A 25-year-old Latina female presents with menstrual cramping that has been getting worse over time

A 25-year-old Latina female presents with menstrual cramping that has been getting worse over time

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.

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Walden University

NURS 6551: Primary Care of Women

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. A 25-year-old Latina female presents with menstrual cramping that has been getting worse over time

—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:

• 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*

*These Learning Objectives support Assignments that are due this week, but were assigned in Weeks 1 and 2.

Photo Credit: PhotoAlto/PhotoAlto Agency RF Collections/Getty Images

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in

the Course Materials section of your Syllabus. A 25-year-old Latina female presents with menstrual cramping that has been getting worse over time.

Required Readings

Schuiling, K. D., & Likis, F. E. (2017). Women’s gynecologic health (3rd ed.). Burlington, MA: Jones and Bartlett

Publishers.

• Chapter 11, “Contraception” (pp. 209-244)

This chapter explores advantages and disadvantages of various contraceptive options. It also describes patient factors

that impact the selection of contraceptive options, as well as noncontraceptive benefits of contraceptives.

• Chapter 17, “Unintended Pregnancy” (pp. 397-416)

This chapter examines the scope of unintended pregnancy in the United States. It also provides strategies for

supporting women with unintended pregnancies, including options for abortion and adoption.

• Chapter 23, “Menstrual-Cycle Pain and Premenstrual Conditions” (pp. 549-571)

This chapter examines strategies for assessing, diagnosing, treating, and managing symptoms for women experiencing

menstrual cycle pain and discomfort from conditions such as dysmenorrhea and premenstrual syndrome.

Tharpe, N. L., Farley, C., & Jordan, R. G. (2017). Clinical practice guidelines for midwifery & women’s health (5th ed.).

Burlington, MA: Jones & Bartlett Publishers.

• Chapter 6, “Care of the Well Woman Across the Life Span”

◦ “Care of the Woman Interested in Barrier Methods for Birth Control and STI Prevention” (pp. 311-314)

This section explores types of barrier contraceptives. It examines the efficacy of each method and includes

recommendations for educating patients about the use of each method.

◦ “Care of the Woman Interested in Emergency Contraception” (pp. 314-316)

This section describes available forms of emergency contraception. It also examines factors that must be considered

when selecting emergency contraception and strategies for educating patients about appropriate usage.

◦ “Care of the Woman Interested in Hormonal Contraception” (pp. 319-325)

This section examines the use of hormonal contraception. It explores strategies for assessing a woman’s ability and

motivation to properly use hormonal contraception, as well as risk factors associated with hormonal contraception

use.

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.

◦ “Care of the Woman with an Unintended Pregnancy” (pp. 333-338)

This section describes the role of the health care provider in offering support to women with unintended or unwanted

pregnancies. A 25-year-old Latina female presents with menstrual cramping that has been getting worse over time

• Chapter 7, “Care of the Woman with Reproductive Health Conditions”

◦ “Care of the Woman with Dysmenorrhea” (pp. 389-391)

This section provides strategies for assessing, diagnosing, treating, and managing patients with dysmenorrhea.

◦ “Care of the Woman with Premenstrual Symptoms, Syndrome, or Dysphoric Disorder” (pp. 437-441)

This section examines the prevalence of premenstrual symptoms, PMS, and PMDD in women. It also provides

strategies for assessing and managing patients with these conditions.

Dragoman, M., Davis, A., & Banks, E. (2010). Contraceptive options for women with preexisting medical conditions.

Journal of Women’s Health, 19(3), 575–580.

Note: Retrieved from the Walden Library databases.

This article examines the provider’s role in discussing contraceptive options with patients. It also explores contraceptives

based on their effectiveness for pregnancy prevention and ability to help treat chronic diseases.

Gagan, M. J. (2009). The SOAP format enhances communication. Kai Tiaki Nursing New Zealand, 15(5), 15.

Note: Retrieved from the Walden Library databases.

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.

Optional Resources

Centers for Disease Control and Prevention. (2012b). Women’s health. Retrieved from http://www.cdc.gov/women/

National Institutes of Health. (2012). Office of Research on Women’s Health (ORWH). Retrieved from

http://orwh.od.nih.gov/

U.S. Department of Health and Human Services. (2012a). Womenshealth.gov. Retrieved from

http://www.womenshealth.gov/

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:

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. A 25-year-old Latina female presents with menstrual cramping that has been getting worse over time.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to

your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to

complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you

cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information

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.

