This week, as you continue exploring common gynecologic conditions, you consider diagnosis, treatment, and management strategies for patients. You also explore ways to educate patients on these conditions.

Learning Objectives – NURS 6551: Week 5: Common Gynecologic Conditions, Part 2

By the end of this week, students will:

• Assess patients with common gynecologic conditions
• Evaluate differential diagnoses for common gynecologic conditions
• Analyze treatment and management plans for patients with common gynecologic conditions
• Analyze strategies for educating patients on the treatment and management of common gynecologic conditions
• Understand and apply key terms, principles, and concepts related to common gynecologic conditions
• Evaluate common gynecologic conditions in patients
• Analyze treatment modalities for common gynecologic conditions

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.

Required Readings

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

• • Chapter 24, “Normal and Abnormal Uterine Bleeding” (pp. 575-599)

This chapter differentiates normal uterine bleeding from abnormal and dysfunctional uterine bleeding. It also examines causes of abnormal bleeding and identifies assessment strategies for diagnosing and managing these conditions.

• • Chapter 25, “Hyperandrogenic Disorders” (pp. 603-618)

This chapter explores the etiology, clinical presentation, and impact of hyperandrogenic disorders. It also provides strategies for assessing, diagnosing, and managing patients with these conditions, including adolescents and pregnant women.

• • Chapter 26, “Benign Gynecologic Conditions” (pp. 621-652)

This chapter explains the incidence, presentation, assessment, and management of common benign gynecologic conditions. It also explores differential diagnoses for these conditions and types of treatment options.

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 Amenorrhea” (pp. 372-376)

This section differentiates between primary and secondary amenorrhea and describes treatment options for managing patients with this condition.

• • • “Care of the Woman with Abnormal Uterine Bleeding” (pp. 368-372)

This section explains the causes of dysfunctional uterine bleeding and recommends treatment options for managing this condition.

• • • “Care of the Woman with Endometriosis” (pp. 395-398)

This section identifies the prevalence of endometriosis in women. It also provides strategies for diagnosing, treating, and managing patients with this condition.

• • • “Care of the Woman with Fibroids” (pp. 398-401)

This section describes the classification of fibroids and their prevalence in women of childbearing age. It also presents methods for identifying, diagnosing, and treating this common benign tumor.

• • • “Care of the Woman with Polycystic Ovarian Syndrome” (pp. 433-437)

This section identifies the criteria for a polycystic ovarian syndrome diagnosis. It also presents treatment options for this disorder, including therapeutic options and alternative measures.

Optional Resources – NURS 6551: Week 5: Common Gynecologic Conditions, Part 2

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: Diagnosing and Managing Gynecologic Conditions

Gynecologic conditions can be difficult to diagnose for a variety of reasons, including overlapping symptoms, lack of patient knowledge, or even patient fear or embarrassment about sharing information. Your role provides you the opportunity to develop a relationship of trust and understanding with these patients so that you can gather the appropriate details related to medical history and current symptoms. When caring for this patient population, it is important to make these women an integral part of the process and work collaboratively with them to diagnose and develop treatment and management plans that will meet their individual needs. For this Discussion, consider diagnosis, treatment, and management strategies for the patients in the following four case studies:

Case Study 1:

A 32-year-old African American female is concerned about increasing dysmenorrhea over the past three years. In the past year, this was associated with painful intercourse. She has been in a monogamous relationship with one male partner for the past five years. They tried to have children without success. Menarche was at age 10; menstrual cycles are 21 days apart and last for 6–7 days. The first day of her last menstrual period was 10 days ago and was normal. She denies vaginal itching or discharge. On gynecologic exam there was no swelling, external lesions, or erythema, urethral swelling, or vaginal discharge. Cervix is pink without lesions or discharge. Uterus was small, retroverted, and non-tender. Adnexa were small and non-tender. Nodules are noted along the cul de sac.

Case Study 2:

A 42-year-old African American female is in the clinic for a routine gynecologic exam. When asked, she admits to noticing bleeding in between her menstrual periods for the past several months. She has been pregnant three times and has three children. She is sexually active with one male sex partner in a monogamous relationship. During her bimanual exam, you note an irregular intrauterine non-tender mass about 4 cm in diameter. The mass is palpable abdominally. The remainder of her gynecologic exam was normal.

Case Study 3:

A 48-year-old Caucasian female is in the clinic concerned about prolonged menstrual bleeding for three weeks now. Her prior menstrual periods have been irregular for the past eight months, lasting no more than three days each. There have been one to two months when she had no menstrual cycles at all. She reports occasional hot flushes and mood swings.

