QUESTION: "A 24-year-old client admitted to the hospital is suspected of having an ectopic pregnancy. On admission, which of the following would be most important to assess?"
CHOICES
( X ) a.) Sexual patterns.
( X ) b.) Use of a diaphragm.
( X ) c.) Type of oral contraceptives.
( O ) d.) Date of last menstrual period.
RATIONALE: Although it may be important to obtain information from a client with suspected ectopic pregnancy concerning when she last had intercourse, whether she is taking birth control pills, and whether she has been pregnant previously, it is most important to determine the date of her last menstrual period and if she has experienced amenorrhea. Such information helps establish an accurate diagnosis. Usually the client with an ectopic pregnancy often suspects or knows that she is pregnant, having missed one or two menstrual periods. However, if the client's menstrual cycle is irregular, she may be unaware that she is pregnant. Obtaining information about sexual practices would be important for the sexual history and helping to identify the frequency of sexual intercourse and possibility of pregnancy. However, this information is only helpful after obtaining the date of client's last menstrual period. Information about birth control methods, such as use of a diaphragm, is important once the date of the client's last menstrual period is determined. Information regarding the type of oral contraceptive used helps to provide additional information about the client once the date of her last menstrual period has been determined. Pregnancy also must be established. NURSING PROCESS STEP: Assessment CLIENT NEEDS CATEGORY: Physiological integrity CLIENT NEEDS SUBCATEGORY: Physiological adaptation
