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Case Study 41 maternal newborn and baby answer key

Case study for OB and maternal child and health nursing. Answer key fo...
Course

Child Health (PHAS 029)

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Students shared 6 documents in this course
Academic year: 2021/2022
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Warren G Harding High School

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Case Study 4 Fertility

A couple in their mid-twenties is in the office to discuss fertility. They have been trying to conceive for 18 months with no luck.

What questions would you ask the couple? Questions that the nurse should ask the couple includes:

  • The woman's age at menarche and menstrual characteristics such as frequency, regularity, duration, amount of flow, and presence of pain.
  • Any pregnancies, complications, and their outcomes
  • Contraceptive methods
  • Previous fertility of the man or woman with other partners
  • Previous surgeries, infections (including childhood infections), pelvic inflammatory disease, STDs, abnormal Pap tests and treatments, serious illness
  • Pattern of intercourse in relation to the woman's cycles
  • Length of time the couple has had intercourse without contraception
  • Exposure to possible toxins, prescribed and over-the-counter medications
  • Family history of multiple pregnancy losses, birth defects, intellectual disabilities
  • Any home tests the couple has used, such as over-the-counter ovulation predictor kits (McKinney et al, 2019, p. 678).

What are the essential components of fertility? Some essential components include ovulation, which is the most important factor. If a female has regular menstrual cycles, she is probably ovulating. Other components include age, previous pregnancies, duration, timing and frequency of sexual intercourse. Lifestyle factors, weight, and smoking and caffeine are also important factors to fertility (McKinney et al, 2019, p. 678).

What questions/teachings are included in the initial physical and psychological exam for a couple with fertility issues? Determine at what point the couple is in their infertility treatment. Couples who have just discovered their infertility may be shocked yet optimistic that therapy will result in a baby for them. Couples with long-standing infertility may have a deeper sense of failure and a pessimistic outlook. Evaluate how infertility has affected the partners' relationship. Are there conflicts or differences in their values? Observing their body language, such as eye contact, can provide clues about differences in their commitment to diagnosis and treatment. Ask them how their relationship has changed. Are they more or less satisfied with their relationship than they were before they had problems conceiving? Ask about support systems. Determine how the couple's culture, religion, or personal values view infertility and the effect of these values on treatment. Are any therapies unacceptable to one or both partners? Determine how the couple is coping with the stresses of treatment. How much has infertility cost them in time, money, and discomfort? Identify the successes and failures they have experienced. Their ages, especially the woman's, add another unavoidable stressor (McKinney et al, 2019, p. 685).

What is included in initial fertility work-ups for male and female? Describe the nurse’s role in support and teaching for this couple during their work-up? Men Semen analysis is often the first test. Several semen specimens are obtained over a period of weeks to obtain the best evaluation. Depending on your medical history, physical examination, and semen analysis, other diagnostic tests might be done (hormone assay, an ultrasound of your reproductive organs, a biopsy of your testicles, and specialized tests of sperm function). Potential corrective measures include medications, surgery, and methods to reduce the scrotal temperature (McKinney et al, 2019, p. 678). Women The first evaluation is usually to determine whether you are ovulating each month. An ovulation predictor kit is most often used for this purpose. Self-assessment of your basal body temperature, or temperature immediately on awakening each morning, and cervical mucus may also be taught. These assessments are often done at the same time as other tests. Other common evaluations include an ultrasound examination of your reproductive organs and imaging your uterus and fallopian tubes with dye (hysterosalpingogram). For some tests and therapies, an operative procedure is required (hysteroscopy, laparoscopy, laser surgery, microsurgery). Typically, infertility evaluations and treatments require more of the woman's time, energy, physical discomfort, and risk than the man's. Corrective measures depend on the problem identified. Examples include medications, surgery, and advanced reproductive techniques, such as in vitro fertilization (McKinney et al, 2019, p. 678). The nurse should be supportive, understanding and reassuring.

