WC NURS648 Discussions Latest 2022 July (Full)

NURS648 Women Health

Week 1 Discussion

Denise, a 19-year-old female presents to the clinic for an annual physical exam.  She is G0P0, and presents with irregular menses only occurring every 3-4months apart within the past 2 years. She is sexually active and only using condoms occasionally. She is not on any other birth control methods. She denies any significant medical or surgical health history and denies any other current health problems.  She has never had a Pap smear or any pelvic exam tests before today. Her pregnancy test is negative and her vital signs are all WNL.

And

Ellen is a 35-year-old female whose latest Pap smear result reports HSIL with positive HPV.  Ellen reports no h/o of STIs or previous abnormal Pap smear results. She had only two previous Pap tests 7 and 14 years ago.  Ellen is G1P0 with a TAB at age 25.  She and her partner are undecided whether they want to have children.  She has been monogamously married to a female partner for the last 5 years, but she considers herself bisexual and has previously engaged in sexual activities with males and females.  Ellen denies any significant medical history or current health problems. Her LMP was 5 days ago and her VS are WNL.  Her BMI is 24.7.  Her pregnancy test is negative.

NURS648 Women Health

Week 2 Discussion

Lisa is a 19-year-old female who presents to the clinic c/o abnormal vaginal discharge for one week after having unprotected vaginal intercourse with a new male partner she has been dating for a couple of weeks.  Lisa’s pregnancy test is negative and her LMP was 2 weeks ago. As her health care provider, you will need to perform testing to determine if Lisa has contracted a sexually transmitted infection or other vaginal infection.

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Tina is a 27-year-old female who presents to the clinic complaining of a painful burning sensation in her left labial area for 3 days.  She reports recently having unprotected vaginal intercourse with a new male partner. Upon examination, you note fluid-filled vesicles on the left labia minora that are painful to touch.

NURS648 Women Health

Week 3 Discussion

Tonia is an 18-year-old female who presents to your office complaining of two months of amenorrhea. Her pregnancy test is positive and her LMP indicates she is 5.6 weeks EGA. She reports she has had some bleeding for the past 3 days, that started as spotting, but has continued to be a light period- like bleeding today. She denies any pain. She indicates plans to continue the pregnancy.

And

Lisa is a 29-year-old female G3P2 at 28 weeks EGA who is coming to the clinic for her routine checkup. She is Rh negative. Her VS are normal and prenatal routine screenings are WNL. Lisa asks if it is normal to be experiencing frequency and mild burning when she urinates which she says has increased over the last 2 days. She has been drinking more water recently and thinks that maybe this is causing the urinary frequency.

NURS648 Women Health

Week 4 Discussion

Hannah is 38 years old, G1P0, 32 weeks EGA and comes to you for her routine prenatal appointment.  Her BP is 156/96 and her urine has 2+ protein.  She complains of having a headache that will not go away and just not feeling “right” for the past 7 days.

Write a brief SOAP note regarding this patient. Make sure to include your answers to these questions in your SOAP note.

And

Jennifer is a G2P1, 31-year-old pregnant female at 24 weeks EGA who has come to the clinic for her 24-week prenatal visit and recommended screening tests.  Maria’s one hour glucose test result is 156 mg/DL.  Maria’s BP is 118/78 T 98.7 F, P 68, RR 18, fundal height is 25 cm, no urine/protein in urine, weight is 145 lbs at 5 lbs increased from last visit 4 weeks ago, her height is 5’ 5”.

NURS648 Women Health

Week 5 Discussion

Madeline is a 41-year-old female who complains of a small lump she feels in her right breast. Upon physical examination, you palpate an approximately 2x2 cm firm, non-tender, immobile mass in the right upper outer quadrant of the right breast at approximately 10 o’clock, 1 cm above the areola.

Write a brief SOAP note regarding this patient. Make sure to include your answers to these questions in your SOAP note.

And

Natalie is a 31-year-old G0 P0 female who complains of intermittent breast pain. She thinks she feels lumps in the outer quadrants of her breasts but is unsure of the location today. She has no family or personal history of cancers, she menstruates regularly, is not pregnant, and uses condoms consistently for BCM and STI protection.

NURS648 Women Health

Week 6 Discussion

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

And

Donna is 35-year-old African American female who comes to the clinic complaining of pelvic pain that started as intermittent, but now is almost constant. She also complains of irregular vaginal bleeding/spotting that has occurred in between her monthly menses for the last six months. She has no family history of breast or ovarian cancer. Her vital signs (VS) and BMI are all within normal limits (WNL), but upon physical examination, you palpate a firm, raised area on her uterus. You note no cervical motion tenderness (CMT), no adnexal tenderness (AT), and no other abnormalities. She is G2 P2 with both normal spontaneous vaginal deliveries (NSVD) 10 and 8 years ago.

NURS648 Women Health

Week 7 Discussion

Barbara is 48-year-old female who complains her menstrual cycle has recently become irregular, and she is experiencing hot flashes and vaginal dryness. She has also noticed a decrease in her desire for sex lately. She has been married to a man for 20 years, is in a stable relationship, and has two daughters ages 16 and 18. She is otherwise healthy with an unremarkable medical history. Her pregnancy test is negative. Her Pap smear and STI panel are all negative.

Write a brief SOAP note regarding this patient. Make sure to include your answers to these questions in your SOAP note.

And

Hillary is a 63-year-old woman G7P7 all uncomplicated NSVDs, complains of inadvertently urinating on herself whenever she coughs, sneezes, or heartily laughs. It has been happening intermittently since the birth of her last 3 children, but it now happens so often that she must wear a sanitary pad, and she is afraid there can be an odor at times. She now also feels “something at the entrance.” Upon physical exam, you note that there is an organ about 1cm covering at the 12 o’clock of her vaginal entrance. She asks you what, if anything, can be done to alleviate this that does not have to entail having surgery.

NURS648 Women Health

Week 8 Discussion

Gayle is a 25-year-old woman who comes to your office for her first Pap smear exam. She tried to have a Pap smear before, but she was unable to tolerate insertion of the speculum. She cannot use tampons during her menses due to pain at her introitus when she tries to insert the tampon. Her last boyfriend broke up with her after 6 months because she was unable to have intercourse with him due to pain at her introitus when trying to insert his penis. The patient cannot remember exactly when this pain started because she didn’t attempt to use tampons until she was 19 years old. She did not attempt intercourse until she was 21 years old. She thinks she noticed this pain the first time she attempted to insert a tampon but cannot be sure. She is extremely anxious and almost in tears about the thought of having a Pap smear but thinks she “must” have one even though she reports being unable to ever have vaginal intercourse.

And

Ty is 22-year-old who comes to your office for an annual physical exam. On the intake paperwork, you note the gender box is blank. The patient selected both the “have sex with females” and the “have sex with males” box in the sexual history.

Answer the following in complete sentences or in question format as if you are asking the patient these questions:

1. How will you verify the patient’s name and preferred name?

2. How will you ask for the patient’s gender?

3. How will you ask for the patient’s preferred pronouns?