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Questions and Answers
What is a common weight-related issue experienced by patients with PCOS?
Which medication is commonly used to address insulin resistance in PCOS patients?
What is one of the primary fertility treatments offered to women with PCOS?
What role do nurses primarily play in the management of PCOS?
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Which of the following treatments effectively targets hirsutism in PCOS patients?
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Which of the following complications is associated with poorly managed PCOS?
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What symptom is NOT typically associated with PCOS?
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What is the primary purpose of prescribing oral contraceptives for women who do not desire pregnancy?
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What is the role of progestin in the management of women with PCOS?
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Which of the following is a characteristic sign of androgen excess in women with PCOS?
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Which surgical procedure can be performed to induce ovulation in women who have not responded to other treatments for PCOS?
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What support should nurses provide to women with negative self-image due to PCOS?
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In managing PCOS, which dietary recommendation is crucial for women?
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What common concern should nurses address for women dealing with PCOS?
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What is a significant health risk associated with untreated androgen excess in women with PCOS?
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What weight management strategy is considered the most effective for restoring normal ovulation in women with PCOS?
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What is one of the key responsibilities of nurses for women undergoing diagnostic tests for PCOS?
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Which medication is commonly used to improve insulin sensitivity in women with PCOS when weight loss efforts are unsuccessful?
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What fertility treatment can stimulate ovulation in women with PCOS?
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Which of the following is NOT a recommended treatment for hirsutism?
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What is an important consideration when using Metformin for treating PCOS?
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What dietary recommendation may help women with PCOS who are seeking to manage insulin resistance?
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Which medication is recommended for women with PCOS who do not desire pregnancy but wish to treat hirsutism?
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What role should nurses prioritize while caring for women with PCOS?
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Study Notes
Menstrual Irregularity and Endometrial Hyperplasia
- Intermittent progestin or oral contraceptives can help regulate menstrual cycles and reduce androgen levels in women who don't desire pregnancy.
- Progestin is typically prescribed as medroxyprogesterone 5-10 mg once daily for 10-14 days every 1-2 months.
Surgery
- Ovarian drilling can induce ovulation in women with PCOS who haven't responded to other treatments.
- The procedure involves destroying a small portion of ovarian tissue using an electrical current delivered through a needle inserted into the ovary.
Role of Nurses
- Nurses play a crucial role in educating women about PCOS, its associated risks, and self-image concerns related to physical manifestations.
- Nurses encourage positive lifestyle changes, arrange diagnostic tests and provide reassurance to alleviate anxiety during the diagnostic process.
- Nurses emphasize that most ovarian cysts are benign but stress the importance of follow-up care.
- Nurses actively listen to patient concerns about appearance, infertility, and facial hair growth.
- Nurses offer suggestions for improving self-esteem and health.
- Nurses refer patients to local support groups to build coping skills.
- Nurses clarify treatment options for women with PCOS.
PCOS Symptoms
- Irregular menstrual periods (oligomenorrhea, amenorrhea)
- Excess androgens (hirsutism, acne, oily skin, male-pattern baldness or thinning hair)
- Enlarged ovaries with multiple cysts
- Weight gain, especially around the belly
- Small pieces of excess skin on the neck or armpits (skin tags)
- Dark or thick skin patches on the neck, armpits, and under the breasts
- Pelvic pain
- Type 2 diabetes
- High cholesterol
- High blood pressure
PCOS Diagnosis
- Medical history: Gathering information about menstrual cycles, weight changes, and other symptoms.
- Physical examination: Checking height, weight, and blood pressure.
- Pelvic examination: Visually and manually inspecting reproductive organs for signs of masses, growths, or abnormalities.
- Vaginal Ultrasound: Examining ovaries for cysts and the endometrium (uterine lining), which may be thickened due to irregular periods.
- Laboratory tests (Hormonal Levels): Blood tests measure hormone levels to exclude other causes of menstrual abnormalities or androgen excess.
- Additional blood testing: Includes fasting cholesterol and triglyceride levels and a glucose tolerance test to assess glucose levels.
- Ultrasound: Checking ovaries and the lining of the uterus.
PCOS and Pregnancy
- Increased risk of miscarriage.
- Gestational diabetes.
- Pregnancy-induced blood pressure.
- Premature delivery.
PCOS Complications
- Type 2 diabetes.
- High blood pressure.
- Heart and blood vessel problems.
- Uterine cancer (irregular periods can lead to endometrial thickening due to lack of progesterone, increasing the risk of endometrial hyperplasia or cancer).
- Infertility.
PCOS Management
- Management is tailored to the patient's goals, focusing on:
- Lowering insulin levels.
- Restoring fertility.
- Treating hirsutism or acne.
- Restoring regular menstruation and preventing endometrial hyperplasia and cancer.
Diet
- Weight loss is highly effective in restoring ovulation/menstruation but can be challenging to achieve and maintain.
- Low-carbohydrate diets, regular exercise, and low-GI diets (emphasizing fruits, vegetables, and whole grains) may be beneficial.
- Vitamin D deficiency may play a role in metabolic syndrome, so treating any deficiency is essential.
Medications: Diabetic Medications
- Metformin (500-1000 mg twice daily) can improve insulin sensitivity and reduce free testosterone levels.
- Metformin can induce ovulation, requiring contraception if pregnancy is not desired.
- Glucose, kidney function, and liver function should be monitored periodically while on metformin.
Fertility Medication
- Medications that stimulate ovulation can help women with PCOS become pregnant.
- Other causes of infertility in both the woman and man should be ruled out before using fertility medications.
- Fertility medications can increase the risk of multiple births.
- Options include: clomiphene, metformin, and gonadotropins.
Hirsutism and Acne
- For hirsutism, physical methods (bleaching, electrolysis, plucking, waxing, depilation) can be used.
- Eflornithine cream 13.9% twice daily may help remove unwanted facial hair.
- In women who don't desire pregnancy, hormone therapy that decreases androgen levels or spironolactone can be tried.
- Acne can be treated with common drugs (benzoyl peroxide, tretinoin cream, topical and oral antibiotics).
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Description
This quiz focuses on the management of Polycystic Ovary Syndrome (PCOS), including treatment options such as progestin and surgery. The critical role of nurses in educating and supporting women with PCOS is also highlighted, emphasizing their importance in promoting positive lifestyle changes and self-image.
