NURS 6551 Week 5 Discussion: Diagnosing and Managing Gynecologic Conditions
For a variety of reasons, including overlapping symptoms, patient ignorance, or even patient fear or embarrassment about disclosing information, can be challenging to diagnose. As part of your job, you have the chance to build a rapport of trust and understanding with these patients so that you may learn the pertinent information about their medical background and present symptoms. Making these ladies an integral part of the process and working cooperatively with them to diagnose and create treatment and management plans that will meet their specific needs are crucial while taking care of this patient population. Consider the following four for this discussion:
A 32-year-old African-American woman is concerned about her dysmenorrhea, which has worsened over the last three years. This was linked to unpleasant sexual experiences the previous year. She has been in a monogamous relationship with a single male for the past five years. They attempted but failed to become pregnant. Menstrual cycles are 21 days apart and last 6-7 days; menarche occurred when I was 10 years old. Her last period began on the first day of the month, which was 10 days ago. She denies that her vagina is swollen or discharged. There was no vaginal discharge, urethral edema, exterior lesions, or erythema on gynecologic examination. The cervix is pink with no discharge or lesions. The uterus was small, retroverted, and unresponsive. Adnexa, you’re small and unappealing. Along the cul de sac, nodules can be seen.
A 42-year-old African American woman is at the clinic for a routine gynecologic exam. She admits that there has been bleeding between her monthly periods for the past few months. She is the mother of three children and has been pregnant three times. She has one male sex partner and is in a monogamous relationship. During her bimanual examination, you discover an uneven, non-tender intrauterine lump with a diameter of about 4 cm. Abdominally, the lump is palpable. Her gynecologic examination was completed normally.
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NURS 6551 Week 5 Discussion 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.
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NURS 6551 Week 5 Discussion 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:
- 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 of NURS 6551 Week 5 Discussion
- 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.
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 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.
Post at least 250 words (no introduction or conclusion)
- An explanation of the differential diagnosis for the patient in the case study you selected (do not simply restate the case study instead show how symptoms might indicate a diagnosis)
- 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. (take care to you current clinical guideline to back up your recommendations)
- Finally, explain strategies for educating patients on the disorder. (please mention the fact about montly breast exams, yearly mammograms, and other preventative stratiegies for women, espescaily for women with a family history of breast cancer)
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