NURS 6551: Primary Care of Women Essay Assignment Paper
NURS 6551: Primary Care of Women Essay Assignment Paper Help
NURS 6551 Entire Course Weekly Discussions And Assignments Walden University
NURS 6551 Week 1: Women’s Health and Health Promotion
Given Women’s roles in our society as child-bearers, caregivers for the family, the increasing number of female head of households worldwide, and unfortunately, our disproportionate numbers of women who are living in poor economic status, I feel that it’s especially important that we focus attention on the unique health needs of women to help them be the healthiest they can be.
—Rebecca Lee, Clinical Nurse Specialist
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Advanced practice nurses who provide care for women must consider the vast array of factors that might impact a woman’s life. Contemporary women fulfill multiple roles in family units, which can be challenging and often leave them with little time for their own care. In your role as an advanced practice nurse, being aware of issues that impact women’s health will help you better understand and address the unique needs of this patient population.
This week you examine the impact of political, social, and sociocultural factors on women’s health issues. You also explore nursing theories and feminist perspectives in relation to clinical practice.
Learning Objectives: Get NURS 6551: Primary Care of Women Essay Assignment Help
By the end of this week, students will:
- Evaluate the impact of political, social, and sociocultural factors on women’s health issues
- Understand and apply key terms, principles, and concepts related to the health promotion of women
- Analyze nursing theories and feminist perspectives in relation to clinical practice
Discussion: Political, Social, and Sociocultural Influences on Women’s Health
As an advanced practice nurse, you must remain current on health issues that commonly impact women such as birth control, abortion, family planning, the human papillomavirus (HPV) vaccine, and human immunodeficiency virus (HIV). Many of these women’s health issues are heavily influenced by political, social, and sociocultural factors. These influences might not only affect a woman’s ability or desire to receive care, but also a provider’s ability or willingness to offer care. How might political, social, and sociocultural factors influence your personal perceptions of these women’s health issues?
To prepare:
- Review this week’s media presentation, as well as Chapter 1 of the Schuiling and Likis text.
- Select and research one of the following women’s health issues: birth control, abortion, family planning, human papillomavirus (HPV) vaccine, human immunodeficiency virus (HIV) in women, or another issue approved by the course Instructor.
- Consider the impact of political, social, and sociocultural factors on the women’s health issue you selected.
- Reflect on how the personal perceptions of providers might influence their ability or willingness to care for women in relation to this issue.
By Day 3
Post an explanation of the women’s health issue you selected, including the impact of political, social, and sociocultural factors on this issue. Explain how personal perceptions of providers might influence their ability or willingness to care for women in relation to this issue.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days who selected different issues than you did. Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or contrasting perspectives
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NURS 6551 Week 2: Common Screenings for Women
Many screening procedures are often recommended and routinely used with women to detect diseases in the earliest stages possible. Consider Cindy, who was 28 years old when she received the results of her annual pap smear. The results of the test were abnormal, leading to a diagnosis of human papillomavirus (HPV). While Cindy’s type of HPV did not require treatment, subsequent annual pap smears were highly recommended due to risks associated with the disease. Five years later, after another round of abnormal screening results, Cindy was diagnosed with aggressive cervical cancer, which was then successfully treated (Tamika & Friends, Inc., 2011). For diseases like cervical cancer, screenings and early detection can save patients’ lives, as it did in Cindy’s case. As an advanced practice nurse caring for women, you must be able to provide recommendations for screening tests, interpret test results, and develop care plans that meet the unique needs of patients.
This week you explore guidelines for common screenings for women, including their strengths and limitations and their role in clinical decision making. You also examine patient histories, diagnoses, and treatment and management plans as you begin working on your Comprehensive Patient Assessment, which focuses on the care of one patient from your Practicum Experience.
Learning Objectives
By the end of this week, students will:
- Evaluate strengths and limitations of guidelines for screening procedures
- Analyze the influence of guidelines on clinical decision making
- Analyze the impact of advanced practice nurses on issues related to screening guidelines
- Evaluate diagnoses for patients
- Evaluate treatment and management plans
- Understand and apply key terms, principles, and concepts related to clinical guidelines on screening procedures
- Analyze differences between common screenings for younger women and common screenings for older women
Discussion: Guidelines on Screening Procedures
The goal of health promotion and education is to help prevent disease in patients. However, this is not always successful, and disease it not always preventable. With disease, early detection is ideal, often making screening procedures a routine part of clinical care. Unfortunately, many patients do not utilize these health services. This can be attributed to lack of awareness or access to care, financial concerns, or even levels of comfort with health care providers. In your role as the advanced practice nurse, you must be aware of potential obstacles for patients and implement strategies to ensure patients receive necessary screenings. Although a variety of screening procedures are recommended for women at various stages of life, not all screenings are appropriate for all patients. Understanding the strengths and limitations of each screening, as well as current guidelines for use is essential to effectively facilitate patient care. For this Discussion, the course Instructor will assign a specific topic for you to research.
To prepare: NURS 6551: Primary Care of Women Essay Assignment Help
- Review this week’s media presentation, as well as Chapters 6 and 8 of the Tharpe et al. text and the U.S. Department of Health and Human Services article in the Learning Resources.
