415 Maternal Child EAQ

The nurse teaches a high school sex education class that herpes genitalis infection cannot be cured, but the disease is marked by remissions and exacerbations. What else should the students be taught about this infection?

-Although exacerbations occur they are not as severe as the initial episode. The initial infection is both local and systemic; exacerbations are milder and localized. Although optimum health habits may limit exacerbations, they will not prevent them. There is no treatment that will limit the number of exacerbations. Exacerbations are precipitated by physical and emotional stress, not by sexual activity.

A 24-year-old woman wants to use her basal body temperature (BBT) in natural family planning but is unsure when to take her temperature. When should the nurse explain is the best time for accurate BBT assessment?

Each morning before getting out of bed or increasing her activity The most accurate BBT is taken before a woman gets out of bed and begins any type of activity that could increase the body's temperature even slightly. BBT should be charted daily on a calendar to permit interpretation of temperature fluctuations. A BBT taken in the evening may be increased after a day of activity. Daily assessment and recording of BBT during the first half of the menstrual cycle is also crucial, because a woman's BBT is lower then than during the second half of her cycle. The BBT temperature may rise slightly with ovulation

A 15-year-old client tells a school nurse, "I have this awful pain during my periods—it never stops." What should the nurse encourage her to do?

Have a gynecologic examination. Persistent pain of any kind during menstruation (dysmenorrhea) usually indicates a problem, and the client should seek medical attention. Although diversion is a means of altering pain perception, the presence of pain requires investigation of possible causes. Although a nutritious diet is beneficial, iron does not prevent the pain of dysmenorrhea. Voluntary relaxation of the abdominal muscles does not result in cessation of dysmenorrhea

A client arrives at the fertility clinic for a diagnostic workup and is told by the nurse to prepare for a Papanicolaou (Pap) test. The client states, "I do not want this test. I want to speak to the person in charge." How should the nurse respond to this statement?

Inform the primary healthcare provider of the client's request. The client has the right to refuse the Pap test; the nurse must accept the client's need to talk with the primary healthcare provider first. Although the client may eventually be encouraged to comply, her immediate need must be recognized first. Expressing some disapproval of the client's lack of cooperation is a subjective conclusion; the client has the right to refuse the test. Reminding the client of the importance of early cancer detection is inappropriate; this action is not client centered.

A 37-year-old client with endometriosis visits the women's health clinic because she has dysmenorrhea and dyspareunia. Which statement is the most accurate description of dysmenorrhea?

Pain with menses Dysmenorrhea is defined as pain with menses. Endometrial hyperplasia results from anovulation and persistent estrogen stimulation. Bleeding between menses is metrorrhagia. Heavy bleeding with menses is menorrhagia.

A nurse is assessing a client for the potential for osteoporosis. Which factor in the client's history increases the risk for this disorder?

Prolonged immobility Prolonged immobility results in bone demineralization because there is decreased bone production by osteoblasts and increased resorption by osteoclasts. Estrogen helps prevent bone demineralization. Hypoparathyroidism decreases mobilization of calcium from the bones, thereby reducing the serum level of calcium. Decreased calcium intake or absorption may precipitate osteoporosis.

The nurse is interviewing a 41-year-old woman who is being seen in the infertility clinic for her first visit. She and her husband have been married for 3 years and have not used any form of contraception during this time. Neither the woman nor her husband has children from previous relationships. She asks the nurse what test or treatment will be done first. What should the nurse inform her that she and her husband should expect?

Semen analysis Semen analysis is painless, is less costly than other interventions, and provides important information regarding the male partner's fertility. Fertility medication would not be initiated until an evaluation of ovulatory function had been completed. Simpler evaluations and therapies are completed before more complex efforts such as surgical procedures like laparoscopy and hysteroscopy are performed.

A 25-year-old woman comes to the clinic complaining of increased vaginal discharge, milky gray in color with a "fishy" odor that both she and her husband have noticed. A wet smear is performed and the presence of "clue cells" confirmed. Which type of infection does the nurse suspect?

Bacterial Vaginosis Signs of bacterial vaginosis include a milky gray vaginal discharge that has a characteristic fishy odor. "Clue cells" noted on wet smear are indicative of BV. Candidiasis is a yeast infection caused by the organism Candida albicans. The most common symptom of a yeast infection is vulvar and vaginal pruritus. Vaginal discharge in a candidal infection is thick, white, and lumpy. A woman with a trichomoniasis infection may present with a frothy yellowish-green vaginal discharge. Vulvar irritation, pruritus, and dyspareunia are usually present. Group B Streptococcus may be considered part of the normal vaginal flora in a woman who is not pregnant, and no treatment is necessary.

A nurse is assessing a 55-year-old client who is experiencing postmenopausal bleeding. The tentative diagnosis is endometrial cancer. Which findings in the client's history are risk factors associated with endometrial cancer? Select all that apply.

Obesity, Cigarette Smoking, Family hx of endometrial cancer, previous hormone replacement therapy. Obesity is a risk factor for endometrial cancer because adipose cells store estrogen; the extent of exposure to estrogen is the most significant risk factor. Nulliparity, not multiparity, is a risk factor for endometrial cancer because of the increased exposure to estrogen. Cigarette smoking has been identified as a risk factor for endometrial cancer. Late, not early, onset of menopause is a risk factor for endometrial cancer because of the increased exposure to estrogen. Although endometrial cancer has not been proven to have a genetic predisposition, it is more common in families who have gene mutations for hereditary nonpolyposis colon cancer.

A nurse is evaluating a client's understanding regarding postoperative concerns after a mastectomy. Which unanticipated development near and around the incision noted by the client should be reported to her primary healthcare provider?

Swelling with erythema Swelling and erythema are signs of infection and should be reported to the primary healthcare provider immediately. Itching is a sign of healing that is expected. Decreased sensation results from the severing of nerves and formation of scar tissue and is expected. There is little subcutaneous fat in the thoracic area, and the skin may be taut at the operative site, appearing irregular; this commonly occurs.