Reference no: EM133800547

Case: Kelly is a 19-year-old female who comes to your clinic complaining of severe menstrual pain that is usually worse just prior to and during the first two days of her menses. The pain is sometimes so severe that she has fainted. She states that defecation can cause severe pain and she therefore frequently becomes constipated. She often must miss work when experiencing the severe pain. Her periods are heavy and last seven days with a tapering of the bleeding from days 3 to 7. Her BMI is 23.9 and her VS are all WNL. She is G0 P0. Place Your Order Now!

Subjective
CC: severe dysmenorrhea, heavy periods, painful defecation, symptoms interfere with life style 
HPI: 19 y/o F, G0P0 presents to clinic today with complains of menstrual pain and heavy menstrual bleeding. Patient states that pain is usually worse just prior to and during the first two days of her menses. Patient describes pain as severe, causing patient to faint and often causing her to miss work. Patient reports periods lasting seven days with a tapering of the bleeding from days 3 to 7.  Patient also mentions that defecation can cause severe pain and she therefore frequently becomes constipated. 
What other relevant questions should you ask regarding the HPI?
When did you start experiencing pain? Was onset sudden or gradual?
Where does pain occur? Is it localized or diffused? Lower abdomen, lower back, inner thighs? 
What does the pain feel like? Is it sharp, dull, burning, aching, cramping etc.,? 
Is there anything which makes this pain better or worse (compress, hot shower, physical exercise)? 
Does this pain in your breast radiate anywhere in your body?  
Would you say that your pain is getting progressively worse over time? 
Do you experience pain between menstrual periods?
How severe is the pain on the scale from 0 to 10? 
Did you attempt to take any medications  to help relieve pain? Was it successful? 
Did you always heavy periods from onset of menses? 
Do you have an bleeding between periods? 
Are you sexually active? Is your intercourse painful? 
How frequent are your BM?
Did you notice any blood in your stool? 
When did you start experiencing painful defecation and constipation?