Question

e. Nitrates and lllo LEARNING APPLICATION Critical Thinking 1. Ca lculate an expected date of confinement (EDC) using Nägele's rule. The patient's monthly period (LMP) was April 20, 2017 EDC: ay of 2. A pregnant woman, who has had no prenatal care, has not had a period for 6 months. She has calledl GYN clinic to schedule an appointment because she is experiencing vaginal bleeding. She contin fetal movement. a. What laboratory tests or procedures will the provider order? What might you say to the patient to reassure her during this stressful time? 3. Lower abdominal pain and back pain that increases just before and during menses may be caused byst condition? With your knowledge of this condition, what might the provider order for treatment of th condition and why?

Answer 1

1. Nageles rule - LMP( last menstrual periods ) + 9 months + 7days

LMP of this patient is 20 April ,2017

Applying nageles formula :

Adding 9months and 7days to LMP

Her EDC = 27, November ,2017

2. a) The laboratory test or procedures that will be ordered by the provider are :-

- fetal heart rate and sound assessment

- ultrasound

- amniocentesis

2.b) Don't take stress , sometimes it happens like this , it might be due to various reasons like abortion , poor development etc but it has to be confirmed first .

3. Lower abdominal pain and back pain in mensus because hormonelike substances (prostaglandins) are involved in pain and inflammation trigger the uterine muscle contractions. Higher levels of prostaglandins are associated with more-severe menstrual cramps. Low back pain during menstruation is typically muscular in nature and thought to be caused by hormone changes. Heavy contractions can lead to low back pain, as the pain can radiate from the lower abdomen into the low back. The medications prescribed by the provider for menstrual pain are :-

- ibuprofen

- acetaminophen

- NSAIDS etc

4. The primary reason for cervical punch biopsy and endocervical curettage.

1. Grossly abnormal cervix regardless of pap smear results.

2. Satisfactory abnormal colposcopic examination .

Post cervical punch biopsy instructions include :-