OB PrepU: Difficulty Conceiving a Child: Chapter 8

A client comes to the reproductive clinic for their every 3 month depot medroxyprogesterone (Depo-Provera) injection. When discussing prevention of long-term side effects, which nursing question is a priority?

"How much do you eat to increase calcium in your diet.?"

A nursing instructor is teaching about fertility and realizes a need for further instructions when a student states:

"In most couples with a subfertility problem, it is the man who is subfertile.

A nurse should instruct a client who has secondary erectile dysfunction related to type 2 diabetes to make which lifestyle modification?

Control blood sugar

A nurse has completed as assessment of a male client for subfertility. Which finding will the nurse interpret as increasing the client's risk for experiencing a limited sperm count?

Using a hot tub and sauna 4 to 5 times a week.

A client is to take clomiphene citrate for infertility. Which outcome should the nurse explain is the expected action of this medication?

Stimulate the release of ova.

A client has been given instructions about a schedule sonohysterosalpingram. Which statement, if made by the client, should indicate to a nurse that the client has an adequate understanding of the instructions?

"They will place a catheter in my uterus and use an ultrasound dot see what the problem is."

A nurse is conducting an assessment on a female client being seen for infertility issues. Which assessment data leads the nurse to believe that anovulation is occurring? Select all that apply.

(1) BMI 14.6 (2) No fluctuation on BBT graph

A couple who has not conceived after 6 years of not using birth control are being seen in the infertility clinic. In assessing the client's psychosocial response to infertility, which might the nurse expect to find? Select all that apply.

(1) Guilt related to the lack of conception (2) Anger toward others who have conceived (3) Fear of the possible outcome of the testing

A nursing instructor is teaching about subfertility to nursing students and perceives their understanding when they define subfertility existing when a pregnancy has not occurred after how much time of engaging in unprotected sex?

12 months

A nursing instructor is teaching about subfertility to nursing students and preceives their understanding when they define subfertility existing when a pregnancy has not occurred after how much time engaging in unprotected sex.

12 months

The nurse is working at a genetic counseling and fertility clinic. In reviewing the morning appointments, which couple would the nurse consider as having the highest risk for infertility?

A 40 year old female with a 42 year old male partner, the couple. Have experienced subfertility for one year.

A female client is having a procedure this morning that involves radiologic examination of the fallopian tubes using a radiopaque medium. What procedure should the nurse document as being performed?

A Hysterosalpingography

A nursing instructor is teaching about causes of infertility and identifies a need for further instruction when a student states which of the following?

Diet does not play a role in infertility

Inability to conceive can be very stressful on a couple. What is one psychological aspect of infertility?

Loss of intimacy

What intervention will the nurse perform for a couple trying to work through the stress that fertility testing is placing on their lives?

Encourage them to join a support group for infertile couples.

What intervention will the nurse perform for a couple trying to work through the stress that fertility testing is placing on their lives?

Encourage them to join a support group for infertility couples.

A woman and her partner have been unable to conceive. The female client's chart reveals a history of pelvic inflammatory disease (PID), oral contraception usage for 5 years, blood pressure 98/72 mm Hg, pulse 78 beats/min, temperature 99*F (37.2*C), and white blood cells (WBC) count 9,500 mm3 (9.5 x 10 9/1). Which order will the nurse anticipate for this client.

Hysterosalpingography

A 45 year old client and her spouse are present in the clinic. Results of fertility testing indicate that the client has damage to her fallopian tubes. Which would be the most appropriate infertility option for this client?

In vitro fertilization

A 34-year-old female client with a chronic pelvic infection expresses a desire to conceive posttreatment. The client asks the nurse, "Do you see any problems that I may have since I keep having this issue?" Which nursing response is appropriate?

"Chronic infection may lead to scarring or narrowing of the fallopian tubes."

Which question would be most appropriate for a nurse to ask a client to assist in establishing a nursing diagnosis of deficient knowledge to measure to promote fertility?

"How often do you and your partner engage in intercourse?"

The nurse is conducting a health history on a couple planning to become pregnant over the next few months. Which statement by the male client most concerns the nurse?

"I have a degree as a chemical engineer and work at the local plant."

A client who is scheduled for hysteroscopy says to a nurse, "I thought I would be able to have children, but now I know that will never be possible. "Which response would be most appropriate for the nurse to make?

"I will call the health care provider to come visit with you."

