MN577
Clinical - Womens Health Focus
Unit 1
Discussion
The purpose of this unit is to focus on performing the
necessary components of the women’s health exam and to learn to identify
crucial exams and necessary age appropriate screenings for the women’s health
client.
Discuss how the age of the female patient, demographics,
race, and lifestyle will drive your exam and plan of care. Give examples and
support with evidence-based practice.
MN577
Clinical - Womens Health Focus
Unit 2
Discussion
Describe how your first 2 weeks of women’s health clinicals
are going.
Describe your clinical setting and the 10 most common
diagnoses.
How are you feeling about caring for women’s health patient
populations? What are your learning goals for this rotation?
Be sure to provide constructive and scholarly feedback to at
least two other students’ posts and follow the grading rubric for full credit.
MN577
Clinical - Womens Health Focus
Unit 3
Discussion
Women's bodies go through a myriad of changes during the
course of their life. Hormones play an integral role in those changes at each
stage of development, from puberty to post-menopause.
Discuss how hormones across a lifespan can impact a woman's
physical and mental health. Give examples.
MN577
Clinical - Womens Health Focus
Unit 4
Discussion
Contraceptive counseling provides education, dispels
misinformation, facilitates selection of a method that will be successful for
the individual, and encourages patient involvement in healthcare decisions and
life goals. Discussing contraception brings the nurse practitioner and patient
together to create a tailored plan that meets the individual's reproductive
needs over a lifetime.
Discuss any clinical encounters that you may have had
relating to contraception. How did you counsel patients on their choices and
possible risks? Describe how you would explain the differences to your patients
in the long acting reversal contraceptive devices.
MN577
Clinical - Womens Health Focus
Unit 5
Discussion
Sexuality affects individuals and society across a broad
spectrum of activities through health, but also through factors at multiple
levels, such as gender relations, reproduction, and economics. Physiologic,
behavioral, and affective measurement of sexuality and sexual behavior is
complicated by cultural values and norms but is essential to individual health
(including happiness) as well as public health. Cultural or structural norms
that stigmatize aspects of sexuality, such as sexual orientation, have adverse
effects on individuals across their lifespan, with homophobia being a prominent
example of such.
Discuss how one's age, race, lifestyle, and demographics
have an impact on your choice to complete a sexual history when working in the
primary care setting with women across a lifespan.
MN577
Clinical - Womens Health Focus
Unit 6
Discussion
Women often present to the primary care setting with a
variety of breast complaints. Many of these are benign conditions but can be
concerning to the patient. Breast complaints are common across the lifespan,
and it is imperative for the nurse practitioner to be comfortable in assessing,
diagnosing, and treating breast complaints.
Discuss any encounters you have had with patients who have
had breast concerns. Review the evidence-based guidelines for evaluating and
treating breast conditions. How did you approach the assessment and the
evaluation of breast complaints seen in the clinic setting?
MN577
Clinical - Womens Health Focus
Unit 7
Discussion
Chronic pelvic pain can be defined as intermittent or
constant pain in the lower abdomen or pelvis of a woman of at least 6 months in
duration, not occurring exclusively with menstruation or intercourse and not
associated with pregnancy. It is a symptom, not a diagnosis. Chronic pelvic
pain presents in primary care as frequently as migraine or low-back pain and may
significantly impact a woman’s ability to function.
Discuss the common causes of pelvic pain and who, when, and
why you would decide to refer the patient for diagnostics and second opinions.
MN577
Clinical - Womens Health Focus
Unit 8
Discussion
CDC's Division of Nutrition, Physical Activity, and Obesity
(DNPAO) is committed to increasing breastfeeding rates throughout the United
States and to promoting and supporting optimal breastfeeding practices toward
the ultimate goal of improving the public's health.
Discuss the CDC breastfeeding initiative and describe how
you will support this when interacting with your pregnant and postpartum women
in the primary care setting.
MN577
Clinical - Womens Health Focus
Unit 9
Discussion
An adolescent’s concerns about privacy can prevent them from
seeking primary health care, especially for specific sensitive health care
services such as STI screening and family planning issues. Those with privacy
concerns are also less likely to talk openly with a health care clinician about
important health issues, such as substance use, mental health, and risky sex.
Recognizing that confidentiality is critical to high-quality care for
adolescent women, professional health care organizations have adopted policy
statements and practice guidelines that support the provision of confidential
services.
