Chapter 4: Common Gynecologic Issues

A nurse is preparing a presentation for a health fair on the topic of vasectomy. Which information should the nurse point out in the presentation? Relatively easy procedure with few complications Birth control measures are not required Regular sperm counts are not essential Procedure is effective immediately

Correct response: Relatively easy procedure with few complications Explanation: The nurse should inform the individuals that vasectomy is a relatively easy procedure with few complications. Regular sperm counts following a vasectomy are important, as it will take approximately a month for the remaining sperm to exit the body. The client should use birth control measures until his sperm count remains at zero for 6 weeks.

A male client asks the nurse to explain which structure is cut during a vasectomy. What response should the nurse give the client? the vas deferens the epididymis the ejaculatory ducts the scrotum

Correct response: the vas deferens Explanation: The two vas deferens or ductus deferentia are ligated and cut in the male sterilization procedure, called a vasectomy. The epididymis serves as a site for sperm to mature and be stored until ejaculation occurs. The ejaculatory ducts empty into the urethra and receive secretions from the prostate gland to make up semen. The scrotum is a sac-like structure that sits behind the penis and houses the testicles.

A nurse is completing an informed consent on a client preparing for a tubal ligation. Which statement by the client would require the nurse to notify the health care provider? "I may need to use a second form of contraception for a while." "I will be able to have my third child in about a year from now." "I will not be able to have children after this procedure." "I will continue to have my menstrual cycle every month."

Correct response: "I will be able to have my third child in about a year from now." Explanation: The nurse should recognize that the client does not understand the consequences of the procedure and therefore is required to call the health care provider. The health care provider needs to explain the procedure, consequences of the procedure, and answer any questions before the informed consent is signed.

During a routine health visit for an 11-year-old girl, her mother asks the nurse, "My daughter just got her period about 4 months ago, but they haven't been very regular so far. How long might it take until she gets regular?" Which response by the nurse would be most appropriate? "She should start getting regular after about 2 to 3 more months." "It can take up to 2 years once she starts for the periods to become regular." "That's odd. Her periods should be getting regular by now." "If her periods are not regular now, odds are they will be irregular from now on."

Correct response: "It can take up to 2 years once she starts for the periods to become regular." Explanation: Once menarche has occurred, cycles may take up to 2 years to become regular, ovulatory cycles. Telling the mother that her daughter's periods would get regular in 2 to 3 months or that she should be having regular periods by now is incorrect. Also, telling the mother that her daughter's periods will continue to be irregular is untrue and inappropriate.

Which statement would be most appropriate when explaining endometriosis as a cause of a woman's infertility? "Your uterine cervix fails to close because it is engorged with tissue." "Menstrual sloughing does not occur, so there is never a new base for embryo growth." "You do not ovulate because of endometrial implants on the ovaries." "Ovulation does take place; however, the misplaced endometrial tissue interferes with transport of the ovum."

Correct response: "Ovulation does take place; however, the misplaced endometrial tissue interferes with transport of the ovum." Explanation: With endometriosis, endometrial tissue migrates into the fallopian tubes and peritoneum or other sites outside of the uterus. Ovulation occurs, but the egg may be trapped by the misplaced tissue.

The school nurse is counseling a sexually active 16-year-old adolescent about the various forms of contraception. She is afraid of getting pregnant or contracting a sexually transmitted infection because her boyfriend refuses to use a condom. In answering the client's questions as to which option will be best suit her needs, which form should the nurse recommend? Oral contraceptive Coitus interruptus Tubal ligation Female condom

Correct response: Female condom Explanation: The female condom would be the best choice for this client, as it provides protection against both STIs and conception. A tubal ligation would not be recommended for a 16-year-old girl, as it is a permanent measure and she may decide to have children in the future. Neither an oral contraceptive nor coitus interruptus would provide protection against STIs.

The nurse is instructing a client with dysmenorrhea on how to manage her symptoms. Which suggestions should the nurse include in the teaching plan? Select all that apply. Increase water consumption. Avoid keeping legs elevated while lying down. Increase intake of salty foods. Increase exercise and physical activity. Use heating pads or take warm baths.

Correct response: Increase water consumption. Use heating pads or take warm baths. Increase exercise and physical activity. Explanation: When instructing a client with dysmenorrhea on how to manage her symptoms, the nurse should ask her to increase water consumption, use heating pads or take warm baths, and increase exercise and physical activity. Water consumption serves as a natural diuretic, heating pads or warm baths help increase comfort, and exercise increases endorphins and suppresses prostaglandin release. The nurse should also tell the client to limit salty foods to prevent fluid retention during menstruation and to keep legs elevated while lying down because this helps increase comfort.

