Discussion: Guidelines on Screening Procedures

“THYROID DISEASE”

The goal of health promotion and education is to help prevent disease in patients. However, this is not always successful, and disease it not always preventable. With disease, early detection is ideal, often making screening procedures a routine part of clinical care. Unfortunately, many patients do not utilize these health services. This can be attributed to lack of awareness or access to care, financial concerns, or even levels of comfort with health care providers. In your role as the advanced practice nurse, you must be aware of potential obstacles for patients and implement strategies to ensure patients receive necessary screenings. Although a variety of screening procedures are recommended for women at various stages of life, not all screenings are appropriate for all patients. Understanding the strengths and limitations of each screening, as well as current guidelines for use is essential to effectively facilitate patient care. For this Discussion, the course Instructor will assign a specific topic for you to research.

To prepare:

• Review this week’s media presentation, as well as Chapters 6 and 8 of the Tharpe et al. text and the U.S. Department of Health and Human Services article in the Learning Resources.
• Research guidelines on screening procedures for the topic assigned to you by the course Instructor (e.g., guidelines on screening for domestic violence, safety, nutrition, osteoporosis, heart disease, mental health, eating disorders, thyroid disease, pap smear, mammogram, cancer, and sexually transmitted infections). Note: The course Instructor will assign a topic to you by Day 1 of this week.
• Reflect on strengths and limitations of the screening guidelines.
• Consider how the guidelines might support your clinical decision making.

By Day 3

Post an explanation of the guidelines on screening procedures for the topic assigned to you “THYROID DISEASE”. Include an explanation of strengths and limitations of the guidelines. Then, explain how the guidelines might support your clinical decision making.

By Day 6

Respond to at least two of your colleagues on two different days who were assigned different topics than you. Explain a patient scenario in which your colleague’s guidelines might not be appropriate. Then, explain how you would provide care for the patient in the scenario. Finally, explain how you, as an advanced practice nurse, might be able to impact issues related to these screening guidelines.

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: Primary Care of Women Assignments.

 

 

SAMPLE ANSWER

Guidelines on Clinical Screening Procedures for Women

Introduction

The American College of Obstetricians and Gynecologists (ACOG) has issued guidelines on clinical screening procedures for women. These include breast examination, cervical cancer screening (Pap smear) and pelvic examination. Pelvic ultrasonography is also recommended for some women who have risk factors for developing certain cancers, such as those with a family history of cancer or who are overweight or obese

Guidelines on Clinical Screening Procedures for Women

To help ensure that women are aware of the importance of screening procedures, clinicians should:

• Ensure that women are made aware of their upcoming screening appointment. This can be done by providing information in person or by sending an email reminder a few days before your appointment.

• Encourage women to attend their screening appointment if they have not previously been screened or if they have concerns about participating in these screenings. Women who choose not to participate should be given explanations and encouraged to discuss them with their health care provider at another time (i.e., after the initial consultation).

• Inform each patient about benefits and risks associated with cancer screenings; refer them for further information about specific tests based on individual needs; ensure that patients understand any potential side effects from treatment options discussed during this visit; provide support when discussing difficult topics such as loss/grief related issues so that patients feel comfortable expressing themselves openly without fear of judgmental behavior from others present in our office space.”

Breast Examination

Breast examination is the best way to detect breast cancer. A breast exam should be performed by your healthcare provider once a year, after age 40 and before age 50.

The following guidelines can help you decide when it is time for you to have a breast exam:

• If you are older than 40 years old and haven’t had a mammogram in the past two years, ask your doctor when they recommend that you get one again.

• If there is any change in your breasts or nipples (including their appearance), report these changes immediately to your doctor so that they can determine if they are related to any other symptoms or concerns. These changes may include lumps or bumps on either side of each nipple; pain while touching them; increased size/swelling around these areas; feeling like something may have broken off inside one of them but not being able to see anything sticking out from underneath either side (this could mean an infection); severe tenderness throughout both sides at least once every day for more than 24 hours straight.*

Cervical Cancer Screening (Pap Smear)

The Pap test is a screening procedure that uses visual inspection and microscopic examination to detect cancerous cells in the cervix. It involves taking samples of cervical tissue, usually from the external portion of the cervix, for examination under a microscope. The sample is collected in an endocervical brush or brush-like device called a speculum.

The results of your pap test will be sent to you by mail within two weeks after your visit with us at our clinic (or home if no appointment was made). These results are available online under “My Health” on this site!

Pelvic Examination

• Pelvic examination is used to look for abnormalities in the vagina, cervix and uterus.

• Pelvic examination is a routine part of the physical examination for women.

• It may also be called a bimanual exam or vaginal ultrasound.

Pelvic Ultrasound

Pelvic ultrasound is a safe and painless procedure that may be used to check for abnormalities in the ovaries and uterus. It can be done at any time during your menstrual cycle, but most doctors recommend doing it around day 15 or 16 of your cycle (for example, if you’re going to get an abortion).

Pelvic ultrasounds are performed with a handheld device called a transvaginal probe. The probe is inserted into your vagina and moved around until it finds an area that contains both ovaries or uterine tissue (depending on where you want information about).

Some women may require additional screening procedures, depending on the results of the above.

Some women may require additional screening procedures, depending on the results of the above. These include:

 

• Women who have abnormal results for breast cancer risk factors or genetic markers.

• Women with a family history of breast or ovarian cancer or who have had breast cancer in the past.

• Women who have had genetic testing done for BRCA1/2 mutations (or other mutations).

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