A patient with endometriosis is being treated with the ...

[colton]

A patient with endometriosis is being treated with the gonadotropin-releasing hormone (GnRH) agonist leuprolide (Lupron Depot). A nurse is teaching the patient about the drug.
 
  Which statement by the patient indicates understanding of the teaching?
  a. I can continue to take the medication if I get pregnant.
  b. I can expect the medication to cure my symptoms.
  c. I may have menopausal-like symptoms when taking this medication.
  d. I will need to take the medication for several years.

Question 2

A patient with polycystic ovary syndrome (PCOS) asks the nurse what she can do to improve her chances of getting pregnant. Which statement by the patient indicates a need for further teaching?
 
  a. Clomiphene will help induce ovulation but will not treat the other symptoms of polycystic ovarian disease.
  b. If I lose weight, my infertility and irregular periods could resolve without medications.
  c. Metformin improves insulin sensitivity and reduces male hormone levels.
  d. Spironolactone, which reduces androgens and facial hair, is helpful if I'm trying to conceive.

[Liamb2179]

Answer to Question 1

ANS: C
Because the GnRH agonists deprive the ovary of the stimulation to produce estrogen, women may experience symptoms associated with menopause, including hot flashes, vaginal dryness, decreased libido, mood changes, and headache. GnRH agonists are teratogenic and should not be used during pregnancy. The medication does not produce a cure; symptoms return in up to 50 of women after discontinuation of the drug. GnRH agonists should be discontinued after 6 months of treatment because of the risk of osteoporosis.

Answer to Question 2

ANS: D
Spironolactone is antiandrogenic; it can reduce hirsutism and acne, but it also can harm the fetus and should not be used in patients trying to conceive. Clomiphene helps induce ovulation but does not treat symptoms of PCOS. Patients who lose weight might experience a reversal of symptoms without medications, although weight loss may be difficult to achieve. Metformin reduces serum insulin levels by increasing insulin sensitivity and indirectly lowers androgen levels.

[colton]

Excellent

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