Schuiling, K. D., & Likis, F. E. (2022). Gynecologic health care (4th ed.). Jones and Bartlett Learning.

Chapter 10, “Women’s Health After Bariatric Surgery” (pp. 165 – 171)

Curry, S. J., & U.S. Prevent Services Task Force. (2018). Screening for intimate partner violence, elder abuse, and abuse of vulnerable adults US preventive services task force final recommendation statement. JAMA320(16), 1678–1687. https://doi.org/10.1001/jama.2018.14741

Fanslow, J., Wise, M. R., & Marriott, J. (2019). Intimate partner violence and women’s reproductive health. Obstetrics, Gynaecology & Reproductive Medicine, 29(12), 342–350. https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.1016/j.ogrm.2019.09.003

Lockwood, C. J. (2019). Key points for today’s ‘well-woman’ exam: A guide for ob/gynsContemporary OB/GYN, 64(1), 23–29. https://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=134229869&site=ehost-live&scope=site&authtype=shib&custid=s6527200

Case # (1, 2, 3 or 4) and Description of the Case Chosen:

  • Case 1:  Cindy
  • Case 2:  Maxine
  • Case 3:  Lucy
  • Case 4:  Nadine
Outline Subjective data. 

Identify data provided in your chosen case and any additional data needed.

OutlineObjective findings.

 

Identify findings provided in your chosen case and any additional data needed.

Identify diagnostic tests, procedures, laboratory work indicated. 

Describe the rationalefor each test or intervention with supporting references.

Distinguish at least three differential diagnoses. 

Describethe rationales for your choice of each diagnosis with supporting references.

Identify appropriate medications, treatments or other interventions associated with each differential diagnosis. 

Describe rationales and supporting references for each.

 

Explain keySocial Determinants of Heath (SDoH) for your chosen case. Describe collaborative care referrals and patient education needs for your chosen case. 

Describe rationales and supporting references for each.

 

 

Case Study Discussion: Common Gynecologic Conditions, Part 2

Description

Case studies provide the opportunity to simulate realistic scenarios involving patients presenting with various health problems or symptoms. Such case studies enable nurse learners to apply concepts, lessons, and critical thinking to interviewing, screening, diagnostic approaches, as well as to the development of treatment plans.

Photo Credit: Erica Smit / Adobe Stock

For this Case Study Discussion, you will develop a case study that demonstrates a gynecological disease process from your practicum experience or your professional practice that would be quite challenging for you as a clinician. You will then explore this case study to determine the diagnosis, diagnostic tests, and treatment options for the patient.

To prepare:

  • Consider a case study related to a patient that demonstrates a gynecological disease process in your practicum experience or professional practice that would be your biggest challenge as a clinician. Note: Possibly use your “FNP or AGPCNP Skills and Procedures Self-Assessment” in your practicum experience to guide your case study selection.
  • Review the Learning Resources for this week and specifically review the clinical guideline resources specific to your proposed case study.
  • Use the Focused SOAP Note Template found in the Learning Resources to support your discussion. Complete a Focused SOAP note and critically analyze this and focus your attention on the diagnostic tests. 

By Day 3

Based on your case study, post the following:

  • POST A Focused SOAP NOTE only and describe your case study.  
  • Provide a differential diagnosis (dx) with a minimum of 3 possible conditions or diseases.
  • Define what you believe is the most important diagnosis. Be sure to include the priority in conducting your assessment.
  • Explain which diagnostic tests and treatment options you would recommend for your patient and explain your reasoning.
  • Also, share with your colleagues your experiences as well as what you learned from these experiences.

Use your Learning Resources and/or evidence from the literature to support your thinking and perspectives.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues’ posts on two different days and explain how you might think differently about the types of tests or treatment options that your colleagues suggested and why. Use your learning resources and/or evidence from the literature to support your position.

 

Description

Case Study 2

Case Study: STI Investigation

Susan Lang is a 24-year-old Caucasian female presenting to the clinic for regular care. She works full-time as an administrative assistant, and relates she loves her job. She has no medical or surgical history, takes no medication, and has no allergies. Family history is non-contributary. Social history is remarkable for cigarette smoking at a rate of ½ packs per day (PPD) since age 14, / ETOH only on weekends, 6-8 hard liquor/ daily, and marijuana smoking. Gyn history is onset of menses age 13, menses every 28-32 days, lasting 4-6 day and using 3 tampons daily. She has some cramping during her menses for which she takes otc Pamprin. She jogs 3-4 times a week, wears seatbelts when in the car, and “occasionally” uses sunscreen. Susan relates she has been having some postcoital bleeding for the past 6 weeks and has had a sore throat for past 3 weeks. She did have a fever for a day or two, but Tylenol took care of it and she thought it was allergies.

