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 would be important to include when interviewing a
patient with
...
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 would 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 co
[Show More]
