Order Now

NRNP 6552 GYNECOLOGIC HEALTH AYESHIA ESSAY

NRNP 6552 GYNECOLOGIC HEALTH AYESHIA ESSAY

NRNP 6552 GYNECOLOGIC HEALTH AYESHIA ESSAY

Episodic/Focused SOAP Note Template

Patient Information: Case Study 1

Initials: C.B, Age: 22 years, Sex: Female, Race: White

Struggling to meet your deadline ?

Get assistance on

NRNP 6552 GYNECOLOGIC HEALTH AYESHIA ESSAY

done on time by medical experts. Don’t wait – ORDER NOW!

Meet My Deadline

S.

CC (chief complaint):” Burning and discharge.”

HPI: C.B. is a 22-year-old White female who presents with complaints of burning and discharge. She mentions that the symptoms have lasted for one week. Her boyfriend recently tested positive for chlamydia. The patient denies having any other sexual partners besides her boyfriend. She takes LoEstrin daily for oral contraception.

ORDER A PLAGIARISM-FREE PAPER HERE ON; NRNP 6552 GYNECOLOGIC HEALTH AYESHIA ESSAY

Additional questions to ask the patient in the HPI are:

  1. What is the color of the discharge (yellowish, whitish, gray, or green)?
  2. What is the smell of the discharge (fishy, malodorous, no smell)?
  • Do you experience vulvar itchiness?
  1. When do the symptoms exacerbate?
  2. What have you used to relieve the symptoms?
  3. How often do you use condoms with your boyfriend?
  • Was your boyfriend initiated on treatment for Chlamydia infection?

Current Medications: Daily multivitamin.

Allergies: No drug allergies.

PMHx: No history of chronic illnesses. Immunization is current.

Soc& Substance Hx: The patient admits to taking alcohol on social occasions. She denies using tobacco and any recreational drugs.

Fam Hx: The patient’s mother is alive and has breast cancer in remission and hypothyroidism. Her father has HTN, diabetes type 2, and hyperlipidemia. Her paternal grandfather has prostate cancer. Her sister has type 1 diabetes well.  She has one brother with no medical history.

Surgical Hx: Her surgical history is unremarkable

Mental Hx: She has a history of anxiety and depression.

Violence Hx: No abuse concerns.

Reproductive Hx: Para 0, Gravida 0

ROS

GENERAL: Denies weight changes, fever, chills, body weakness, or low energy levels.

HEENT: Eyes: Denies visual changes or eye pain. Ears, Nose, Throat: Denies tinnitus, hearing loss, congestion, sneezing, or sore throat.

SKIN: Denies skin rash, bruises, or itching.

CARDIOVASCULAR: Denies chest pain/ pressure, palpitations, dyspnea, or edema.

RESPIRATORY: Denies SOB, wheezing, cough, or sputum.

GASTROINTESTINAL: Denies anorexia, nausea, vomiting, abdominal pain, or bowel changes.

NEUROLOGICAL: Denies headache, dizziness, paralysis, numbness, or paresthesia.

MUSCULOSKELETAL: Denies muscle pain, joint pain, or stiffness.

HEMATOLOGIC: Denies anemia, bleeding, or bruising.

LYMPHATICS: Denies swollen nodes.

PSYCHIATRIC: Positive history of depression and anxiety.

ENDOCRINOLOGIC: Denies excessive sweating, cold/heat intolerance, increased urination, or hunger.

GENITOURINARY/REPRODUCTIVE: Positive for vaginal burning and abnormal discharge.  Denies dysuria, urinary frequency, or urgency.

ALLERGIES: Negative for asthma, hives, or rhinitis.

O.

Physical exam:

Vital Signs: Height-5’ 5,  Weight-148, BMI-24.6,  BP-132/68, P- 62

HEENT:   WNL

Neck: Lymph nodes are non-palpable.

Lungs/CV: Chest is clear to auscultation bilaterally, normal respiration, rhythm, and depth upon exam.