Susan’s vital signs are taken and were temperature 97.8, pulse 68, BP 112/64, height 5’6” and weight 118 lbs. (which was the same as last year). BMI 19.04

HEENT: WNL except some anterior cervical adenopathy bilaterally, and throat appears reddened.

Lung: clear to auscultation

CV:  regular sinus rhythms without murmur or gallop

  • Abd:  soft, non-tender, liver normal,  

Breasts:  fibrocystic changes bilaterally, no masses, dimpling, redness or discharge, no adenopathy, and bilateral nipple piercings.

VVBSU: wnl, slight frothy yellow discharge by cervix, clitoral piercing noted

  • Cervix:  friable, some petechia no cervical motion tenderness. 

Uterus: mid mobile, non-tender

Adnexa: without masses or tenderness

  • Perineum: wnl 

Rectum: wnl

Extremities:  full rom, skin clear, no edema, reflexes 1+.

  • Neurological:  CN II-12 grossly intact. Case Study Discussion: Common Gynecologic Conditions, Part 1

Case studies provide the opportunity to simulate realistic scenarios involving patients presenting with various health problems or symptoms. Such case studies enable nurse learners to apply concepts, lessons, and critical thinking to interviewing, screening, and diagnostic approaches, as well as to the development of treatment plans.

Photo Credit: Teodor Lazarev / Adobe Stock

  • For this Case Study Discussion, you will once again review a case study scenario to obtain information related to a comprehensive well-woman exam and determine differential diagnoses, diagnostics, and develop treatment and management plans.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

  • Review the Learning Resources for this week and specifically review the clinical guideline resources specific to your assigned case study.

Use the Focused SOAP Note Template found in the Learning Resources to support your Discussion. Complete a FOCUSED SOAP note and critically analyze this and focus your attention on the diagnostic tests. Please post your FOCUSED SOAP note. This information will help you develop your differential diagnosis and additional questions

By Day 3

  • Please POST your FOCUSED SOAP NOTE and post your primary diagnosis. Include the additional questions you would ask the patient and explain your reasons for asking the additional questions. Then, explain the types of symptoms you would ask. Be specific and provide examples. (Note: When asking questions, consider sociocultural factors that might influence your question decisions.)

Based on the preemptive diagnosis, explain which treatment options and diagnostic tests you might recommend. Use your Learning Resources and/or evidence from the literature to support your recommendations.

Read a selection of your colleagues’ responses.

  • By Day 6

Respond to at least two of your colleagues’ posts on two different days and explain how you might think differently about the types of diagnostic tests you would recommend and explain your reasoning. Use your Learning Resources and/or evidence from the literature to support your position.

Learning Resources

Schuiling, K. D., & Likis, F. E. (2022). Gynecologic health care (4th ed.). Jones and Bartlett Learning. Chapter 17, “Breast Conditions” (pp. 337-349)
Chapter 18, “Alterations in Sexual Function” (pp. 353-364)
Chapter 20, “Infertility” (pp. 383-398)
Chapter 21, “Gynecologic Infections” (pp. 401-432)
Chapter 22, “Sexually Transmitted Infections” (pp. 437-466)

Reproductive Health Access Project (2020). Your birth control choiceshttps://www.reproductiveaccess.org/wp-content/uplo…

Clinical Guideline Resources 

As you review the following resources, you may want to include a topic in the search area to gather detailed information (e.g., breast cancer screening guidelines; for CDC – zika in pregnancy).

American College of Obstetricians and Gynecologists (ACOG). (2020).  https://www.acog.org/

American Nurses Association (ANA). (n.d.). Lead the profession to shape the future of nursing and health care. https://www.nursingworld.org/

HealthyPeople 2030. (2020). Healthy People 2030 Framework.  https://www.healthypeople.gov/2020/About-Healthy-P…

The American Association of Nurse Practitioners (AANP). (2020). https://www.aanp.org/

