FSU Womens Health Assessment and Diagnosis Discussion Reply
Please respond to discussion below using current APA edition and 2 scholarly references. Must be 150 words.
This week was a success for me as I got to experience all type of patients. I had patients come in for yearly pap smears to pregnancy confirmations. Every patient no matter the diagnosis is so different and feel different. The same two women can have the same diagnosis and yet feel so different. Knowing this, I learned to listen very carefully to each patient and take a full gynecological history to best diagnose the patient. My preceptor is very good at explaining to me the different ways to maneuver to get the most information out of the patient and having them trust you. Although this has taught me a lot, it is still a challenge getting accustomed to the difference in patient symptoms.
The way I have been getting over my challenges is doing more and more assessments as the weeks go by. My preceptor also asks me questions throughout the day that make me critical think. It has been an excited clinical thus far.
Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnosis with rationales.
This week I had a 27 female patient who presented to the clinic with abdominal cramping and pain. The patient described her pain as a constant pressure and as if she needed to push for a bowel movement. The patient stated the pain started this morning and she thought it was a “period cramp” and made a quick appointment to see us. The patient took Midol to alleviate the pain, but nothing has worked. Although the patient is in excruciating pain and probably should have gone to the ED, me and my preceptor went ahead and assessed the patient. The patient laid down flat facing up on the bed. We palpated her lower abdomen where the pain was and noticed inflammation on the left side of her ovary. We took her bowel movement history and did an ultrasound on her as well as sent her for more tests to further confirm diagnosis. At this time the three possible differential diagnosis would be: ovarian cyst, which is a solid or fluid sac within an ovary (Holt, 2023). An ovarian cyst would fit the description for this patient as she is experiencing pelvic pain that is constant and dull (Holt, 2023). The patient also presented with pressure on her abdomen which is another symptom of an ovarian cyst. The second diagnosis would be appendicitis, which is the inflammation in the appendix that causes lower abdominal pain (Bhangu, 2020). A patient with appendicitis can also experience fever, nausea, and vomiting (Bhangu, 2020). The third diagnosis would be pregnancy. This patient is at a baby bearing age which causes concern for pregnancy. This can be caused by muscle pain, gas, constipation or even the baby growing and uterus stretching. During the patient’s assessment and US, it did not show signs of pregnancy.
Mention the health promotion intervention for this patient.
Health promotion intervention for this patient would be safety. The patient should be aware of signs and symptoms of ovarian cysts, appendicitis, and pregnancy. Patient should distinguish whether if the pain is so severe to go to the closest E.D. to get evaluated. Patient should be using protection during sexual intercourse to prevent unwanted pregnancies. Patient is to be educated on each topic and differential diagnosis for future references.
What did you learn from this week’s clinical experience that can be beneficial for you as an advanced practice nurse?
This week I learned that many women’s health illnesses and problems tend to have similar signs and symptoms and it is up to us the provider to decipher between them to get the patient the best care. As a provider, one must ask the right questions and make sure to get the full story even if it’s not about women’s health. This patient could have been constipated and could’ve had nothing to do with women’s health but with the right assessment we came to the correct diagnosis and got the patient the care she needed.
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