Menopause/Osteoporosis

Question 1

What is climacteric?

Answer 1

Physical and emotional changes occurring at the end of a woman’s reproductive period. Also informally called menopause, although this term does not encompass all changes.

Question 2

What is Premenopause? Give an example.

Answer 2

The early part of the climacteric, before menstruation ceases but after the woman experiences some of the climacteric symptoms, such as irregular menses.

Question 3

What is Perimenopause?

Answer 3

It’s the time of premenopause, menopause, and at least 1 year after menopause.

Question 4

What is post menopause?

Answer 4

The phase after menopause, when menstrual periods have ceased altogether.

Question 5

(T/F) Once a woman is postmenopausal, unplanned vaginal bleeding should always be investigated

Answer 5

True, it is highly suggestive of endometrial cancer.

Question 6

What is the difference between menopause and climacteric?

Answer 6

Menopause simply means “the end of menstruation,” usually 2 consecutive months without menses. Climacteric encompasses everything to do with menopause and is the correct term.

Question 7

When does the women’s reproductive function fall?

Answer 7

Ages 45-50, the ovarian hormones decline and then cease

Question 8

(T/F) Low estrogen causes bone density loss

Answer 8

True

Question 9

What does vasomotor instability cause?

Answer 9

Hot flashes

Question 10

What two medication/supplements are important to have for osteoporosis?

Answer 10

Calcium supplements to help bones, and Vitamin D to help absorption of calcium.

Question 11

What is osteoporosis?

Answer 11

Increased spaces in bone; increases after menopause

Question 12

What are the two most common sites for bone fractures?

Answer 12

The vertebrae and hips

Question 13

What age do you commonly reach peak bone density?

Answer 13

Around 30

Question 14

What are risk factors associated with osteoporosis? There are 7, 3 of which is from class review (and also found in textbook)

Answer 14

Family history of the disease, late menarche (first occurrence of period), early menopause, and a sedentary lifestyle. Smoke, drink alcohol, or consume excessive amounts of caffeine

Question 15

What are early signs and symptoms of osteoporosis?

Answer 15

Loss of height and back pain that occurs when the vertebrae collapse

Question 16

What are later signs of osteoporosis? There are two, one from review.

Answer 16

The “dowager’s hump,” which occurs when the vertebrae can no longer support the upper body in an upright position. Secondary to this, the waistline disappears and the abdomen protrudes because the rib cage moves closer to the pelvis.

Question 17

A woman older than 50 needs how many mg of calcium daily?

Answer 17

1200

Question 18

(T/F) Estrogen alone can be used for women who have an uterus

Answer 18

False, estrogen alone is used for women without an uterus

Question 19

(T/F) Liver disease is a contraindication for hormone replacement therapy

Answer 19

True

Question 20

A postmenopausal woman presents with constipation, flatulence, and difficulty defecating.
Palpation of the posterior wall of the vagina reveals a soft bulge of tissue. Which intervention would the nurse anticipate for this patient?

Insertion of a pessary
Anterior colporrhaphy
Referral to an oncologist
Elimination of bladder irritants

Answer 20

Insertion of a pessary; These are symptoms of rectocele (supportive wall of tissue between a woman’s rectum and vaginal wall weaken). With rectocele, bowel elimination can be facilitated by putting pressure on the posterior vaginal wall to prevent the rectocele from protruding during bowel movement.

Question 21

A patient reports constant, dull, bilateral pain that usually begins the day before menstruation. This is indicative of which disorder?

Mittelschmerz
Endometriosis
Premenstrual syndrome (PMS)
Primary dysmenorrhea

Answer 21

Endometriosis; Mittelschmerz is unilateral pain associated with ovulation.

Question 22

Which nursing consideration would be included in the plan of care for a postmenopausal woman presenting to the clinic with abnormal vaginal bleeding?

Screening for human papillomavirus (HPV)
Assisting with colposcopy
Teaching about hysterectomy
Laparoscopic removal of ovariess

Answer 22

Teaching about a hysterectomy; Abnormal vaginal bleeding near or after menopause is a primary symptoms of endometrial cancer. The highest cure rate is with surgery (hysterectomy)

Question 23

Which course of action would the nurse typically suggest for a patient with premenstrual syndrome who states, “I’ve had depression, anxiety, irritability, breast tenderness, and headaches before my period for the last 3 months”?

Teaching about laser ablation
Administering fluoxetine as prescribed
A diet rich in protein and low in carbohydrates
Heat application to the lower abdomen or back

Answer 23

Administering fluoxetine as prescribed; This patient may have premenstrual dysphoric disorder (PDD), which is associated with abnormal serotonin response to estrogen level changes during menses. Diagnosis is based on five or more symptoms like depression, anxiety, irritability, breast tenderness, and headaches occurring before menstruation for at least 3 months. Treatment includes use of selective serotonin reuptake inhibitors like fluoxetine.

Question 24

Which screening tool would be added for a female patient older than 65 years of age who is underweight, physically inactive, and is a chronic smoker?
Tuberculosis testing
Bone-density testing
Thyroid-stimulating hormone testing
Mammography with ultrasonography

Answer 24

Bone density testing

Question 25

What is the reproductive period?

Answer 25

Refers to the first menstrual period (puberty( and the permanent stopping of menstrual cycles (around age 50)

Question 26

What are the two hormones that affect the reproductive system? (Regarding menstrual cycle)

Answer 26

FSH and LH

Question 27

Which hormone inhibits FSH? When during the menstrual period?

Answer 27

Estradiol, the 1st 2 weeks

Question 28

Which hormone inhibits LH and when during the menstrual period?

Answer 28

Progesterone, during the 2nd two weeks.

Question 29

How much vitamin D is needed for patients 50 years and older?

Answer 29

600 IU

Question 30

Name 3 lifestyle factors that contribute to bone loss.

Answer 30

Excessive alcohol, smoking, caffeine

Question 31

What items are considered part of the personal history when obtaining a females’ health history. Select all that apply.

Reason for visit
Number of sexual partners
Allergies
Age of 1st menstrual period
Medications
Patterns of elimination
Exercise patterns

Answer 31

Reason for visit
Allergies
Medication
Patterns of elimination
Exercise patterns(?)

Question 32

What items are considered part of the menstrual history when obtaining a females’ health history? Select all that apply.

Age of 1st period
Use of tampons
Regularity of cycle
Relief measures for menstrual discomfort
Birth control used

Answer 32

Age of 1st period
Regularity of cycle
Relief measures for menstrual discomfort

Question 33

What items are considered part of the sexual history when obtaining a females’ health history? Select all that apply.

Number of sexual partners
Breast cancer history
Age when first sexually active
Previous sexually transmitted diseases and treatments
Marital Status
Method of Contraception

Answer 33

Number of sexual partners
Age when first sexually active
Previous STDs and treatments
Method of contraception