Case Study 4:

A 16-year-old Caucasian female comes to the clinic concerned because she has not had a menstrual period for three months. She’s a junior in high school and active in sports. She has lost about 10 lbs. in the past two months. She is currently 5 ft. 4 in. and weighs 100 lbs.

To prepare:

• Review Chapter 26 of the Schuiling and Likis text and Chapter 7 of the Tharpe et al. text.
• Review and select one of the four provided case studies. Analyze 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 disorder.

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 missing information from the patient history might change the diagnoses for the patients in the case studies your colleagues selected.
• 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! NURS 6551: Week 5: Common Gynecologic Conditions, Part 2.

ADDITIONAL INFO 

Common Gynecologic Conditions

Introduction

Gynecologic conditions are terms used to describe any disease or disorder that affects the reproductive organs of a woman. There are many different types of gynecologic conditions, some more common than others. Here’s what you need to know about them:

Pelvic Inflammatory Disease

PID, or pelvic inflammatory disease (PID), is an infection of the female reproductive organs. It can cause infertility and ectopic pregnancy, as well as other complications. PID is caused by a bacterial infection called chlamydia or gonorrhea that enters through your vagina and travels up into your uterus, ovaries and fallopian tubes (the tubes that connect your ovaries to the womb).

If you have recently been sexually active with someone who has had PID symptoms—such as pain during sex or unusual bleeding between periods—you may be at risk for catching it yourself if you don’t take steps to prevent it. You should see a doctor immediately if you have any signs of PID: fever over 101 F; painful urination; redness or swelling around your genital area; vaginal discharge that looks like cottage cheese; pain when peeing especially after sex; bleeding between periods for no obvious reason

Endometriosis

Endometriosis is a condition in which tissue that normally lines the uterus grows outside of the uterus. It can cause pain, infertility, and other problems.

Endometriomas are relatively small cysts that develop on or near your ovaries. They are not cancerous; instead they grow from scar tissue left over from previous surgeries to remove endometrial tissue from your body (endometriosis surgery).

The best way to treat endometriosis is with medication and surgery—but many women don’t have access to those options because they live far away from doctors who specialize in gynecologic care or because insurance companies won’t cover them (or both).

Ovarian Cysts

Ovarian cysts are common. They are usually benign and asymptomatic, but they may be a sign of another disorder.

Ovarian cysts can also be caused by endometriosis, which is when endometrium tissue grows outside the uterus (womb). Endometrial tissue is the lining that normally covers your womb during pregnancy and after childbirth. In some women, this tissue gets trapped inside the ovary instead of being shed properly during menstruation or through your monthly cycle. This causes inflammation in the ovary and leads to an enlarged sac called an ovarian cyst.

Uterine Fibroids

Uterine fibroids are non-cancerous tumors that grow in the wall of your uterus. They can cause symptoms such as heavy bleeding, pain and pressure. They can be removed surgically or used to treat other conditions like severe cramping or infertility.

Uterine fibroids are common in women over 35 years old, but they may develop at any age as long as you’re not pregnant.

Cervical Dysplasia

Cervical dysplasia is one of the most common gynecologic conditions. It occurs when the cervix is abnormal, and it can be detected during a Pap test. The tests are done to check for cervical cells that have become abnormal.

Cervic dysplasia is treated with medications, such as antibiotics or birth control pills (the pill). You may need surgery if your symptoms do not improve after taking these treatments for long periods of time.

If you have been diagnosed with cervical dysplasia, talk with your doctor about whether abortion would be an option for you if pregnancy continues despite having taken medication and undergone treatment options recommended by specialists who specialize in this area of medicine

There are many different types of gynecologic conditions.

There are many different types of gynecologic conditions. The most common ones include:

• Endometriosis

• Vulvodynia (burning pain) in the vulvar area

• Chronic pelvic pain syndrome (CPPS) or chronic pelvic pain  or simply known as pelvic pain or vulvodynia, is a very common condition that affects about 7% to 10% of women at some point in their lives. It can be hard for doctors to diagnose CPPS because it doesn’t have any clear symptoms and can look like other types of chronic medical conditions such as irritable bowel syndrome, fibromyalgia and even arthritis . However, if you have been diagnosed with CPPS then there is usually no cause found after testing has been done by a doctor. The treatment options include medications such as antidepressants , muscle relaxants , anticonvulsants and physical therapy treatments which may help manage your symptoms better than before.”

Conclusion

And that’s it! We hope you found this article informative and helpful. If you want more information on any of these conditions, we recommend visiting your doctor. The best way to stay healthy is by making sure that both you and your partner are up to date with all necessary STD testing, screenings and preventative care.