Discuss these guidelines and the laws in your state that
address adolescent confidential health care.
MN577
Clinical - Womens Health Focus
Unit 10
Discussion
Hormones and depression: Today, millions of women around the
world use hormonal contraceptives that have expanded beyond the pill to
patches, implants, injections, and uterine devices. Decades of research support
their safety, and serious but very rare side effects such as blood clots are
finally much better understood. But other areas of research lag, and we still
do not know as much as we would like about how these medications affect women's
mental health.
Discuss the guidelines for prescribing hormonal birth
control to women with a known history of depression and/or anxiety. How will
you manage a patient who reports feeling depressed after starting hormonal
birth control?
MN577
Clinical - Womens Health Focus
Unit 1
Assignment
Please upload the preceptor contact form to the Dropbox as
soon as possible. Your faculty will use this form to contact preceptors in
Units 1 and 2 for welcome calls and information. Please ensure that email
addresses and phone numbers are correct, and if possible, are sent directly to
the preceptor. Office managers are not appropriate contacts for faculty. This
is a mandatory Assignment.
MN577
Clinical - Womens Health Focus
Unit 5
Assignment
Midterm Clinical Evaluation — 25 pointsFor the midterm
clinical evaluation in week 5, you will be required to schedule a preceptor
call with your instructor and preceptor utilizing the faculty directions in the
course Announcements. Failure to schedule or complete this preceptor call could
result in failure of the course.
Grading will follow the rubric and will be a collaboration
between your faculty and preceptor. Any area of clinical concern will require
faculty and student conference as well as implementation of an individual
learning plan. You can find the rubric located in Course Resources.
MN577
Clinical - Womens Health Focus
Unit 6
Assignment
During your first 5 weeks of clinical, you have probably had
patients with vaginal complaints and possible infections. For this Assignment,
you will choose three STIs (e.g., bacterial vaginosis, HPV, chlamydia, HIV,
trichomoniasis). Then fill in the chart for all columns including presenting
symptoms, physical findings, laboratory/diagnostic findings, and management or
treatment. Do not leave any section blank.
When complete, upload your chart to the Dropbox.
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Infection
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Patient presenting symptoms
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Physical findings on exam
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Laboratory or diagnostic exams
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Management
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Patient counseling
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Referrals (if any)
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Other
pertinent
information
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MN577
Clinical - Womens Health Focus
Unit 9
Assignment
Assignment Directions
For this Assignment, you will select one of the following
case studies below. Then, using the case information and best evidence,
complete the chart below. Make sure to address all columns in the chart.
Select a case study of interest to you from the listed
scenarios below.
Case #1: Jane
Jane is a 42-year-old G4P2103. Jane is divorced and works
long, hard hours as a real estate agent. Jane was having irregular and heavy
menses for 6 months, and then they abruptly stopped 3 months ago. Jane has been
having nausea and vomiting for 6 weeks but attributed it to having the flu
recently. She also admits to gaining about 10 pounds in the last few months and
experiencing breast tenderness. Jane comes to the clinic today to discuss
menopause symptoms and treatment. During the visit, a urine pregnancy test came
back positive. During the exam, you palpate a 16-week-size uterus and get fetal
heart tones of 165. Jane is in disbelief.
Case #2: Natalie
Natalie is a 27-year-old G4P0120. Natalie is married; she
and her husband both work two part-time jobs to cover the bills. Natalie
presents to your office at about 20 weeks gestation for her initial OB visit.
Natalie states she has not been evaluated prior to today for the pregnancy
because of lack of funds and ability to get off of work. Natalie also complains
of multiple yeast infections during this pregnancy. During your interview with Natalie,
you find she has no known medical diagnoses, she is not taking medications, she
is a smoker, and she has a negative surgical history. Natalie’s OB history
includes two spontaneous losses at 8 and 12 weeks gestation and a loss of a 32
weeks infant following premature rupture of membranes. The 32 week infant was 7
pounds; lived 24 hours; and experienced hypoglycemia, respiratory distress, and
sepsis infections. Natalie tells you she waited to seek prenatal care until
this point because she did not have enough money to pay for the visit. She and
her husband are still paying off medical expenses from the death of their 32
week infant. She tells you that she probably would have waited longer, but she
keeps getting these terrible yeast infections. On exam you note a fundal height
of 26 weeks and urine dip reveals 1+ leukocytes, 1+ protein, trace blood and 3+
glucose.
