411 Chapter 4

which information should the nurse provide the client about using a contraceptive sponge?

1. Wet the sponge with water before inserting it 2. insert the sponge 24 hours before intercourse 3. leave the sponge in place for at least 6 hours following intercourse

A client would like some information about the use of a cervical cap. Which information should the nurse include in the teaching plan of this client

1. inspect the cervical cap before insertion 2. Wait for 30 mins after insertion before engaging in intercourse 3. do not use the cervical cap during menses

Which misconceptions will the nurse need to clear up with the client?

1. taking birth control pills protects against STDs 2. douching after sex will prevent pregnancy 3. irregular menstruation prevents pregnancy

client reports not being comfortable about using any barrier methods and would like the option of regaining fertility after a couple of years. which method should the nurse suggest to this client?

CycleBeads or medroxyprogesterone

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.

Guilt related to the lack of conception Anger toward others who have conceived Fear of the possible outcome of the testing

Amenorrhea

absence of menstruation

metrorrhagia

bleeding between periods

A client reports that she has multiple sex partners and has a lengthy history of various pelvic infections. She would like to know if there is any temporary contraceptive method that would suit her condition. Which method should the nurse suggest for this client?

condoms

A couple is be assessed for infertility. the male partner is required to collect a semen sample for analysis. what instruction should the nurse give him?

deliver sample for analysis within 1-2 hours after ejaculation

A woman at the infertility clinic for the first time asks, "What could have caused my infertility?" Learning has taken place when the woman can identify which common causes of infertility? Select all that apply.

endometriosis blocked fallopian tubes ovarian dysfunction

Causes of primary amenorrhea

extreme weight gain or loss, stress from major life event, excessive exercise, or eating disorder. also caused by congenital abnormalities of the reproductive system, Cushings, polycystic ovarian syndrome, hypothyroidism, and Turner syndrome; other causes are imperforate hymen, chronic illness, pregnancy, cystic fibrosis, congenital heart disease, and ovarian or adrenal tumors

menometrorrhagia

heavy bleeding occurring at irregular intervals with flow lasting more than 7 days

what are the risk factors associated with endometriosis

increasing age, family history, short menstrual cycle, long menstrual flow, young age at menarche, and few or no pregnancies

A client is seeking information about specific safety precautions for extending oral contraceptive regimen

it carries the same safety profile as the 28-day regimen

____________ is the direct visualization of the internal organs with a lighted instrument inserted through an abdominal incision

laparoscopy

a 52-year-old client is seeking treatment for menopause. She is not very active and has a history of cardiac problems. which therapy option should the nurse recognize as contraindicated for this client.

long term hormone replacement therapy because of increase risk of heart attacks and stroke

The nurse informs the client that a diaphragm is an example of which type of contraception?

mechanical barrier

in a _________ abortion, the woman takes certain medications to induce miscarriage to remove the products of conception

medical

Oral contraceptives called_____________, contain only progestin and work primarily by thickening the cervical mucous to prevent penetration of the sperm and make the endometrium unfavorable for implantation

minipills

____________is a condition in which bone mass declines to such an extent that fractures occur with minimal trauma

osteoporosis

primary dysmenorrhea is caused by increased ___________ production by the endometrium in an ovulatory cycle

prostaglandin

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.

semen analysis ovulation monitoring tubal patency

at the onset of ovulation, cervical mucous that is more abundant, clear, slippery, and smooth is known as ___________ mucus

spinnbarkeit

counseling and education should the nurse provide when talking about amenorrhea

the nurse should address the diverse causes of amenorrhea, the relationship to sexual identity, and possibility of infertility and more serious problems. In addition the nurse should inform the patient about the purpose of each diagnostic test, how it is done, and when the results will be available

a nurse is teaching a female client about fertility awareness as a method of contraception. which should the nurse mention as an assumption for this method

the unsafe period is approx 6 days

A client in her second trimester of pregnancy asks the nurse for information regarding certain oral medications to induce a miscarriage. What information should this client be given about such medications

they can be taken only in the first trimester

What are the intrauterine systems

IUSs are small, plastic, T-shaped objects that are placed inside the uterus to provide contraception. they prevent pregnancy by making the endometrium of the uterus hostile to implantation of a fertilized ovum, by causing a nonspecific inflammatory reaction.

________________ involves the ingrowth of the endometrium into the uterine musculature

adenomyosis

the nurse is assessing a client for amenorrhea. during the assessment, the nurse notes facial hair and acne. the nurse knows this could be related to

an androgen excess secondary to a tumor

What are the common lab tests ordered to determine the cause of amenorrhea

karyotype, ultrasound to detect ovarian cysts, pregnancy test, thyroid function studies, prolactin level, FSH level, LH level, 17-ketosteroids tests, laparoscopy, and CT scan of head

During___________, the ovary begins to falter, producing irregular and missed periods and an occasional hot flash

perimenopause

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

oligomenorrhea

bleeding occurring at intervals of more than 35 days

A 30-year-old client would like to try using basal body temp as a fertility awareness method. which instruction should the nurse provide the client

take temperature before rising and record it on a chart.

male sterilization is accomplished with a surgical procedure known as______________

vasectomy

A client 6 weeks postpartum is preparing to receive a depot medroxyprogesterone acetate (Depo-Provera) injection. Which statement by the client indicates that further teaching is necessary?

I need to be patient as it will take a while before I can get pregnant

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 will be able to have my third child in about a year form now

Client asks the nurse about cervical changes during ovulation. about which should the nurse inform the client

cervix is high or deep in the vagina

what is menopause

cessation of regular menstrual cycles. it is the end of menstruation and childbearing capacity. natural menopause is defined as 1 year without a menstrual period. the average age at which it occurs is 51 years.

dysmenorrhea

difficult or painful menstruation

compare and contrast primary and secondary infertility

infertility refers to the ability to conceive a child after a yer of regular sexual intercourse unprotected by contraception, or the inability to carry a pregnancy to term Secondary infertility results when an individual is unable to conceive after having done so in the past.

A client has opted to use an intrauterine device (IUD) for contraception. about which effect of the device on monthly periods should the nurse inform the client

periods become lighter

The nurse is preparing a teaching session for a client considering tubal ligation. Which factor should the nurse prioritize in this session?

this is a permanent and irreversible procedure for birth control

the ____________ body temperature refers to the lowest body temperature and is reached upon awakening

basal

Treatments for amenorrhea

involves correcting any underlying disorders as well as providing estrogen replacement therapy to stimulate the development of secondary sexual characteristics

What is the Two-Day Method for contraception

women observe the presence or absence of cervical secretions by examining toilet paper or underwear or by monitoring their physical sensations. Everyday the woman asks two simple questions: "Did I note any secretions yesterday?" and "Did I note any secretions today?" If the answer to either question is yes, she considers herself fertile and avoids unprotected intercourse. if the answers are no, she is unlikely to become pregnant from unprotected intercourse on that day.

A woman visits the family planning clinic to request a prescription for birth control pills. Which factor would indicate that an ovulation suppressant would not be the best contraceptive method for her?

she has a family history of thromboembolism