– Please reply to the following discussion with one reference. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates.
Discussion:
Kyla is a sixteen-year-old female who presents with severe pelvic pain. Initially, the interview should focus on the pain, whether the pain is continuous or not, and if anything causes the pain to worsen. I would also like to know the beginning of her pain, whether the problem was gradual or spontaneous. In addition, we should see the level of her stress and if she has taken any medication. She also presents with nausea; it is essential to know if she has vomited. Lastly, it is vital to understand whether she is sexually active and if she is using protection.
This clinical presentation corresponds to ovarian torsion because of the onset of acute pain in the lower abdomen accompanied by nausea and vomiting. The patient also presents with pelvic or abdominal tenderness and palpable adnexal mass.
The first diagnostic study should include a pelvic exam. During the pelvic exam, the healthcare professional performing it can feel the cyst in the lower abdomen.
The primary diagnosis is ovarian torsion, which refers to the twisting of the ovary around its stalk, and it’s associated with severe abdominal pain, nausea, and vomiting. The differential diagnoses include ectopic pregnancy, pelvic inflammatory disease, and ovarian cysts.
The best treatment plan for the patient will include urgent surgery to remove the ovary and prevent ovarian necrosis; with surgery, we reduce the chance of infection on the necrotic ovary. In some cases, the ovary is not damaged yet, and the ovary’s untwisting can be made. After surgery patient will be instructed to take antibiotics and pain medications. A follow-up visit will be necessary a week after surgery.
References
Diagnostic excellence 03: 16-year-old female with pelvic pain. (n.d.). South University College of Nursing and Public Health Graduate Online Nursing Program. https://southu-nur.meduapp.com/document_set_document_relations/30270
Leik, M. T. (2013). Family nurse practitioner certification intensive review: Fast facts and practice questions (2nd ed.). Springer Publishing Company.
Vallerand, A. H., & Sanoski, C. A. (2018). Davis’s drug guide for nurses.
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