NRS 204 OB Exam 1 ALL SOLUTION 2024/25 EDITION GUARANTEED GRADE A+
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Course
NRS 204 OB Exm 1
Institution
NRS 204 OB Exm 1
A nurse in a provider's office is providing information to a client who has dysfunctional uterine bleeding (DUB). Which of the following client statements indicate understanding of the information? (Select all that apply.)
A.) "My heavy bleeding can be due to a hormonal imbalance."
B.) "If I ex...
NRS 204 OB Exam 1 ALL SOLUTION
2024/25 EDITION GUARANTEED GRADE
A+
A nurse in a provider's office is providing information to a client
who has dysfunctional uterine bleeding (DUB). Which of the following
client statements indicate understanding of the information? (Select
all that apply.)
A.) "My heavy bleeding can be due to a hormonal imbalance."
B.) "If I experience menstrual pain, I should take aspirin."
C.) "I can't take oral contraceptives, because I have heavy uterine
bleeding."
D.) "My doctor may preform a D&C to find out what's causing my
abnormal bleeding."
E.) "My condition is more common in people who are in their 30s."
A.) "My heavy bleeding can be due to a hormonal imbalance."
D.) "My doctor may preform a D&C to find out what's causing my
abnormal bleeding."
You (the nurse) are reviewing the educational packet provided to a
patient about tubal ligation. What is an important fact you should
point out? (Select all that apply.)
a. "It is highly unlikely that you will become pregnant after the
procedure."
b. "This is an effective form of 100% permanent sterilization. You
won't be able to get pregnant."
c. "Sterilization offers some form of protection against sexually
transmitted infections (STIs)."
d. "Sterilization offers no protection against STIs."
e. "Your menstrual cycle will greatly increase after your
sterilization."
a. "It is highly unlikely that you will become pregnant after the
procedure."
d. "Sterilization offers no protection against STIs."
The menstrual cycle...
prepares uterus for pregnancy
Menstruation begins approximately...
14 days after ovulation if pregnancy does not occur
Endometrial cycle 4 phases
,1. Menstrual
2. Proliferative
3. Secretory
4. Ischemic
Endometrial cycle phase 1: Menstrual
-Bleeding begins the 4 phases
-Shedding of the endometrium
Endometrial cycle phase 2: Proliferative
-Restoration of the endometrium
-day 5 to ovulation
-depends on estrogen from the ovarian follicle
Endometrial cycle phase 3: Secretory
-Ovulation
- increased progesterone
-endometrium becomes a suitable place for implantation of fertilized
ovum
Endometrial cycle phase 4: Ischemic
-If fertilization and implantation do not occur, estrogen and
progesterone secretion is decreased as the corpus luteum regresses.
-Blood supply is blocked, necrosis and menstruation marking day 1 of
the menstrual cycle.
Hypothalamic-Pituitary cycle occurs...
at the end of the menstrual cycle. (Ischemic phase)
Hypothalamic-Pituitary cycle
(note when this cycle begins)
When the blood levels of estrogen and progesterone decrease toward
the end of the menstrual cycle
↓
this stimulates hypothalamus to secrete GnRH;
↓
which stimulates anterior pituitary secretion of FSH;
↓
which stimulates development of ovarian graafian follicles and their
own production of estrogen
Now estrogen levels will slowly decrease and the GnRH will trigger
the anterior pituitary to release LH. This combination of LH surge
and a lower estrogen peak happen about 24 to 36 hours before the ovum
is pushed out of the graafian follicle in the ovary. This means the
LH surge is on day 12-13 of the 28 day cycle.
, If fertilization and implantation do not occur, the corpus luteum
becomes non functional, the estrogen and progesterone levels drop,
menstruation occurs and the hypothalamus begins again the cycle of
stimulating GnRH
What is GnRH?
gonadotropin releasing hormone
Ovarian cycle phases
1. follicular phase
2. luteal phase
Ovarian Cycle: Luteal Phase
-Begins after ovulation and ends with day 1, menstruation.
-Requires @ 14 days
-8 days after ovulation the corpus luteum reaches its peak in
secreting estrogen & progesterone
-At the same time, the fertilized ovum is implanted into the
endometrium.
-If no fertilization or implantation has occurred within 2 weeks
after ovulation, menstruation begins.
Ovarian Cycle: Follicular Phase
-Graafian follicles contain immature oocytes
-Before ovulation ↑estrogen and FSH >follicles begin to mature
-increased LH affects one follicle, oocyte matures, ovulation, empty
follicle transforms into the corpus luteum
-Estrogen levels drop, withdrawal bleeding
Pap smear
•Diagnostic cytologic test for cancer
•Done during pelvic with speculum
•Should not be menstruating or no douching before test
•Suspicious pap not always cancer, but follow up is needed
Physical assessment of the breast...
1.Inspection-->Size and Symmetry
2. Palpation--> sitting up and lying down
Diagnostic tests for the breast...
1. Mammography
2. Ultrasound
3. Fine needle aspiration
4. Core-needle biopsy
5. Surgical biopsy
6. MRI
7. Galactography (indicated for duct abnormalities)
**In order to diagnose cancer a sample MUST be obtained
Conditions of the breasts: Nipple discharge
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