Menstrual Dysfunction

________ is the absence of menstruation by age 14 without having undergone other changes associated with puberty or by age 15 with having undergone normal physical changes of puberty. A) Primary amenorrhea B) Oligomenorrhea C) Secondary amenorrhea D) Metrorrhagia

Answer: A Primary amenorrhea is the absence of menstruation by age 14 without having undergone other changes associated with puberty or by age 15 with having undergone normal physical changes of puberty. Secondary amenorrhea occurs when a previously menstruating woman does not spot or bleed for a period of time that is three times that of her normal cycle length. Oligomenorrhea is light or infrequent menstruation and occurs when cycles are longer than 6-7 weeks. Metrorrhagia is bleeding of variable amount between menstrual periods

The nurse is assessing the sexual health of a 20-year-old female client. Which of the following findings should the nurse identify as risk factors for dysfunctional uterine bleeding? Select all that apply. A) High level of stress B) Weight gain of 20 pounds in 2 months C) Use of birth control pills for contraception D) History of peptic ulcer disease E) Limited intake of high-fat foods

Answer: A, B, C A number of factors may predispose a woman to dysfunctional uterine bleeding. These factors include stress, extreme weight changes, and use of hormonal birth control. Dysfunctional uterine bleeding is usually related to hormonal imbalances and not associated with peptic ulcer disease or low-fat diets

In what way does menometrorrhagia differ from menorrhagia? A) Menometrorrhagia involves excessive menstruation, whereas menorrhagia does not. B) Menometrorrhagia involves irregular menstruation, whereas menorrhagia does not. C) Menometrorrhagia involves prolonged menstruation, whereas menorrhagia does not. D) Menometrorrhagia involves the absence of menstruation, whereas menorrhagia does not.

Answer: B Menorrhagia is excessive or prolonged menstruation that occurs at regular intervals. Menometrorrhagia is irregular, excessive, prolonged menstruation. It is essentially a combination of the heavy bleeding of menorrhagia and the irregularity of metrorrhagia.

Which of the following statements is true regarding the etiology and pathophysiology of primary dysmenorrhea? A) Primary dysmenorrhea is caused by decreased levels of prostaglandins, which cause uterine contractions to increase in strength. B) Primary dysmenorrhea begins within the first three or four menstrual periods after menarche and will occur with each ovulatory cycle during a woman's teens and twenties. C) Secondary dysmenorrhea is more common than primary dysmenorrhea. D) Causes of primary dysmenorrhea include endometriosis, tumors, cysts, pelvic adhesions, pelvic inflammatory disease, infections, cervical stenosis, uterine leiomyomas, and adenomyosis.

Answer: B Pain associated with menses, called dysmenorrhea, is one of the most common menstrual dysfunctions. Primary dysmenorrhea is common among women with normal menstrual function and is more common than secondary dysmenorrhea. Primary dysmenorrhea is caused by the release of prostaglandins that cause the contractions of the uterus needed to expel menstrual fluid and tissue. Primary dysmenorrhea begins within the first three or four menstrual periods after menarche and will occur with each ovulatory cycle during a woman's teens and twenties. Secondary dysmenorrhea is related to pathology or diseases that affect the uterus and pelvic area. Causes of secondary dysmenorrhea include endometriosis, tumors, cysts, pelvic adhesions, pelvic inflammatory disease, infections, cervical stenosis, uterine leiomyomas, and adenomyosis.

The nurse is caring for a young adult client who reports that she has painful periods. Which assessment findings suggest that this client is experiencing primary dysmenorrhea? Select all that apply. A) Bleeding between menstrual periods B) Headache C) Fatigue D) Diarrhea E) Scant menses

Answer: B, C, D Manifestations of primary dysmenorrhea include headache, diarrhea, fatigue, vomiting, breast tenderness, and pain radiating to the lower back and thighs. Scant menses is a symptom of hormone imbalance. Bleeding between menstrual periods is characteristic of metrorrhagia.

Which of the following interventions should the nurse recommend to a client who is experiencing primary dysmenorrhea? Select all that apply. A) Increase caffeine intake. B) Use a heating pad. C) Try relaxation techniques. D) Engage in regular exercise. E) Avoid vitamin supplements.

Answer: B, C, D Regular aerobic activity helps decrease dysmenorrhea symptoms. Caffeine intake should be restricted to reduce irritability. Relaxation techniques may be useful because they promote the release of pain-relieving endorphins. Vitamin supplements should not be avoided and may be needed to help control symptoms. A heating pad can help reduce abdominal cramping and pain.

The nurse is working with a client who experiences severe premenstrual syndrome. Which of the following interventions should the nurse suggest to assist the client in coping with this disorder? A) "Take frequent rest periods." B) "Consider drinking 4 ounces of wine each day." C) "Be sure to exercise and use relaxation techniques on a regular basis." D) "Avoid contraception during menstruation when engaging in sexual intercourse."

Answer: C Interventions to promote effective coping in a client with severe premenstrual syndrome include encouraging exercise and use of relaxation techniques. Alcohol intake should be avoided, so the client should not be encouraged to have 4 ounces of wine each day. The client should be instructed to use contraception if engaging in sexual intercourse during menstruation because ovulation and pregnancy can occur. Frequent rest periods would be beneficial for a client with dysfunctional uterine bleeding but not a client with premenstrual syndrome.

A nurse is preparing to teach a group of young women about strategies for the relief of menstrual cramping. What should be the focus of these strategies? A) Minimizing menstrual flow B) Avoiding uterine contraction C) Increasing blood flow to the uterine muscle D) Decreasing estrogen production

Answer: C Menstrual cramping is a result of muscle ischemia that occurs when the client experiences powerful uterine contractions. Increasing blood flow to the uterine muscle through rest, certain exercises, application of heat to the abdomen, and presence of milder uterine contractions (such as those associated with orgasm) can decrease pain and cramping. There is no connection between pain and the actual amount of menstrual flow. Estrogen production should follow normal patterns and should not be altered.

A young adolescent client is concerned about experiencing severe cramps with menstruation. She tells the nurse, "I don't like the pain, and I'm also worried the cramps mean there is something wrong with me." How should the nurse respond to this client? A) "Menstrual cramping is not normal but is something that can be treated." B) "You have cramps because you started your periods too early." C) "Cramps are common in young women who just started having their periods, but they can be managed and often become less severe over time." D) "You need to see a gynecologist for a pelvic examination."

Answer: C Primary dysmenorrhea occurs without specific pelvic pathology and is most often seen in girls who have just begun menstruating, usually becoming less severe after a woman's mid-20s. The client is an early adolescent, so she is in the normal age range to start having periods. Cramps are common in this age range, so the client does not need to see a gynecologist for a pelvic examination. However, the client would benefit from teaching about how to reduce and manage her menstrual pain.

The nurse instructs a client on ways to reduce premenstrual difficulty. Which statement on the part of the client indicates that the instruction was beneficial? A) The client states the need to increase dietary sugar intake to promote energy. B) The client states that guided imagery does not help with premenstrual symptoms. C) The client states the need to increase intake of simple carbohydrates. D) The client states that reducing caffeine intake will help.

Answer: D The client stating that a reduction in caffeine intake will help reduce premenstrual difficulty is evidence that the instruction was beneficial. The other client statements all indicate the need for additional instruction, because guided imagery can be used to reduce stress and promote relaxation and intake of simple carbohydrates and sugars should be reduced.