Grading Criteria

Week 3 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 3 Discussion

Quiz: Week 3

This Quiz covers the content you have explored throughout the week. The Quiz may include the following topics:

• Contraception methods—condoms, diaphragms, fertility awareness–based methods, intrauterine devices, patches, pills,

spermicides, sponges, etc.

• Dysmenorrhea

• Irregular menses

• Premenstrual syndrome

• Unintended pregnancy

By Day 7

This Quiz is due. You have 30 minutes to complete the Quiz. You may only attempt this Quiz once.

This quiz is a test of your knowledge in preparation for your certification exam. No outside resources including books, notes,

websites, or any other type of resource are to be used to complete this quiz. You are expected to comply with Walden

University’s Code of Conduct. A 25-year-old Latina female presents with menstrual cramping that has been getting worse over time

Submit by Day 7

To submit this Quiz:

Week 3 Quiz

Assignment: Practicum – SOAP Note and Time Log

In addition to Journal Entries, SOAP Note submissions are a way to reflect on your Practicum Experiences and connect these

experiences to your classroom experience. SOAP Notes, such as the ones required in this course, are often used in clinical

settings to document patient care. Please refer to this week’s Learning Resources for guidance on writing SOAP Notes.

Select a patient that you examined during the last three weeks. With this patient in mind, address the following in a SOAP Note:

• Subjective: What details did the patient provide regarding her personal and medical history?

• Objective: What observations did you make during the physical assessment?

• Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest

priority to lowest priority. What was your primary diagnosis and why?

• Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management,

including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and followup parameters, as well as a rationale for this treatment and management plan.

• Reflection notes: What would you do differently in a similar patient evaluation?

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.

By Day 7

This Assignment is due. You will submit your Journal Entries (Weeks 1 and 2), the Week 3 SOAP Note, and your Practicum

Time Log by Day 7 of Week 3 (this week)

Note: Be sure to submit your Assignment to the appropriate submission link below.

Submissions should match the following:

• Week 3 SOAP Note: Submit to the Assignment Part 1 – Week 3 submission link.

• Week 1 & 2 Journal Entry: Submit to the Assignment Part 2 – Week 3 submission link.

• Week 3 Practicum Time Log: Submit to the Assignment Part 3 – Week 3 submission link.

For the Journal Entries and Practicum Time Logs—which are assessed with a Satisfactory (S) or Unsatisfactory (U) score—the

numerical grade will show as 0 points and the “S” or “U” will be posted in the Feedback area by your Instructor. These scores of

0 points do not affect your grade; they simply allow for a placeholder to place the “S” or “U” scoring. This concept also applies

to Weeks 7 and 11. A 25-year-old Latina female presents with menstrual cramping that has been getting worse over time

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the following naming convention: “WK3PTXAssgn+lastname+first initial”.

• Click the Week 3 Assignment Part X links.

• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as

“WK3PTXAssgn+last name+first initial.(extension)” and click Open. If you are submitting multiple files, repeat until all files

are attached.

• Click on the Submit button to complete your submission.

Grading Criteria

Week 3 Assignment Part 1 Rubric

Week 3 Assignment Part 2 Rubric

Week 3 Assignment Part 3 Rubric

Submit Your Assignments Part by Day 7

To submit your Assignment Part 1:

Week 3 Assignment

To submit your Assignment Part 2:

Week 3 Assignment

To submit your Assignment Part 3:

Week 3 Assignment

Week in Review

This week you evaluated and analyzed appropriate contraception selections and treatments including the diagnoses for

patients and their treatment and management plans.

Next week you will begin to explore common gynecologic conditions including strategies for diagnosing, treating, managing

and educating patients with STIs.

Looking Ahead

Week 9

In Week 2, you began to plan and write a comprehensive assessment that focuses on one patient from your current practicum

setting. By the end of Week 3, identify the patient who will be the focus of this Assignment. Review the Week 2 Assignment

section and the Comprehensive Write-up Guide in the Week 2 Learning Resources for additional guidance. Contact the course

Instructor with any questions. You submit the comprehensive assessment in Week 9.

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. A 25-year-old Latina female presents with menstrual cramping that has been getting worse over time