This week you explore guidelines for common screenings for women, including their strengths and limitations and their role in clinical decision-making. You also examine patient histories, diagnoses, and treatment and management plans as you begin working on your Comprehensive Patient Assessment, which focuses on the care of one patient from your Practicum Experience.

Learning Objectives – Discussion: Guidelines on Screening Procedures Paper

By the end of this week, students will:

• Evaluate strengths and limitations of guidelines for screening procedures
• Analyze the influence of guidelines on clinical decision making
• Analyze the impact of advanced practice nurses on issues related to screening guidelines
• Evaluate diagnoses for patients
• Evaluate treatment and management plans
• Understand and apply key terms, principles, and concepts related to clinical guidelines on screening procedures
• Analyze differences between common screenings for younger women and common screenings for older women

Learning Resources

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

• • Chapter 5, “Gynecologic Anatomy and Physiology” (pp. 77-93)

This chapter explores female anatomy and physiology with a focus on the female reproductive anatomy. It also describes the physiology of the menstrual cycle, including the hormonal feedback system and the ovarian and endometrial cycles.

• • Chapter 6, “Gynecologic History and Physical Examination” (pp. 95-133)

This chapter identifies the core knowledge and skill base required for obtaining a gynecologic health history and performing physical examinations such as pelvic and breast exams.

• • Chapter 7, “Periodic Screening and Health Maintenance” (pp. 135-149)

This chapter explores preventive health services for women such as screening tests, counseling, immunization, and chemoprevention. It also compares screening recommendations from organizations such as the U.S. Preventive Services Task Force, American College of Obstetricians and Gynecologists, and American Cancer Society.

• • Chapter 13, “Intimate Partner Violence” (pp. 303-322)

This chapter defines intimate partner violence (IPV) and describes the epidemiology and health effects of IPV. It also examines screening tools for assessing IPV and strategies for managing patients experiencing IPV, particularly pregnant women, adolescents, and older women.

• • Chapter 14, “Sexual Assault” (pp. 327-349)

This chapter examines strategies for identifying sexual violence and providing care to women who are victims of sexual violence. It explores potential health consequences of sexual violence on women, including physical injury, spread of sexually transmitted diseases, and unintended pregnancy.

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 6, “Care of the Well Woman Across the Life Span”
    • “Primary Preventive” Health Care for Well Women” (pp. 301-303)

This section examines social, mental, and physical issues that affect women during different stages of their lives. It also examines the provider’s role in prevention and care.

• • • “Care of the Well Woman: Health Assessment and Screening for Women of Childbearing Age” (pp. 303-310)

This section provides a list of health information for the health care provider to address during well-woman examinations, as well as an immunization schedule for women across the life span.

• • • “Care of the Well Woman: Health Assessment and Screening During Menopause” (pp. 338-349)

This section explains the physiologic changes that occur during menopause, including health issues that are likely to present. It also examines treatment and management options related to diet, exercise, sleep, and sexual comfort. Discussion: Guidelines on Screening Procedures Paper

• •  
  • • Chapter 8, “Primary Care in Midwifery and Women’s Health”
      • “Care of the Woman: Prevention of Osteoporosis” (pp. 576-584)

This section explores factors that increase risks of osteoporosis in women, particularly postmenopausal women. It also provides strategies for identifying risk factors of osteoporosis and diagnosing and treating the condition.

• • • • “Care of the Woman in Need of Smoking Cessation” (pp. 471-475)

This section outlines factors that impact successful smoking cessation. It also describes treatment options and patient education strategies for women in need of smoking cessation.

U.S. Department of Health and Human Services. (2012b). Screening tests and vaccines. Retrieved from http://www.womenshealth.gov/screening-tests-and-vaccines/screening-tests-for-women/

This article provides guidelines for recommended screening tests for women. The guidelines are categorized by age and type of test.

Document: Comprehensive Write-up Guide (PDF)

Required Media – Discussion: Guidelines on Screening Procedures Paper

Laureate Education (Producer). (2013d). Women’s issues and tough conversations. Retrieved from CDN database. (NURS 6551)

In this media presentation, Dr. Rebecca Lee and Cindy Nypaver discuss the importance of the role of the advanced practice nurse when caring for women.

Please click on the following link for the transcript: Transcript (PDF)

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: Guidelines on Screening Procedures Paper

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 healthcare 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. Include an explanation of strengths and limitations of the guidelines. Then, explain how the guidelines might support your clinical decision making.

Read a selection of your colleagues’ responses.

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!

Discussion: Guidelines on Screening Procedures Paper

ADDITIONAL INFORMATION;

Discuss common screenings for women

Introduction

Women should get the screenings for common diseases that are important for them to know about. Some of these diseases can be prevented by taking steps to prevent or treat them, or by getting treatment if they occur. It is important to know what screening options are available and how often you need to go through them so you can make an informed decision about what’s best for your health.

