A nurse counseling a client with endometriosis understands which statements regarding the management of endometriosis are accurate? (Select all that apply)
Women without pain and who do not want to become pregnant need no treatment.
Surgical intervention often is needed for severe or acute symptoms.
Side effects from the steroid danazol include masculinizing traits.
Bone loss from hypoestrogenism is not reversible.
Take NSAIDs to manage pain.
Correct Answer : A,B,E
Choice A reason: Women without pain and who do not want to become pregnant need no treatment, as endometriosis is a benign condition that does not affect the general health or well-being of the woman. The nurse should explain to the client that endometriosis is a chronic condition that causes the growth of endometrial tissue outside the uterus, and that it can cause symptoms such as pelvic pain, dysmenorrhea, dyspareunia, and infertility. However, if the woman is asymptomatic and has no desire for pregnancy, she can choose to monitor the condition without any intervention.
Choice B reason: Surgical intervention often is needed for severe or acute symptoms, as endometriosis can cause complications such as adhesions, cysts, inflammation, or obstruction of the pelvic organs. The nurse should inform the client that surgery can be performed to remove or destroy the endometrial implants, or to perform a hysterectomy or oophorectomy in severe cases. The nurse should also discuss the benefits and risks of surgery, and the possibility of recurrence or persistence of symptoms.
Choice C reason: Side effects from the steroid danazol include masculinizing traits, as danazol is a synthetic androgen that suppresses the ovarian function and reduces the production of estrogen and progesterone. The nurse should warn the client that danazol can cause adverse effects such as acne, hirsutism, weight gain, voice changes, decreased breast size, and menstrual irregularities. The nurse should also advise the client to use a non-hormonal contraceptive method while taking danazol, as it can harm the fetus if pregnancy occurs.
Choice D reason: Bone loss from hypoestrogenism is not irreversible, as it can be prevented or treated with calcium and vitamin D supplements, bisphosphonates, or hormone replacement therapy. The nurse should educate the client that hypoestrogenism is a condition where the estrogen levels are abnormally low, and that it can occur as a result of some medications or surgical procedures for endometriosis. The nurse should also explain that hypoestrogenism can increase the risk of osteoporosis, which is a condition where the bones become weak and brittle.
Choice E reason: Women with mild pain who may want a future pregnancy may take nonsteroidal anti-inflammatory drugs (NSAIDs), as NSAIDs can reduce the inflammation and pain caused by endometriosis. The nurse should recommend the client to take NSAIDs as needed, and to follow the dosage and instructions on the label. The nurse should also inform the client that NSAIDs are not effective in treating the underlying cause of endometriosis, and that they may have side effects such as gastrointestinal irritation, bleeding, or ulcers.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Raising the woman's legs is not the best initial response, as it may worsen the dizziness and light-headedness. This is because raising the legs can increase the blood flow to the lower extremities and decrease the blood flow to the brain, which can cause hypotension (low blood pressure) and hypoxia (low oxygen) in the woman and the fetus.
Choice B reason: Having the woman breathe into a paper bag is not the best initial response, as it may not address the underlying cause of the dizziness and light-headedness. This technique is usually used for hyperventilation (rapid breathing), which can cause respiratory alkalosis (high blood pH) and reduce the carbon dioxide levels in the blood. However, the woman may not be hyperventilating, but rather experiencing supine hypotensive syndrome (low blood pressure when lying on the back) due to the pressure of the uterus on the inferior vena cava (a large vein that returns blood to the heart)².
Choice C reason: Turning the woman on her side is the best initial response, as it can relieve the dizziness and light-headedness by improving the blood flow to the brain and the fetus. This is because turning the woman on her side can reduce the pressure of the uterus on the inferior vena cava and increase the cardiac output (the amount of blood pumped by the heart) and the blood pressure. The left lateral position is preferred, as it can also optimize the placental perfusion (the blood flow to the placenta) and the fetal oxygenation.
Choice D reason: Assessing the woman's blood pressure and pulse is an important response, but not the first one. After turning the woman on her side, the nurse should monitor the vital signs and the fetal heart rate to evaluate the condition of the woman and the fetus. The nurse should also check for other signs and symptoms of supine hypotensive syndrome, such as nausea, sweating, and visual disturbances.
Correct Answer is ["A","B","C"]
Explanation
Choice A reason: Normal weight women should gain 11.5 to 16 kg during pregnancy, according to the Institute of Medicine (IOM) guidelines. This is based on the body mass index (BMI) of 18.5 to 24.9 before pregnancy.
Choice B reason: Underweight women should gain 12.5 to 18 kg during pregnancy, according to the IOM guidelines. This is based on the BMI of less than 18.5 before pregnancy. Underweight women are at risk of having low birth weight infants, so they need to gain more weight to support fetal growth and development.
Choice C reason: Adolescents are encouraged to strive for weight gains at the upper end of the recommended scale, according to the IOM guidelines. This is because adolescents are still growing themselves and need extra nutrients and calories to meet their own needs and those of the fetus.
Choice D reason: In twin gestations, the weight gain recommended for a single fetus pregnancy should not be simply doubled. The IOM guidelines suggest that women with twin gestations should gain 16.5 to 24.5 kg if they have a normal weight before pregnancy, 14 to 22.5 kg if they are overweight, and 11 to 19 kg if they are obese.
Choice E reason: Obese women should gain at least 7 to 11.5 kg during pregnancy, according to the IOM guidelines. This is based on the BMI of 30 or more before pregnancy. Obese women are at risk of having complications such as gestational diabetes, preeclampsia, and cesarean delivery, so they need to limit their weight gain to avoid further complications.
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