Characteristics
Characteristics
Cannot Make ATP
Elementary body infects
Intraepithelial
Reticulate Body Replicates
Diagnosis
Cell Wall Lacks Muramic Acid
Giemsa Stain
Inclusion Bodies
Treatment
Azithromycin (Preferred)
Doxycycline
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2 mins
Neisseria gonorrhoeae Disease
Signs & Symptoms
Dysuria
Pelvic Inflammatory Disease (PID)
Fitz-Hugh-Curtis Syndrome
Neonatal Conjunctivitis
Pharyngitis
Septic Arthritis
Tenosynovitis
Pustules On Hands And Feet
Treatment
Ceftriaxone
Azithromycin
Doxycycline
Considerations
C5-9 Complement Deficiency (Recurrent Infections)
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2 mins
Neisseria gonorrhoeae Characteristics
Characteristics
Gram Negative
Diplococci
Chocolate Agar
Thayer-Martin Media
VPN
Oxidase Positive
Glucose Fermenting
Pilus
Opa Surface Protein
Rapid Antigenic Variation
IgA Protease
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2 mins
Gonorrhea
Mechanism
Neisseria gonorrhoeae
Assessment
Dysuria
Yellowish-Green Discharge
Increased Urinary Frequency
Women Often Asymptomatic
Interventions
Ceftriaxone (IM)
Chlamydia
Doxycycline
Azithromycin
Considerations
Treat Partners
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2 mins
Genital Herpes
Mechanism
Herpes Simplex Virus 1 and 2 (HSV)
Assessment
May Be Asymptomatic
Oral or Genital Lesions
Vesicles in Clusters
Pain
Flu-like Symptoms
Antiviral Medications
Acyclovir
Valacyclovir
Famciclovir
Considerations
Infectious During Recurrences
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2 mins
Genital Warts - Condylomata Acuminata
Mechanism
Human Papillomavirus (HPV)
Assessment
Papillary Cauliflower Like Growths
Bleeding
Vaginal Discharge
Interventions
Wart Removal
Trichloroacetic acid (TCA)
Podophyllin resin
Cryotherapy
Considerations
HPV Vaccine
Cervical Cancer
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2 mins
Syphilis
Mechanism
Treponema pallidum
Assessment
Primary Stage
Painless Chancre
Secondary Stage
Rash on Palms and Soles
(Generalized) Lymphadenopathy
Condylomata Lata
Latent Stage
Asymptomatic
Tertiary (Late) Stage
Aortitis
Neurosyphilis
Gummas
Interventions
Penicillin
Jarisch-Herxheimer Rash
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3 mins
Candida Albicans
Fungi
Yeast with Pseudohyphae at 20 Degrees C
Germ Tube Formation at 37 Degrees C
Pruritic Vaginitis
White Cottage Cheese Discharge
Fiery Red Mucosa
Diabetics
Antibiotic Use
Esophageal Thrush in Immunocompromised
Diaper Rash
Endocarditis in IV Drug Users
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2 mins
Herpes Simplex Virus (HSV)
Characteristics
Enveloped
Double Stranded DNA
Linear
Signs and Symptoms
Type 1 HSV
Gingivostomatitis
Keratoconjunctivitis
Encephalitis of Temporal Lobes
Latent in Trigeminal Ganglia
Type 2 HSV
Genital Vesicles
Neonatal Herpes
TORCHES
Latent in Sacral Ganglia
Diagnosis
Tzanck Test
Multinucleated Giant Cells
Cowdry A Inclusions
Treatment
Acyclovir
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2 mins
TORCHeS Screening
TORCHES
Toxoplasmosis
Other
Rubella
Cytomegalovirus (CMV)
Herpes Simplex Virus (HSV)
Syphilis
Considerations
Diagnostic Testing
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3 mins
Trichomonas vaginalis
Characteristics
Protozoa
Signs and Symptoms
Vaginitis
Pruritus
Foul-smelling Greenish Frothy Discharge
Strawberry Cervix
Diagnosis
Corkscrew Motility on Wet Prep
Treatment
Metronidazole
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2 mins
Pelvic Inflammatory Disease (PID) Assessment
Mechanism
Untreated Cervicitis
Assessment
May Be Asymptomatic
Dysuria
Vaginal Discharge with Odor
Fever
Dyspareunia
Lower Abdominal Pain
Spotting
Cervical Motion Tenderness
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2 mins
Pelvic Inflammatory Disease (PID) Interventions
Antibiotics
No Intercourse for 3 Weeks
Semi-Fowler's Position
Analgesics
Monitor Temperature
Treat Partners
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2 mins
Contraception
Indications
Preventing Unplanned Pregnancy
Barrier Methods
Spermicides
Diaphragm
Cervical Cap
Contraceptive Sponge
Male Condom
Hormonal Method
Oral Contraceptive
Intrauterine Device (IUD)
Injectable Progestins
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2 mins
Penicillin
Mechanism of Action
Weakens Cell Wall
Indications
Gram-Positive Infections
Prophylaxis
Side Effects
Pain at IM Injection Site
Allergic Reaction
Considerations
Skin Tests
Allergy ID
Medication Education
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2 mins
Acyclovir (Zovirax)
Mechanism
Guanosine Analog
Inhibits Viral Replication
Thymidine Kinase Activation
Indications
Herpes Simplex Virus (HSV)
Varicella Zoster Virus (VZV)
Side Effects (Oral)
Headache
GI Distress
Side Effects (IV)
CNS Toxicity
Nephrotoxicity (Crystalline Nephropathy)
Considerations
Prevents Recurrent Episodes
Slow IV Infusion
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2 mins
Human Immunodeficiency Virus (HIV) Assessment
Assessment
RNA Retrovirus
CD4+ Helper T Cells
Primary Infection
Flu-like Symptoms
Lymphadenopathy
Symptomatic Stage
Fatigue
Diarrhea
Unexplained Weight Loss
White Spots on Tongue
Persistent Fever
Night Sweats
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2 mins
Human Immunodeficiency Virus (HIV) Diagnosis
HIV-1/2 Antigen/Antibody Immunoassay
HIV-1/2 Antibody Differentiation Immunoassay
Nucleic Acid Testing (NAT)
Viral Load
Polymerase Chain Reaction (PCR) in Neonates
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3 mins
Human Immunodeficiency Virus (HIV) Stages
Primary Infection
Within 3 Weeks
Flu-like Symptoms
Asymptomatic Stage
Years
Symptomatic Stage
CD4+ < 500
AIDS
Opportunistic Infections
CD4+ < 200
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2 mins
Human Immunodeficiency Virus (HIV) Interventions
Interventions
Adequate Nutrition
Small Frequent Meals
IV Hydration
Emotional Support
HIV Medications
HAART
Considerations
Transmission Education
Strict Asepsis for Invasive Procedures
Treat Opportunistic Infections
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2 mins

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