Breast: Normal breast exam.

Abdomen: WNL

VVBSU: WNL

Cervix: Firm, smooth, yellow watery discharge in large amounts present.

Uterus: RV, mobile,  non-tender

Adnexa: WNL

Diagnostic results:

Diagnostic tests that will be ordered for this patient include:

  1. Saline Wet Mount: The test will be important to establish the presence of Bacterial vaginosis. The test is 60% sensitive and 98% specific for bacterial vaginosis.
  2. KOH preparation: A negative test result is 65%-85% sensitive to candidal infection. The test can be positive for Trichomonas vaginitis (Hillier et al., 2021).
  • Vaginal nucleic acid amplification test (NAAT): The test will be used to confirm or rule out N. gonorrhea, Trichomoniasis, and Chlamydia trachomatis. NAAT is more sensitive for the diagnosis of trichomoniasis in women (Hillier et al., 2021).
  1. Urinalysis: To assess for leukocytes and erythrocytes in urine and identify or rule out Urinary tract infection (UTI).

A.

Primary and Differential Diagnoses

Trichomoniasis: This is the most prevalent non-viral sexually transmitted disease. The primary presentation is abnormal vaginal discharge and vaginal irritation. Vaginal discharge is typically copious, frothy, malodorous, and gray or yellow-green (Kissinger et al., 2022). Other symptoms include soreness of the vulva and perineum, dysuria, and dyspareunia. Burning, abnormal discharge and copious yellow watery discharge make this a presumptive diagnosis.

Vaginal Candidiasis: The most common symptom is vaginal pruritus which is usually accompanied by an abnormal vaginal discharge (Paladine & Desai, 2018). The characteristic vaginal discharge is usually thick and white. Vaginal Candidiasis is a differential based on symptoms of burning and abnormal discharge.

Bacterial Vaginosis (BV): The presentation of BV includes abnormal vaginal discharge and odor. The vaginal discharge in BV is typically homogenous, thin, gray-white/yellow-white, adherent to the vaginal mucosa, and malodorous with a foul fishy odor (Jones, 2019). Vulvar irritation is rare. The abnormal yellow vaginal discharge makes this a likely diagnosis.

P.

Further Diagnostic Tests: HIV test. The patient has an STD and has a high risk of contracting HIV.

Medication: Metronidazole (Flagyl) 2 g orally as a single dose (Muzny et al., 2020).

Alternative: Tinidazole 2 g orally in a single dose.

Health Education: The patient will be advised to avoid alcohol during medication since a mixture of Metronidazole and alcohol causes nausea, vomiting, fast heartbeat, and flushing of the face (Kissinger et al., 2022). Health education on safe sexual practices such as using condoms to prevent the recurrence of Trichomoniasis and other STDs (Patel et al., 2018). Advise the patient to bring the boyfriend for treatment for Chlamydia if he was not initiated on medication. Recommend having cervical cancer screening through Pap smears every three years to help in the early detection and treatment of cervical cancer.

Referrals: If the symptoms persist despite medication, the patient will be followed up with her primary care provider.

Follow-up: Follow-up after one week to evaluate the improvement of symptoms with medication.  Rescreening of Trichomoniasis three months posttreatment since she is sexually active and due to the high rate of reinfection (Patel et al., 2018).

Reflection: I agree with the diagnosis since the patient presented with symptoms consistent with Trichomoniasis. The patient’s boyfriend had Chlamydia which increased the risk of developing the STD. I also agree with the treatment since 5-Nitroimidazole drugs (metronidazole, tinidazole, and secnidazole) are the only widely used medications for trichomoniasis (Muzny et al., 2020. The patient is sexually active and thus health promotion should focus on promoting safe sexual practices to prevent STDs.

