Case Scenario1 Reproductive
Case Scenario1 Reproductive
Case Scenario1 Reproductive
Andrea misses at least 1 day of school every month from menstrual period pain.
Menarche was at 16 years of age. Her usual pattern is 30 days interval with 7
days duration of menses. Cramping begins at start of menses and lasts at least 24
hours. Her last menstrual period was 2 weeks ago. She takes an over-the-counter
combination (acetylsalicylic acid, acetaminophen, and caffeine) 10 g every 4
hours for pain.
The client has been sexually active for 4 months with a monogamous 18-year-old
partner. She states she knows safer sex practices. Her boyfriend uses condoms for
both safer sex and their reproductive life planning method.
FAMILY PROFILE:
She lives with parents and one male sibling, 12 years old, in a suburban community.
Her father works as garage mechanic; her mother as a receptionist at a real estate
firm. She works part-time as a member of a “garage band.” She describes family
finances as, “We’re not rich, but okay.”
PAST MEDICAL ILLNESSES:
She had a surgery for appendectomy at 6 years of age. She had no complications.
She had chickenpox about age 7 years. She has “bad acne” since eighth grade. She
has a “sensitive stomach” or develops nausea easily.
HISTORY OF FAMILY ILLNESSES:
Her father had a left lung lobe removed for lung cancer followed by
chemotherapy 2 years ago. There is no apparent reoccurrence to date. A
maternal aunt has valvular heart disease. A paternal aunt had severe
pelvic inflammatory disease with arthritis and is now undergoing
fertility studies for fallopian tube strictures
DAY HISTORY
Neck: Full range of motion; one node palpable in left anterior chain; midline trachea: thyroid not
enlarged
Chest: Tanner 4; one supernumerary nipple present, 3 cm below right nipple; lung sounds normal; respiratory rate: 22
breath/min
1.Andrea was advised to use a new analgesic. She was also found to have iron-
deficiency anemia and was asked to revisit in 1 month. Based on this, which
would be the priority nursing diagnosis for Andrea?
A. Ineffective health maintenance related to abnormal endothelial tissue
B. Pain related to uterine cramping from menstruation
C. Fear related to possible pregnancy
D. Anxiety related to lack of knowledge about menses
Rationale:
Answer: A.Menorrhagia.
Menorrhagia is a heavy menstrual flow related
to endometriosis and myoma and is risk for
anemia (Page 1330)
4. Why is ibuprofen usually an effective drug to relieve menstrual
pain?
A. It shortens the length of menstrual periods.
B. It does not cause painful stomach irritation.
C. It reduces inflammation as well as reducing pain.
D. It is effective and is associated with a modest risk of developing
dependence
Rationale:
Answer: A.Gynecomastia.
Boys especially those who are obese may notice a
temporary increase in their breast size at puberty, termed
gynecomastia and is considered a normal change in
puberty. (Page 92)
12. To obtain a sexual history on Andrea, what is the best question
you should begin with?
A. Are you sexually active?
B. Are you worried you have AIDS?
C. Have you ever been pregnant?
D. How many boyfriends have you had?
Rationale:
Answer: A. A pear
orgasm occurs when stimulation proceeds through the plateau stage to a point
at which a vigorous contraction of muscle in the pelvic area expels or dissipates
blood and fluid from the are of congestion.(P.96)
18. Andrea states she hopes she’ll have early menopause. What will happen to
the ovarian function during menopause?
A. The time when a woman no longer has menstrual cycles and the production of
ova stops.
B. The time when only 1000 ova are believed to be left undeveloped
C. The point at which ovaries become fibrotic and scarred
D. The point when the fimbria becomes thinned and nonfunctional
Rationale:
Answer: A. The time when a woman no longer has menstrual cycles and the
production of ova stops.
Answer:BADC
B. Excitement
A. Plateau
D. Orgasm
C. Resolution
They described the sexual response as a cycle with four discrete
stages;excitement,plateau, orgasm and resolution. Whether stages are felt as
separate steps this way or blended into one smooth process of desire, arousal
and orgasm is individualized.