Discuss the questions that would be important to include when interviewing a patient with this issue. Describe the clinical findings that may be present in a patient with this issue. Are there any diagnostic studies that should be ordered on this patient? Why? List the primary diagnosis and three differential diagnoses for this patient. Explain your reasoning for each. Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups. This is a sample to the home work. please rewrite and include the missing questions. In-text citation and references within the past 5 years. Sample: Discuss the questions that would be important to include when interviewing a patient with this issue. • • • Onset, location, duration, characteristics, aggravating factors, reliving factors, timing and severity of the pain? • Has she had this pain before? • What are the events surrounding this pain? • Have you tried anything to make the pain better? • When was her last menstrual period? • Are her periods regular? • Does she have bleeding between cycles? • Are her periods painful? • How many days does she bleed? • Is her bleeding during periods heavy? • If so how many pads or tampons per day? • Does she have any vaginal discharge? • If yes what is the consistency of it? • Has she ever been pregnant? • If so what is her gravida/para? • Any possibility that she is pregnant? • Sexually active? With how many partners? • Is sex painful? • Does she use birth control? • Do you have breast tenderness? • When was her last pap smear and were the results abnormal? • Has she ever been diagnosed with any STD’s or pelvic inflammatory disease? • Any fever, nausea or vomiting? (Pinnaduwage, Honeyford, Lackie, & Tunde-Byass, 2018) Describe the clinical findings that may be present in a patient with this issue. • • • Sharp pain • This pain may be intermittent and may vary in intensity from person to person. • The pain may present in a many places i.e. pelvis, abdomen, shoulder or neck. • Vaginal bleeding • Gastrointestinal symptoms such as nausea, vomiting. • Weakness, dizziness or syncope Are there any diagnostic studies that should be ordered on this patient? Why? • Pregnancy test. A blood sample will be taken to test for the hormone human chorionic gonadotropin (hCG). This hormone rises during pregnancy. • Transvaginal ultrasound. This will determine if there is a sac, fetal pole and a heartbeat. There are several symptoms of pregnancy that can be alarming to women. Bleeding can occur when implantation occurs. Pain can also be normal, this may occur when a corpus luteum cyst that can form in the ovary after ovulation. List the primary diagnosis and three differential diagnoses for this patient. Explain your reasoning for each. • Primary Diagnosis: • Ectopic Pregnancy. The patient has several signs and symptoms of ectopic pregnancy. Frank red blood located in the vagina, pain that is located on one side. Additionally, the blood test and transvaginal ultrasound confirm this diagnosis. • Differential Diagnosis: • Pelvic inflammatory disease, this will cause pain in the pelvis, lower back and or vagina. • Endometriosis, this occurs when tissue that is located in the endometrium is growing outside of it, this causes severe pain. • Ovarian cysts, these are fluid filled sacs that attach to the ovaries and tend to get larger with each ovulation. They are very painful and continue to grow until the rupture and the pain is relieved.