- Research guidelines on screening procedures for the topic assigned to you by the course Instructor (e.g., guidelines on screening for domestic violence, safety, nutrition, osteoporosis, heart disease, mental health, eating disorders, thyroid disease, pap smear, mammogram, cancer, and sexually transmitted infections). Note: The course Instructor will assign a topic to you by Day 1 of this week.
- Reflect on strengths and limitations of the screening guidelines.
- Consider how the guidelines might support your clinical decision making.
By Day 3
Post an explanation of the guidelines on screening procedures for the topic assigned to you. Include an explanation of strengths and limitations of the guidelines. Then, explain how the guidelines might support your clinical decision making.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days who were assigned different topics than you. Explain a patient scenario in which your colleague’s guidelines might not be appropriate. Then, explain how you would provide care for the patient in the scenario. Finally, explain how you, as an advanced practice nurse, might be able to impact issues related to these screening guidelines.
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NURS 6551 Week 3: Gynecologic Health
There’s a reason birth control was included as preventive health care—a panel of doctors recommended it. The nonpartisan Institute of Medicine (IOM) recommended that birth control be covered as women’s preventive care because it is fundamental to improving not only women’s health, but the health of their families as well. Medical research has demonstrated this fact for decades.
—Planned Parenthood Action Fund, Inc.
As this quote suggests, contraceptive care is a critical part of women’s health. Contraceptives not only help prevent unintended pregnancies—which account for nearly half of all pregnancies (CDC, 2012a)—but are also used to treat and manage gynecologic conditions. Although contraceptive care might be difficult to discuss with some patients, as the advanced practice nurse, you must facilitate this discussion and help patients select treatment options that meet their health needs. Imagine you are treating a 20-year-old patient who has questions about which contraceptive method is right for her. She says she does not have insurance, worries about potential side effects of contraceptives, and does not know which options are available to her or how to properly use them. What recommendations would you make and how would you educate this patient?
This week you explore contraception treatments, an integral part of women’s gynecologic health. You examine contraceptive options and strategies for selecting appropriate contraception treatment for patients.
Learning Objectives
By the end of this week, students will: Get NURS 6551: Primary Care of Women Essay Assignment Help
- Evaluate appropriate contraception treatments for individual patients
- Analyze ways to facilitate the selection of contraception treatments with patients
- Understand and apply key terms, principles, and concepts related women’s gynecologic health
- Evaluate diagnoses for patients
- Evaluate treatment and management plans
- Analyze nursing theories and feminist perspectives in relation to clinical practice*
- Analyze differences between common screenings for younger women and common screenings for older women*
Discussion: Contraception Treatments
Considering the potentially negative consequences of unintended pregnancy for a woman’s health and well-being, effective contraceptive treatments are an important part of gynecologic care. There are a variety of contraceptive treatment methods available for women, including hormonal, barrier, and fertility awareness options. Each method has its own strengths and limitations, and each patient often has individual factors that might also impact appropriateness of use. In your role as the advanced practice nurse, it is important to keep in mind that while you may make contraceptive recommendations to patients, contraceptive selection is a joint decision between the patient and the provider. For this Discussion, consider which contraceptive treatments would be most appropriate for the patients in the following three case studies:
Case Study 1:
A 23-year-old Caucasian female presents with concerns about mood swings around the time of her menses. She believes she has PMS and wants to know if there is medication to control it.
Case Study 2:
A 25-year-old Latina female presents with menstrual cramping that has been getting worse over time. She has never been pregnant and she has one male sex partner. Her gynecologic exam is normal.
Case Study 3: Get NURS 6551: Primary Care of Women Essay Assignment Help
A 33-year-old Caucasian female is being seen in clinic for contraception. She is using birth control pills, but forgets to take them because her work schedule changes every week. She has been married for 14 years and has two children. She is looking for an effective method that will be easy to remember. She has a history of chronic headaches and hypertension during pregnancy. She has never been treated for a sexually transmitted infection and is in a mutually monogamous relationship. Family history is significant for an aunt with breast cancer. She smokes half a pack of cigarettes per day. She is 5 ft. 8 in. and 215 lbs. Her vital signs are: BP 120/78, p 72, reg.
To prepare:
- Review Chapter 12 of the Schuiling and Likis text and the Dragoman et al. article in this week’s Learning Resources
- Select one of the three provided case studies. Reflect on the patient information.
- Consider an appropriate contraception treatment for the patient case study you selected.
- Think about how you might facilitate the selection of contraception treatments with patients who do not agree with your recommendations.
By Day 3
Post an explanation of the contraception treatment that would be most appropriate for the patient in the case study you selected, and explain why. Explain how you might work with patients who do not agree with your recommendations.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days who selected different case studies than you did. Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or contrasting perspectives.
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NURS 6551 Week 4: Common Gynecologic Conditions, Part 1
Each year, approximately 448 million patients are diagnosed with sexually transmitted infections (STIs) worldwide (World Health Organization, 2011). Many of these STIs are preventable and curable; however, new cases continue to emerge due to lack of patient education and/or access to health care. In your role, you have the opportunity to educate patients on risks of STIs, as well as provide treatment and management support for patients living with STIs. How can you, as an advanced practice nurse, help improve the incidences of patient infection within your community?
This week, as you begin your exploration of common gynecologic conditions, you examine strategies for diagnosing, treating, managing, and educating patients with STIs. You also consider the sociocultural factors that might impact the care of women with or at risk of STIs.