Which information is important for a woman to understand before undergoing a scheduled tubal ligation? The procedure will reduce her menstrual flow in amount. She will have lessened dysmenorrhea following the procedure. She must think of the procedure as irreversible. She should schedule it to be done just before a menstrual flow.

Correct response: She must think of the procedure as irreversible. Explanation: Sterilization by fallopian tube obstruction does not alter menstrual symptoms or flow. Ectopic pregnancy could result if it is done following ovulation; reversing the process is difficult.

A couple consults with the nurse regarding their infertility issues. The female says "I don't know what I have done so bad that God would punish me like this." What would be the most appropriate nursing diagnosis for this couple? Hopelessness related to inability to conceive Anticipatory grieving related to infertility Powerlessness related to infertility Spiritual distress related to inability to conceive

Correct response: Spiritual distress related to inability to conceive Explanation: The client is experiencing spiritual distress in trying to understand that the couple's infertility issue is a punishment from God. The nurse should plan interventions specifically related to education of the health problems they are experiencing so that the clients have a better understanding. In addition, the nurse should identify community resources for the client.

A woman uses a diaphragm for contraception. The nurse would instruct her to return to the clinic to have her diaphragm fit checked after which occurrence? six months of nonuse cervical infection a weight gain of 10 lb (4.5 kg) a vaginal infection

Correct response: a weight gain of 10 lb (4.5 kg) Explanation: A substantial weight gain or weight loss of 10 pounds (4.5 kilograms) or more may shift the relationship of pelvic organs enough that the diaphragm no longer fits correctly.

The nurse is planning to speak at a local community center to a group of middle-aged women about osteoporosis. Which measure would the nurse be sure to include as effective in reducing the risk for osteoporosis? limiting intake of cholesterol and saturated fats drinking at least 1 glass of wine per day engaging in daily weight-bearing exercise decreasing vitamin D intake

Correct response: engaging in daily weight-bearing exercise Explanation: Engaging in daily weight-bearing exercise such as walking helps to reduce a woman's risk for osteoporosis. To prevent osteoporosis, women should increase their calcium and vitamin D intake. Avoiding excessive alcohol ingestion helps prevent osteoporosis. Limiting intake of cholesterol and saturated fats helps reduce the risk for cardiovascular disease, not osteoporosis.

Which definition best explains the term "subfertility/infertility"? inability to achieve pregnancy following a previous viable pregnancy failure to achieve pregnancy after 6 months of unprotected intercourse failure to achieve pregnancy after 1 year of unprotected intercourse inability to achieve pregnancy because of a known factor that prevents conception

Correct response: failure to achieve pregnancy after 1 year of unprotected intercourse Explanation: Infertility is the failure to achieve conception after 1 year of unprotected intercourse. Because most couples have the potential to conceive but are just less able to conceive without additional help, the term subfertility is more often used today.

A couple in their mid-30s are at their primary care provider's office because they have been unable to conceive for 3 years. They already have one child who is 4 years of age. The care provider explains to them that they are dealing with what kind of infertility? secondary infertility primary infertility tertiary infertility There is no name for different kinds of infertility.

Correct response: secondary infertility Explanation: There are two main types of infertility: primary and secondary. A couple who has never been able to conceive has primary infertility, whereas a couple who has been able to conceive in the past but is currently unable to do so has secondary infertility.

When using the contraceptive patch, a client should understand that it: is immediately effective after application. should be applied to the breasts, hips, or back. should be applied to the abdomen, buttocks, or back. should be covered when swimming in a pool because of chlorine's effect on the adhesive.

Correct response: should be applied to the abdomen, buttocks, or back. Explanation: The patch should be applied only to the buttocks, back, abdomen, or torso (never the breasts). The patch is safe for wearing during swimming and bathing. The patch requires application for 1 week before becoming effective.

A nurse is helping a couple choose a contraception method that is right for them. Which is the least likely factor the nurse should consider? whether the method will affect sexual enjoyment financial factors ability to use a method correctly the popularity of the method among the couple's friends

Correct response: the popularity of the method among the couple's friends Explanation: Important things to consider when helping a couple to choose a method that will be right for them include the following: personal values, ability to use a method correctly, whether the method will affect sexual enjoyment, financial factors, whether a couple's relationship is short-term or long-term, prior experiences with contraception, and future plans. The popularity of the method is the least likely factor the nurse should consider.