The patient we assessed and for whom developed a care plan was a female aged 40 years old. Patient is a
dialysis patient however her current chief complaint was acute pain on her lower abdomen. She said that she
had had this problem for some years. On questioning her, she revealed to me that she had been using oral
contraceptive pills since she was 25 years old, but she stopped using them a few years ago. She also revealed
that she lost some weight when she stopped using the pills and she somehow feels good about it. Her major
concern was the excruciating pain that she has been enduring some days before and during her menses.
Previously, she has used acetaminophen and ibuprofen to manage her pain. Other symptoms that she
indicated included diarrhea, nausea, bloating and increased gases in her stomach during her menstruation. We
decided to do a full body examination. We did not find anything abnormal with her based on the findings.
From the palpation of the lower abdominal region, we never observed any tenderness. Neither were there any
palpated masses when we did a bimanual palpation. We suggested that she takes a test for STIs but she
objected the suggestion citing that she had taken one a month ago. Her primary diagnosis revealed
dysmenorrhea and the differential diagnosis included adenomyosis, endometriosis, adhesions, and uterine
fibroids (Casanova, 2018). In order to rule out possibilities of secondary causes of dysmenorrhea, a
transvaginal ultrasound was recommended for this patient and a follow up visit to the gynecologist. We also
educated her that a combination of oral contraceptives would be useful in managing symptoms of
dysmenorrhea, and this is why she started experiencing pain when she stopped using the pills (DeCherney,
2019). We advised her to take regular exercises and avoid anything that might stress her. Ensuring adequate
hydration and high intake of fibers could also help in the symptomatic management of her condition.
Additionally, a combination of TENS and tropical heat therapies could also be effective in managing this
condition (Conti, 2020). The patient had a choice to make between taking pharmacological or nonpharmacological therapies for her condition and she was advised to call back in case she changed her mind.
The clinical experience I acquired from this week was instrumental in making me have more confident as a
future nurse practitioner. I learned important aspects of developing independent care plans. I also acquired
useful experiences that will help me to establish alternative and complementary therapies could be
administered for patients suffering from acute dysmenorrhea. Besides the pharmacological interventions, I also
learned other non-pharmacological therapies that can be given to patients who are diagnosed with
dysmenorrhea.
References
Casanova, R. (2018). Beckmann and Ling’s obstetrics and gynecology (8th ed.). New York, NY: LWW.
Conti, J., Ruiz, D., & Cho, M. (2020). The vagina book: An owner’s manual for taking care of your down there
9/5/2020 Order 325306928
https://admin.writerbay.com/orders_available?subcom=detailed&id=325306928 3/3
(1st ed.). London, UK: Chronicle Books.
DeCherney, A., Roman, A., Nathan, L., & Laufer, N. (2019). Current diagnosis & treatment obstetrics &
gynecology (12th ed.). New York, NY: McGraw-Hill Education / Medical.
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