Case #3: Katie
Katie is a 17-year-old G1P0. She presents to your office
with four missed periods in a row. Katie is a high school student; she is in
the 10th grade. She lives with her mother and four siblings. You ask Katie
about the father of the baby and she tells you he states “that baby is not
mine.” They are not speaking to each other right now. Katie tells you she has
been “vomiting a lot and her stomach hurts when she pees.” A urine pregnancy
test comes back positive. Katie is so confused because she has been using
douching after intercourse as her method of birth control. You ask Katie about
the father of the baby, and she tells you he states “that baby is not mine.”
They are not speaking to each other right now.
Katie’s past medical history is positive for chlamydia twice
in the last year. She was treated at the Health Department but never went back
for a follow up. Katie has had no surgeries and is on no medication. When
asked, Katie states her last known weight was about 120. Katie’s V/S are BP
110/70, temp 102.5, weight 107. You note enlarged cervical lymph nodes, FHTs
are 160, fundal height is 18. Katie’s urine reveals 2+ ketones, 2+ nitrates,
and 3+ leukocytes.
Case #4: Sara
Sara is a 32-year-old G1P1001. She presents to your office
for a 6-week postpartum check following a normal vaginal delivery of a healthy
baby girl. Sara had an 18-hour labor with Pitocin augmentation and delivered a
7 pound 2 oz. girl with a second degree laceration repaired with sutures. Sara
spent 2 days in the hospital and was discharged home with her infant and
husband. Over the last few weeks, Sara has called the office multiple times
with questions about breastfeeding and her sutures healing. Upon walking into
the exam room to see Sara, you see her baby in the stroller crying and Sara
sitting on the exam table crying into her hands.
Complete the following chart:
MN577 Unit 9 Pregnancy Case Review Chart
Description of the case chosen:
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Subjective data, identify both given and
needed data
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Objective findings, identify both given and
needed data
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Diagnostic or laboratory testing needed with
rationales
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List of three differential diagnoses with
rationales
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Medications and or treatments needed with
rationales
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Patient education needed
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Referrals for collaborative care needed with
rationales
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Make sure to address all sections. Do not leave any section
blank.
Include relevant subjective and physical objective findings.
Identify appropriate diagnostic and laboratory testing
needed.
List at least three differential diagnoses with rationales
for choosing.
Identify usual medications, treatments, or patient education
needed.
Determine referrals for collaborative care.
Summarize the case study and include any further research,
diagnostics, procedures, or follow-up needed.
Provide evidence-based references.
Assignment Requirements
Before finalizing your work, you should:
be sure to read the Assignment description carefully (as
displayed above);
consult the Grading Rubric (under the Course Resources) to
make sure you have included everything necessary; and
utilize spelling and grammar check to minimize errors.
Your writing Assignment should:
follow the conventions of Standard English (correct grammar,
punctuation, etc.);
be well ordered, logical, and unified, as well as original
and insightful;
display superior content, organization, style, and
mechanics; and
use APA 6th Edition format.
How to Submit:
Submit your Assignment to the unit Dropbox before midnight
on the last day of the unit.
When you are ready to submit your Assignment, click the
Dropbox tab and select this unit's basket from the dropdown menu, then attach
your file. Make sure to save a copy of your work and be sure to confirm that
your file uploaded correctly.
MN577
Clinical - Womens Health Focus
Unit 10
Assignment
Final Clinical Evaluation — 300 points
This unit will contain the mandatory preceptor final
evaluation in Rxpreceptor. Your preceptors will receive an automatic email from
the Rxpreceptor system during week 8 and then weekly until week 9 to complete
evaluations. Once it is complete, you will review it and upload to the Unit 10
Dropbox for grading. Grading will follow the scale below and will be a
collaboration between your faculty and preceptor. Any area of assessment with a
score of 2.4 or below will receive an entire evaluation score of 0 points as
failure in any area of assessment constitutes a failing evaluation. Any element
of the evaluation that states the student is not safe or is unsafe will result
in a "0" for the final evaluation and failure of the course.
Final evaluation will be worth 300 points and will follow
the grading rubric below:
Score of 4
to 5 = all 300 points awarded
Score of 3
to 3.9 = 240/300 points awarded
Score of
2.5 to 2.9 = 210/300 points awarded
Score of
2.4 and below = 0
Students must also complete both the evaluation of their
preceptor and site for credit. The evaluations provide faculty an overview of
your clinical performance and experiences with your preceptor and clinical
location. The final clinical evaluation is required to pass the course.
