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
Washing bedding and recently worn clothing in hot water (above 54°C or 130°F) helps to kill lice and their nits (eggs) that may be present on these items, preventing re-infestation or spread to others. The heat denatures the proteins essential for the lice's survival.
Choice B rationale
Sealing non-washable items in a plastic bag for 2 weeks suffocates any lice and allows any hatched nymphs to die due to lack of a blood meal. Lice cannot survive for extended periods away from a human host.
Choice C rationale
Both washing bedding and clothing in hot water and sealing non-washable items are crucial steps in eliminating head lice and preventing recurrence or transmission. Therefore, all of the above instructions should be provided to parents.
Choice D rationale
Notifying the school allows for screening of other children and implementation of appropriate measures to prevent further spread of the head lice within the school environment. While important for public health, it is an action separate from the direct treatment and environmental control measures that parents should undertake at home.
Correct Answer is C
Explanation
Choice A rationale
Isotretinoin absorption is enhanced with high-fat meals because it is a lipophilic drug. While this is important for maximizing the medication's effectiveness, it is not the priority nursing action related to the significant risks associated with the drug.
Choice B rationale
Isotretinoin can cause increased photosensitivity, making the skin more susceptible to sunburn. Monitoring for and educating the child and family about sun protection measures, such as sunscreen and protective clothing, is crucial to prevent skin damage.
Choice C rationale
Isotretinoin is a known teratogen, meaning it can cause severe birth defects if taken during pregnancy. Therefore, ensuring that female patients of childbearing potential are using two effective forms of contraception and have a negative pregnancy test before starting treatment is a paramount safety concern and a priority nursing action.
Choice D rationale
There is no specific contraindication or recommendation regarding increased dairy intake for children receiving isotretinoin. Dairy intake does not directly address the major risks associated with the medication.
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