Unit 13 - Repro Flashcards
two main sexual/repro hormones in females
estrogen & progesterone
T/F: female hormones affect every system of the body
T
Estrogen is mostly secreted by ____
ovaries
progesterone is secreted by ______
corpus luteum (sack that contains egg expelled from ovary)
at the end of the menstruation cycle, the negative feedback loop shuts off ______
secretion
What hormone:female: ova maturation, estrogen productionmale: sperm production
FSH
What hormone:female: triggers ovulation & dev corpus luteum = progesteronemale: testosterone
LH
What hormone:dev. sec. characteristics, regulates ovarian & menstrual cycles
Estrogen/Progesterone
estrogen ____ LDL
decreases
estrogen ____ HDL
increases
estrogen _____ strength & length of bones
increases
T/F: estrogen prevents cardiac disease & osteoporosis
T
What is estrogen combined with to counteract adverse effects
progestins
Therapeutic effect of estrogen
Treatment of hot flashes & night sweats, relieve painful intercourse, prevent osteoporosis, treat prostate and some breast cancers
contraindications/interactions of estrogen
- hx of breast/cervical/endometrial/prostate cancer- hx of blood clots (estrogen increases clotting)- lipid disorders (estrogen raises HDLs & triglycerides)***pregnancy category X
adverse effects of estrogen
- HA- N, V*- libido (sex drive) changes- weight gain- dose dependent (higher dose = more significant effects)
nursing considerations/pt. teaching for estrogen
BLACK BOX WARNING: when used alone, risk for endometrial cancer in postmenopausal women- CV disorders- thromboembolism disorder- repo cancers- monitor for allergies to soy- discourage use of plant estrogens with conjugated astrogens- no pregnancy/breast feeding- report s/s resp. distress- mo. breast exams- report sudden onset of HA, chest pain- can not use tampons while on vaginal cream: will make med less ineffective- monitor for relief of menopausal symptoms
what hormone promotes breast development
progesterone
decreased levels of progesterone causes ____
menses
what hormone maintains endometrium in early pregnancy
progesterone
2 problems progesterone treats
- dysfunctional uterine bleeding2. endometrial cancer
progesterone ____ midcycle LH surge = ____
inhibits = prevents ovulation
progesterone ____ thick cervical mucus
encourages
difference between progesterone & estrogen
estrogen encourages endometrial growthprogesterone limits/stabilizes endometrial growth
why is medroxyprogesterone usually only given 5-10 days
because that is the time a women is usually menstruating
therapeutic effects of medroxyprogesterone
Prevents endometrial proliferation and decreases dysfunctional bleeding, prevents ovulation, treatment for endometrial cancers
contraindications/interactions of medroxyprogesterone
- clotting disorders- pregnancy- hepatic impairment- breast, uterine, vaginal cancer- depression
adverse effects of medroxyprogesterone
BLACK BOX: if combined with estrogen = increase risk for stroke, DVTs, MI, PE, or breast cancer*- injectable form decreases bone mineral density (osteoporosis)- breast tenderness- breakthrough bleeding
nursing considerations/pt. teaching for medroxyprogesterone
- decreased effects c rifampin barbiturates- used for decreasing vaginal bleeding, method of BC- discourage smoking- possible breakthrough bleeding- monitor bone density, may increase bone loss- no pregnancy- s/s of fab 4- encourage self-breast exams- mid-cycle spotting can occur- s/s DVT- infertility can last up to 18 mo.- black box: check for lumps, breast cancer- monitor wt for fluid retention, BP, pulse, labs- report sudden severe HA, V, dizziness, fainting, numbness in arms, chest pain
Therapeutic effects of Estradiol/Norethindrone
Prevent conception, treat acne, treat endometriosis, regulate bleeding, decrease pain with menstruation
contraindications/interactions of Estradiol/Norethindrone
- absolute contraindication: current breast cancer, cirrhosis of liver, major surgery with immobility, migraines, decreased cardiac function, valvular HD, hypertension, smokers, hx of stroke, lupus, hx or risk of DVTs