Learning Objectives
By the end of this week, students will:
- Assess patients with sexually transmitted infections
- Evaluate differential diagnoses for sexually transmitted infections
- Analyze treatment and management plans for patients with sexually transmitted infections
- Analyze strategies for educating patients on the treatment and management of sexually transmitted infections
- Evaluate the impact of sociocultural factors on the treatment and management of sexually transmitted infections
- Understand and apply key terms, principles, and concepts related to sexually transmitted infections in patients
- Evaluate vaginal infections in patients
Discussion: Sexually Transmitted Infections
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The Centers for Disease Control and Prevention estimates that there are 19 million new cases of sexually transmitted infections every year in the United States (CDC, 2010b). STIs may present serious health implications for infected patients—especially for those who are unaware of their health condition. Studies show that women are not only at greater risk of contracting these infections, but they also tend to have more severe health problems resulting from infections than men (U.S. Department of Health and Human Services, 2009b). As an advanced practice nurse, you must educate female patients and emphasize the importance of prevention and STI testing for all women regardless of marital status, race, ethnicity, or socioeconomic status. For this Discussion, consider STI education strategies for the three patients in the following case studies:
Case Study 1:
A 19-year-old Asian American female comes into the clinic for a well-woman checkup. She states that about three weeks ago she had a non-tender sore on her labia that resolved without treatment. Her gynecologic exam is normal but she has maculopapular lesions on her trunk, neck, palms, and soles of her feet. The remainder of her exam was unremarkable.
Case Study 2:
A 31-year-old African American female is concerned about a white vaginal discharge. She has self-treated in the past with over-the-counter vaginal creams with some success. She has had no relief thus far for this episode.
Case Study 3:
A 21-year-old nulligravida comes to see you concerned about vague lower abdominal pain for two days associated with a yellowish, nonodorous, vaginal discharge. Past history reveals regular menstrual periods and no previous surgeries or significant medical problems. Her last menstrual period was normal and ended two days ago. She had a similar episode about eight months ago for which she did not seek care because of lack of health insurance. She is currently sexually active with one partner and has had two partners in the past year. She is not using any type of contraception. On physical exam you note a temperature of 38º C, a regular pulse of 100, and a BP of 110/65. Her abdomen is diffusely tender in both lower quadrants. Pelvic exam reveals a yellowish cervical discharge with cervical motion tenderness and a tender fullness in both adnexa.
To prepare: NURS 6551: Primary Care of Women Essay Assignment
- Review Chapter 20 of the Schuiling and Likis text and the Centers for Disease Control and Prevention article in this week’s Learning Resources.
- Review and select one of the three provided case studies. Reflect on the patient information.
- Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
- Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.
- Consider strategies for educating patients on the treatment and management of the sexually transmitted infection you identified as your primary diagnosis.
By Day 3
Post an explanation of the differential diagnosis for the patient in the case study you selected. Provide a minimum of three possible diagnoses, and list them from highest priority to lowest priority. Explain which is the most likely diagnosis for the patient and why. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients on the sexually transmitted infection.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days in both of the ways listed below. Respond to colleagues who selected different case studies than you did.
- Explain how sociocultural factors might impact the diagnosis, management, and follow-up care of patients with the sexually transmitted infections your colleagues discussed.
- Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or contrasting perspectives.
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NURS 6551 Week 5: Common Gynecologic Conditions, Part 2
Symptoms of gynecologic conditions vary from severe to so mild that they are unrecognizable to women as signs of a problem. Consider patients representing both ends of the spectrum—Sonja Thorkildsen and Brie-Anne Paterson. Thorkildsen experienced extremely heavy and irregular menstrual cycles for years. She only sought medical care after her condition became so severe that she believed she was hemorrhaging. Thorkildsen did not realize that her menstrual cycles were abnormal and actually signs of endometrial cancer, her underlying condition (Seattle Cancer Care Alliance, 2013). While Thorkildsen’s initial symptoms were not apparent enough to prompt her to seek medical care, Paterson’s symptoms of chronic pelvic pain were so overwhelming, she visited multiple providers and tried a variety of treatments to minimize pain. After persistently seeking medical care, she was eventually diagnosed with endometriosis, which had spread to her kidney, bladder, colon, and rectum (Yadegaran, 2010). As these two cases demonstrate, patients’ insights to their conditions will vary, making it your responsibility to recognize signs and symptoms of gynecologic conditions to ensure prompt diagnosis and treatment.
This week, as you continue exploring common gynecologic conditions, you consider diagnosis, treatment, and management strategies for patients. You also explore ways to educate patients on these conditions.