References

Hillier, S. L., Austin, M., Macio, I., Meyn, L. A., Badway, D., & Beigi, R. (2021). Diagnosis and Treatment of Vaginal Discharge Syndromes in Community Practice Settings. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America, 72(9), 1538–1543. https://doi.org/10.1093/cid/ciaa260

Jones, A. (2019). Bacterial Vaginosis: A Review of Treatment, Recurrence, and Disparities. The Journal for Nurse Practitioners, 15(6), 420-423.  https://doi.org/10.1016/j.nurpra.2019.03.010

Kissinger, P. J., Gaydos, C. A., Seña, A. C., Scott McClelland, R., Soper, D., Secor, W. E., Legendre, D., Workowski, K. A., & Muzny, C. A. (2022). Diagnosis and Management of Trichomonas vaginalis: Summary of Evidence Reviewed for the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America, 74(Suppl_2), S152–S161. https://doi.org/10.1093/cid/ciac030

Muzny, C. A., Van Gerwen, O. T., & Kissinger, P. (2020). Updates in trichomonas treatment including persistent infection and 5-nitroimidazole hypersensitivity. Current opinion in infectious diseases, 33(1), 73–77. https://doi.org/10.1097/QCO.0000000000000618

Paladine, H. L., & Desai, U. A. (2018). Vaginitis: diagnosis and treatment. American family physician, 97(5), 321-329.

Patel, E. U., Gaydos, C. A., Packman, Z. R., Quinn, T. C., & Tobian, A. A. R. (2018). Prevalence and correlates of Trichomonas vaginalis infection among men and women in the United States. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 67(2), 211–217. https://doi.org/10.1093/cid/ciy079

BUY A CUSTOM-PAPER HERE; NRNP 6552 GYNECOLOGIC HEALTH AYESHIA ESSAY

GYNECOLOGIC HEALTH

 

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, diagnostic approaches, as well as the development of treatment plans.

For this Case Study Discussion, you will review a case study scenario to obtain information related to a comprehensive well-woman exam and determine differential diagnoses, diagnostics, and develop treatment and management plans.

RESOURCES

 

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

LEARNING RESOURCES

Required Readings

CLINICAL GUIDELINE RESOURCES

Required Media

  • Gynecologic Health – Comprehensive Well-Woman Exam
    Dr. Phyllis Morgan discusses the comprehensive well-woman exam and any pertinent information related to this topic (27 mins).
  • SeattlePTC (2015). Examination of Vaginal Wet Preps [Video]Links to an external site.. https://www.youtube.com/watch?v=8dgeOPGx6YI&t=3s
    • Note: This media program is approximately 15 minutes.
    • Note: As you review this video, consider this as a basic microscopy (yeast, BV).

Optional Resources

  • Hatcher, R. A., Nelson, A. L., Trussell, J., Cwaik, C., Cason, P., Policar, M. S., Kowal, D. (2018). Contraceptive technology (21st ed.). PDR Network, LLC.

Note: In Weeks 1-10, these resources are optional for your review. In Week 11, you will be required to review each of the PowerPoint slides from the text Gynecologic Health Care (4th ed.).

To prepare:

  • By Day 1 of this week, you will be assigned to a specific case study scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your case study assignment from your Instructor.
  • Review the Learning Resources for this week and pay close attention to the media program related to the basic microscope skills. Also, consider re-reviewing the media programs found in Week 1 Learning Resources.
  • Carefully 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. Complete a FOCUSED SOAP note and critically analyze this and focus your attention on the diagnostic tests. Please post your SOAP note. This will help you develop your differential diagnosis and additional questions

BY DAY 3

Please post your FOCUSED SOAP NOTE with your differential diagnosis. Include the additional questions (additional questions ONLY related to the HPI/CC) you would ask the patient. Be sure to include an explanation of the tests you might recommend, ruling out any other issues or concerns and include your rationale. Be specific and provide examples. Use your Learning Resources and/or evidence from the literature to support your explanations. Your differential diagnosis, additional questions, additional diagnostic tests and rationales are what this assignment and grading is focused on. Your critical thinking for this assignment

Read a selection of your colleagues’ responses.

