Menstrual Cycle
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Study Tools For Menstrual Cycle
Menstrual Cycle (Image)
Full Menstrual Cycle (Image)
Phases of Menstrual Cycle (Image)
Ovulatory Hormones I – Follicular Phase (Picmonic)
Ovulatory Hormones II – Luteal Phase (Picmonic)
Menstrual Cycle (Cheatsheet)
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Outline
Overview
- Average of a 28-day cycle in which either a period or pregnancy occur
- Hormones – FSH, LH, estrogen, progesterone
- Organs – brain, ovaries, and uterus
Nursing Points
General
Timeline of the menstrual cycle is as follow:
- Pituitary gland releases FSH and LH, which stimulates follicles in ovaries to mature
- Each follicle contains one ovum – ”egg”
- Maturing follicles secrete estrogen
- When estrogen peaks→ this begins ovulation and the brain is told to ↓ FSH and ↓ LH production
- Ovulation – The most mature ovum bursts out of its follicle and starts traveling towards the uterus via the fallopian tube to potentially become fertilized by a sperm
- In the ovary, the now-empty follicle, the corpus luteum, secretes progesterone
- Stimulates uterine lining (endometrium) to plump with blood and nutrients to prepare for implantation of a fertilized ovum
- If an ovum gets fertilized, it implants itself into the plump wall of the uterus.
- Conception → Pregnancy
- Fertilization occurs when with the sperm and ovum unite
- Fertilized ovum is called a zygote
- Zygote implants approximately 6-8 days after ovulation
- Zygote matures into a blastocyst
- Blastocyst causes the body to produce human chorionic gonadotropin (hCG).
- hCG tells the corpus luteum to continue secreting progesterone
- Maintains the pregnancy until the placenta takes over production, 2-3 months later.
- If the ovum does not get fertilized, the progesterone and estrogen levels drop
- This tells the uterine lining to shed, because it’s not needed to support a pregnancy.
- Blood, tissue, and the ovum are shed and leave the body via the vagina.
- This can take up to 7 days.
- This is a period or menses.
Assessment
- So what are menstrual cramps?
- The uterus is a muscle, which contracts to release the unused contents.
- Vasoconstriction occurs during these contractions of the uterine muscle.
- This causes temporary oxygen deprivation, which then causes the pain (or dysmenorrhea) associated with menses.
- How long is the cycle?
- The cycle usually occurs every 28 days on average.
- Women are sometimes regular and can count out their cycle and others are irregular and don’t occur at the same time every month
- Ovarian Phases
- Follicular phase
- Before the egg release/Pre-Ovulation
- Starts FSH + LH secretion (follicles are maturing)
- Ovulatory phase
- Egg is released → follicular rupture and release of ovum
- Luteal phase
- Egg has been released
- Corpus luteum secretes progesterone and continues to if pregnancy occurs
- Follicular phase
- Uterine Phases
- Menstrual phase (4-6 days)
- Starts with menstruation → ends with ↑ FSH, starting a new cycle (all if pregnancy did not occur)
- Endometrial tissue is shed, “self-cleaning”
- Menstrual phase (4-6 days)
Therapeutic Management
- This is a normal process, no treatment is required
- NSAIDs can be used to manage pain
- Eat complex carbohydrates and avoid high sugar items
- Exercise
Nursing Concepts
- Reproduction
- Comfort
Patient Education
- Use contraception if pregnancy is not desired
- Diet and medication education to aid in dysmenorrhea
- Ensure proper hygiene during menses to avoid UTI
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Transcript
We are going to be talking about the menstrual cycle and all the details in hopefully a more understandable way. So to start the main couple of things to know are that it is a recurring cycle, usually 28 days. Ovulation or when the egg is released is around day 14 of the cycle. During the cycle 2 things can happen. You either have a pregnancy or menses start. And the next thing to understand are the hormones involved. The hormones are FSH or Follicle Stimulating Hormone, LH or luteinizing hormone, Estrogen, Progesterone.
Let’s start talking about these hormones and their jobs. So we have a pituitary gland that is going to release FSH and LH. These are going to stimulate the follicles in the ovaries to mature. So what does mature mean? It means they grown, they get bigger! Each follicle is going to contains 1 ovum or egg. As the follicles grow they secrete estrogen. LH surges and Estrogen peaks causing ovulation to happen. So what does this mean? The follicle ruptures and the egg is released. The egg release is ovulation which happens when? Around day 14 of the cycle! So where does the egg go? That egg is going to travel down the fallopian tube in hopes of finding sperm and being fertilized. Fertilization will occur in the tube. So you ask, what now? Now FSH and LH decrease. And do you remember that follicle that ruptured and released the egg? That ruptured follicle will now become the corpus luteum and secrete progesterone. Progesterone is the hormone of pregnancy because it maintains the pregnancy (if there is one). That progesterone is going to get the uterus thick and ready for implantation if fertilization has occurred. Well what if fertilization does not occur? Estrogen and progesterone decrease and the uterine lining (endometrium) is shed. This is menses or period. This is the way the body self cleans. The uterus is like a self cleaning oven. You never need to douche or do anything because a cycle happens every month on its own and cleans it out!
