Nursing Polycystic Ovarian Syndrome Case Study 2022

Running head: NURSING
Nursing
Name of the Student:
Name of the University:
Author Note:

NURSING1
Introduction:
The provided case scenario deals with the patient Ms. Sharon Munroe who is 26 years
old and has a medical history of Polycystic Ovarian Syndrome for the previous 6 years. The
provided medical history of the patient states that the patient had gained a body weight of 20
Kgs and her menstrual cycle had ceased several years ago. In addition to this, it has further
been stated that at present the patient suffers from problems of acne outburst, hirsutism,
miscarriages and infertility. This paper intends to make use of the evidence based practice in
order to devise an appropriate care plan for the patient.
Pathophysiology:
The endocrine abnormality of Polycystic Ovarian Syndrome initiates post menarche.
The two primary causes that lead to PCOs can be mentioned as a rise in the level of
Luteinizing hormone or the LH and insulin resistance. The genetic mechanism that could
possibly lead to a rise of the LH level is unknown. Research studies mention that the rise in
the level of LH or insulin resistance are not the individual causes that trigger the onset of
polycystic ovarian syndrome. As stated by Dokras et al. (2017), elevated level of LH and
hyperinsulinemia work synergistically and promote the ovarian growth which in turn
stimulates androgen production and formation of ovarian cysts. Research studies further
mention that obesity is one of the primary causes that attributes to 50% to 65% of the
Polycystic Ovarian Syndrome cases (Alchami et al., 2015). Obesity has been studied to
increase insulin resistance and cause hyperinsulinemia (Moran et al., 2017). However, the
evidence base also suggests that hyperandrogenism and insulin resistance is also found in
non-obese as well as obese women, which subsequently contradicts the assumption that only
obese woman would experience insulin resistance. The phenomenon of Insulin resistance can
be explained as the impaired action of insulin uptake and metabolism of glucose. The

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impaired functioning of the Insulin hormone leads to a rise in the insulin level which affect
the synthesis of 2 binding proteins that include sex hormone binding globulin (SHBG) and
Insulin like growth factor binding protein (IGFBP-1). The IGFBP-I protein binds with the
OGFBP-II protein and the SHBG protein binds to sex steroids such as Androgen (Moran et
al., 2017). Research studies mention that patients suffering from Polycystic Ovarian
Syndrome are affected with the conditions of hyperandrogenism, insulin resistance and
Acanthosis nigricans (Brennan et al., 2017).
Acanthosis nigricans can be explained as a dark, hyperpigmented hyperplasia of the
skin that manifests around the axilla as well as nape of the neck and is a characteristic clinical
symptom of insulin resistance. In addition to this, the symptoms of hyperandrogenism include
Hirsutism which refers to excess facial or body hair, emergence of acne and elevated blood
pressure (128/76mm Hg) which is characterised by the vital assessment documentation.
Another characteristic symptom of hyperandrogenism is excessive weight gain which leads to
obesity and is characterized by the documented BMI of the patient which is equivalent to 32.
Research studies define obesity as a condition where the body mass index of an individual
becomes equivalent to 30 or above (Kyrou et al., 2015). The provided case information
suggests that the patient’s height is equivalent to 172 cm and the body weight is equivalent to
96 kg. Based on the information the BMI can be calculated to be 32. In addition to this, the
case scenario also states that the patient has gained 20 kg body weight over the years.
Diagnostic assessment:
Physical assessment include high level of androgen hormone and excessive hair
growth and acne outburst on the surface of the skin. Other assessment tests include, body
weight and BMI examination and pelvic exam to check the ovaries (Teede et al., 2018). Other
assessment tests include, referral to blood tests for the estimation of hormone level in the