NCM109 LEC

• Infertility


  The inability of the couple to conceive a child or sustain a pregnant to birth within a least after a year of unprotected sex
• Subinfertility


  Couples that have the potentials to conceive but are just less able to without additional help
• Symptoms of infertility

  • Inability for a couple to get pregnant
  • Irregularity or absent menstrual periods
  • Hormonal problems (changes in hair growth or sexual function)
• Causes of infertility

  • The reason for infertility can involve one or both partners
  • 1/3 of the cases involves only the male
  • 1/3 of the cases involves only the female
  • In the remaining cases involves both the male and female, or no cause can be identified
• Causes of male infertility

  • Abnormal sperm production or function due to various problems like obstruction on sperm passage way
  • Undescended testicles
  • Genetic defects
  • Health problems such as diabetes,hypertension (impotence)
  • Infections such as mumps
  • Enlarged veins in the testes (varicocele) can increase blood flow and heat, affecting the number and shape of sperm
  • Problems with the delivery of sperm due to sexual problems like premature ejaculation, semen entering the bladder instead of emerging through the penis during orgasm, certain genetic diseases, structural problems, damage or injury to the reproductive organs
  • Overexposure to certain environmental factors like pesticides, radiation, certain medications, frequent exposure to heat
  • Damage related to cancer and its treatment like radiation therapy and chemotherapy
• Undescended testicles


  A condition where one or both testicles fail to descend into the scrotum
• Varicocele


  Enlarged veins in the testes that can increase blood flow and heat, affecting the number and shape of sperm
• Premature ejaculation


  Reaches ejaculation or orgasm consistently before or very soon after entering the vagina, leaving the partner with no sexual gratification
• Causes of premature ejaculation

  • Biological causes (abnormal hormone levels, inflammation and infection of the prostate or urethra)
  • Psychological issues (stress, depression, lack of confidence)
• Diagnosis of premature ejaculation

  • Health history
  • Physical exam
  • Blood test
  • Hormonal level test (abnormal level)
• Treatments for premature ejaculation

  • Behavioral techniques (focusing on other types of sexual play to remove pleasure)
  • Topical anesthetics (creams and sprays that contain numbing agents like benzocaine, lidocaine, prilocaine)
  • Counseling
  • Pelvic floor exercises (Kegel exercises)
• Pelvic floor muscles (Kegel exercise)


  Exercises that involve tightening the muscles that keep you from passing gas or urinating
• Causes of female infertility

  • Ovulation disorders
  • Uterine or cervical abnormalities
  • Fallopian tube damage or blockage
  • Endometriosis
  • Primary ovarian insufficiency (early menopause)
  • Pelvic adhesions
  • Thyroid problems
  • Cancer and its treatment
  • Other conditions like celiac disease, Cushing's disease, sickle cell disease, kidney diseases, diabetes
• Polycystic ovary syndrome


  A hormonal disorder that may cause the ovaries to produce too much of the male hormone testosterone
• Hyperprolactinemia


  A condition where the body produces too much of the hormone prolactin, which stimulates breast milk production
• Uterine fibroids


  Benign tumors in the wall or abnormalities in the shape of the uterus that can distort the uterine cavity and interfere with implantation of the fertilized egg
• Salpingitis


  Inflammation of the fallopian tube
• Causes of fallopian tube damage or blockage

  • Pelvic inflammatory disease
  • Endometriosis
  • Adhesions
• Endometriosis


  A condition where endometrial tissues implant and grow outside of the uterus, often affecting the function of the ovaries, uterus and fallopian tubes
• Primary ovarian insufficiency


  When the ovaries stop working and menstruation ends before age 40, often caused by immune system diseases, radiation, chemotherapy, and smoking
• Causes of pelvic adhesions

  • Pelvic infection
  • Appendicitis
  • Abdominal or pelvic surgery
• Thyroid problems


  Disorders of the thyroid gland like hyperthyroidism or hypothyroidism that can interrupt the menstrual cycle or cause infertility
• Other causes of female infertility

