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Common Health Conditions with Implications for Women

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Case Study Discussion: Common Health Conditions with Implications for Women
Case studies provide the opportunity to simulate realistic scenarios involving patients presenting with various health problems or symptoms. Such case studies enable nurse learners to apply concepts, lessons, and critical thinking to interviewing, screening, and diagnostic approaches, as well as to the development of treatment plans.
Case Study 2
Case Study: Dysfunctional Uterine Bleeding Gretchen Abernathy is a 38-year-old G2P2002 Caucasian female who presents to the clinic with complaints of frequent menstrual bleeding. Her menstrual calendar shows bleeding frequency 17-36 days, lasting 5-10 days in duration and on her heaviest day she needs to change her super tampon every 2 hours. She relates this has been getting worse since stopping her OCP’s when she had a bilateral tubal ligation 4 months after having her second child 9 months ago. She is upset as no one told her that weight gain could happen after and relates she has gained 27 lbs. since her surgery. She states that all this bleeding is making her tired and she cannot keep herself awake. Gretchen’s mother told her she probably just had “low iron” and if she took vitamins, she would feel better.
HEENT: wnl, hair dry, neck supple without adenopathy
CV: RSR without murmur or gallop
Lungs: clear to p&a.
Abd soft, non-tender, BS all 4 quadrant.
VVBSU: WNL
Cervix: firm, smooth, parous, w/o CMT
Uterus: mid mobile non tender, approximately 10 cm
Adnexa: without masses or tenderness
Extremities: negative homan’s, reflexes 2+ = bilaterally, no edema
Photo Credit: Dimco / Adobe StockFor this Case Study Discussion, you will propose a differential diagnosis with a minimum of 3 possible conditions or diseases. You will prioritize these diagnoses and explain which you would recommend.
To prepare:
By Day 1 of this week, you will be assigned to a specific scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
Review the Learning Resources for this week as well as Weeks 5 and 6 and specifically review the clinical guideline resources specific to your assigned case study.
Use the Focused SOAP Note Template found in the Learning Resources to support Discussion. Based on the case study scenario provided, complete a SOAP note and critically analyze this and focus your attention on the diagnostic tests. By Day 3Based on your assigned case study, post a Focused SOAP NOTE with the following:
Differential diagnosis (dx) with a minimum of 3 possible conditions or diseases.
Define what you believe is the most important diagnosis. Be sure to include the first priority in conducting your assessment.
Explain which diagnostic tests and treatment options you would recommend for your patient and explain your reasoning.
Read a selection of your colleagues’ responses.
By Day 6Case Study 2Case Study: Dysfunctional Uterine Bleeding Gretchen Abernathy is a 38-year-old G2P2002 Caucasian female who presents to the clinic with complaints of frequent menstrual bleeding. Her menstrual calendar shows bleeding frequency 17-36 days, lasting 5-10 days in duration and on her heaviest day she needs to change her super tampon every 2 hours. She relates this has been getting worse since stopping her OCP’s when she had a bilateral tubal ligation 4 months after having her second child 9 months ago. She is upset as no one told her that weight gain could happen after and relates she has gained 27 lbs. since her surgery. She states that all this bleeding is making her tired and she cannot keep herself awake. Gretchen’s mother told her she probably just had “low iron” and if she took vitamins, she would feel better.
HEENT: wnl, hair dry, neck supple without adenopathy
CV: RSR without murmur or gallop
Lungs: clear to p&a.
Abd soft, non-tender, BS all 4 quadrant.
VVBSU: WNL
Cervix: firm, smooth, parous, w/o CMT
Uterus: mid mobile non tender, approximately 10 cm
Adnexa: without masses or tenderness
Extremities: negative homan’s, reflexes 2+ = bilaterally, no edema
Respond to at least two of your colleagues’ posts on two different days and explain how you might think differently about the types of tests or treatment options your colleagues suggested and why. Use your learning resources and/or evidence from the literature to support your position.
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!Schuiling, K. D., & Likis, F. E. (2022). Gynecologic health care (4th ed.). Jones and Bartlett Learning. Chapter 17, “Breast Conditions” (pp. 337-349)
Chapter 32, “Anatomy and Physiologic Adaptations of Normal Pregnancy” (pp. 677–673)
Chapter 19, “Pregnancy Diagnosis, Decision-Making support, and Resolution” (pp. 367-379)
General Guidelines for Health Screenings American Academy of Family Practice (AAFP). (2020). Browse AAFP clinical recommendations. https://www.aafp.org/home.htmlAmerican Cancer Society, Inc. (ACS). (2020). Cancer A-Z. https://www.cancer.org/
Note: As you review this resource, select the “Cancer A-Z” topic in the navigation to review information and Resources about for Cancer: Breast, Colon, Lung, Prostate, Skin.American College of Obstetricians and Gynecologists (ACOG). (2020). Clinical topics. https://www.acog.org/ Note: As you review this source, make sure to navigate to the “Topics” section in the navigation to review the clinical topics.HealthyPeople 2030. (2020). Healthy People 2030 Framework. https://www.healthypeople.gov/2020/About-Healthy-P…U.S. Preventive Services Task Force (USPTFS). (2017, September). Search and Filter All Recommendation Topics. https://www.uspreventiveservicestaskforce.org/usps…FNP Resources Centers for Disease Control and Prevention. (CDC). (n.d.). Disease & conditions. https://www.cdc.gov/DiseasesConditions/ The American Association of Nurse Practitioners (AANP). (2020). AANP practice: Clinical Resources, Business, acumen and opportunities for professional recognition. https://www.aanp.org/practiceGeriatric Resources
Nicholas, J. A., & Hall, W. J. (2011). Screening and preventive services for older adults. The Mount Sinai Journal of Medicine, New York, 78(4), 498–508. https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.1002/msj.20275Document: Focused SOAP Note Template (Word document)Document: General Guidelines for Health Screenings Matrix Template (Word document)

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