adverse effects of Estradiol/Norethindrone
- vision changes- N- weight gaine- breast tenderness- breakthrough bleedings- increased BP
nursing considerations/pt. teaching for Estradiol/Norethindrone
BLACK BOX: smoking significantly increases risk of cardiovascular side effects, especially in pt’s over 35- adverse effects of mimics of pregnancy: N, V, breast tenderness- no pregnancy! no breast feeding!*- take as prescribed- report fab 4: PE, stroke, MI, DVT- report abnormal vaginal bleeding- monitor VS (BP)- s/s CV issues, abdominal pain- anovulation or amenorrhea may occur up 6 mo. after stopping med- use barrier method of birth control within 1st wk of taking- report if 2 periods are missed- patch? only use 1 at a time- monitor wt. gain for fluid retention- breast feeding? use alternate birth control
how emergency contraception works
prevents ovulation, does not affect already released egg (abortion), huge dose of estrogen
what hormone matures male reproduction system
testosterone
what hormone causes sec. sex characteristics for males
testosterone
T/F: testosterone builds skeletal mass & causes bone growth
T
testosterone ______ erythropoietin = increased RBCs
increases
T/F: testosterone cause be used to treat anemia, muscle wasting diseases, & some cancers
T
Schedule of testosterone
schedule 3 = potential for abuse
Therapeutic effects of testosterone
Matures male sex organs, promotes male sex characteristics, treats ED, treatment for breast CA, treats renal failure anemia, treats muscle wasting in AIDS patients
contraindications/interactions of testosterone
*- caution: prosthetic hyperplasia (prostate is growing bigger, testosterone already grows prostate)
adverse effects of testosterone
- libido changes- oligospermia (not enough sperm at high doses)
nursing considerations/pt. teaching for testosterone
BLACK BOX: verialization: masculinization/growth of sec. sex characteristics in women & children (secondary exposure) = dev male like characteristics- monitor weight gain because of sodium&water retention- report s/s hypercalcemia- if diabetic, caution of hypocalcemia- monitor for signs of overdose- monitor adolescent/prepubital males- labs: LFTs, electrolytes, cholesterol, CBC- soreness @ injection site- report priapism- pregnant? avoid! - watch out for liver disease- monitor VS, BP, for fluid retention- monitor for abuse- teach to avoid skin to skin contact if using gel while gel is wet- s/s liver probs- no abusing, no sharing
adverse effects of anabolic steroids (building muscle)
schedule 3:Men:- oligospermia- testicular atrophy- impotence- acne- aggression- dependenceWomen:- menstrual irregularities- hair growth- decrease breast sizeBoth:- liver damage- HPT- increased LDLs - decreased HDLs
Definition:- decreased libido- erectile dysfunction- ejaculation problems- infertility
male sexual dysfunction
hormone medication used for male sexual dysfunction
Sildenefil (phosphorous 5 inhibitors)
general duration of action for Sildenefil (phosphorous 5 inhibitors)
noticeable 1-4 hours
Therapeutic effect of Sildenafil
Increases blood flow to the penis enhancing erection, treatment for pulmonary HTN, treatment for Raynaud’s
contraindications/interactions of Sildenafil
- concurrent use of nitrates
adverse effects of Sildenafil
(vasodilation)- dizziness- flushing- nasal congestion
nursing considerations/pt. teaching for Sildenafil
- do not cause erection (only help maintain)- do not use with nitrates (can cause dangerous hpt)- NO MORE THAN ONE/DAY- good med hx on these pts- baseline VS of nothing less than 90/60- fatty meal will make med take longer- best to to within 30-60 min of intercourse- careful with orthostatic hpt
function of alpha 1 adrenergic blockers
Blocks adrenergic receptors and relaxes smooth muscle tissue in the urethra, bladder neck, and prostate
function of 5-alpha reductase inhibitors
Blocks the enzyme that converts testosterone into active metabolite and shrinks prostate epithelial tissue
BPH
benign prosthetic hypertrophy- enlargement of the prostate (occurs in older men)- causes difficulty c urination
