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Summary NR507 Week 8 Final Exam Study Guide / NR 507 Week 8 Final Exam (Newest 2022/2023): Advanced Pathophysiology: Chamberlain College of Nursing $17.49   Add to cart
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Summary NR507 Week 8 Final Exam Study Guide / NR 507 Week 8 Final Exam (Newest 2022/2023): Advanced Pathophysiology: Chamberlain College of Nursing
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NR507 Week 8 Final Exam Study Guide / NR 507 Week 8 Final Exam (Newest 2022/2023): Advanced Pathophysiology: Chamberlain College of Nursing

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NR507 iPATH iFINAL iEXAM iSTUDY iGUIDE i

REPRODUCTIVE
Endometrial icycle iand ioccurrence iof iovulation

Manifestation iof ifemale ireproductive ifunctioning iis imenstrual ibleeding, iwhich istarts iwith imenarche i(1st
iperiod) iand iends iwith imenopause i(cessation iof imenstrual iflow ifor i1 iyear). iAverage iage iof imenarche iis

i12 iwith ia irange iof i9-17. iAppears ito ibe ir/t ibody iweight, iespecially ibody ifat iratio. iAt ifirst icycles iare

ianovulatory iand ivary ifrom i10-60 idays ior i>. iThen iin iadulthood irange iform i25-35 idays. iLength ivaries

iconsiderably.



Cycle iand iregular iovulation iare idependent ion

• The iactivity iof igonadostat
• Initial ipituitary isecretion iof igonadotropin iFSH
• Estrogen ipositive ifeedback ifor ithe ipreovulatory iFSH iand iLH isurge, ioocyte imaturation, iand
icorpus iluteum iformation iand iproduction iof iprogesterone.



The iaverage imenstrual icycle ilasts i27 ito i30 idays iand iconsists iof ithree iphases, iwhich iare inamed ifor iovarian iand
iendometrial ichanges: ithe ifollicular/proliferative iphase, ithe iluteal/secretory iphase, iand ithe iischemic/menstrual

iphase.

Phase i1-is ithe ifollicular iphase iin iwhich ibegins ion iday ione iof ione’s imenstrual icycle. iIt ilasts iuntil iaboutiday
i14.

-In iphase i1 ithe iendometrium igrows ito iform ia ilush ilining iinside iof ithe iuterus.

Phase i2: iLuteal iphase-this iis iwhere ithe ibody isecretes ithe ihormones iestrogen iand iprogesterone.

-These ihormones iwork itogether ito iprepare ithe ilining iof ithe iuterus ifor iimplantation.

-This ilast ifor i12 idays.

Phase i3: iMenstrual iphase-The iestrogen iand iprogesterone istart ito idecline iand ithe iendometrial ilining
begins ito ished. i This ilasts ifor i3-5 idays iand ithe iprocess irestarts.
i




Ovulation

-Release iof iovum

-Present iat ithe ibeginning iof ithe iluteal/secretory iphase.

-The iovarian ifollicle ibegins ito itransform iinto ithe icorpus iluteum.

-Pulsatile isecretion iof ithe iLH ifrom ithe ianterior ipituitary istimulates ithe icorpus iluteum ito isecrete
iprogesterone.




-This iwill iinitiate ithe isecretory iphase iof iendometrial idevelopment.

,-Glands iand iblood ivessels iin ithe iendometrium ibranch iand icurl ithrough ia ifunctional ilayer, iand ithe iglandsibegin
to isecrete ia ithin iglycogen-containing ifluid= ithe isecretory iphase.
i




*If iconception ioccurs ithe inutrient-laden iendometrium iis iready ifor iimplantation.

*The iHCG ihormone iis isecreted i3 idays iafter ifertilization iby iblastocytes iand imaintains ithe icorpus iluteum
once iimplantation ioccurs iat iday i6 ior i7.
i




*HCG ican ibe idetected iin imaternal iblood ior iurine iabout i8-10 idays iafter iovulation.