Learning Objectives
By the end of this week, students will:
- Assess patients with common gynecologic conditions
- Evaluate differential diagnoses for common gynecologic conditions
- Analyze treatment and management plans for patients with common gynecologic conditions
- Analyze strategies for educating patients on the treatment and management of common gynecologic conditions
- Understand and apply key terms, principles, and concepts related to common gynecologic conditions
- Evaluate common gynecologic conditions in patients
- Analyze treatment modalities for common gynecologic conditions
Discussion: Diagnosing and Managing Gynecologic Conditions
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Gynecologic conditions can be difficult to diagnose for a variety of reasons, including overlapping symptoms, lack of patient knowledge, or even patient fear or embarrassment about sharing information. Your role provides you the opportunity to develop a relationship of trust and understanding with these patients so that you can gather the appropriate details related to medical history and current symptoms. When caring for this patient population, it is important to make these women an integral part of the process and work collaboratively with them to diagnose and develop treatment and management plans that will meet their individual needs. For this Discussion, consider diagnosis, treatment, and management strategies for the patients in the following four case studies:
Case Study 1:
A 32-year-old African American female is concerned about increasing dysmenorrhea over the past three years. In the past year, this was associated with painful intercourse. She has been in a monogamous relationship with one male partner for the past five years. They tried to have children without success. Menarche was at age 10; menstrual cycles are 21 days apart and last for 6–7 days. The first day of her last menstrual period was 10 days ago and was normal. She denies vaginal itching or discharge. On gynecologic exam there was no swelling, external lesions, or erythema, urethral swelling, or vaginal discharge. Cervix is pink without lesions or discharge. Uterus was small, retroverted, and non-tender. Adnexa were small and non-tender. Nodules are noted along the cul de sac.
Case Study 2:
A 42-year-old African American female is in the clinic for a routine gynecologic exam. When asked, she admits to noticing bleeding in between her menstrual periods for the past several months. She has been pregnant three times and has three children. She is sexually active with one male sex partner in a monogamous relationship. During her bimanual exam, you note an irregular intrauterine non-tender mass about 4 cm in diameter. The mass is palpable abdominally. The remainder of her gynecologic exam was normal.
Case Study 3:
A 48-year-old Caucasian female is in the clinic concerned about prolonged menstrual bleeding for three weeks now. Her prior menstrual periods have been irregular for the past eight months, lasting no more than three days each. There have been one to two months when she had no menstrual cycles at all. She reports occasional hot flushes and mood swings.
Case Study 4:
A 16-year-old Caucasian female comes to the clinic concerned because she has not had a menstrual period for three months. She’s a junior in high school and active in sports. She has lost about 10 lbs. in the past two months. She is currently 5 ft. 4 in. and weighs 100 lbs.
To prepare: NURS 6551: Primary Care of Women Essay Assignment
- Review Chapter 26 of the Schuiling and Likis text and Chapter 7 of the Tharpe et al. text.
- Review and select one of the four provided case studies. Analyze the patient information.
- Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
- Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.
- Consider strategies for educating patients on the treatment and management of the sexually transmitted infection you identified as your primary diagnosis.
By Day 3
Post an explanation of the differential diagnosis for the patient in the case study you selected. Provide a minimum of three possible diagnoses and list them from highest priority to lowest priority. Explain which is the most likely diagnosis for the patient and why. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients on the disorder.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days in both of the ways listed below. Respond to colleagues who selected different case studies than you did.
- Explain how missing information from the patient history might change the diagnoses for the patients in the case studies your colleagues selected.
- Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or contrasting perspectives.
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NURS 6551 Week 6: Common Gynecologic Conditions, Part 3
With over 3 million women battling breast cancer today, everywhere you turn there is a mother, daughter, sister, or friend who has been affected by breast cancer.
—Betsey Johnson, breast cancer survivor, advocate, and fashion designer
Breast conditions are among the most common gynecologic conditions, and an estimated 290,000 women are diagnosed with breast cancer each year (American Cancer Society, 2012). Carla Hickey, a 36-year-old mother of three, was one of these women. After finding a lump in her breast, Hickey scheduled a mammogram with her health care provider. The mammogram and additional diagnostic testing confirmed that the breast condition was stage II breast cancer. While Hickey was struggling to cope with the psychological impact of her diagnosis, her mother was also diagnosed (MD Anderson Cancer Center, 2012). While a family history of the condition may be a risk factor as it was in Hickey’s case, 85 percent of women diagnosed with breast cancer have no family history (Breastcancer.org, 2012). In your role as the advanced practice nurse, you can educate and support women by helping them understand their individual risks and encouraging preventive care.
This week, as you continue exploring common gynecologic conditions, you examine strategies for diagnosing, treating, managing, and educating patients with breast conditions such as breast cancer. You also consider sociocultural factors that might impact the care of women with or at risk of these conditions.
Learning Objectives
By the end of this week, students will:
- Assess patients with breast conditions
- Evaluate differential diagnoses for breast conditions
- Analyze treatment and management plans for patients with breast conditions
- Analyze strategies for educating patients on the treatment and management of breast conditions
- Evaluate the impact of sociocultural factors on the treatment and management of breast conditions
- Understand and apply key terms, principles, and concepts related to common gynecologic conditions
- Evaluate breast conditions in patients
Discussion: Breast Conditions
Throughout a woman’s life, her breasts go through many normal, healthy changes. However, patients do not always understand these changes and often visit health care providers for treatment. When examining these patients, you must be able to identify when a breast condition is the result of a safe and normal physiological change and when it is the result of an abnormal change requiring treatment and management. A diagnosis of a breast condition resulting from an abnormal change can be devastating for women, making emotional support as vital to women’s well-being as proper assessment, diagnosis, and management. For this Discussion, consider how you might diagnose, manage, and support the following two patients presenting with breast conditions:
Case Study 1:
You are seeing a 60-year-old Latina female, Gravida 4 Para 3104, who is concerned about a thick greenish discharge from her left breast for the past month. The discharge is spontaneous and associated with dull pain and burning. Upon questioning, she also tells you that she breastfed all her children and is currently not on any medications except for occasional Tylenol for arthritis. Her last mammogram, 14 months ago, was within normal limits. On exam, her left breast around the areola is slightly reddened and edematous. Upon palpation of the right quadrant, a greenish-black discharge exudes from the nipple. You note an ovoid, smooth, very mobile, non-tender 1 cm nodule in the RUIQ at 11:00 5 cm from the nipple. No adenopathy, dimpling, nipple discharge, or other associated findings. Her right breast is unremarkable. The patient expresses her desire to proactively decrease her risk for developing breast cancer.