2 BPH drugs
- alpha 1 adrenergic blockers- 5-alpha reductase inhibitors
can you reverse BPH
no, you can only manage symptoms up until pt. needs surgery to remove prostate
what drugs make BPH worse
- alpha agonists (phenylephrine)- anticholinergics (antihistamines)- testosterone (it feeds the prostate already)
how do 5-alpha reductase inhibitors work
blocks testosterone to shrink prostate (takes several months)- also prevent propecia (male pattern baldness)
therapeutic effects of finasteride
Reduces testosterone in the prostate gland thereby shrinking it, alleviates urinary problems caused by compression of the urethra, used for male-pattern baldness
contraindications/interactions of finasteride
**pregnancy category X- can not donate blood unless it was to be given to a pregnant woman- not be exposed to pregnant nurses or partners
adverse effects of finasteride
- HA- N- rash- dizziness- gynecomastia- impotence- decreased libido- ejaculatory disorders- infertility
classify finasteride
5-alpha reductase inhibitor
Q: Which female hormone is mostly responsible for ovulation?A. estrogenB. progesteroneC. LHD. GnRH
C. LH
Q: Which of the following is NOT a therapeutic use of conjugated estrogen?A. relieve night sweatsB. relieve painful intercourseC. relieve hot flashesD. relieve urinary incontinence
D. relieve urinary incontinence
Q: What is the black box warning associated with conjugated estrogen?A. increased risk of endometrial cancerB. increased risk of suicidal ideationsC. increased risk of hemorrhageD. increased risk of blindness
A. increased risk of endometrial cancer
Q: What are two common adverse effects of medroxyprogesterone?Multiple answers: You can select more than one optionA. breast tendernessB. breakthrough bleedingC. prevention of pregnancyD. urinary tract infections
A. breast tendernessB. breakthrough bleeding
Q: Which TWO medication classes decrease the effectiveness of oral combination birth control (OC’s)?Multiple answers: You can select more than one optionA. anti-inflammatoriesB. anti-convulsantsC. anti-depressantsD. antibiotics
B. anti-convulsantsD. antibiotics
Q: Which of the following is a therapeutic use of testosterone?A. to win the Tour de FranceB. to look like the HulkC. to treat primary hypogonadismD. to treat prostate cancer
C. to treat primary hypogonadism
Q: What is the black box warning for testosterone? A. It increases the risk of heart attack.B. It increases the risk of virilization in women.C. It increases the risk of suicidal ideations.D. It increases the risk of yellow teeth.
B. It increases the risk of virilization in women.
Q: What is one of the adverse effects of anabolic steroids?A. testicular enlargementB. kidney damageC. nail overgrowthD. decreased sperm
D. decreased sperm
Q: Which of the following is a medication used for the treatment of erectile dysfunction (ED)?A. nonoxynol 9B. mifepristoneC. sildenafilD. finasteride
C. sildenafil (fil)
Q: How does finasteride help to treat the symptoms of benign prostatic hypertrophy?A. It blocks testosterone and shrinks the prostate.B. It prevents the smooth muscle in the prostate from contracting.C. It dilates the urethra.D. It diverts blood flow away from the prostate.
A. It blocks testosterone and shrinks the prostate.
T/F: saline osmotics are safe to use
FALSE! They are unsafe and used for bowel problems such as diarrhea = dehydrationalso, bisocodyl, stimulants, & saline are not safe to use every day
T/F: bulk forming & surfactants are safe to use every day
T
Nursing Considerations/pt. teaching for Finasteride
- men can’t donate blood- monitor kidney & liver function- going to take several months to work (4-12 mo.)- will need to take for rest of life, symptoms come back if stopped- report urinary retention (that means med isn’t working)- use barrier method birth control- avoid exposure to child baring age women- decreased libido/impotence- report breast tenderness/enlargement, testicular pain, rash, itching, or swelling of face & lips
(13) How does finasteride help to treat the symptoms of benign prostatic hypertrophy?