Failure to complete all clinical hours or all associated
Rxpreceptor documentation (clinical time log, patient encounter log, preceptor
evaluation of student, and student evaluation of preceptor) will result in
failure of the course.
[Unit 10 Assignment Dropbox]
Upload a copy of your evaluation of the preceptor and
clinical site. The form can be found in Rxpreceptor.
MN577
Clinical - Womens Health Focus
Unit 1 Quiz
Question 1
During a breast exam, you note all of the findings below as
normal except:
Question options:
asymmetrical size
a supernumerary nipple
hyperpigmentation
breasts that move up symmetrically with raising the arms
Question 2
When performing a pelvic examination, the first part of the
external genitalia exam is:
Question options:
speculum examination
palpation
inspection
cervical sampling
Question 3
When performing a bimanual exam, all of the following are
noted as normal findings except:
Question options:
retroverted uterus
anteflexed uterus
fixed immobile uterus
smooth, firm ovary
Question 4
In preparing to do the pelvic exam, which of the following
statements would be least beneficial in helping the patient feel comfortable?
Question options:
“Relax now. I am not going to hurt you.”
“Try to relax if you can, although I realize that is easier
for me to say than for you to do.”
“Let me know if anything is uncomfortable and I can stop.”
“I am going to touch you now.”
Question 5
Which of the following is not a part of a vaginal speculum?
Question options:
Upper blade
Lower blade
Thumb screw
Biopsy forceps
MN577
Clinical - Womens Health Focus
Unit 4 Quiz
Question 1
A 38-year-old nulliparous woman who smokes two and a half
packs a day is in an "on-and-off" relationship. The woman presents
seeking contraception. Of the choices listed, which one represents the most
appropriate method?
Question options:
Contraceptive ring (NuvaRing)
COC
Contraceptive patch (Ortho Evra)
Vaginal diaphragm
Question 2
With DMPA in depot injection (Depo-Provera), the recommended
length of use is usually:
Question options:
less than 1 year
no more than 2 years
as long as the woman desires this form of contraception
as determined by her lipid response to the medication
Question 3
When prescribing the vaginal ring (NuvaRing), the NP
considers that:
Question options:
these are progestin-only products
candidates include women who have difficulty remembering to
take a daily pill
there is significant drug interactions with both products
contraceptive efficacy is less than with COC
Question 4
According to the U.S. Medical Eligibility Criteria for
Contraception Use, is a 33-year-old who smokes two packs per day a candidate
for a copper-containing IUD?
Question options:
True
False
Question 5
According to the U.S. Medical Eligibility Criteria for Contraception
Use, is a 25-year-old with hypertension a candidate for a copper-containing
IUD?
Question options:
True
False
MN577
Clinical - Womens Health Focus
Unit 7 Quiz
Question 1
A 22-year-old woman complains of pelvic pain. Physical
examination reveals cervical motion tenderness and uterine tenderness. Which of
the following would further support a diagnosis of PID?
Question options
Temperature less than 100ºF (37. 8ºC)
Absence of white blood cells in vaginal fluid
Mucopurulent vaginal discharge
Laboratory documentation of cervical infection with E. coli
Question 2
Early warning signs of ovarian cancer include all of the
following except:
Question options:
increase in abdominal size
indigestion and bloating
constipation
thyroid enlargement
Question 3
The risk of a woman developing ovarian cancer increases with
age.
Question options:
True
False
Question 4
A 39-year-old woman comes to the office complaining of an
increasingly heavy period and a feeling of “pelvic pressure.” She had a tubal
ligation 5 years ago. Her pelvic exam reveals a 12 cm irregular uterus that is
movable and no adnexal masses or tenderness. Based on this information, the
most likely reason for the heavy menses is:
Question options:
menopausal symptoms
ovarian cyst
fibroid uterus
constipation
Question 5
A 76-year-old female known to you comes in complaining that
she cannot take “this bulge coming from my vagina any longer.” She has been
diagnosed in the past with a third degree cystocele, rectocele, and vaginal
prolapse. She has a significant history of cardiovascular disease. Which of the
following would be the best treatment option?
Question options:
A-P repair
La Forte procedure
Pessary
None of the above
