What type of adnexal disorder is causing her pain?
A 34-year-old married daycare worker comes to your office, complaining of severe pelvic pain for the last 6 hours. She states that the pain was at first cramp-like but is now sharp. Nothing makes the pain better or worse. She has had no vaginal bleeding or discharge. She has had no pain with urination. She has had some nausea for the last few days but denies vomiting, constipation, or diarrhea. She states she feels so bad that when she stands up she has fainted. Her past medical history consists of two prior cesarean sections and an appendectomy. She is married and has two children. She denies any tobacco, alcohol, or drug use. Her parents are both healthy. On examination you find a pale young woman who is obviously in a great deal of pain. She is lying on her right side with her eyes closed. Her blood pressure is 90/60 and her pulse is 110. She is afebrile. She has bowel sounds and her abdomen is soft. The speculum examination reveals a bluish cervix but no blood or purulent discharge at the os. There is a mild amount of tenderness with palpation of the cervix. The uterus is nongravid but the right adnexal area is swollen and very tender. Urine analysis is normal and the urine pregnancy test is pending.
A) Ovarian cysts
B) Tubal pregnancy
C) Pelvic inflammatory disease
B) Tubal pregnancy
Tubal pregnancies start to cause pain as the fetus grows too large to be contained in the tube. Eventually the tube begins to rupture and bleeding ensues, leading to hypotension, tachycardia, and syncope. On visualization of the cervix, the purple to bluish color of pregnancy may be seen.
You might also like to view...
The nurse is caring for a 4-year-old boy who has undergone an appendectomy. The child is unwilling to use the incentive spirometer. Which of the following approaches would most likely elicit the child's cooperation?
A) "Can you cough for me please?" B) "You must blow in this or you might get pneumonia." C) "If you don't try, I will have to get the doctor." D) "Can you blow this cotton ball across the tray?"
Package inserts are provided by the FDA
Indicate whether the statement is true or false
The nurse is instructing a new mother on the technique for bottle-feeding her newborn. What should the nurse include when teaching the mother? (Select all that apply.)
A) Sit upright while feeding the baby B) Gently shake the bottle before feeding C) Observe the baby's color while feeding D) Prop the baby up on a pillow for feeding E) Feed 4 oz of formula and then burp the baby
Which laboratory value would the nurse review to validate a diagnosis of a myocardial infarction (MI) that was suspected of occurring approximately 3 hours earlier?
1. CK 2. Troponin T assay 3. Myoglobin 4. PTT