A. It blocks testosterone and shrinks the prostate.
B. It prevents the smooth muscle in the prostate from contracting.
C. It dilates the urethra.
D. It diverts blood flow away from the prostate.
A. It blocks testosterone and shrinks the prostate.
(13) TQ: Which of the following circumstances are likely to contribute to stress ulcer?
a. caffeinated fluids or fried fatty foods
b. emergency room treatment of whiplash
c. eating spicy foods
d. severe burns that require intensive care unit hospitalization
d. severe burns that require intensive care unit hospitalization
(13) TQ: The nurse should question an order for an anti-diarrheal medication for which pt?
a. one who has traveler’s diarrhea
b. one who has c. diff
c. one who has eaten an excessive amt. of hot peppers
d. one who has been on antibiotics for the past 7 days
b. one who has c. diff
(13) TQ: a school nurse is teaching a youth maturation class
a. it promotes the synthesis of erythropoietin
b. it restricts bone growth and causes osteoporosis
c. it is resposnsible for the enlargement of the tests, scrotum, an penis
d. it contributes to the dev. of muscle mass
a. it promotes the synthesis of erythropoietin
c. it is responsible for the enlargement of the tests, scrotum, an penis
d. it contributes to the dev. of muscle mass
(13) TQ: when completing the medication history of a male client with sexual dysfunction, which two drugs classes should the nurse be attentive for as possible contributors to male sexual dysfunction?
a. nonsteroidal anti-inflammatory drugs (NSAIDS) & antidepressents
b. antipsychotics and antidepressents
c. antidepressants & antihypertensives
d. antihypertensives & benzodiazepines
c. antidepressants & antihypertensives
(13) TQ: which assessment finding indicates a therapeutic effect of finasteride therapy in a client?
a. less painful urination
b. resoluution of hematuria
c. decreased flow rate of urine
d. ability to initiate a steady urine stream
d. ability to initiate a steady urine stream
(13) TQ: Because theophylline is a xanthine, which of the following should pt’s be advised to avoid?
a. grapefruit juice
b. milk
c. coffee
d. water
c. coffee
(13) TQ: Which condition does dabigatran help prevent
a. high cholesterol
b. hyperglycemia
c. hypertension
d. strokes
d. strokes
(13) TQ: Which of the following explanations should the nurse provide when explaining how clopidegrel helps prevent blood clots
it prevents platelet aggregation
(13) TQ: which of the following factors predisposes a pt to digitalis toxicity?
a. hyperglycemia
b. hypokalemia
c. hyperthyroidism
d. low serum albumin
b. hypokalemia
(13) TQ: the nurse assess a pt. who is takin digoxin, furosemide, and potassium, and the pt states, “What a lovely yellow shirt” and the shirt is not yellow…
evaluate….
(13) TQ: what should hypertensive pt’s taking propranolol, a nonselective beta adrenergic blocker, be observed for?
a. bronchospasm
b. diarrhea
c. tachycardia
d. urinary retention
a. bronchospasm
(13) TQ: a client is started on lisinopril. Which common adverse effects of ACE inhibitor therapy should the nurse instruct the client about?
dry cough
(13) TQ: a nurse is discharging a pt. receiving an anticholinergic med…what are pt. teachings?
a. alert to that drowsiness may occur and to avoid driving a car
b. instruct pt. to use sunglasses in bright light for presence of pupil dilation
c. suggest hard candy, chewing gum, and oral hygiene for dry mouth
d. decrease fluid and fiber intake to avoid diarrhea
a. alert pt that drowsiness may occur and to avoid driving a car
b. instruct pt. to use sunglasses in bright light for presence of pupil dilation
c. suggest hard candy, chewing gum, and oral hygiene for dry mouth