After a history and physical, the couple will undergo testing to identify the cause of their infertility. What assessments will be made to assess the man and woman’s fertility/infertility? Assessments that could be made to assess infertility includes semen analysis which evaluates the structure and function of sperm and composition of semen fluid. Endocrine tests to evaluate the function of the hypothalamus, pituitary gland, and the response of the testicles. Assays are made to determine testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) levels. Ultrasonography which Evaluates structure of prostate gland, seminal vesicles, and ejaculatory ducts by use of a transrectal probe. Testicular biopsy which is an invasive test for obtaining a sample of testicular tissue; identifies pathology and obstructions. Sperm penetration assay which Evaluates fertilizing ability of sperm; assesses ability of sperm to undergo changes that allow penetration of a hamster ovum from which the zona pellucida has been removed. In females diagnostics test includes Ovulation prediction which identifies the surge of LH that precedes ovulation by 24- 36 hr; improves ability to time intercourse to coincide with ovulation, and identifies the absence of ovulation. Ultrasonography that evaluated the structure of pelvic organs, cyclic endometrial changes, ovarian follicles and releases of ova at ovulation, and the presence of ectopic or multifetal pregnancy. Hysterosalpingogram is another diagnostics test. It evaluates patency of uterus and fallopian tubes by injection of contrast medium into the cervix while imaging the pelvis to visualize passage of the dye. Lastly, postcoital test which Evaluates characteristics of cervical mucus and sperm function within that mucus at time of ovulation (McKinney et al, 2019, p)

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Case Study 41 maternal newborn and baby answer key

Course: Child Health (PHAS 029)

6 Documents
Students shared 6 documents in this course

University: Howard University

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Case Study 4
Fertility
A couple in their mid-twenties is in the office to discuss fertility. They have been trying to
conceive for 18 months with no luck.
What questions would you ask the couple?
Questions that the nurse should ask the couple includes:
• The woman's age at menarche and menstrual characteristics such as frequency, regularity,
duration, amount of flow, and presence of pain.
• Any pregnancies, complications, and their outcomes
• Contraceptive methods
• Previous fertility of the man or woman with other partners
• Previous surgeries, infections (including childhood infections), pelvic inflammatory disease,
STDs, abnormal Pap tests and treatments, serious illness
• Pattern of intercourse in relation to the woman's cycles
• Length of time the couple has had intercourse without contraception
• Exposure to possible toxins, prescribed and over-the-counter medications
• Family history of multiple pregnancy losses, birth defects, intellectual disabilities
• Any home tests the couple has used, such as over-the-counter ovulation predictor kits
(McKinney et al, 2019, p. 678).
What are the essential components of fertility? Some essential components include
ovulation, which is the most important factor. If a female has regular menstrual cycles, she is
probably ovulating. Other components include age, previous pregnancies, duration, timing
and frequency of sexual intercourse. Lifestyle factors, weight, and smoking and caffeine are
also important factors to fertility (McKinney et al, 2019, p. 678).
What questions/teachings are included in the initial physical and psychological exam
for a couple with fertility issues? Determine at what point the couple is in their infertility
treatment. Couples who have just discovered their infertility may be shocked yet optimistic
that therapy will result in a baby for them. Couples with long-standing infertility may have a
deeper sense of failure and a pessimistic outlook. Evaluate how infertility has affected the
partners' relationship. Are there conflicts or differences in their values? Observing their body
language, such as eye contact, can provide clues about differences in their commitment to
diagnosis and treatment. Ask them how their relationship has changed. Are they more or less
satisfied with their relationship than they were before they had problems conceiving? Ask
about support systems. Determine how the couple's culture, religion, or personal values view
infertility and the effect of these values on treatment. Are any therapies unacceptable to one
or both partners? Determine how the couple is coping with the stresses of treatment. How
much has infertility cost them in time, money, and discomfort? Identify the successes and
failures they have experienced. Their ages, especially the woman's, add another unavoidable
stressor (McKinney et al, 2019, p. 685).

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