Question

A nurse at a provider's office is caring for a client who is 28 years of age.

Drag 1 condition and 1 client finding to fill in each blank in the following sentence.

History and Physical
Day 1 at 1000:
Gravida 3, Para 2, Abortion 1
Asthma (managed with levalbuterol inhaler as needed)
Pelvic inflammatory disease (PID)
Spontaneous vaginal delivery X 2 (hypertension with first pregnancy at 20 years of age)
Voluntary termination of pregnancy (3rd pregnancy)

Nurses' Notes
Day 1 at 1000:
Client presents to the office with concerns of late menses, abdominal pain, and scant dark red vaginal spotting. Client reports menstrual period is usually regular and is 2 weeks late. Last menstrual period: 2/20/XX. Client reports occasional dull abdominal pain and rates it as 2 on a 0 to 10 pain scale. Client is alert and oriented, appears anxious. Speech clear. Skin warm and dry to touch. Heart rate regular at 90/min. Respirations even and non-labored. Lungs slight inspiratory wheezes. Bowel sounds hyperactive in all four quadrants. Abdomen tender to touch right lower quadrant. Perineal pad with scant amount of dark red vaginal spotting.

Vital Signs
Day 1 at 1000:
Temperature 37.2° C (98.9° F), Heart rate 90/min, Respirations 16/min, Blood pressure 120/74 mm Hg, Oxygen saturation 97% room air

Diagnostic Results
Day 1 at 1015:
Urine human chorionic gonadotropin (HCG) positive (negative)

After reviewing the client's current assessment findings, the nurse should identify that the client is experiencing
A. Acute asthma attack
B. Pyelonephritis
C. Placenta previa
D. Ectopic pregnancy
E. Abruptio placentae

As evidenced by
A. A history of regular period
B. Respiratory rate
C. Hyperactive bowel sounds
D. Temperature
E. Right lower quadrant abdominal tenderness

Answer 1

The nurse should conclude that the client presents with an ectopic pregnancy, evidenced by the positive HCG, lower abdominal pain, and right lower quadrant tenderness, alongside a history of PID, which is a risk factor for this condition. The answer is option D and E respectively.

Step-by-step explanation:

After reviewing the client's current assessment findings, the nurse should identify that the client is experiencing E. Ectopic pregnancy. This condition is indicated by a positive urine human chorionic gonadotropin (HCG) test along with abdominal pain and vaginal spotting. The findings related to an ectopic pregnancy are particularly pointed out by E. Right lower quadrant abdominal tenderness in conjunction with the missed period and vaginal spotting described in the client's symptoms.

An ectopic pregnancy occurs when a fertilized egg implants outside the uterine cavity, often in a fallopian tube, which can cause lower abdominal pain and spotting. It is a medical emergency requiring prompt attention. Other clues that support this diagnosis over the other options include the client's history of PID, which can increase the risk of ectopic pregnancy due to potential scarring and damage to the reproductive organs.

Hence, The answer is option D and E respectively.