Ch.7 Difficulty conceiving a child prep u questions
Which question would be most appropriate for a nurse to ask a client to assist in establishing a nursing diagnosis of Deficient knowledge related to measure to promote fertility?
"How often do you and your partner engage in intercourse?" An initial question that will gauge the knowledge level of the client related to reproduction is how frequently she engages in intercourse.
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 radiologic examination of the fallopian tubes using a radiopaque medium, is a frequently used technique.
Inability to conceive can be very stressful on a couple. What is one psychological aspect of infertility?
Loss of intimacy Intimacy, love, and support—essential components of a couple's sexual relationship—may be lost because intercourse takes on a clinical and mechanical tone.
A nurse should instruct a client who has premenstrual syndrome (PMS) to make which of these lifestyle modifications?
Reduce caffeine, walk several times a week, use relaxation techniques, and maintain a regular sleep schedule. A healthy lifestyle contributes to a general sense of well-being. Encourage regular exercise, reduction or elimination of caffeine and alcohol, and adequate and regular sleep. Reference:
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 coitus at least 5 or 6 times per week to optimize their chance of success. What can the nurse educate the couple about frequency of coitus? a) The couple should consider decreasing the frequency of coitus to 2 to 3 times per week to increase the male partner's sperm count. b) engage in coitus daily c) engage in 4 to 6 times a week
The couple should consider decreasing the frequency of coitus to 2 to 3 times per week to increase the male partner's sperm count. Couples who engage in coitus daily, hoping to cause impregnation, may actually have more difficulty conceiving than those who space coitus to every other day. This is because too frequent coitus can lower a man's sperm count to a level below optimal fertility.
A nurse is assessing a man who, along with his partner, has been having trouble conceiving. When assessing the man, which area would the nurse most likely include as possibly affecting his fertility? a) Testes exposed to radiation b) History of a sexually transmitted disease c) History of mental illness d) A 24-hour food intake e) A job that requires sitting all day
a, b, d, e Because of the wide variety of factors that may be responsible for subfertility, the nurse should consider, among other things, a 24-hour food intake and look for a history of a sexually transmitted disease, testes exposed to radiation, and a job that requires sitting all day. History of a fractured bone or of mental illness would not affect the man's fertility.
A client asks the nurse, "What would be the best way to get pregnant." The nurse would incorporate which of the following in the response? a) age of sperm in the ejaculate affects its viability b) timing of intercourse affects the sex of the pregnancy c) conception is more likely when intercourse occurs within 72 hours of ovulation d) conception is more likely to occur with an orgasm
conception is more likely when intercourse occurs within 72 hours of ovulation Conception is more likely when sexual intercourse occurs within 72 hours of ovulation. There is no evidence that age of sperm in the ejaculate affects its viability or that the timing of intercourse affects the sex of the pregnancy. Studies have also shown that conception is more likely in the absence of orgasm.
A 40-year-old female client with a chronic pelvic infection expresses her desire to conceive post-treatment. When discussing this with the client the nurse keeps in mind that the client is at increased risk for which of the following? a) decreased menses b) ectopic pregnancy c) early menopause d) gestational diabetes
ectopic pregnancy Chronic pelvic infection increases the risk for narrowed or blocked fallopian tubes. It decreases the possibility of fertility or increases the risk of ectopic pregnancy. Only in case of a premature ovarian failure will the client experience symptoms of menopause earlier than expected. A client with hyperthyroidism will experience decreased or absent menses. The client with chronic pelvic infection is not susceptible to gestational diabetes. Clients with multiple gestations are more susceptible to gestational diabetes.
A nurse is assessing a client diagnosed with pelvic inflammatory disease (PID). Which finding would the nurse most likely assess? Select all that apply. a) oral temperature of 102°F (39°C) b) painful urination c) right upper quadrant pain d) tenderness with cervical motion e) negative pregnancy history f) clear vaginal discharge
oral temperature of 102°F (39°C), painful urination, tenderness with cervical motion, negative pregnancy history History and physical examination findings of PID include dysmenorrhea, dysuria, lower abdominal tenderness, cervical or vaginal mucopurulent discharge, and cervical motion tenderness. Typically the client has a fever above 101° F (38° C) and is nulliparous.
A 28-year-old married female client is planning to delay attempting pregnancy for another 10 years and is eager to know if there will be any complications involved. Which of the following information should a nurse provide to this client regarding delaying pregnancy? Risk of low blood pressure increases with age Immune system weakens with age Quality and number of ova declines with age Risk of pregnancy complications decreases
Quality Women who delay attempting pregnancy until later in life may find that their biological clock has moved more quickly than anticipated. The nurse should inform the client that the quality and number of ova, as well as the quality of sperm, decline with age. Blood pressure problems if present during pregnancy are likely to affect the fetus, but a pregnancy after peak years does not result in low blood pressure. Increased age is considered a risk factor for several complications of pregnancy. The client's immune system does not weaken with age either.
A female client who comes to the clinic for a visit is diagnosed with Turner's syndrome. The nurse would expect the client to experience which of the following? a) cystic fibrosis in males b) compromised or absent fertility c) respiratory distress syndrome d) tubal problems
compromised or absent fertility A client with Turner's syndrome, a genetic condition in which one of the two sex chromosomes is completely or partially absent, will have a compromised or absent fertility. Cystic fibrosis in males is a genetic condition, but the male child will not develop cystic fibrosis due to client's Turner's syndrome. The client's child is not susceptible to respiratory distress syndrome due to the client's genetic disorder. Preterm babies are at increased risk for respiratory distress syndrome. Turner's syndrome will not cause tubal problems in the client. Tubal problems are caused due to ascending pelvic infections, inflammation from intrauterine device, surgical adhesions or previous ectopic pregnancy.
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.
Anger toward others who have conceived, Fear of the possible outcome of the testing, Guilt related to the lack of conception Couples who have experienced infertility may experience guilt related to the lack of conception, anger toward others, and fear of the outcome. The nurse should be prepared to visit with the couple regarding these feelings, and should view these feelings as a normal process.
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. a) Do you use drugs or use alcohol excessively? b) "Do you have a regular girlfriend?" c) "Have you ever had any type of trauma or surgery on or near your testicles?" d) "Are you exposed to X-rays or other radioactive substances?"
a, c, d Conditions that may inhibit sperm production are trauma to the testes, surgery on or near the testicles that results in impaired testicular circulation, and endocrine imbalances, particular of the thyroid, pancreas, or pituitary glands. Drug use or excessive alcohol use and environmental factors such as exposure to X-rays or radioactive substances have also been found to negatively affect spermatogenesis. Men exposed to radioactive substances in their work environments should be provided adequate protection for the testes.
