A 20-year-old G1P0A0 female presents to your clinic complaining of crampy lower abdominal pain and spotting. She states her last period was 5 weeks ago, she took a home pregnancy test yesterday and it was positive. She states she tried to make an OB appointment but they could not get her in for several weeks. What questions would you ask this patient? Describe how you would assess and treat this patient using evidence-based practice.
1. what questions would you ask this patient
2. Her Dx. will be Treated for abortion
3. Describe how you would assess and treat this patient using evidence-based practice?
What questions would you ask this patient?
The patient presented with crampy lower abdominal pain, spotting and reported a positive home pregnancy test. A history taking and physical examination would be an essential initial step. During history taking, the patient will be asked the standard questions for all women with gynecologic concerns. These are questions on gynecologic and obstetric history. Such questions include the date of the last menstrual period, the frequency of menstrual periods, the current amount of vaginal bleeding, contraception use and choice, whether the patient is sexually active and the number of sex partners. It would also be essential to ask the patient whether she experiences any pain during sexual intercourse or has a history of the sexually transmitted disease. Other essential questions are whether there were previous pregnancies, the previous delivery method and previous gynecologic procedures.
A pelvic exam will be performed to assess for external disease symptoms such as areas of pain, tenderness, or a mass in the pelvic area that could be causing the lower abdominal pain and bleeding (Mouri, Hall & Rupp, 2021). In addition, a human chorionic gonadotropin blood test will be ordered to confirm the pregnancy. A transvaginal ultrasound will be ordered to determine the whether the pregnancy in intra- or extrauterine. An ectopic pregnancy is a common cause of vaginal bleeding in the first trimester. Blood tests, including a Rhesus test and complete blood count will also be performed to check for negative Rhesus, abnormal hormone levels and anemia. Low progesterone and negative rhesus are common causes of bleeding during pregnancy and a threatened miscarriage (Hendriks, MacNaughton & MacKenzie, 2019).
The patient was diagnosed with threatened abortion. An Analgesia will be prescribed to help relieve discomfort from cramping. Use of NSAIDs during pregnancy should be avoided as it can increase the risk of miscarriage. A progesterone injection will be administered to increase levels of the hormone and an Rh immunoglobulin since the patient has Rh-negative blood (Xu et al., 2017). This stops the body from creating antibodies against the child’s blood. To further reduce chances of miscarriage, the patient was given bed rest and advised to avoid sexual intercourse until the symptoms disappears (Zhou et al., 2019). The patient was given strict return precautions concerning abdominal pain, excessive vaginal bleeding or fever.