Let’s look at it seperated in the phases. Follicular, ovulatory, and luteal phase.
First the follicular phase. FSH and LH increase which remember stimulates new follicles to mature. One of the follicles becomes the dominant one and produces estrogen. LH also begins to rise.
In the ovulatory phase LH surges and the ovum (egg) is RELEASED from the follicle. This is ovulation which occurs when? Yes, around day 14 of the cycle. The egg starts to travel down the fallopian tube. Estrogen tells the uterus to get ready.
So now we enter the luteal phase. Ovulation has happened so now FSH and LH decrease. Do you remember where the corpus luteum comes from? That ruptured follicle that contained the egg becomes the corpus luteum and secretes progesterone. Progesterone and estrogen tell the uterus to get ready for implantation in case fertilization occurred. So what does get ready mean? It means the uterus is going to start to thicken and plump up with blood supply for possible implantation. If implantation occurs it means we have a pregnancy but without fertilization/implantation there is no pregnancy so the hormone levels all drop and menses occur.
What are women going to feel during this? Typically nothing until menses begins. If menses starts then menstrual cramps will likely occur. This is usually accompanied by some skin breakouts, breast tenderness and mood swings because remember those hormones are fluctuating up and crashing down. The uterus is a muscle so it is going to contract to release the unused contents- this is the cause of the cramps. This is a normal process and no treatment is required however,NSAIDs can be used to manage pain. Diet can be modified to help with pain and complex carbohydrates should be encouraged verses high sugar items. Everyone craves those high sugar items like sweets but this can cause more discomfort! Exercise can also be beneficial.
The patient is pregnant so we consider reproduction as a concept. Comfort is another concept because it is likely that pain will occur for the patient with menses.
So lets review the key points to remember. It is a 28 day cycle with ovulation occurring at around day 14. FSH, LH, Estrogen, and Progesterone are the hormones involved. The cycle ends with either pregnancy or menses.
Make sure you check out the resources attached to this lesson. Now, go out and be your best selves today. And, as always, happy nursing.
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Diarrhea – Treatment Nursing Mnemonic (BRAT)
Digoxin (Lanoxin) Nursing Considerations
Diphenhydramine (Benadryl) Nursing Considerations
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
Eczema
EENT Assessment
Enuresis
Epiglottitis
Epiglottitis – Signs and Symptoms Nursing Mnemonic (AIR RAID)
Epispadias and Hypospadias
Famotidine (Pepcid) Nursing Considerations
Fever
Fever Case Study (Pediatric) (30 min)
Flu Symptoms Nursing Mnemonic (FACTS)
Fluid Compartments
Fluid Pressures
Fluid Shifts (Ascites) (Pleural Effusion)
Fluid Volume Deficit
Fluticasone (Flonase) Nursing Considerations
Gas Exchange
Gentamicin (Garamycin) Nursing Considerations
Glucose Lab Values
Gluten Free Diet Nursing Mnemonic (BROW)
Guaifenesin (Mucinex) Nursing Considerations
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
Hematocrit (Hct) Lab Values
Hemoglobin (Hbg) Lab Values
Hemophilia
Hierarchy of O2 Delivery
Hydrocephalus
Hypoxia – Signs and Symptoms (in Pediatrics) Nursing Mnemonic (FINES)
Ibuprofen (Motrin) Nursing Considerations
Immunizations (Vaccinations)
Imperforate Anus
Impetigo
Indomethacin (Indocin) Nursing Considerations
Influenza – Flu
Integumentary (Skin) Assessment
Intussusception
Intussusception for Certified Emergency Nursing (CEN)
Iron Deficiency Anemia
Isolation Precaution Types (PPE)
Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)
Lactulose (Generlac) Nursing Considerations
Leukemia
Levels of Consciousness (LOC)
Levetiracetam (Keppra) Nursing Considerations
Lung Sounds
Marfan Syndrome
Meningitis
Meningitis Assessment Findings Nursing Mnemonic (FAN LIPS)
Meningitis for Certified Emergency Nursing (CEN)
Methylphenidate (Concerta) Nursing Considerations
Mixed (Cardiac) Heart Defects
Mumps
Nephroblastoma
Nephrotic Syndrome
Nephrotic Syndrome Case Study (Peds) (45 min)