BY DAY 6

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 you might recommend and explain 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 Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!

BUY A CUSTOM-PAPER HERE; NRNP 6552 GYNECOLOGIC HEALTH AYESHIA ESSAY

NRNP_6552_Week3_Case_Study_Discussion_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeMain Posting:Response to the case study discussion questions includes appropriate diagnoses with explanations of appropriate diagnostic tests and treatment options as directed, is based on evidence-based research where appropriate, and is incorporates syntheses representative of knowledge gained from the course readings for the module and current credible sources.
44 to >39.16 ptsExcellent Point range: 90–100

Thoroughly responds to the discussion question(s)… Post includes appropriate diagnoses including explanations of appropriate diagnostic tests and treatment options… Incorporates syntheses representative of knowledge gained from the course readings for the module and current credible sources, with no less than 75% of post the post having exceptional depth and breadth… Supported by at least 3 current credible sources.

 39.16 to >34.76 ptsGood Point range: 80–89

Responds to most of the discussion question(s)… Post includes approprite diagnoses with explanations of appropriate diagnostic tests and treatment options… Somewhat incorporates syntheses representative of knowledge gained from the course readings for the module and current credible sources with no less than 50% of the post having exceptional depth and breadth… Supported by at least 3 credible references.

 34.76 to >30.36 ptsFair Point range: 70–79

Responds to some of the discussion question(s)… Post contains incomplete or vague diagnoses or explanations of appropriate diagnostic tests and treatment options… Is somewhat lacking in synthesis of knowledge gained from the course readings for the module and current credible sources… Post is cited with fewer than 2 credible references.

 30.36 to >0 ptsPoor Point range: 0–69

Does not respond to the discussion question(s)… Post contains incomplete diagnoses or explanations of appropriate diagnostic tests and treatment options, or diagnoses and/or explanations are missing… Lacks synthesis gained from the course readings for the module and current credible sources… Contains only 1 or no credible references.
44 pts
This criterion is linked to a Learning OutcomeMain Posting:Writing
6 to >5.34 ptsExcellent Point range: 90–100

Written clearly and concisely… Contains no grammatical or spelling errors… Further adheres to current APA manual writing rules and style.

 5.34 to >4.74 ptsGood Point range: 80–89

Written concisely… May contain one to two grammatical or spelling errors… Adheres to current APA manual writing rules and style.

 4.74 to >4.14 ptsFair Point range: 70–79

Written somewhat concisely… May contain more than two spelling or grammatical errors… Contains some APA formatting errors.

 4.14 to >0 ptsPoor Point range: 0–69

Not written clearly or concisely… Contains more than two spelling or grammatical errors… Does not adhere to current APA manual writing rules and style.
6 pts
This criterion is linked to a Learning OutcomeMain Posting:Timely and full participation
10 to >8.9 ptsExcellent Point range: 90–100

Meets requirements for timely, full, and active participation… Posts main discussion by due date.

 8.9 to >7.9 ptsGood Point range: 80–89

Posts main discussion by due date… Meets requirements for full participation.

 7.9 to >6.9 ptsFair Point range: 70–79

Posts main discussion by due date.

 6.9 to >0 ptsPoor Point range: 0–69

Does not meet requirements for full participation… Does not post main discussion by due date.
10 pts
This criterion is linked to a Learning OutcomeFirst Response:Post to colleague’s main post that is reflective and justified with credible sources.
9 to >8.01 ptsExcellent Point range: 90–100

Response exhibits critical thinking and application to practice settings… Responds to questions posed by faculty… The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

 8.01 to >7.11 ptsGood Point range: 80–89

Response has some depth and may exhibit critical thinking or application to practice setting.

 7.11 to >6.21 ptsFair Point range: 70–79

Response is on topic, may have some depth.