The nurse is completing a medication review when the male client states a desire to start a family, and thus he is no longer going to take his prescribed antihypertensive medication. He adds that he has difficulty obtaining an erection and believes this problem started when he began taking this medicine. Which nursing response related to the client's concern is best?

"Let's talk with the primary health care provider to see if you can change your prescription.

The nurse is assessing a male client who is concerned about his ability to produce enough sperm to have a child. He tells the nurse, "I have had some issues in my younger years. "What questions would be important for the nurse to ask this client? Select all that apply.

(1) Do you use drugs or use alcohol excessively. (2) Are you exposed to X-ray or other radioactive substances. (3) "Have you ever had any type of trauma or surgery on or near your testicles?"

A couple comes to the clinic and states to the nurse, "I don't think we are ever going to be able to have children. We have been trying but have had no luck." What assessments does the nurse anticipate will be performed for this couple? Select all that apply.

(1) Semen analysis (2) Ovulation monitoring (3) Tubal patency

A female client has been trying to conceive for 1 year comes to the fertility clinic and will be undergoing a subfertility evaluation. When discussing the components involved, which information would the nurse most likely include? Select all that apply.

(1) Semen analysis of the partner. (2) Ovulation monitoring (3) Tubal patency assessment

A female client is concerned about the rate of fertility because the client is older than age 35 years. The client states, "Have I given up the chance to be a parent?" Which response from the nurse is accurate."

A woman's fertility peaks in the 20's declines gradually until age 35, and then rapidly declines until it ends.

The experienced nurse working in a fertility clinic identifies concerns of clients when they have to "schedule" sexual relations. Which nursing suggestion would be most helpful to a couple to help prevent further stress on their relationship?

Begin a new activity together

A 36 year old male client whose wife has been unable to conceive is referred for semen analysis. The client prefers to collect the specimens at home. Which instruction should the nurse provide about collecting and transporting the specimen?

Carry the semen specimen in an inner pocket.

A nurse is teaching a female client who is unable to conceive how to monitor her basal body temperature. Which instruction would the nurse prioritize for this client?

Chart body temperature for at least a month.

A 25 year old client having a yearly checkup and medication review informs the nurse that they have stopped taking oral contraceptions pills (OCPs) because the couple wants to start a family. The client states, "I know I will get pregnant right away because my mother was very fertile. "What is the nurse's best response?

Clients who recently used oral birth control may have difficulty becoming pregnant for several months.

A female client who comes to the clinic for a visit is diagnosed with Turner syndrome. The nurse would expect the client to experience which of the following?

Compromised or absent fertility

The nurse is caring for a couple who are trying to get pregnant and have not been able to for over a year. The nurse explaines to the couple that diagnostic testing usually begins on the male partner as these tests are easier. The couple asks what kind of problems a man can have that can cause infertility. What should be the nurse's response?

Men can have problems that increase the temperature around their testicles. Which decreases the quality of their semen.

A couple is seeking guidance for their inability to conceive a child after trying for 15 months. They are morbidly obese but states they have friends with the same weight problem who have had no difficulty conceiving. What education can the nurse provide this couple to increase their chances of success?

Obesity may interfere with effective penetration and deposition of sperm. We will look at several factors to discover what issues you may be encountering.

A woman has just been prescribed clomiphene citrate to stimulate ovulation. Which possible effect should the nurse warn the woman about?

Overstimulation of the ovary resulting in potential multiple births.

A client is scheduled to start taking tadalafil for erectile dysfunction. A nurse should teach the client to observe for side effects and notify a health care provider immediately if what occurs?

Priapism

A couple comes in and tells the nurse that they have been trying diligently to conceive for the last 3 months and are subfertility. What should the nurse explain to the couple about the definition of subfertility?

Subfertility is said to exist when a pregnancy has not occurred after at least 1 year of engaging in unprotected subfertility.

A couple comes to the clinic and informs the nurse that they have been trying to conceive for 6 months with no success. The husband states that they have sex at least 5 or 6 times per week to optimize their chance of success. What can the nurse educate the couple about the frequency of sex.

The couple should consider decreasing the frequency of coitus to 2 to 3 times per week to increase the male partner's sperm count.

A female client had a tubal ligation 8 years ago. She has remarried, would like to have a child with her current husband, and is requesting a surgical procedure to reopen the tubes. Which information would the nurse most likely include when discussing the success rate for this procedure?

The success rate of the operation is not greater that 70% to 80%.