Neuro Assessment
NSAIDs
Nursing Care Plan (NCP) for Acute Bronchitis
Nursing Care Plan (NCP) for Appendicitis
Nursing Care Plan (NCP) for Asthma
Nursing Care Plan (NCP) for Asthma / Childhood Asthma
Nursing Care Plan (NCP) for Attention Deficit Hyperactivity Disorder (ADHD)
Nursing Care Plan (NCP) for Bronchiolitis / Respiratory Syncytial Virus (RSV)
Nursing Care Plan (NCP) for Burn Injury (First, Second, Third degree)
Nursing Care Plan (NCP) for Celiac Disease
Nursing Care Plan (NCP) for Cerebral Palsy (CP)
Nursing Care Plan (NCP) for Cleft Lip / Cleft Palate
Nursing Care Plan (NCP) for Clubfoot
Nursing Care Plan (NCP) for Congenital Heart Defects
Nursing Care Plan (NCP) for Constipation / Encopresis
Nursing Care Plan (NCP) for Cystic Fibrosis
Nursing Care Plan (NCP) for Decreased Cardiac Output
Nursing Care Plan (NCP) for Dehydration & Fever
Nursing Care Plan (NCP) for Eczema (Infantile or Childhood) / Atopic Dermatitis
Nursing Care Plan (NCP) for Enuresis / Bedwetting
Nursing Care Plan (NCP) for Epiglottitis
Nursing Care Plan (NCP) for Fluid Volume Deficit
Nursing Care Plan (NCP) for Hemophilia
Nursing Care Plan (NCP) for Hydrocephalus
Nursing Care Plan (NCP) for Impaired Gas Exchange
Nursing Care Plan (NCP) for Imperforate Anus
Nursing Care Plan (NCP) for Impetigo
Nursing Care Plan (NCP) for Infective Conjunctivitis / Pink Eye
Nursing Care Plan (NCP) for Influenza
Nursing Care Plan (NCP) for Intussusception
Nursing Care Plan (NCP) for Marfan Syndrome
Nursing Care Plan (NCP) for Meningitis
Nursing Care Plan (NCP) for Mumps
Nursing Care Plan (NCP) for Neural Tube Defect, Spina Bifida
Nursing Care Plan (NCP) for Omphalocele
Nursing Care Plan (NCP) for Otitis Media / Acute Otitis Media (AOM)
Nursing Care Plan (NCP) for Pediculosis Capitis / Head Lice
Nursing Care Plan (NCP) for Pertussis / Whooping Cough
Nursing Care Plan (NCP) for Phenylketonuria (PKU)
Nursing Care Plan (NCP) for Reye’s Syndrome
Nursing Care Plan (NCP) for Rheumatic Fever
Nursing Care Plan (NCP) for Rubeola – Measles
Nursing Care Plan (NCP) for Scoliosis
Nursing Care Plan (NCP) for Sickle Cell Anemia
Nursing Care Plan (NCP) for Tonsillitis
Nursing Care Plan (NCP) for Varicella / Chickenpox
Nursing Care Plan (NCP) for Vomiting / Diarrhea
Nursing Care Plan for (NCP) Autism Spectrum Disorder
Nursing Case Study for Pediatric Asthma
Obstructive Heart (Cardiac) Defects
Ocular Infections (Conjunctivitis, Iritis) for Certified Emergency Nursing (CEN)
Omphalocele
Opioid Analgesics
Pancrelipase (Pancreaze) Nursing Considerations
Pediatric Bronchiolitis Labs
Pediatric Gastrointestinal Dysfunction – Diarrhea
Pediatric Oncology Basics
Pediatrics Course Introduction
Pediculosis Capitis
Pertussis – Whooping Cough
Phenylketonuria
Phenytoin (Dilantin) Nursing Considerations
Platelets (PLT) Lab Values
Pneumonia
Promotion and Evaluation of Normal Elimination Nursing Mnemonic (POOPER SCOOP)
Pulmonary Function Test
Red Blood Cell (RBC) Lab Values
Respiratory Acidosis (interpretation and nursing interventions)
Reye’s Syndrome
Reyes Syndrome Case Study (Peds) (45 min)
Rheumatic Fever
ROME – ABG (Arterial Blood Gas) Interpretation
Rubeola – Measles
Salmeterol (Serevent) Nursing Considerations
Scoliosis
Selegiline (Eldepyrl) Nursing Considerations
Sickle Cell Anemia
Spina Bifida – Neural Tube Defect (NTD)
Steroids – Side Effects Nursing Mnemonic (6 S’s)
Stoma Care (Colostomy bag)
Strabismus
Sudden Infant Death Syndrome (SIDS)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Thorax and Lungs Assessment
Tonsillitis
Topical Medications
Tracheal Esophageal Fistula – Sign and Symptoms Nursing Mnemonic (The 3 C’s)
Transient Incontinence – Common Causes Nursing Mnemonic (P-DIAPERS)
Treatment of Sickle Cell Nursing Mnemonic (HOP to the hospital)
Umbilical Hernia
Vaccine-Preventable Diseases (Measles, Mumps, Pertussis, Chicken Pox, Diphtheria) for Certified Emergency Nursing (CEN)
Varicella – Chickenpox
Varicella Case Study (Peds) (30 min)
Vitals (VS) and Assessment
Vomiting
White Blood Cell (WBC) Lab Values
X-Ray (Xray)
ADLs (Activity of Daily Living) Nursing Mnemonic (BATTED)
Emotions and Motivation
Growth & Development Theories
Maslow’s Hierarchy of Needs in Nursing
Psychological Disorders
State of Consciousness
Stress and Crisis