NURS6551 Week 3 Discussion: Contraception Treatments

Considering the potentially negative consequences of unintended pregnancy for a woman’s health and well-being, effective contraceptive treatments are an important part of gynecologic care. There are a variety of contraceptive treatment methods available for women, including hormonal, barrier, and fertility awareness options. Each method has its own strengths and limitations, and each patient often has individual factors that might also impact appropriateness of use. In your role as the advanced practice nurse, it is important to keep in mind that while you may make contraceptive recommendations to patients, contraceptive selection is a joint decision between the patient and the provider. For this Discussion, consider which contraceptive treatments would be most appropriate for the patients in the following three case studies:

Case Study 1:

A 23-year-old Caucasian female presents with concerns about mood swings around the time of her menses. She believes she has PMS and wants to know if there is medication to control it.

Case Study 2:

A 25-year-old Latina female presents with menstrual cramping that has been getting worse over time. She has never been pregnant and she has one male sex partner. Her gynecologic exam is normal.

Case Study 3:

A 33-year-old Caucasian female is being seen in clinic for contraception. She is using birth control pills, but forgets to take them because her work schedule changes every week. She has been married for 14 years and has two children. She is looking for an effective method that will be easy to remember. She has a history of chronic headaches and hypertension during pregnancy. She has never been treated for a sexually transmitted infection and is in a mutually monogamous relationship. Family history is significant for an aunt with breast cancer. She smokes half a pack of cigarettes per day. She is 5 ft. 8 in. and 215 lbs. Her vital signs are: BP 120/78, p 72, reg.

To prepare:

Review Chapter 12 of the Schuiling and Likis text and the Dragoman et al. article in this week’s Learning Resources

Select one of the three provided case studies. Reflect on the patient information.

Consider an appropriate contraception treatment for the patient case study you selected.

Think about how you might facilitate the selection of contraception treatments with patients who do not agree with your recommendations.

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NURS6551 Week 4 Discussion: Sexually Transmitted Infections

The Centers for Disease Control and Prevention estimates that there are 19 million new cases of sexually transmitted infections every year in the United States (CDC, 2010b). STIs may present serious health implications for infected patients—especially for those who are unaware of their health condition. Studies show that women are not only at greater risk of contracting these infections, but they also tend to have more severe health problems resulting from infections than men (U.S. Department of Health and Human Services, 2009b). As an advanced practice nurse, you must educate female patients and emphasize the importance of prevention and STI testing for all women regardless of marital status, race, ethnicity, or socioeconomic status. For this Discussion, consider STI education strategies for the three patients in the following case studies:

Case Study 1:

A 19-year-old Asian American female comes into the clinic for a well-woman checkup. She states that about three weeks ago she had a non-tender sore on her labia that resolved without treatment. Her gynecologic exam is normal but she has maculopapular lesions on her trunk, neck, palms, and soles of her feet. The remainder of her exam was unremarkable.

Case Study 2:

A 31-year-old African American female is concerned about a white vaginal discharge. She has self-treated in the past with over-the-counter vaginal creams with some success. She has had no relief thus far for this episode.

Case Study 3:

A 21-year-old nulligravida comes to see you concerned about vague lower abdominal pain for two days associated with a yellowish, nonodorous, vaginal discharge. Past history reveals regular menstrual periods and no previous surgeries or significant medical problems. Her last menstrual period was normal and ended two days ago. She had a similar episode about eight months ago for which she did not seek care because of lack of health insurance. She is currently sexually active with one partner and has had two partners in the past year. She is not using any type of contraception. On physical exam you note a temperature of 38º C, a regular pulse of 100, and a BP of 110/65. Her abdomen is diffusely tender in both lower quadrants. Pelvic exam reveals a yellowish cervical discharge with cervical motion tenderness and a tender fullness in both adnexa.

To prepare:

Review Chapter 20 of the Schuiling and Likis text and the Centers for Disease Control and Prevention article in this week’s Learning Resources.

Review and select one of the three provided case studies. Reflect on 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.