NURS664B Week 5 | Nursing in Health Care - Westcoast university

NURS664B Primary Care Women's Health Theory Week 5 Discussion Select one of the following case studies to address. In the subject line of your post, please identify which prompt you are responding to, for example, #2 a post-menopausal 57-year old woman. Discuss what questions you would ask the patient, what physical exam elements you would include, what further testing you would want to have performed, differential and working diagnosis, treatment plan, including inclusion of complementary and OTC therapy, referrals, and other team members needed to complete patient care. Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas. Please refer to evidence-based guidelines to support your decision-making. In your peer replies, please reply to at least one peer who chose a different case study.

1. A 48-year-old female complains her menstrual cycle has recently become irregular, and she is experiencing hot flashes. 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.

What are your presumptive and differential diagnoses? What test(s), if any, will you order to confirm your diagnosis? What is your plan of care for this patient?

1. A 53-year-old woman comes to the clinic complaining of vaginal dryness that is so bothersome that it makes intercourse attempts very painful. She has been unable to have intercourse for the last year because of it. She denies vaginal bleeding and has been postmenopausal since age 51. Her VS are WNL, but her BMI is 27 and she reports she has gained 30 pounds over the last three years without any changes in her diet or activity levels from her 40s. Her PE is unremarkable except for noted vaginal atrophy and dryness

What are your presumptive and differential diagnoses for this patient? What is your plan of care, and why?

1. A 43-year-old G3 P3 White female presents complaining of hot flashes, amenorrhea for 4 months, and then this month she had spotting for 3 days. She has breast tenderness, vaginal itching, and dyspareunia. Her husband had a vasectomy 20 years ago. She wants to know what she can do for relief. Her last Pap was 2 years ago and was negative. Her last MMGM was 5 years ago and was negative. FSH is 39. Height 5' 8", weight 145 lbs.

What is your differential diagnosis? What is your plan of care? What complementary therapies might be helpful for this patient? Support with evidence-based literature.