Classic triad: irregular or absent menses (anovulation), signs of excess androgens (hirsutism, acne, male-pattern hair thinning), and polycystic ovaries on ultrasound.
Before you read
Test yourself first: 3 questions
Question 1 of 3
A client with acute coronary syndrome is having chest pain and receives sublingual nitroglycerin. After the first tablet, the pain persists. What is the nurse's appropriate action?
Answer: B. For ongoing chest pain, the standard teaching is to give one sublingual nitroglycerin tablet every 5 minutes for up to 3 doses, checking blood pressure between doses because nitroglycerin causes vasodilation and hypotension. If pain is unrelieved, emergency care or provider notification is needed. Giving all three at once, waiting 30 minutes, or doubling the dose are unsafe.
Question 2 of 3
A nurse scores a newborn with neonatal abstinence syndrome. Which findings are consistent with NAS?
Answer: A. NAS produces central nervous system signs (high-pitched cry, tremors, irritability, hypertonia, exaggerated Moro, poor sleep), autonomic signs (sweating, sneezing, yawning, nasal stuffiness, fever), and GI signs (poor feeding, vomiting, diarrhea, frantic sucking). A consistently calm, easily consoled infant who sleeps well is not exhibiting NAS.
Question 3 of 3
A client receiving IV vancomycin develops flushing of the face and neck, pruritus, and hypotension during a rapid infusion. Which is the priority nursing action?
Answer: B. Vancomycin infusion reaction (formerly called red man syndrome) results from rapid infusion causing histamine release. The priority is to stop or slow the infusion; the reaction is usually prevented by infusing over at least 60 minutes.
Keep the streak going with more questions like these, each with a full rationale.
What is polycystic ovary syndrome?
Insulin resistance is central, linking PCOS to type 2 diabetes and metabolic syndrome. It is a leading cause of infertility.
Key points to remember
- Classic triad: irregular or absent menses (anovulation), signs of excess androgens (hirsutism, acne, male-pattern hair thinning), and polycystic ovaries on ultrasound.
- Insulin resistance is a core feature, increasing risk for type 2 diabetes, obesity, dyslipidemia, and metabolic syndrome.
- PCOS is a common cause of infertility due to lack of ovulation.
- Chronic anovulation causes unopposed estrogen, raising the risk of endometrial hyperplasia and cancer.
- First-line management includes weight loss and lifestyle change; metformin improves insulin sensitivity and ovulation.
- Combined oral contraceptives regulate cycles and reduce androgen symptoms; clomiphene or letrozole induce ovulation for those seeking pregnancy.
Signs & symptoms
- Irregular/absent menses
- Hirsutism, acne, alopecia
- Obesity, infertility
Nursing priorities
- Screen for insulin resistance and diabetes with fasting glucose, A1C, or oral glucose tolerance testing.
- Promote weight loss and exercise, which can restore ovulation and improve metabolic markers.
- Educate on prescribed oral contraceptives, metformin, or ovulation-induction agents and their purpose.
- Provide emotional support addressing body image, fertility concerns, and risk of depression/anxiety.
- Monitor blood pressure and lipid profile for cardiovascular risk.
Labs & values
Patient teaching
- Even a 5-10% weight loss can restore regular ovulation and reduce diabetes risk.
- Regular menstrual cycles protect the uterine lining; report cycles fewer than 8-9 per year.
- PCOS raises lifelong risk for diabetes and heart disease, so ongoing screening is important.
- Take metformin with meals to reduce GI upset and report persistent nausea or diarrhea.
Red flags: report now
- Prolonged or heavy abnormal uterine bleeding — may signal endometrial hyperplasia requiring evaluation.
- Signs of metformin-associated lactic acidosis (rare): muscle pain, fatigue, difficulty breathing — report immediately.
References
Clinical references for this topic
