A 12-year-old girl presents to the pediatric clinic with complaints of severe lower abdominal pain during her menstrual periods, which started six months ago.
She describes the pain as cramping and rates it as 8 out of 10 on the pain scale.
Her mother reports that over-the-counter pain medications have provided little relief.
What would be the recommended first-line treatment for her and what is the medical term for this condition?
Start oral contraceptive pills to regulate her menstrual cycle and reduce pain.
Suggest increasing the intake of dairy products to improve calcium levels and reduce pain.
Prescribe non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to relieve pain.
Recommend a heating pad to be used on the abdomen during painful periods.
The Correct Answer is C
Choice A rationale
Oral contraceptive pills primarily work by suppressing ovulation and thinning the uterine lining, leading to lighter and less painful periods. While effective for dysmenorrhea, they are not typically the first-line treatment for a 12-year-old experiencing recent onset, as other less hormonally impactful options are usually tried first.
Choice B rationale
Increasing dairy intake primarily impacts bone health due to its calcium content. While calcium plays a role in muscle function, there is no strong scientific evidence directly linking increased dairy consumption to the reduction of menstrual pain caused by prostaglandins and uterine contractions in dysmenorrhea.
Choice C rationale
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen inhibit the production of prostaglandins, which are key mediators of inflammation and pain. During menstruation, the uterus releases prostaglandins, causing contractions and pain. By blocking prostaglandin synthesis, NSAIDs effectively reduce the intensity of menstrual cramps. The medical term for severe pain during menstruation is dysmenorrhea.
Choice D rationale
Applying a heating pad to the abdomen provides localized warmth, which can help to relax the smooth muscles of the uterus and increase blood flow. This can offer symptomatic relief from menstrual cramps by reducing muscle spasms and alleviating discomfort, but it does not address the underlying physiological cause of dysmenorrhea.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition characterized by pruritus (itching), erythema (redness), and scaling. Topical corticosteroids are the first-line treatment due to their potent anti-inflammatory and immunosuppressive properties, which help to reduce the inflammatory response in the skin and alleviate itching.
Choice B rationale
Psoriasis is a chronic autoimmune skin disorder characterized by thickened, scaly plaques. Topical calcineurin inhibitors are used to treat psoriasis by suppressing the activity of T-cells, which are involved in the inflammatory process. The presentation of an itchy rash as the primary finding is less consistent with typical psoriasis.
Choice C rationale
Contact dermatitis is an inflammatory skin reaction resulting from direct contact with an irritant or allergen, often presenting with redness, swelling, and vesicles in addition to itching. While topical antihistamines can help with itching associated with allergic reactions, topical corticosteroids are generally more effective for managing the inflammation in contact dermatitis.
Choice D rationale
Tinea corporis, or ringworm, is a fungal infection of the skin characterized by circular, raised, scaly patches with central clearing. Topical antifungals are the appropriate treatment for tinea infections as they inhibit the growth and reproduction of the dermatophyte fungi causing the infection.
Correct Answer is C
Explanation
Choice A rationale
Irritability after feedings can be a common symptom of GER due to stomach acid refluxing into the esophagus and causing discomfort. While it should be reported, it is not necessarily an immediate sign of a serious complication.
Choice B rationale
A slight decrease in appetite can occur with GER due to discomfort or a learned aversion to feeding. While it warrants monitoring, it is not typically an immediate red flag for severe complications.
Choice C rationale
Coughing or wheezing during sleep can indicate aspiration of gastric contents into the airway due to severe GER. Aspiration can lead to respiratory complications such as pneumonia, making this a serious sign that requires immediate medical attention.
Choice D rationale
Occasional spitting up after feedings is a common manifestation of GER in infants and is often physiological. While frequent or forceful spitting up should be monitored, occasional spitting up in a 9-month-old with known GER is not necessarily a sign of a serious complication requiring immediate reporting.
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