*Production iof iestrogen iand iprogesterone icontinue iuntil iplacenta ican iadequately imaintain ihormonal
iproduction.




*Ovulatory icycles ihave ia ilength iof i24-26.5 idays.

*The iprimary iovarian ifollicle irequires i10-12.5 idays ito idevelop.

*The iluteal iphase iappears iat i14 idays.

Ovarian ievents iof ithe imenstrual icycle iare icontrolled iby igonadotropins. iHigh iFSH ilevels istimulate ifollicle iand iovum
imaturation i(follicular iphase), ithen ia isurge iof iLH icauses iovulation, iwhich iis ifollowed iby idevelopment iof ithe icorpus

iluteum i(luteal iphase).



Ovarian ihormones icontrol ithe iuterine i(endometrial) ievents iof ithe imenstrual icycle. iDuring ithe
ifollicular/proliferative iphase iof ithe iovarian icycle, iestrogen iproduced iby ithe ifollicle icauses ithe iendometrium ito

iproliferate i(proliferative iphase) iand iinduces ithe iLH isurge iand iprogesterone iproduction iin ithe igranulosa ilayer.

During ithe iluteal/secretory iphase, iestrogen imaintains ithe ithickened iendometrium, iand iprogesterone
causes iit ito idevelop iblood ivessels iand isecretory iglands i(secretory iphase). iAs ithe icorpus iluteum idegenerates,
iproduction iof iboth ihormones idrops isharply, iand ithe i“starved” iendometrium idegenerates iand isloughs ioff, icausing

imenstruation, ithe iischemic/menstrual iphase.



Cyclic ichanges iin ihormone ilevels ialso icause ithinning iand ithickening iof ithe ivaginal iepithelium, ithinning iand
ithickening iof icervical isecretions, iand ichanges iin ibasal ibody itemperature.



Uterine iProlapse

descent iof icervix ior ientire iuterus iinto ivaginal icanal. iIn isevere icases ithe iuterus ifalls icompletely ithroughithe
ivagina iand iprotrudes ifrom ithe iintroitus. iSymptoms iof iother ipelvic ifloor idisorders imay ialso ibe ipresent.

iTx idepends ion iseverity iof isymptoms iand iphysical icondition iof iwoman. iFirst iline itreatment iis ioften ia

ipessary- iremovable imechanical idevice ithat iholds iuterus iin iposition. iThe ipelvic ifascia imay ibe

istrengthened ithrough ikegels ior iby iestrogen itherapy iin imenopausal iwomen. iHealthy iBMI, ipreventing

iconstipation, iand itreating ichronic icough imay ialso ihelp. iSurgical irepair iwith ior iwithout ihysterectomy iis ithe

ilast iresort.




Page-771 ifig i25.11

-Dropping iof ithe icervix ior ithe ientire iuterus iinto ithe ivaginal icanal.

,-In isevere icases ithe iuterus icompletely ithrough ithe ivagina iand iprotrudes ifrom ithe iintroitus.

-Symptoms iof iother ipelvic ifloor idisorders imay ialso ibe ipresent.

Symptoms: iurinary-sensation iof iincomplete iemptying iof ibladder, iincontinence,frequency,bladderisplinting
to iaccomplish ivoiding.
i




Bowel-constipation ior ifeeling iof irectal ifullness, idifficult idefecation, istool ior iflatus iincontinence.

*Pain ior ibulging iincludes ipelvic ipressure, ilow iback ipain, iand ivagina, ibladder ior irectum ibulging.

*Sexual-decreased isensation, ilubrication ior iarousal.

-Dyspareunia

Treatment:

-Depends ion iage iand iseverity.

-Isometric iexercise-strengthen ithe ipubococcygeal imuscle. iKEGELS*

-Estrogen-to iimprove itone iand ivascularity iof ifascial isupport i POSTMENOPAUSAL*

-Pessary—a iremovable idevice ito ihold ipelvic iorgans iin iplace.

