An infertile patient has received two 5-day courses of clomiphene ...

[Wadzanai]

An infertile patient has received two 5-day courses of clomiphene (Clomid) to help her conceive. An ultrasound 1 week after the last dose reveals that follicular maturation has occurred without ovulation.
 
  The nurse expects the next step for this patient to be:
  a. administration of human chorionic gonadotropin (hCG).
  b. an order for cabergoline to be given twice weekly.
  c. evaluation of ovarian and pituitary function.
  d. repeating clomiphene once daily for 5 days.

Question 2

A patient is being treated for infertility. An examination reveals cervical mucus that is scant, thick, and sticky. The nurse suspects that the patient has been taking which medication?
 
  a. Clomiphene (Clomid)
  b. Estrogen
  c. Follicle-stimulating hormone (FSH)
  d. Progesterone

[brittrenee]

Answer to Question 1

ANS: A
When treatment with clomiphene has failed to produce ovulation after two courses, hCG is used to promote ovulation after follicular maturation has occurred. Cabergoline is used to treat hyperprolactinemia when excessive prolactin secretion occurs. Ovarian and pituitary function should be evaluated before a patient begins treatment with clomiphene. If ovulation had occurred, another cycle of clomiphene would be indicated.

Answer to Question 2

ANS: A
Because clomiphene has antiestrogenic actions, it can force the production of scant and viscous cervical mucus, which interferes with conception. Estrogen is given to create a favorable cervical mucous environment that is more hospitable to sperm. FSH and progesterone do not alter cervical mucus in this way.

[Wadzanai]

Excellent

TYSM