Julia Crenshaw is 18 years old. She began menstruating shortly after turning 13 and has had fairly regular 28-to-30-day cycles since her 14th birthday. Although she has had sports physicals for school, she has declined to have regular pelvic examinations or screenings, explaining that she has not been sexually active and intends to wait until marriage. However, today during a precollege physical, she complains that her periods have become heavier in the past year and that she has increasing discomfort. This discomfort includes slight weight gain, headaches, fatigue, and mood swings. For the first 2 days of her period, she has painful cramps and takes ibuprofen, which offers some relief
Objective Data
Julia is 5'5" weight is 54.5 kg (BMI 19.9). P. 62, BP, 117/64, RR 16, Hgb=11.6, Hct=34. She is up to date on all vaccine except the papillomavirus vaccine, Gardasil, which she has declined.
Questions:
1. What should be reviewed in Julia's past history?
2. Which current findings should be addressed by the nurse?
3. What health information should the nurse offer in regards to Julia's complaints? (Are her periods and symptoms "normal," or what is important for Julia to understand?)