# Five days after an ovulation-trigger injection following follitropin alfa therapy, a client reports severe pelvic pain, rapid weight gain, dyspnea, and markedly decreased urine output. Which action is the priority?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522604&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

Five days after an ovulation-trigger injection following follitropin alfa therapy, a client reports severe pelvic pain, rapid weight gain, dyspnea, and markedly decreased urine output. Which action is the priority?

## Option

1. Hold further gonadotropin exposure and obtain urgent evaluation for ovarian hyperstimulation syndrome. **✔ Correct answer**
2. Reassure the client that oliguria and breathing difficulty are expected evidence of successful ovulation.
3. Encourage strenuous exercise and fluid restriction to redistribute the accumulating abdominal and chest fluid.
4. Administer another ovulation-trigger dose before the ovaries recover and reassess urine output tomorrow.

**Correct answer: 1**

## Explanation

Severe pelvic pain, rapid weight gain, dyspnea, and oliguria after gonadotropin therapy indicate potentially serious ovarian hyperstimulation syndrome with fluid shifts and cardiopulmonary or thromboembolic risk.

## In-depth explanation

Quick answer
Escalate delayed ovarian hyperstimulation syndrome after gonadotropin exposure.

Why this is correct
OHSS can develop after treatment stops and can progress rapidly. Serious cases require cessation of gonadotropins and assessment for hospitalization and supportive management.

Easy analogy or mental picture
Use a closed medication-safety loop: identify the immune or cytotoxic exposure, connect the new findings, interrupt further harm, stabilize the client, and verify the response over time.

Memory hook
Exposure, immune effect, organ toxicity, infection risk, immediate action, and serial reassessment.

NCLEX decision rule
Choose the action that reduces the most immediate medication-related risk while preserving diagnostic evaluation and authorized treatment.

Why the other choices are wrong
Options that continue the exposure, treat only one symptom, or delay reassessment leave the toxic or infectious process active.References
1DailyMed: GONAL-f (follitropin alfa)Ovarian hyperstimulation syndrome, rapid fluid shifts, respiratory and thromboembolic complications, and urgent evaluation

## Clinical scenario

Oncology, transplant, and biologic safety review
Verify the indication, immune status, infection screen, interacting medicines, current organ findings, authorized action, and measurable follow-up.

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