Home test kits

Home test kits are a great way to get an idea of your ovulation cycle and determine when you’re most fertile. These tests can also be used as a way to predict if you’re pregnant, but they aren’t always accurate.

The benefits of home ovulation kits include:

• They’re easy to use just dip the applicator into your urine and wait for results!

• You don’t have to go through any extra steps like taking a sample or mailing it somewhere else in order to get results; simply dip the applicator into your urine, wait for results, and compare them with other tests on hand (or purchase another kit) if needed.

The drawbacks include:

Breast self-exams and mammograms

Breast self-exam is the practice of examining your own breasts to feel for lumps or other abnormalities.

Mammograms are X-ray images of the breast that can detect many types of cancer, including those that aren’t felt by palpation (touching). Mammograms are often used as an initial screening tool for women, who should have one every year from age 30 until age 50.

Cervical cancer screening

Cervical cancer is the second most common cancer in women worldwide, and it’s estimated that over 4 million women are diagnosed with cervical cancer every year. Screening is the best way to detect cervical cancer early.

Cervical cancer can be prevented by getting periodic Pap tests at age 21 (or earlier if your doctor recommends it). Women should also get an HPV test every five years starting at age 26, and they should continue having routine Pap tests as long as they’re sexually active. The American Cancer Society recommends that all women between ages 30-65 be screened for cervical precancerous changes using HPV DNA testing alone or combined with cytology (a sample of cells from the cervix). If you’ve been diagnosed with precancerous changes on your cervix, you’ll need a colposcope exam an instrument used by doctors to examine tissue samples during a biopsy procedure to check for signs of precancerous changes before they develop into full-blown cancer in order to prevent progression toward death from this disease!

Ovarian cancer screening

If you are over the age of 40, it is recommended that you have at least one screening test for ovarian cancer. The CA-125 blood test and transvaginal ultrasound (TUS) are two common screening tests that can detect early signs of ovarian cancer. However, both tests are not very effective in detecting small tumors or cancers that have spread to other parts of the body. Oophorectomy may be required if there is no evidence for malignancy on these tests but this procedure has risks associated with it so it should only be done if absolutely necessary.

The recommended interval between screenings varies depending on your age:

• Women aged 35–39 years should get checked every 2 years;

• Women aged 40–44 years should get checked every 3 years; and

• Women aged 45–49 years should get checked every 5 years;

Cancers of the anus, vulva, vagina, and penis

The cancers of the anus, vulva, vagina and penis are rare. These cancers are more common in men than women.

The most common types of cancer that affect these organs include:

• Squamous cell carcinoma – This type of skin tumor can occur anywhere on your body (except for your nose). It usually appears as a small red or pink bump that looks like a pimple but may be larger than a pinhead. If you have any concerns about this type of cancer or if it has spread to other parts of your body then contact your doctor immediately!

Colon cancer screening

Colon cancer screening is recommended for people over 50 and those with a family history of colon cancer. You can do your own screening by having a stool test or sigmoidoscopy or colonoscopy every few years, if you want to.

If you’re having symptoms like bleeding from the rectum or unexplained weight loss, see your doctor right away so they can check out what’s going on!

Lung cancer screening

Lung cancer screening is recommended for:

• People who have never smoked or have quit smoking.

• Women older than 35 years of age who have had a hysterectomy, tubal ligation or removal of ovaries resulting in menopause at least 5 years before the screening.

Screening can include either a chest x-ray and/or sputum cytology test.

Skin cancer screening

Skin cancer screening is a good idea if you’re at risk of developing skin cancers. It’s recommended that everyone over the age of 50 have a yearly skin exam by their doctor, but it’s also recommended for women who are going through changes in their reproductive system or have been diagnosed with certain types of cancer.

• Men and women should be screened for melanoma (a type of skin cancer) every year after turning 65 years old.

• Most people should get pap smears every three years starting when they turn 30 years old; this is especially important if you’ve had abnormal Pap test results in the past or have a strong family history of cervical cancer or high-risk HPV infection (the virus that causes most HPV-related cancers).

Women should pay attention to their health by going through the following screenings.

Women should take note of the following screening tests:

• Home test kits. Women can use home testing kits to find out if they have or are at risk for breast cancer, ovarian cancer, uterine fibroids and many other conditions.

• Mammograms. A mammogram is a x-ray that uses invisible electromagnetic energy beams to produce images of internal organs and other tissues in your body. These images are then reviewed by a radiologist who diagnoses abnormalities on the computer screen (like this one). It’s important to know that not all cancers show up on these screens right away sometimes it takes several years before you get an abnormal result! If you have had a negative mammogram within five years of getting one done again then call your doctor immediately because there may be something wrong with you health condition.”

Conclusion

By going through the above-mentioned screenings, women can ensure that they are healthy and do not have any diseases. If you are concerned about your health, then it is important to find a doctor or a specialist who can help you with the monitoring of these tests.