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iHuman Case Study – Pamela Flowers

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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 intervi... ewing 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]

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