A 35-year-old woman has tried for 6 months to become pregnant for the first time
The nurse obtains this reproductive history: onset of menses at 13 years of age; length of monthly cycle, 20 to 24 days; 5 days of heavy bleeding often accompanied by lower backache during her monthly period, with intermittent spotting between periods. She also states that intercourse is sometimes painful. The nurse should suspect that the client has which of these conditions? a. cervical cancer
b. endometriosis of undetermined extent
c. extensive endometriosis
d. pelvic inflammatory disease
B
Endometriosis, the growth of endometrial tissue within the pelvic cavity outside the uterus, occurs most frequently in women over 30, particularly working women who have not had children. The endometrial tissue implanted on other pelvic structures responds to monthly hormonal changes, as does tissue within the uterus, and bleeding at these sites results in formation of adhesions and scar tissue; this process can result in infertility. Manifestations vary depending on the extent of implanted tissue and include lower backache, painful intercourse, pelvic heaviness, and spotting; the extent of the endometriosis may or may not correlate with the severity of the symptoms.
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