A patient receiving menotropin (Repronex) for infertility comes to the clinic for evaluation on the ninth day of treatment. Her serum estrogen level is 200 pg/mL per maturing follicle. An ultrasound reveals that follicles have enlarged to 22 mm
The patient complains of left lower abdominal pain. What will the nurse do?
a. Administer human chorionic gonadotropin, because the ovary has ripened.
b. Assess for abdominal fullness and distension and auscultate lung sounds.
c. Inform the patient that the pain is associated with ovulation.
d. Recommend ibuprofen for pain and administer the next dose of menotropin.
ANS: B
Menotropins can cause ovarian hyperstimulation syndrome, which can cause sudden enlargement of the ovaries. When it occurs rapidly and is accompanied by ascites, pleural effusion, and pain, the patient should be hospitalized and the menotropin should be withdrawn. Although the follicular size and estrogen level indicate a ripened ovary, the first priority is to assess for ovarian hyperstimulation syndrome, because this patient reports pain. Ovulation will not occur until hCG is given, so this pain is not associated with ovulation. Until ovarian hyperstimulation syndrome has been ruled out, it is not appropriate to administer the next dose of menotropins.
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