Case Study 2:
You are seeing a 53-year-old African American female for a lump she found in her right breast two weeks ago in the shower. Her last mammogram was three years ago and she was told it was “benign.” She had two breast biopsies at ages 32 and 34 in her right and left breasts, respectively. At both times she had surgery for removal of fibroadenomas. She does not routinely do breast self-exams. Her mother had a mastectomy for breast cancer at age 63, and she heard that a paternal aunt had a breast removed for cancer when she was in her forties. Both mother and aunt are alive and well today. It was discovered on postmortem exam that her grandfather had prostate cancer. Menarche was at age 15 and she is still having monthly menses. She is Gravida 4 Para 3104 with her first childbirth at age 31. She was on oral contraception for 10 years, has no history of fertility treatments, and had a bilateral tubal ligation after the birth of her last child at age 35. Past medical history is noncontributory. She wants to know how likely it is that she will get breast cancer. Physical exam reveals breasts are symmetrical with no dimpling, retractions, or rash. Her right breast has a 2 cm non-tender, hard, fixed mass at 3:00 6 cm from her nipple. Left breast is non-tender without masses. No nipple discharge bilaterally. No anterior cervical, infra- or supraclavicular, or axillary adenopathy.
To prepare: NURS 6551: Primary Care of Women Essay Assignment
- Review Chapter 15 of the Schuiling and Likis text.
- Review and select one of the two provided case studies. Analyze the patient information.
- Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
- Reflect on the appropriate clinical guidelines. Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.
- Consider strategies for educating patients on the treatment and management of the disorder you identified as your primary diagnosis.
By Day 3
Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Then, based on the appropriate clinical guidelines, explain a treatment and management plan for the patient, including proper dosages for any recommended treatments. Finally, explain strategies for educating patients on the disorder.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days in both of the ways listed below. Respond to colleagues who selected different case studies than you did.
- Explain how sociocultural factors might impact the diagnosis, management, and follow-up care of patients with the disorder your colleagues discussed.
- Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or contrasting perspectives.
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NURS 6551 Week 7: Obstetrics, Part 1
In the United States, approximately six million women are pregnant each year, and nearly half a million of these women give birth to babies without adequate prenatal care (American Pregnancy Association, 2012). Without the proper care and recommended pregnancy procedures and screenings, the potential for pregnancy complications increases, putting the mother and baby’s health at risk. In your role as the advanced practice nurse, how can you facilitate care for these women and their babies? How would you modify pregnancy care plans to meet the unique needs of each individual patient?
This week as you begin to explore obstetrics, you consider care plans for pregnant patients, including implications of missed procedures and screenings. You also examine the impact of sociocultural factors on these care plans.
Learning Objectives
By the end of this week, students will:
- Assess estimated date of delivery for pregnant patients
- Evaluate clinical implications of missed procedures and screenings in pregnant patients
- Analyze care plans for pregnant patients
- Evaluate the impact of sociocultural factors on patient care plans
- Understand and apply key terms, principles, and concepts related to obstetrics
- Evaluate diagnoses for patients
- Evaluate treatment and management plans
- Evaluate vaginal infections in patients*
- Evaluate common gynecologic conditions in patients*
- Analyze treatment modalities for common gynecologic conditions*
- Evaluate breast conditions in patients*
Discussion: Care Plans for Pregnancy
After confirming and dating a pregnancy, you must collaborate with patients to develop a personalized care plan. These pregnancy care plans are integral to prenatal care as they help to ensure the mother and child’s well-being throughout the entire pregnancy. Pregnancy can be a wonderful, yet difficult time for women as a woman’s body goes through many physical, mental, and emotional changes that might be challenging or even overwhelming for some. Whether or not these women share their concerns, as the advanced practice nurse, you must routinely watch for signs and symptoms of any developing physical or mental health issues. By collaborating with patients and discussing concerns, you can modify care plans and often address potential issues before they become a significant health problem. For this Discussion, consider pregnancy care plans for the women in the following case studies:
Case Study 1:
On 1-15-13, you are seeing a 25-year-old Caucasian female in the clinic because she believes she’s pregnant. Her LMP was 12-1-12. Her home pregnancy test was positive, and she has been having nausea and breast tenderness.
Case Study 2:
You are seeing a 28-year-old African American female, G6 P 3115, who is currently on oral combined hormonal contraception. She’s here because she and her partner would like to have another child. She heard “it takes a while to become pregnant after being on the Pill,” so she discontinued them three months ago. They haven’t been using any contraception since then. Upon questioning, she states that on the Pill, sometimes her menstrual periods are very light and once she didn’t have one at all. Her urine pregnancy test in the clinic is positive. Her LMP was 7-14-12. You are seeing her on 12-3-12.
To prepare: NURS 6551: Primary Care of Women Essay Assignment
- Review Chapter 30 of the Schuiling and Likis text and Chapter 2 of the Tharpe et al. text.
