Which assessment findings might raise the nurse's suspicion of endometriosis in the client they are evaluating?

The correct answer is Choice A, Choice D, Choice E.

Choice A rationale

Pain during intercourse, also known as dyspareunia, is a common symptom of endometriosis. Endometrial tissue growing outside the uterus can infiltrate the pelvic organs and ligaments, causing pain and discomfort during sexual activity due to pressure and inflammation in these areas.

Choice B rationale

Painless heavy menstrual bleeding is not typically associated with endometriosis. Endometriosis is characterized by the presence of endometrial-like tissue outside the uterus, which responds to hormonal fluctuations of the menstrual cycle, often leading to painful periods (dysmenorrhea) and potentially heavy bleeding accompanied by pain.

Choice C rationale

Unexplained weight gain is not a typical symptom directly linked to endometriosis. While hormonal imbalances can occur with endometriosis, they do not usually manifest as unexplained weight gain. Other factors are more likely to contribute to weight changes.

Choice D rationale

Infertility is a significant concern for many individuals with endometriosis. The presence of endometrial implants, adhesions, and scarring in the pelvic cavity can distort the anatomy of the reproductive organs, interfering with ovulation, fertilization, and implantation of a fertilized egg.

Choice E rationale

Pain during the menstrual period, known as dysmenorrhea, is a hallmark symptom of endometriosis. The ectopic endometrial tissue undergoes cyclical bleeding and shedding, similar to the uterine lining, but this occurs outside the uterus, causing inflammation, pain, and potentially the formation of scar tissue and adhesions.

Choice A rationale

While support from family is beneficial, advising the client to solely rely on family for stress reduction and baby care without further assessment may delay the identification and treatment of a potential postpartum mood disorder. It's crucial to first understand the underlying cause of her feelings.

Choice B rationale

Encouraging rest is a general recommendation for postpartum recovery and fatigue. However, the client's report of anxiety, irritability, and feelings of inadequacy suggests more than just typical postpartum fatigue and warrants a more focused assessment for a mood disorder.

Choice C rationale

The client's symptoms of anxiety, irritability, inability to sleep despite fatigue, and feelings of inadequacy are indicative of a potential postpartum mood disorder, such as postpartum depression or anxiety. A thorough assessment using standardized screening tools and further questioning about the onset, duration, and severity of these symptoms is the most appropriate initial action to determine the need for further intervention and support.

Choice D rationale

While some emotional fluctuations are common in the immediate postpartum period ("baby blues"), the combination and intensity of the client's reported symptoms, particularly the feelings of inadequacy and persistent sleep disturbance despite fatigue, suggest a need for further evaluation rather than simply reassurance that these feelings are normal and transient. .