  • Female reproductive cancers and their treatment
  • Medical conditions associated with delayed puberty or absence of menstruation like celiac disease, Cushing's disease, sickle cell disease, kidney diseases, diabetes
• Celiac disease


  A digestive problem that damages the small intestine and prevents the body from absorbing nutrients from food
• Symptoms of celiac disease

  • Severe diarrhea, excessive wind and/or constipation
  • Persistent or unexplained gastrointestinal symptoms like nausea and vomiting
  • Recurrent stomach pain, cramping or bloating
  • Iron, vitamin B12 or folic acid deficiency
  • Anemia and tiredness
• Foods to avoid with celiac disease

  • Bread
  • Pasta
  • Cereals
  • Biscuits or crackers
  • Cakes and pastries
  • Gravies and sauces
• Conditions that can develop from untreated celiac disease

  • Type 1 Diabetes Mellitus
  • Multiple sclerosis
  • Infertility
  • Miscarriage
  • Dermatitis herpetiformis
  • Neurological disorders like epilepsy and migraines
  • Anemia
  • Osteoporosis
• Cushing's disease


  A disorder where the body produces too much of the hormone cortisol over a long period of time
• Cortisol


  Also known as the "stress hormone", it helps the body respond to stress and maintain blood pressure
• Symptoms of Cushing syndrome

  • Weight gain in the trunk and face, with thin arms and legs
  • Fatty lump between the shoulders
  • Pink or purple stretch marks on the stomach, hips, thighs, breast and under arms
  • Thin, frail skin that bruises easily
  • Slow wound healing
  • Acne
• Causes of Cushing syndrome

  • Pituitary adenoma (benign tumor) making too much ACTH
  • Adrenal glands making too much cortisol
• Signs of high cortisol

  • Irritability
  • Headaches
  • Intestinal problems (Constipation/diarrhea)
  • Anxiety
  • Depression
• Nursing interventions for Cushing syndrome

  • Hand washing using aseptic technique
  • Limit visitors and or use protective isolation
  • Bedside care with assistance
  • Administer medications as ordered
  • Post partum support
  • Feeding assistance and monitor V/S and cortisol level
  • Serve high fiber food and avoid fatty foods
• Sickle cell disease


  A genetic disorder that affects the red blood cells, leading to lower ovarian reserve, increased miscarriages, reduced fertility, and early menopause
• The only cure for sickle cell disease is blood and bone marrow transplant
• How sickle cell anemia affects pregnancy

  It leads to anemia, which means the pregnant person doesn't have enough healthy red blood cells to carry oxygen to the rest of the body, and can lead to miscarriage, prematurity and more frequent sickle cell crises
• Nursing care for Respiratory Disorders

  1. Respiratory dysfunction in children tends to be more serious than in adults because the lumen of a child's respiratory tract are smaller and therefore more likely to become obstructed

  2. Respiratory illness can begin as early as moments after birth if a newborn has difficulty initiating a first breath or establishing regular respiration

  3. An episode of sudden coughing is suggestive of an acute respiratory disorder

  4. A child admitted to the hospital with a respiratory disorder is usually in an acute stage of illness

  5. Nursing assessment that a child is developing tachypnea or retractions may be the first indication of a child's worsening condition
• Nursing Diagnosis: Alteration in mechanisms of breathing and on the emotional distress such problem can create

  Ineffective airway clearance is a common diagnostic category used in this area, related to factors such as ineffective cough, fatigue, weakness, viscous secretions, pain, aspiration, lack of knowledge about the importance of coughing, impaired gas exchange, ineffective breathing pattern
• Examples of Nursing Diagnosis

  • Activity intolerance related to insufficient oxygenation
  • Fatigue related to impaired gas exchange
  • Fear related to inability to breathe without effort
  • Impaired social interaction related to difficulty in keeping up with physical activities of peers
  • Deficient knowledge related to need for continued treatment
• Planning

  Supporting the child and family through prescribed therapy and keeping parents informed about their child's health status and response to treatment