NURS 6551:Week 4: Common Gynecologic Conditions, Part 1rt 1 Essay Assignment Paper

This week, as you begin your exploration of common gynecologic conditions, you examine strategies for diagnosing, treating, managing, and educating patients with STIs. You also consider the sociocultural factors that might impact the care of women with or at risk of STIs.

Learning Objectives

By the end of this week, students will:

• Assess patients with sexually transmitted infections
• Evaluate differential diagnoses for sexually transmitted infections
• Analyze treatment and management plans for patients with sexually transmitted infections
• Analyze strategies for educating patients on the treatment and management of sexually transmitted infections
• Evaluate the impact of sociocultural factors on the treatment and management of sexually transmitted infections
• Understand and apply key terms, principles, and concepts related to sexually transmitted infections in patients
• Evaluate vaginal infections in patients

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

Learning Resources

Required Readings

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

 

• • Chapter 10, “Sexuality and Sexual Health” (pp. 191-206)

This chapter explores components of female sexuality, including sexual desire, sexual response, and women’s views of themselves in society. It also examines strategies for maintaining satisfactory sexual health in women.

 

• • Chapter 19, “Gynecologic Infections” (pp. 443-462)

This chapter identifies strategies for assessing, diagnosing, and managing patients experiencing gynecologic infections. It also provides recommendations for treating gynecologic infections, including alternative treatments for pregnant women.

 

• • Chapter 20, “Sexually Transmitted Infections” (pp. 465-509)

This chapter describes strategies for preventing, identifying, and managing patients with sexually transmitted infections (STIs). It explores common STIs, such as HPV, HIV, syphilis, and gonorrhea, and identifies risk factors associated with these conditions.

 

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 7, “Care of the Woman with Reproductive Health Conditions”
    • “Care of the Woman with Bacterial Vaginosis” (pp. 376-379)

This section identifies the presentation and incidence of bacterial vaginosis and provides strategies for diagnosing and treating this infection.

 

• • • “Care of the Woman with Chlamydia” (pp. 383-386)

This section describes the presentation and impact of chlamydia on women. Chlamydia screenings and strategies for diagnosis and treatment are also examined.

 

 

• • • “Care of the Woman with Gonorrhea” (pp. 401-404)

This section explains the presentation of gonorrhea and its association with chlamydial infections. It also presents strategies for diagnosing and treating patients with this condition.

 

• • • “Care of the Woman with Hepatitis” (pp. 404-408)

This section identifies the five primary types of hepatitis infections, including appropriate treatment options and recommended follow-up care.

 

• • • “Care of the Woman with Herpes Simplex Virus” (pp. 408-411)

This section examines the herpes simplex virus, including transmission of the condition, special considerations for pregnant women, and recommended treatment and management strategies.

 

• • • “Care of the Woman with Human Immunodeficiency Virus” (pp. 411-415)

This section explores HIV, transmission of the condition, diagnosis, long-term treatment, and implications for women. It also describes the potential impact of the condition on pregnant women and their newborns.

 

• • • “Care of the Woman with Human Papillomavirus” (pp. 415-418)

This section describes the prevalence of HPV and its impact on women. It also identifies screening tests for HPV as well as clinical management guidelines for HPV-infected patients.

 

• • • “Care of the Woman with Parasitic Infestation” (pp. 424-427)

This section explains difficulties of treating and preventing parasitic infestations, including lice and scabies.

 

• • • “Care of the Woman with Syphilis” (pp. 441-444)

This section identifies possible presentations of syphilis. It also presents treatment options for managing this condition, as well as special considerations for pregnant women and their newborns.

 

• • • “Care of the Woman with Trichomoniasis” (pp. 444-447)

This section explores the presentation, impact, and treatment of trichomoniasis on women. It also identifies follow-up care guidelines for patients with this infection.

 

• • • “Care of the Woman with Vulvovaginal Candidiasis” (pp. 447-450)

This section examines the prevalence of vulvovaginal candidiasis, as well as factors that may contribute to a diagnosis of this condition.

Centers for Disease Control and Prevention. (2010a). Sexually transmitted diseases treatment guidelines, 2010. Morbidity and Mortality Weekly Report, 59(RR-12). Retrieved from http://www.cdc.gov/std/treatment/2010/STD-Treatment-2010-RR5912.pdf

This article provides guidelines for treating patients with sexually transmitted diseases, including HIV, syphilis, chlamydia, and HPV. The care of special populations of women is also discussed

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: Sexually Transmitted Infections

The Centers for Disease Control and Prevention estimates that there are 19 million new cases of sexually transmitted infections every year in the United States (CDC, 2010b). STIs may present serious health implications for infected patients—especially for those who are unaware of their health condition. Studies show that women are not only at greater risk of contracting these infections, but they also tend to have more severe health problems resulting from infections than men (U.S. Department of Health and Human Services, 2009b). As an advanced practice nurse, you must educate female patients and emphasize the importance of prevention and STI testing for all women regardless of marital status, race, ethnicity, or socioeconomic status. For this Discussion, consider STI education strategies for the three patients in the following case studies:

Case Study 1:

A 19-year-old Asian American female comes into the clinic for a well-woman checkup. She states that about three weeks ago she had a non-tender sore on her labia that resolved without treatment. Her gynecologic exam is normal but she has maculopapular lesions on her trunk, neck, palms, and soles of her feet. The remainder of her exam was unremarkable.

Case Study 2:

A 31-year-old African American female is concerned about a white vaginal discharge. She has self-treated in the past with over-the-counter vaginal creams with some success. She has had no relief thus far for this episode.

Case Study 3:

A 21-year-old nulligravida comes to see you concerned about vague lower abdominal pain for two days associated with a yellowish, nonodorous, vaginal discharge. Past history reveals regular menstrual periods and no previous surgeries or significant medical problems. Her last menstrual period was normal and ended two days ago. She had a similar episode about eight months ago for which she did not seek care because of lack of health insurance. She is currently sexually active with one partner and has had two partners in the past year. She is not using any type of contraception. On physical exam you note a temperature of 38º C, a regular pulse of 100, and a BP of 110/65. Her abdomen is diffusely tender in both lower quadrants. Pelvic exam reveals a yellowish cervical discharge with cervical motion tenderness and a tender fullness in both adnexa.

To prepare:

• Review Chapter 20 of the Schuiling and Likis text and the Centers for Disease Control and Prevention article in this week’s Learning Resources.
• Review and select one of the three provided case studies. Reflect on the patient information.
• Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
• Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.
• Consider strategies for educating patients on the treatment and management of the sexually transmitted infection you identified as your primary diagnosis.

By Day 3

Post an explanation of the differential diagnosis for the patient in the case study you selected. Provide a minimum of three possible diagnoses, and list them from highest priority to lowest priority. Explain which is the most likely diagnosis for the patient and why. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients on the sexually transmitted infection.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days in both of the ways listed below. Respond to colleagues who selected different case studies than you did.

• Explain how sociocultural factors might impact the diagnosis, management, and follow-up care of patients with the sexually transmitted infections your colleagues discussed.
• Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or contrasting perspectives.

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!