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 C
Explanation
Choice A rationale
Impetigo is a bacterial skin infection characterized by honey-crusted sores, often around the nose and mouth. While it can cause itching, the linear arrangement of papules is not typical of impetigo.
Choice B rationale
Tinea capitis is a fungal infection of the scalp, causing scaly, itchy patches and potential hair loss. It does not typically present as linear papules on the skin.
Choice C rationale
Scabies is an infestation caused by the Sarcoptes scabiei mite, which burrows under the skin, laying eggs and causing intense itching, often worse at night. The characteristic lesions are small, erythematous papules that frequently appear in linear patterns due to the mite burrowing. Close contact in crowded environments like daycare facilitates transmission.
Choice D rationale
Cellulitis is a bacterial infection of the deeper layers of the skin and subcutaneous tissue, characterized by redness, warmth, swelling, and pain. It does not typically present as small, linear papules. .
Correct Answer is A
Explanation
Choice A rationale
For scabies treatment with topical permethrin in children, the medication should be applied from the neck down to the toes, ensuring all skin surfaces are covered because scabies mites can burrow anywhere on the body. The permethrin should be left on for the prescribed duration, typically 8-14 hours or overnight, to allow sufficient contact time to kill the mites and their eggs.
Choice B rationale
Applying permethrin only to affected areas may not be sufficient to eradicate scabies because mites can be present on areas of the skin that do not yet show visible signs of infestation or itching. Complete coverage is necessary to ensure treatment success.
Choice C rationale
Applying permethrin only to the scalp is inadequate for treating scabies, as the mites commonly infest other areas of the body. While scabies can affect the scalp, especially in infants and young children, treatment must extend to all skin surfaces from the neck down.
Choice D rationale
A hot bath should be avoided before applying permethrin. Hot water can irritate the skin and increase absorption of the medication, potentially leading to systemic toxicity or reduced effectiveness. Permethrin is typically applied to cool, dry skin.
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