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N306
N306EXAM
Exam 11 FINAL STUDY
Final Study GUIDE
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
1. Follicular Phase - (from the 1st day of
menstruation to 12-14 days) LH & FSH cause
graafian follicle to mature producing Estrogen
2. Ovulatory Phase - (begins when estrogen levels
peak until oocyte released from graafian follicle) =
OVULATION ^LH
3. 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
https://www.youtube.com/watch?v=MLJTLAKFM3k > If pregnant, corpus luteum will continue to secrete estrogen &
progesterone until placenta matures
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 > If NOT pregnant, corpus luteum degenerates = < in progesterone and
before the secretory phase of the menstrual cycle. beginning of menstruation
The clinic nurse knows that the part of the endometrial cycle occurring from ● Endometrial “Uterine” Cycle: changes in the endometrium
ovulation to just prior to menses is known as the secretory phases occurs from of the uterus in response to the ovarian cycle
the time of ovulation to the period just prior to menses, or approximately days
1. Proliferative Phase - (occurs following
15 to 26.
menstruation ending with ovulation) endometrium
preparing for implantation =more THICK &
VASCULAR
2. Secretory Phase - (after ovulation and ends with
onset menstruation) = continues to THICKEN
^progesterone
3. Menstrual Phase - sloughing off of the
endometrium = PERIOD .
Fertilization: “Conception” occurs when the sperm nucleus enters the
The secretory phases occurs from the time of ovulation to the period
nucleus of the oocyte within the outer third of the fallopian tube.
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 ● The fertilized egg is then called a ZYGOTE and contains a
weeks’ gestation, and this amount increases to approximately 800 mL diploid number of chromosomes = 46
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
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● 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
> Both male & female need to be evaluated ■ Vasectomy
■ Prostatectomy
■ Inguinal hernia
■ Absence of Vas Deferens
○ Disorders of Intercourse
■ Erectile Dysfunction
● 1/3 Female Factor
○ Ovulatory Dysfunction
■ Anovulation
■ 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
TX:
● Laparoscopy -visualize/inspect ovaries
● Males: ●
○ Hormonal Therapy
TX:
○ Lifestyle changes ● Females:
■ Stress reduction, improved nutrition,
○ Same lifestyle changes as men
smoking cessation, eliminating drugs ○ Surgery to open tubes if abnormal
■ Corticosteroids to TX antibodies
○ Myomectomy - removal of uterine fibroids
■ Antibiotics to TX infection ○ Antibiotics to TX infection
■ Repair of inguinal hernia or obstruction
○ Medication stimulating egg production
■ CLOMIPHENE CITRATE: stimulates
A client is to take Clomiphene Citrate for infertility. Which of the following is the release of FSH & LH
expected action of this medication? Stimulate release of FSH and LH
● PO cycle Day 3-7
A couple who has sought infertility counseling has been told that the man’s
S/E: hot flashes, breast discomfort, headaches, insomnia
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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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3. Physiological changes pregnancy by system (pg 54)
CHADWICKS SIGN: BLUISH DISCOLORATION OF THE CERVIX
Cardiovascular system: 10-15bmp increase heart rate
(Woman feels palpitations at second trimester, assessed low blood pressure)
NORMAL
Pregnant woman’s blood volume increases by: 40% to 45%
Blood volume expansion during pregnancy leads to Physiological anemia of
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