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1) Patient L. came to the women’s clinic with
complaints of no menstruation for 3 months.
The woman is also worried about nausea, aversion to eating meat, and
vomiting once in the morning.
Age 25, married, no pregnancies. Menses from 13 years, regular, after 28 days,
4-5 days. When collecting the anamnesis,
it was found out that the patient has the right physique and satisfactory
nutrition. Height 155 cm, body weight 52
kg. The skin and visible mucous
membranes are pale pink, clean. Pelvic
dimensions 26-28- 31-21 cm. Wrist circumference – 15 cm. Blood pressure (BP)
115/66 mm Hg. Art. Pulse 72 beats. / min.
No pathology was detected on the part of the internal organs.

In bimanual examination: the external
genitalia are properly developed, there is cyanosis of the mucous membrane of
the cervix and vagina, the vagina is narrow, the bottom of the uterus is
palpated over the pubic symphysis, soft consistency, on palpation comes into
tone. There is a softening of the
isthmus. Applications are not palpable. Mucus secretion. In the general analysis of blood: hemoglobin
(Hb) – 110 g / l, leukocytes – 9x 109 / l, erythrocyte sedimentation rate (ESR)
– 29 mm / h. In the analysis of urine:
relative density – 1015, protein – 0.003 g / l, leukocytes 0 – 2 in the field
of view, erythrocytes 1 – 2 in the field of view.
A) Solve the clinical case

2) Patient V., 36 years old, went to the gynecological
ward on the 3rd day of the disease with complaints of acute pulsating pain in the left sexual area lips, fever up to 38 s, deterioration of general health, general
weakness and malaise. Pain is exacerbated by exercise and walking, irradiated
in the left leg and perineum. Suffers from diabetes. 2 years therefore, she was
treated in connection with the vaginal abscess. At the patient’s condition is
satisfactory, body temperature is 37.9 C, pulse 92 beats/min, rhythmic. BP
130/70 mm Hg. Art. In blood tests: hemoglobin – 124 g/l, leukocytes – 9.6 g /
l, ESR – 42 mm / h. Gynecological examination: left large labia swollen and
hyperemic, in the area of ​​​​the large gland of the vaginal pile is palpated 6×4
cm in size, sharply painful, quality consistency, in places – fluctuating;
skin over it purple, hyperemic.
a) Solve the clinical case.

3) Patient M., 25 years old, complains of abdominal pain,
menstrual delay 2 weeks, slight bleeding from the genital tract. In history 2
artificial abortions, chronic two-sided adnexitis. At an out Study: Pulse 80
beats/min, blood pressure 100/70 mm Hg. Art. Belly painful in the lower
departments, Schyotkin’s symptom is poorly positive. When examined in the
mirrors: the cervix is ​​clean, the secretion is slightly bloody. In bimanual
examination: the body of the uterus of normal size, movements the neck is
sharply painful to the right of the uterus palpable painful tumor The formation
with fuzzy contours, the posterior vault hangs, painful.
a) Solve the clinical case

 

 

 

 

 

 

 

 

 

 

 

 

 

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NURSING
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