A client who has come to the clinic is diagnosed with endometriosis. What would the nurse expect the primary care provider to prescribe as a first-line treatment?

Choice A: A 26-year-old client who has migraine headaches at the start of each menstrual cycle does not have a contraindication for receiving oral contraceptives. Oral contraceptives are pills that contain synthetic hormones (estrogen and progestin) that prevent ovulation and pregnancy. They can also help regulate menstrual cycles and reduce menstrual pain and bleeding. Some women with migraine headaches may benefit from oral contraceptives, especially if their migraines are related to hormonal fluctuations or menstruation. However, oral contraceptives may worsen migraines in some women, especially if they have aura (visual or sensory disturbances) or other risk factors for stroke. Therefore, oral contraceptives should be used with caution and under medical supervision in women with migraine headaches.

Choice B: A 28-year-old client who has a history of pelvic inflammatory disease does not have a contraindication for receiving oral contraceptives. Pelvic inflammatory disease (PID) is an infection of the female reproductive organs (uterus, fallopian tubes, ovaries) that can cause pain, fever, discharge, or infertility. It can be caused by various bacteria, often sexually transmitted ones such as gonorrhea or chlamydia. Oral contraceptives do not protect against STIs or PID, but they may reduce the risk of PID by thickening the cervical mucus and preventing bacteria from entering the uterus. Therefore, oral contraceptives can be used safely in women with a history of PID, but they should also use condoms or other barrier methods to prevent STIs.

Choice C: A 32-year-old client who has benign breast disease does not have a contraindication for receiving oral contraceptives. Benign breast disease (BBD) is a term that refers to various noncancerous conditions that affect the breast tissue, such as cysts, fibroadenomas, or mastitis. They can cause symptoms such as lumps, pain, or tenderness in the breasts. Oral contraceptives do not cause or increase the risk of BBD, but they may improve some symptoms of BBD by stabilizing the hormonal levels and reducing breast tissue sensitivity. Therefore, oral contraceptives can be used safely in women with BBD, but they should also have regular breast exams and mammograms to monitor their breast health.

Choice D: A 38-year-old client who reports smoking one pack of cigarettes every day has a contraindication for receiving oral contraceptives. Smoking is a habit that involves inhaling the smoke of tobacco or other substances that can cause various health problems, such as lung cancer, heart disease, or stroke. Oral contraceptives can increase the risk of these problems, especially in women who are older than 35 years or smoke more than 15 cigarettes per day. Smoking and oral contraceptives can interact and cause blood clots, high blood pressure, or reduced blood flow to the organs. Therefore, oral contraceptives should be avoided or discontinued in women who smoke, and alternative methods of contraception should be used.

Choice A: Upper back pain is not the correct answer because it is not a common finding associated with uterine fibroids. Upper back pain is a feeling of discomfort or ache in the upper part of the back, between the shoulder blades, or below the neck. It can be caused by various factors such as muscle strain, poor posture, or spinal problems. It is not related to the presence or growth of benign tumors in the uterus.

Choice B: Chronic pelvic pain is the correct answer because it is a common finding associated with uterine fibroids. Chronic pelvic pain is a feeling of discomfort or ache in the lower abdomen or pelvis that lasts for more than six months. It can be caused by various factors such as endometriosis, ovarian cysts, or infection. It is also related to the presence or growth of benign tumors in the uterus, which can press on nerves, blood vessels, or organs and cause inflammation, bleeding, or scarring.

Choice C: Amenorrhea is not the correct answer because it is not a common finding associated with uterine fibroids. Amenorrhea is a condition that causes the absence of menstrual periods for more than three months in a woman who is not pregnant, breastfeeding, or menopausal. It can be caused by various factors such as hormonal imbalance, stress, or weight loss. It is not related to the presence or growth of benign tumors in the uterus, which can cause heavy or irregular menstrual bleeding instead.

Choice D: Diarrhea is not the correct answer because it is not a common finding associated with uterine fibroids. Diarrhea is a condition that causes loose, watery, or frequent stools. It can be caused by various factors such as infection, medication, or food intolerance. It is not related to the presence or growth of benign tumors in the uterus, which can cause constipation or bloating instead.