 6.21 to >0 ptsPoor Point range: 0–69

Response may not be on topic, lacks depth.
9 pts
This criterion is linked to a Learning OutcomeFirst Response: Writing
6 to >5.34 ptsExcellent Point range: 90–100

Communication is professional and respectful to colleagues… Response to faculty questions are fully answered, if posed… Provides clear, concise opinions and ideas that are supported by two or more credible sources… Response is effectively written in Standard, Edited English.

 5.34 to >4.74 ptsGood Point range: 80–89

Communication is mostly professional and respectful to colleagues… Response to faculty questions are mostly answered, if posed… Provides opinions and ideas that are supported by few credible sources… Response is written in Standard, Edited English.

 4.74 to >4.14 ptsFair Point range: 70–79

Response posed in the discussion may lack effective professional communication… Response to faculty questions are somewhat answered, if posed… Few or no credible sources are cited.

 4.14 to >0 ptsPoor Point range: 0–69

Responses posted in the discussion lack effective communication… Response to faculty questions are missing… No credible sources are cited.
6 pts
This criterion is linked to a Learning OutcomeFirst Response:Timely and full participation
5 to >4.45 ptsExcellent Point range: 90–100

Meets requirements for timely, full, and active participation… Posts by due date.

 4.45 to >3.95 ptsGood Point range: 80–89

Meets requirements for full participation… Posts by due date.

 3.95 to >3.45 ptsFair Point range: 70–79

Posts by due date.

 3.45 to >0 ptsPoor< Point range: 0–69

Does not meet requirements for full participation… Does not post by due date.
5 pts
This criterion is linked to a Learning OutcomeSecond Response:Post to colleague’s main post that is reflective and justified with credible sources.
9 to >8.01 ptsExcellent Point range: 90–100

Response exhibits critical thinking and application to practice settings… Responds to questions posed by faculty… The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

 8.01 to >7.11 ptsGood Point range: 80–89

Response has some depth and may exhibit critical thinking or application to practice setting.

 7.11 to >6.21 ptsFair Point range: 70–79

Response is on topic, may have some depth.

 6.21 to >0 ptsPoor Point range: 0–69

Response may not be on topic, lacks depth.
9 pts
This criterion is linked to a Learning OutcomeSecond Response:Writing
6 to >5.34 ptsExcellent Point range: 90–100

Communication is professional and respectful to colleagues… Response to faculty questions are fully answered, if posed… Provides clear, concise opinions and ideas that are supported by two or more credible sources… Response is effectively written in Standard, Edited English.

 5.34 to >4.74 ptsGood Point range: 80–89

Communication is mostly professional and respectful to colleagues… Response to faculty questions are mostly answered, if posed… Provides opinions and ideas that are supported by few credible sources… Response is written in Standard, Edited English.

 4.74 to >4.14 ptsFair Point range: 70–79

Response posed in the discussion may lack effective professional communication… Response to faculty questions are somewhat answered, if posed… Few or no credible sources are cited.

 4.14 to >0 ptsPoor Point range: 0–69

Responses posted in the discussion lack effective communication… Response to faculty questions are missing… No credible sources are cited.
6 pts
This criterion is linked to a Learning OutcomeSecond Response:Timely and full participation
5 to >4.45 ptsExcellent Point range: 90–100

Meets requirements for timely, full, and active participation… Posts by due date.

 4.45 to >3.95 ptsGood Point range: 80–89

Meets requirements for full participation… Posts by due date.

 3.95 to >3.45 ptsFair Point range: 70–79

Posts by due date.

 3.45 to >0 ptsPoorPoint range: 0–69

Does not meet requirements for full participation… Does not post by due date.
5 pts
Total Points: 100

Struggling to meet your deadline ?

Get assistance on

NRNP 6552 GYNECOLOGIC HEALTH AYESHIA ESSAY

done on time by medical experts. Don’t wait – ORDER NOW!

Meet My Deadline
Open chat
WhatsApp chat +1(256) 743-6183
We are online
Our papers are plagiarism-free, and our service is private and confidential. Do you need any writing help?