- Review and select one of the two provided case studies. Analyze the patient information.
- Consider how to date the pregnancy and estimate the date of delivery for the patient in the case study you selected.
- Based on the dating of the pregnancy, reflect on the appropriate clinical guidelines for procedures and screenings. Think about the implications of any missed procedures or screenings.
- Determine a plan of care for the patient. Identify procedures, screenings, diagnostic testing, pharmacologic and nonpharmacologic treatments (if appropriate), management strategies, and patient education.
By Day 3
Post the estimated date of delivery for the patient in the case study you selected. Include an explanation of how you dated a pregnancy and which of the patient’s factors led to your estimated date of delivery. Then, based on the dating of the patient’s pregnancy, explain the appropriate clinical guidelines for procedures and screenings. Explain implications of any missed procedures and/or screenings. Finally, explain a plan of care for the patient, including procedures, screenings, diagnostic testing, pharmacologic and nonpharmacologic treatments, management strategies, and patient education.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days in both of the ways listed below. Respond to colleagues who selected different case studies than you did.
- Explain how sociocultural factors might impact the care plan for patients in the case study your colleagues selected.
- Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or contrasting perspectives.
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NURS 6551 Week 8: Obstetrics, Part 2
Eight hundred twenty thousand pregnant women smoke cigarettes, 221,000 pregnant women use illicit drugs, and 757,000 pregnant women drink alcohol (American Pregnancy Association, 2012). Health promotion and patient education programs are critical components of obstetrics that help ensure safe and healthy pregnancies for mothers and babies. As an advanced practice nurse, you are responsible for educating various populations of women about health promotion during pregnancy. You must facilitate care for these women and encourage lifestyle changes related to issues such as smoking, drug use, and drinking.
This week, as you continue focusing on obstetrics, you examine health promotion during pregnancy. You also consider health promotion methods for select patient populations and design educational media for health promotion during pregnancy.
Learning Objectives
By the end of this week, students will:
- Evaluate health promotion methods for select patient populations
- Understand and apply key terms, principles, and concepts related to obstetrics
- Evaluate health problems common during pregnancy
Discussion: Health Promotion During Pregnancy
When caring for pregnant women, it is important to care for the whole person. This means you not only manage the pregnancy and treat conditions, but you also promote healthy behaviors and good lifestyle choices. Through health promotion, you can help to ensure the safety of both the mother and the baby. Your role in health promotion is to identify health risks that might result in pregnancy complications, educate patients on these risks, and provide the necessary support to help patients mitigate these risks. In this Discussion, you examine implications of drug use, alcohol consumption, dietary habits, and environmental exposures during pregnancy, and you consider ways to educate pregnant women about such risks.
To prepare:
- Review Chapter 2 of the Tharpe et al. text and the article from the Centers for Disease Control and Prevention in this week’s Learning Resources.
- Consider lifestyle changes that pregnant women must make in relation to smoking, drinking, taking drugs (legal and illegal), eating habits, and caring for pets. Select one of these topics to be the focus of an educational media piece you would create for health promotion during pregnancy.
- Think about the patient population that you treat within your practicum setting. Consider ways to educate these patients on health promotion as it relates to the topic you selected. Then, consider the types of educational pieces, such as flyers, posters, public service announcements, or other media, that might be most effective with your patient population.
By Day 3
Post a detailed description of the educational media piece you would create for health promotion during pregnancy. Explain why you selected the particular topic, as well as why you selected the type of media and how and why it is suitable for your patient population.
Note: If you have an educational media piece that you would like to share, attach the file to your Discussion posting.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days in both of the ways listed below. Respond to colleagues who selected different case studies than you did.
- Provide constructive feedback or pose questions to your colleagues about the effectiveness of their selected educational media with their patient population.
- Explain whether your colleagues’ media pieces would be effective with patients at your current Practicum setting. If so, explain why. If not, explain how you would revise the media to reach your patient population.
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NURS 6551 Week 9: Obstetrics, Part 3
When pregnant women use alcohol, tobacco or illicit substances they are risking health problems for themselves and poor birth outcomes for their babies.
—Pamela Hyde, Administrator, Substance Abuse and Mental Health Services Administration
Although most women are aware of the risks associated with alcohol and drug use during pregnancy, too many pregnant women still engage in unsafe behaviors (Preidt, 2012). As an advanced practice nurse caring for expectant mothers, you have to recognize signs and symptoms of risky patient behaviors that can pose health complications for both the mother and the baby. You must work with these patients to develop treatment and management strategies that will meet their individual needs and reduce risky behavior to improve pregnancy outcomes.
This week as you continue exploring obstetrics and health promotion during pregnancy, you analyze signs and symptoms of risky patient behavior and nonadherence to recommended lifestyle changes during pregnancy. You also examine treatment and management strategies for these patients.
