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N306 Exam 1 Study Guide Latest Updated/Hartman.
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* Test 1* Final
N306 Exam 1 Study Guide
(40 questions)
Antepartum Assessments & Care
1. Reproductive Cycle & Fertilization Reproductive Cycle: Menstrual Cycle 28
days MENSTRUAL CYCLE
● Ovarian Cycle: the maturation of the ova consisting of
Follicular Phase - (from the 1st day of menstruation to 12-14 days)
LH & FSH cause graafian follicle to mature producing Estrogen
Ovulatory Phase - (begins when estrogen levels peak until oocyte
released from graafian follicle) = OVULATION ^LH
Luteal Phase - (begins after ovulation and lasts 14 days) ^ estrogen &
progesterone
If pregnant, know that the corpus luteum secretes estrogen &
progesterone until placenta matures and assumes this function
> If pregnant, corpus luteum will continue to secrete estrogen
& progesterone until placenta matures
> If NOT pregnant, corpus luteum degenerates = < in progesterone
https://www.youtube.com/watch?v=MLJTLAKFM3k
and beginning of menstruation
A nurse is teaching a woman about her menstrual cycle. The nurse states that
Proliferation of the endometrium is the most important change that happens● Endometrial “Uterine” Cycle: changes in the endometrium of
before the secretory phase of the menstrual cycle. the uterus in response to the ovarian cycle
Proliferative Phase - (occurs following menstruation ending with
The clinic nurse knows that the part of the endometrial cycle occurring from ovulation) endometrium preparing for implantation =more THICK
ovulation to just prior to menses is known as the secretory phases occurs from & VASCULAR
the time of ovulation to the period just prior to menses, or approximately days
15 to 26. Secretory Phase - (after ovulation and ends with
onset menstruation) = continues to THICKEN
^progesterone
Menstrual Phase - sloughing off of the endometrium = PERIOD .
Fertilization: “Conception” occurs when the sperm nucleus enters the
nucleus of the oocyte within the outer third of the fallopian tube.
●
The fertilized egg is then called a ZYGOTE and contains a
diploid number of chromosomes = 46
➢ The secretory phases occurs from the time of ovulation to the
period just prior to menses, or approximately days 15 to 26.
➢ Amniotic fluid first appears at about 3 weeks.
➢ There are approximately 30 mL of amniotic fluid present at 10 weeks’
,gestation, and this amount increases to approximately 800 mL at 24
weeks’ gestation. After that time, the total fluid volume remains fairly
stable until it begins to decrease slightly as the pregnancy reaches
term.
,2. Infertility Infertility: the inability to conceive or maintain a pregnancy after
12 months of unprotected sexual intercourse
● 6 months for women older than 35 y.o
> Causes
● 1/3 Male Factor
○ Endocrine - < in LH, FSH, Testosterone
○ Spermatogenesis - effects of gonadotoxins
Gonadotoxins include: drugs, infections, systemic illness, heat
exposure, pesticides and radiation to the pelvic region.
○ Sperm Antibodies - < in sperm motility
○ Sperm Transport - blocked transport
■ Vasectomy
■ Prostatectomy
■ Inguinal hernia
■ Absence of Vas Deferens
○ Disorders of Intercourse
■ Erectile Dysfunction
● 1/3 Female Factor
○ Ovulatory Dysfunction
■ Anovulation
> Both male & female need to be evaluated
■ Inconsistent Ovulation
○ Tubal & Pelvic Pathology
■ Damage to the Fallopian tubes
● ENDOMETRIOSIS
■ Uterine Fibroids: benign growth of uterine wall
○ Cervical Mucus Factor
■ Surgical surgeries: cryotherapy (TX cervical dysplasia)
■ Infection not allowing sperm to enter
● 1/3 Both Male and Female Factors
> DX Testing:
● Screening for STI’s and STD’s
● Labs assessing levels of LH, FSH, TSH,
● testosterone Semen Analysis
● Assessment of Ovulatory Dysfunction
○ Daily Morning Body Basal Temp
○ Day 3 of menstrual cycle = FSH & estradiol test
○ taken Detecting LH surge 36hrs before ovulation
● Endometrial Biopsy at end of menstrual cycle
● Hysterosalpingogram radiological exam testing tubal problems
● Laparoscopy -visualize/inspect ovaries
●
TX:
● Females:
○ Same lifestyle changes as men
○ Surgery to open tubes if abnormal
○ Myomectomy - removal of uterine
○ fibroids Antibiotics to TX infection
○ Medication stimulating egg production
■ CLOMIPHENE CITRATE: stimulates release of FSH &
● LH PO cycle Day 3-7
S/E: hot flashes, breast discomfort, headaches, insomnia
, TX:
● Males:
○ Hormonal Therapy
○ Lifestyle changes
■ Stress reduction, improved nutrition, smoking cessation,
eliminating drugs
■ Corticosteroids to TX
■ antibodies Antibiotics to TX
■ infection
Repair of inguinal hernia or obstruction
A client is to take Clomiphene Citrate for infertility. Which of the following is the
expected action of this medication? Stimulate release of FSH and LH
A couple who has sought infertility counseling has been told that the man’s
sperm count is very low. The nurse advises the couple that spermatogenesis is
impaired when which of the following occur? The testes are overheated.
A nurse working with an infertile couple has made the following nursing
diagnosis: Sexual dysfunction related to decreased libido. Which of the following
assessments is the likely reason for this diagnosis? The couple has established
a set schedule for their sexual encounters. Couples who “schedule”
intercourse often complain that their sexual relationship is unsatisfying.
A couple is undergoing an infertility workup. The semen analysis indicates a
decreased number of sperm and immature sperm. Which of the following
factors can have a potential effect on sperm maturity?
The man rides a bike to and from work each day.
The man takes a calcium channel blocker for the treatment of
hypertension
The daily riding of a bike can be the cause of prolonged heat exposure to the
testicles. Prolonged heat exposure is a gonadotoxin. A number of medications,
such as calcium channel blockers, can have an effect on sperm production
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