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
Currant jelly stools (stools mixed with blood and mucus) and drawing the knees to the chest are classic signs and symptoms of intussusception in infants. The telescoping of one part of the intestine into another leads to bowel obstruction, inflammation, and bleeding, resulting in the characteristic stool appearance and abdominal pain that causes the infant to draw their knees up in an attempt to relieve the discomfort.
Choice B rationale
Ribbon-like stools and visible peristalsis are more characteristic of Hirschsprung's disease (congenital aganglionic megacolon), a condition where a segment of the colon lacks nerve cells, impairing motility and leading to constipation and a narrowed segment of the bowel. Visible peristalsis can occur due to the bowel trying to push stool through the narrowed segment.
Choice C rationale
Explosive watery diarrhea and fever are typical signs of gastroenteritis, an inflammation of the gastrointestinal tract usually caused by a viral or bacterial infection. While vomiting can occur in both conditions, the stool characteristics and the presence of fever are more indicative of gastroenteritis rather than intussusception.
Choice D rationale
Bright red blood in the stool without other symptoms is less specific to intussusception. While blood can be present, it is usually mixed with mucus, giving the currant jelly appearance. Bright red blood alone might suggest other conditions like anal fissures or lower gastrointestinal bleeding. .
Correct Answer is A
Explanation
Choice A rationale
Urinary tract infections can cause bladder irritation and dysfunction, leading to symptoms such as frequency, urgency, and nocturia, which can manifest as enuresis, especially secondary enuresis (bedwetting that starts after a period of dryness). Therefore, assessing for a UTI is a crucial first step to rule out a treatable medical cause. Normal urine specific gravity ranges from 1.005 to 1.030, and a urinalysis can detect the presence of bacteria, white blood cells, or nitrites indicative of infection.
Choice B rationale
Psychological stressors can contribute to enuresis, particularly secondary enuresis. Anxiety, family changes, or school-related stress can manifest physically. While important to explore, medical causes like UTIs should be ruled out first.
Choice C rationale
Sleep patterns are relevant in the context of enuresis, as bedwetting occurs during sleep. However, assessing for a medical cause like a UTI should precede a detailed evaluation of sleep habits.
Choice D rationale
A family history of enuresis can suggest a genetic predisposition. However, the immediate nursing priority is to assess for and rule out treatable underlying medical conditions, such as a urinary tract infection.
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