Learning Objectives
By the end of this week, students will:
- Analyze signs and symptoms of patient nonadherence to recommended lifestyle changes during pregnancy
- Evaluate the impact of nonadherence to recommended lifestyle changes on fetuses and patients
- Analyze treatment and management strategies for patients presenting with signs and symptoms of nonadherence to recommended lifestyle changes
- Understand and apply key terms, principles, and concepts related to obstetrics
- Evaluate postpartum depression in patients
- Evaluate diagnoses for patients*
- Evaluate treatment and management plans*
Discussion: Nonadherence to Lifestyle Changes During Pregnancy
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After identifying potential health risks for pregnant patients, providers often recommend behavior changes in lifestyle choices such as drug use, alcohol consumption, dietary habits, and environmental exposures. Even with provider recommendations and patient education programs, some patients still struggle to adhere to recommended lifestyle changes during pregnancy, posing health risks for both the mother and child. In your role as the provider, you must be able to recognize signs of nonadherence to recommended lifestyle changes because not all patients will be forthcoming with the struggles they may be experiencing. Management plans are only successful if patients’ individual needs are recognized and met, so provider-patient collaboration is essential for mitigating nonadherence issues. For this Discussion, consider implications of nonadherence to recommended lifestyle changes and potential management strategies for pregnant patients.
To prepare:
- Review the “During Pregnancy” article in this week’s Learning Resources.
- Think about the health promotion topic that you selected for the Week 8 Discussion (i.e., smoking, drinking, taking drugs, eating habits, and caring for pets).
- With the topic you selected in mind, consider early signs and symptoms that might indicate a patient’s nonadherence to recommended lifestyle changes during pregnancy. Think about the impact of nonadherence on the fetus and the patient.
- Reflect on treatment and management strategies for patients presenting with signs and symptoms of nonadherence to recommended lifestyle changes.
By Day 3
Post an explanation of signs and symptoms that might indicate a pregnant patient’s nonadherence to recommended lifestyle changes related to the topic you selected. Explain the impact of nonadherence to these lifestyle recommendations on the fetus and the patient. Then, explain treatment and management strategies for patients presenting with signs and symptoms resulting from their nonadherence.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days in both of the ways listed below. Respond to colleagues who selected different topics than you did.
- Explain additional signs and symptoms that might indicate a patient’s nonadherence to recommended lifestyle changes as it relates to the topics your colleagues selected.
- Provide alternative treatment and management strategies for patients presenting with signs and symptoms of nonadherence to the recommended lifestyle changes as it relates to the topics your colleagues selected.
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NURS 6551 Week 10: Common Health Conditions with Implications for Women, Part 1
Sixty-one percent of the people who die from stroke are women, and it is really perceived as an old man’s disease. And it isn’t.
—Lynn Goddess, Founder of the Hazel K. Goddess Fund for Stroke Research in Women
Stroke is among the leading causes of death for women in the United States (CDC, 2008b). This common health condition has severe implications for women, yet it is frequently misdiagnosed because the female presentation of stroke often differs from the typical recognized male presentation. Like stroke, many other common cardiovascular and neurologic health conditions also present differently and progress differently in women. As an advanced practice nurse providing care for women, you must be able to quickly identify the unique signs and symptoms of these common health conditions in women.
This week you examine common cardiovascular and neurologic conditions that impact women. You consider differential diagnoses, treatment and management plans, and patient education strategies for women with these conditions. You also examine the Women’s Health Initiative study and research current best practices for assessing and managing common health conditions in women.
Learning Objectives
By the end of this week, students will:
- Assess patients with common cardiovascular and neurologic conditions
- Evaluate differential diagnoses for common cardiovascular and neurologic conditions
- Analyze treatment and management plans for patients with common cardiovascular and neurologic conditions
- Analyze strategies for educating patients on the treatment and management of common cardiovascular and neurologic conditions
- Compare the diagnosis and management of female and male patients with the same conditions
- Evaluate best practices for assessing and managing conditions related to women’s health
- Evaluate the impact of differences in best practices on women’s health
- Understand and apply key terms, principles, and concepts related to common health conditions with implications for women
- Evaluate body system conditions
Discussion: Diagnosing and Managing Common Cardiovascular and Neurologic Conditions
-
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Cardiovascular and neurologic conditions are among the leading causes of death and hospitalization of women in the United States (Centers for Disease Control and Prevention, 2008a). As an advanced practice nurse, you must routinely monitor patients at risk of these conditions and recommend the appropriate health screenings and preventive services. When assessing patients for these conditions, it is important to keep in mind that while some female patients might present with typical signs and symptoms, others might present with atypical signs and symptoms that are unique to women. For this Discussion, consider signs and symptoms presented by the women in the following case studies and develop differential diagnoses:
Case Study 1
A 48-year-old overweight African American female is in the clinic for a wellness visit. A routine fasting lipid panel returned with the following results:
- Total cholesterol: 305 mmol/L
- Low-density lipoprotein (LDL): 180 mg/dl
- High-density lipoprotein (HDL): 30 mg/dl
- Triglycerides: 165 mg/dl
Case Study 2
You are seeing a 63-year-old African American female for a two-week history of intermittent chest pain. The pain varies in intensity and resolves with rest. She does not believe it has increased over time. She is a nonsmoker with a history of hypertension treated with Lisinopril 10 mg once daily. She had an exercise stress test one year ago that was within normal limits. Her physical exam findings are as follows: HR–90, BP–150/92, R–22, O2Sat 98% RA; lungs: clear to auscultation bilaterally; cardiovascular: apical pulse of 90 RRR, no rubs, murmurs, or gallops. Chest wall mildly tender to palpation that reproduces her complaint of pain. Extremities include no clubbing, cyanosis, or edema. The remainder of the exam is within normal limits.
