A client states, I'm sure that I am suffering from PMS. How can I ...

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A client states, I'm sure that I am suffering from PMS. How can I get my doctor to take this seriously? The nurse's best response is:
 
  a. You are probably right. You should remind your doctor of your symptoms every time you visit.
  b. Since you feel certain you are right, you should just treat yourself with over-the-counter medications.
  c. Men are not usually sympathetic to PMS sufferers.
  d. You should keep a daily record of the occurrence and severity of your symptoms for 3 months.

Question 2

Throughout the world the rate of ectopic pregnancy has increased dramatically over the past 20 years. This is believed to be due primarily to scarring of the fallopian tubes as a result of pelvic infection, inflammation, or surgery.
 
  The nurse who suspects that a client has early signs of ectopic pregnancy should be observing her for symptoms including which of the following? Select all that apply. a. Pelvic pain
  b. Abdominal pain
  c. Unanticipated heavy bleeding
  d. Vaginal spotting or light bleeding
  e. Missed period

[amandalm]

Answer to Question 1

D
Assessment of symptom charting from at least 3 months is necessary to make an accurate diagnosis of PMS.
This will not assist in making a diagnosis. Listing symptoms for 3 months will help the phy-sician better assess the diagnosis.
This is inappropriate.
This is inaccurate and will not help the client with the present problem.

Answer to Question 2

A, B, D, E
Correct: A, B, D, E. A missed period or spotting can easily be mistaken by the client as early signs of pregnancy. More subtle signs depend on exactly where the implantation occurs. The nurse must be thorough in her assessment because pain is not a normal symptom of early pregnancy.
Incorrect: C. As the fallopian tube tears open and the embryo is expelled, the client often exhibits severe pain accompanied by intraabdominal hemorrhage. This may progress to hy-povolemic shock with minimal or even no external bleeding. In about half of women, shoul-der and neck pain occurs due to irritation of the diaphragm from the hemorrhage.