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: Discussion: Diagnosing and Managing Gynecologic Conditions

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: Discussion: Diagnosing and Managing Gynecologic Conditions

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: Discussion: Diagnosing and Managing Gynecologic Conditions.

ADDITIONAL INFORMATION;

Diagnosing and Managing Gynecologic Conditions

Introduction

Gynecologic disorders are among the most common health concerns for women. They affect millions of Americans and can have a significant impact on their lives. Diagnosis and management of gynecologic conditions requires accurate diagnosis, appropriate treatment and monitoring by a board-certified physician who is familiar with reproductive health issues.

Uterine Fibroids

Uterine fibroids are growths that develop in or on the wall of the uterus. They can be found in about half of all women, regardless of age or ethnicity. Uterine fibroids may cause problems with fertility, menstrual bleeding and pain.

Uterine fibroids are common, and most women have them at some point in their lives. However, some women will only experience symptoms from a small number of fibroid tumors while others may have large tumors that cause significant bleeding or discomfort during intercourse or other activities such as exercise (such as running).

Endometriosis

Endometriosis is a condition in which tissue similar to the lining of your uterus grows outside your uterus. This can happen on either side of the pelvis, or even in other areas such as your fallopian tubes and ovaries.

Endometriosis is often diagnosed at an early stage because it tends to present with pain and infertility. But if left untreated, endometriosis can cause infertility or even Rectocele (a hernia that occurs when part of the bowel protrudes into its place).

It’s important for women who have symptoms associated with endometriosis—such as pain during intercourse or heavy periods—to see their doctor about this condition so that they can get treatment options that may help reduce their discomfort. Treatment options include surgery (where doctors remove portions of tissue from inside), medication combinations used together like hormonal birth control pills called Progesterone-only pills (which contain no estrogen); hormone replacement therapy; radiation treatment; laparoscopic surgery where doctors make small incisions through thin sheets instead large ones used during open surgeries; cryobiologic freezing treatments sometimes called “cold knife” procedures which freeze cells directly rather than having them die off slowly over time

Pelvic Inflammatory Disease (PID)

PID is an infection of the female reproductive organs. It can cause severe pain and bleeding, as well as other symptoms like fever and abdominal pain.

PID is diagnosed with a pelvic exam and/or pelvic ultrasound (the use of a device that uses sound waves to create images). If you have PID, your doctor will likely recommend treatment with antibiotics such as metronizumab (brand name Mebendazole), tinidazole or doxycycline if there’s no other way to treat it

Ovarian Cysts

Ovarian cysts are fluid-filled sacs that grow on or in the ovary. They can be painful and are a common type of gynecologic growth, particularly when they’re large.

If you have ovarian cyst symptoms, contact your doctor right away. Your doctor will want to rule out other conditions before making any recommendations about treatment options or surgery. You may also be referred to a gynecologist who specializes in women’s health concerns such as ovarian cysts (or “womanhood”).

Vulvar Pain and Skin Conditions

Vulvodynia is a chronic pain condition that affects the vulva, the external female genitalia. Vulvar vestibulitis syndrome (VVS) is a chronic condition that causes severe pain in the area around the opening of the vagina.

• Vowel:

Vulvodynia refers to any type of nerve pain or tenderness in this area, including vulvar vestibulitis syndrome (VVS), which can lead to frustration and embarrassment when trying to have sex or even walk normally.

Takeaway:

For the best health care, you should seek out a doctor with a strong background in gynecology. If you have any questions about the diagnosis and treatment of your condition, ask them! You can also learn more about gynecologic conditions by visiting our website or reading up on them online. The key takeaway from this article is that there are many ways to improve the quality of your life as a woman—and if you’re looking for help in diagnosing and managing gynecologic conditions such as endometriosis or fibroid tumors, we’re here to provide it!

Conclusion

If you have any of the above symptoms, you should visit your doctor as soon as possible. The healthcare team may recommend a variety of treatments depending on the nature of your condition and its severity. They can also advise on how best to manage it at home, including maintaining healthy lifestyle habits such as drinking plenty of water, exercising regularly and eating healthily—all things that are crucial for women’s wellbeing.