N306 Exam 1 Study Guide
Antepartum Assessments & Care
1. Reproductive Cycle & Fertilization
A nurse is teaching a woman about her menstrual cycle. The nurse states that Proliferation of the endometrium is the most important change that happens before the secretory phase of the menstrual ...
N306 Exam 1 Study Guide
Antepartum Assessments & Care
1. Reproductive Cycle & Fertilization Reproductive Cycle: Menstrual Cycle 28
days MENSTRUAL CYCLE
● Ovarian Cycle: the maturation of the ova consisting of
1. Follicular Phase - (from the 1st day of
menstruation to 12-14 days) LH & FSH cause
graafian follicle to mature producing
Estrogen
2. Ovulatory Phase - (begins when estrogen levels
peak until oocyte released from graafian follicle)
= OVULATION ^LH
3. Luteal Phase - (begins after ovulation and lasts
14 days) ^ estrogen & progesterone
If pregnant, know that the corpus luteum secretes estrogen &
progesterone until placenta matures and assumes this function
> If pregnant, corpus luteum will continue to secrete estrogen
https://www.youtube.com/watch?v=MLJTLAKFM3k
& progesterone until placenta matures
A nurse is teaching a woman about her menstrual cycle. The nurse states that
Proliferation of the endometrium is the most important change that happens > If NOT pregnant, corpus luteum degenerates = < in progesterone
before the secretory phase of the menstrual cycle. and beginning of menstruation
The clinic nurse knows that the part of the endometrial cycle occurring from ● Endometrial “Uterine” Cycle: changes in the
ovulation to just prior to menses is known as the secretory phases occurs from endometrium of the uterus in response to the ovarian
the time of ovulation to the period just prior to menses, or approximately days cycle
15 to 26. 1. Proliferative Phase - (occurs following
menstruation ending with ovulation)
endometrium preparing for implantation =more
THICK & VASCULAR
2. Secretory Phase - (after ovulation and ends with
onset menstruation) = continues to THICKEN
^progesterone
3. Menstrual Phase - sloughing off of
the endometrium = PERIOD .
➢ The secretory phases occurs from the time of ovulation to the Fertilization: “Conception” occurs when the sperm nucleus enters the
period just prior to menses, or approximately days 15 to 26. nucleus of the oocyte within the outer third of the fallopian tube.
➢ Amniotic fluid first appears at about 3 weeks.
➢ There are approximately 30 mL of amniotic fluid present at 10 weeks’
gestation, and this amount increases to approximately 800 mL at 24
● The fertilized egg is then called a ZYGOTE and contains
a diploid number of chromosomes = 46
weeks’ gestation. After that time, the total fluid volume remains fairly
stable until it begins to decrease slightly as the pregnancy reaches
term.
,2. Infertility Infertility: the inability to conceive or maintain a pregnancy after 12
months of unprotected sexual intercourse
● 6 months for women older than 35 y.o
> Causes
● 1/3 Male Factor
○ Endocrine - < in LH, FSH, Testosterone
○ Spermatogenesis - effects of gonadotoxins
Gonadotoxins include: drugs, infections, systemic illness, heat
exposure, pesticides and radiation to the pelvic region.
○ Sperm Antibodies - < in sperm motility
> Both male & female need to be evaluated ○ Sperm Transport - blocked transport
■ Vasectomy
■ Prostatectomy
■ Inguinal hernia
■ Absence of Vas Deferens
○ Disorders of Intercourse
■ Erectile Dysfunction
● 1/3 Female Factor
○ Ovulatory Dysfunction
■ Anovulation
■ Inconsistent Ovulation
○ Tubal & Pelvic Pathology
■ Damage to the Fallopian tubes
● ENDOMETRIOSIS
■ Uterine Fibroids: benign growth
of uterine wall
○ Cervical Mucus Factor
■ Surgical surgeries: cryotherapy
(TX cervical dysplasia)
■ Infection not allowing sperm to enter
● 1/3 Both Male and Female Factors
> DX Testing:
● Screening for STI’s and STD’s
● Labs assessing levels of LH, FSH, TSH, testosterone
● Semen Analysis
● Assessment of Ovulatory Dysfunction
○ Daily Morning Body Basal Temp
○ Day 3 of menstrual cycle = FSH & estradiol
test taken
○ Detecting LH surge 36hrs before ovulation
● Endometrial Biopsy at end of menstrual cycle
● Hysterosalpingogram radiological exam testing
tubal problems
TX: ● Laparoscopy -visualize/inspect ovaries
● Males:
○ Hormonal Therapy TX:
○ Lifestyle changes ● Females:
■ Stress reduction, improved ○ Same lifestyle changes as men
nutrition, smoking cessation, ○ Surgery to open tubes if abnormal
eliminating drugs ○ Myomectomy - removal of uterine fibroids
■ Corticosteroids to TX antibodies ○ Antibiotics to TX infection
■ Antibiotics to TX infection ○ Medication stimulating egg production
■ Repair of inguinal hernia or obstruction ■ CLOMIPHENE CITRATE:
stimulates release of FSH & LH
A client is to take Clomiphene Citrate for infertility. Which of the following is the
expected action of this medication? Stimulate release of FSH and LH
,A couple who has sought infertility counseling has been told that the man’s ● PO cycle Day 3-7
sperm count is very low. The nurse advises the couple that spermatogenesis is S/E: hot flashes, breast discomfort, headaches, insomnia
impaired when which of the following occur? The testes are overheated.
A nurse working with an infertile couple has made the following nursing
diagnosis: Sexual dysfunction related to decreased libido. Which of the following
assessments is the likely reason for this diagnosis? The couple has established
a set schedule for their sexual encounters. Couples who “schedule”
intercourse often complain that their sexual relationship is unsatisfying.
A couple is undergoing an infertility workup. The semen analysis indicates a
decreased number of sperm and immature sperm. Which of the following
factors can have a potential effect on sperm maturity?
- The man rides a bike to and from work each day.
- The man takes a calcium channel blocker for the treatment
of hypertension
The daily riding of a bike can be the cause of prolonged heat exposure to the
testicles. Prolonged heat exposure is a gonadotoxin. A number of medications,
such as calcium channel blockers, can have an effect on sperm production
, 3. Physiological changes pregnancy by system (pg 54)
CHADWICKS SIGN: BLUISH DISCOLORATION OF THE CERVIX
Cardiovascular system: 10-15bmp increase heart rate
(Woman feels palpitations at second trimester, assessed low blood
pressure) NORMAL
Pregnant woman’s blood volume increases by: 40% to 45%
Blood volume expansion during pregnancy leads to Physiological anemia of
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