Case Study 3
A 32-year-old Asian American female is in the clinic for a history of recurrent headaches for the past year, occurring monthly, lasting up to 12–18 hours. The headaches are sometimes associated with photophobia, nausea, and vomiting. She takes either acetaminophen or ibuprofen for relief that is not always successful. She uses Ortho Tricyclin for birth control. Her physical exam is within normal limits.
To prepare:
- Review Chapter 8 of the Tharpe et al. text and the McSweeney et al. article in this week’s Learning Resources.
- Review and select one of the three provided case studies. Analyze the patient information.
- Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
- Reflect on the appropriate clinical guidelines. Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.
- Consider strategies for educating patients on the treatment and management of the disorder you identified as your primary diagnosis.
By Day 3
Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Then, based on the appropriate clinical guidelines, explain a treatment and management plan for the patient, including proper dosages for any recommended treatments. Finally, explain strategies for educating patients on the disorder.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days who selected different case studies than you did. Keep in mind the conditions your colleagues identified as their primary diagnoses. Explain signs and symptoms of these conditions that are unique to women or are more commonly seen in women. Then, explain how the assessment, diagnosis, treatment, and management of female patients might differ from male patients with the same conditions.
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NURS 6551 Week 11: Common Health Conditions with Implications for Women, Part 2
Some common health conditions, such as type 2 diabetes, are often associated with a certain age, body type, or ethnicity. However, this can be misleading. Consider 55-year-old Melissa Cross. While attending a women’s health and wellness conference, Cross decided to participate in the free health screenings. At her age, she was most concerned with her bone health. However, to her surprise, her bone health was fine, and she was diagnosed with diabetes. She stayed active, ate well, and maintained a healthy weight, so she never thought she would be a candidate for this condition (Vanderbilt University Medical Center, 2012). Like Cross, many women associate diabetes with unhealthy, obese women. As an advanced practice nurse, you must educate patients on their individual risks of common conditions such as diabetes. It is important for women to understand that there is no “typical” patient, and many common health conditions impact women from various backgrounds.
This week you examine common endocrine and musculoskeletal conditions that impact women. You also explore differential diagnoses, treatment and management plans, and patient education strategies for women with these conditions.
Learning Objectives
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By the end of this week, students will:
- Assess patients with common endocrine and musculoskeletal conditions
- Evaluate differential diagnoses for common endocrine and musculoskeletal conditions
- Analyze treatment and management plans for patients with common endocrine and musculoskeletal conditions
- Analyze strategies for educating patients on the treatment and management of common endocrine and musculoskeletal conditions
- Compare the diagnosis and management of female and male patients with the same endocrine and musculoskeletal conditions
- Understand and apply key terms, principles, and concepts related to common health conditions with implications for women
- Evaluate diagnoses for patients
- Evaluate treatment and management plans
- Evaluate health problems common during pregnancy*
- Evaluate postpartum depression in patients*
- Evaluate body system conditions*
- Evaluate best practices for assessing and managing conditions related to women’s health*
- Evaluate the impact of differences in best practices on women’s health*
Discussion: Diagnosing and Managing Common Endocrine and Musculoskeletal Conditions
Endocrine and musculoskeletal conditions, especially when left untreated, can have a significant impact on women’s health. Many of these conditions present unique challenges for women, making risk assessments and routine screenings an important part of primary care. As an advanced practice nurse, you must identify signs and symptoms of these conditions and educate at-risk patients so they can also monitor themselves. For this Discussion, consider how you would diagnose, treat, and educate the patients in the following three case studies:
Case Study 1
A 33-year-old Caucasian female presents with concerns about a four-month history of diffuse musculoskeletal pain and stiffness associated with fatigue and dry eyes. The pain varies with the weather and is worse in the morning. Her menstrual periods are irregular and she has frequent dyspareunia. Physical exam is remarkable for pain at different points all over the body, including neck, back, chest, elbows, hips, buttocks, and knees
Case Study 2
A 28-year-old Latina obese female presents to the clinic with increasing body hair and irregular menses. She now has coarse body hair on her chest and upper back. Her menstrual periods used to be fairly regular, but now she can skip three or four months before her next menstrual cycle. She has never been pregnant. She has one male sex partner.
Case Study 3
A 28-year-old Caucasian female comes to clinic concerned about three episodes of urinary incontinence associated with difficulty walking. The first two episodes resolved spontaneously after a couple of days without residuals, but this current episode has lasted a week. Today she began to have some blurred vision. Physical exam is remarkable for mild edema of the optic disc and difficulty with heel-to-toe walking. Deep tendon reflexes are 2+ and there is no extremity weakness.
To prepare: NURS 6551: Primary Care of Women Essay Assignment
- Review Chapter 8 of the Tharpe et al. text and the McSweeney et al. article in this week’s Learning Resources.
- Review and select one of the three provided case studies. Analyze the patient information.
- Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
- Reflect on the appropriate clinical guidelines. Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.
- Consider strategies for educating patients on the treatment and management of the disorder you identified as your primary diagnosis.
By Day 3
Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Then, based on the appropriate clinical guidelines, explain a treatment and management plan for the patient, including proper dosages for any recommended treatments. Finally, explain strategies for educating patients on the disorder.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days who selected different case studies than you did. Keep in mind the conditions your colleagues identified as their primary diagnoses. Explain signs and symptoms of these conditions that are unique to women or are more commonly seen in women. Then, explain how the assessment, diagnosis, treatment, and management of female patients might differ from male patients with the same or similar conditions.
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