-Weight iloss

-Stool isofteners ito iavoid iconstipation

-tx iof ilung iand icough iconditions

PCOS

Polycystic iovary isyndrome i(PCOS) iis ia idifficult isyndrome ito idiagnose ibecause iseveral ifactors iare
iinvolved. iIt iis ia isyndrome iin iwhich iat ileast itwo iof ithe ifollowing iare ipresent: ioligo-ovulation ior

ianovulation, ielevated ilevels iof iandrogens, ior iclinical isigns iof ihyperandrogenism iand ipolycystic iovaries.

iProlonged ianovulation ileads ito iinfertility, imenstrual ibleeding idisorders, ihirsutism, iacne, iendometrial

ihyperplasia, icardiovascular idisease, iand idiabetes imellitus iin iwomen iwith ihyperinsulinemia.



Presenting is/s: iobesity, imenstrual idisturbance, ioligomenorrhea, iamenorrhea, iregular imenstruation,
ihyperandrogenism, iinfertility ior ithey icould ibe iasymptomatic.



Diagnosis iof iPCOS iis ibased ion ievidence iof iandrogen iexcess, ichronic ianovulation, iand iinappropriate igonadotropin isecretion.
iTests ifor iimpaired iglucose itolerance iare irecommended. iAs istated, ipolycystic iovaries ido inoT ihave ito ibe ipresent iand, iconversely,

itheir ipresence ialone idoes inot iestablish ithe idiagnosis. iGoals iof itreatment iinclude ireversing isigns iand isymptoms iof iandrogen

iexcess, iinstituting icyclic imenstruation, irestoring ifertility, iand iameliorating iany iassociated imetabolic ior iendocrine, ior iboth,

idisturbances.

, *Most icommon icause iof ianovulation iand iovulatory idysfunction iin iwomen.


*Leading icause iof iinfertility iand imost icommon iendocrine idisturbance.


*Mostly icommon iin iyounger iwomen


*Usually ihas itwo/three iof ithe ifollowing: iirregular iovulation, ielevated ilevels iof iandrogens i(testosterone), iand ithe iappearance iof
i polycystic iovaries ion iultrasound.


*Polycystic iovaries ido inot ineed ito ibe ipresent ito idx iPOS.


*Thyroid idysfunction, ihyperprolactinemia, iand icongenital iadrenal ihyperplasia imust ibe iruled iout ifirst.


*Associated iwith imetabolic idysfunction, idyslipidemia, iinsulin iresistance, iand iobesity.


*Strong igenetic icomponent iand ipossibly idifferentially iinherited.


*Difficult ito idiagnose ias isymptoms imay ichange iover itime.


*80% iof iwomen ihave ione ior imore iof ithe isymptoms iwith inormal iovaries.


*More iprominent isx ias iwe iage.


*May ibe iassociated iwith iCushing’s isyndrome, iacromegaly, ipremature iovarian ifailure, iobesity, icongenital iadrenal ihyperplasia,
i thyroid idisease iand iandrogen iproducing iadrenal itumors.


Pathophysiology:


*Underlying icause iis iunknown


*Genetic iinvolvement isuggested ibecause iof isteroid iand iandrogen ibiosynthesis.


*No isingle ifactor iaccounts ifor iabnormalities iof ipcos.


***A iHYPERANDROGENIC iSTATE iIS iA iCARDINAL iGEATURE iIN iTHE iPATHOGENSIS iOF iPCOS***


-3 iX iLIKELY iTO iHAVE iINSULIN iRESISTENCE.


*Insulin istimulates iandrogen isecretion iby ithe iovarian istroma iand ireduces ithe iserum isex ihormone-binding iglobulin.


* iFree itestosterone ilevels iincrease


*Excessive iandrogens iaffect ifollicular igrowth iand iinsulin iaffects ifollicular idecline iby isuppressing iapoptosis

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