*NURSING > CASE STUDY > NSG 6430 WH Week 5 Discussion | iHuman Case Study – Pamela Flowers (All)
iHuman Case Study – Pamela Flowers Pamela Flowers is a 24-year-old presenting with a chief complaint of vaginal bleeding and pelvic pain for the past 24 hours. Discuss the questions that wou... ld be important to include when interviewing a patient with this issue. What are the events surrounding the start of your abnormal vaginal bleeding? Do you have any other symptoms associated with your abnormal vaginal bleeding? How severe is your abnormal vaginal bleeding? Have you had abnormal vaginal bleeding like this before? Do you have any menstrual irregularities? Do you have bleeding between your menstrual cycles? Have you recently missed or stopped taking your birth control or hormone pills? When did your last period begin? How severe (1-10 scale) is your pelvic pain? When and what was the result of your last gynecological exam? Is it possible that you are pregnant? Have you had a previous ectopic pregnancy, abortion, miscarriage, uterine surgery, pelvic inflammatory disease, history of STD/STI’s, and/or history of fibroids? In addition to gathering information based on your chief complaint, it is important to ask about past medical history, prior surgeries/hospitalizations, prescription and over the counter medications (Schuiling & Likis, 2016). Describe the clinical findings that may be present in a patient with this issue. Clinical assessment findings of ectopic pregnancy include spotting, vaginal bleeding, dizziness, pelvic and/or abdominal pain (Buttaro, Trybulski, Polgar-Bailey, & Sandberg-Cook, 2017). Patients often present with complaints of a unilateral pelvic pain that is cramping or sharp (Buttaro et al., 2017). The nurse practitioner (NP) may find that on physical examination with a speculum there is a Chadwick’s sign, a bluish color of the cervix, possible uterine enlargement, abdominal tenderness with guarding and possible cervical motion tenderness (Buttaro et al., 2017). Are there any diagnostic studies that should be ordered on this patient? Why? Human chorionic gonadotropin (HCG) serum to check for pregnancy along with a plateau or fall in the titer which is indicative of an ectopic pregnancy or miscarriage (Buttaro et al., 2017). Complete blood [Show More]
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