POST

Case Study Discussion: Common Gynecologic Conditions, Part 1Case studies provide the opportunity to simulate realistic scenarios involving patients presenting with various health problems or symptoms. Such case studies enable nurse learners to apply concepts, lessons, and critical thinking to interviewing, screening, and diagnostic approaches, as well as to the development of treatment plans.Photo Credit: Teodor Lazarev / Adobe StockFor this Case Study Discussion, you will once again review a case study scenario to obtain information related to a comprehensive well-woman exam and determine differential diagnoses, diagnostics, and develop treatment and management plans.To prepare:By Day 1 of this week, you will be assigned to a specific case study scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.Review the Learning Resources for this week and specifically review the clinical guideline resources specific to your assigned case study.Use the Focused SOAP Note Template found in the Learning Resources to support your Discussion. Complete a FOCUSED SOAP note and critically analyze this and focus your attention on the diagnostic tests. Please post your FOCUSED SOAP note. This information will help you develop your differential diagnosis and additional questionsBY DAY 3Please POST your FOCUSED SOAP NOTE and post your primary diagnosis. Include the additional questions you would ask the patient and explain your reasons for asking the additional questions. Then, explain the types of symptoms you would ask. Be specific and provide examples. (Note: When asking questions, consider sociocultural factors that might influence your question decisions.)Based on the preemptive diagnosis, explain which treatment options and diagnostic tests you might recommend. Use your Learning Resources and/or evidence from the literature to support your recommendations.Read a selection of your colleagues’ responses.BY DAY 6Respond to at least two of your colleagues’ posts on two different days and explain how you might think differently about the types of diagnostic tests you would recommend and explain your reasoning. Use your Learning Resources and/or evidence from the literature to support your position.Case Study 2Case Study: STI InvestigationSusan Lang is a 24-year-old Caucasian female presenting to the clinic for regular care. She works full-time as an administrative assistant, and relates she loves her job. She has no medical or surgical history, takes no medication, and has no allergies. Family history is non-contributary. Social history is remarkable for cigarette smoking at a rate of ½ packs per day (PPD) since age 14, / ETOH only on weekends, 6-8 hard liquor/ daily, and marijuana smoking. Gyn history is onset of menses age 13, menses every 28-32 days, lasting 4-6 day and using 3 tampons daily. She has some cramping during her menses for which she takes otc Pamprin. She jogs 3-4 times a week, wears seatbelts when in the car, and “occasionally” uses sunscreen. Susan relates she has been having some postcoital bleeding for the past 6 weeks and has had a sore throat for past 3 weeks. She did have a fever for a day or two, but Tylenol took care of it and she thought it was allergies.Susan’s vital signs are taken and were temperature 97.8, pulse 68, BP 112/64, height 5’6” and weight 118 lbs. (which was the same as last year). BMI 19.04HEENT: WNL except some anterior cervical adenopathy bilaterally, and throat appears reddened.Lung: clear to auscultationCV: regular sinus rhythms without murmur or gallopAbd: soft, non-tender, liver normal,Breasts: fibrocystic changes bilaterally, no masses, dimpling, redness or discharge, no adenopathy, and bilateral nipple piercings.VVBSU: wnl, slight frothy yellow discharge by cervix, clitoral piercing notedCervix: friable, some petechia no cervical motion tenderness.Uterus: mid mobile, non-tenderAdnexa: without masses or tendernessPerineum: wnlRectum: wnlExtremities: full rom, skin clear, no edema, reflexes 1+.Neurological: CN II-12 grossly intact.

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Name: NRNP_6552_Week5_Case_Study_Discussion_Rubric

Show Descriptions

Main Posting:
Response to the case study discussion questions includes appropriate diagnoses with explanations of appropriate diagnostic tests and treatment options as directed, is based on evidence-based research where appropriate, and is incorporates syntheses representative of knowledge gained from the course readings for the module and current credible sources.–

Excellent
Point range: 90–100

40 (40%) – 44 (44%)

Thoroughly responds to the discussion question(s).

Post includes approprite diagnoses including explanations of appropriate diagnostic tests and treatment options.

Incorporates syntheses representative of knowledge gained from the course readings for the module and current credible sources, with no less than 75% of post the post having exceptional depth and breadth.

Supported by at least 3 current credible sources.

Good
Point range: 80–89

35 (35%) – 39 (39%)

Responds to most of the discussion question(s)

Post includes approprite diagnoses with explanations of appropriate diagnostic tests and treatment options.

Somewhat incorporates syntheses representative of knowledge gained from the course readings for the module and current credible sources with no less than 50% of the post having exceptional depth and breadth.

Supported by at least 3 credible references.

Fair
Point range: 70–79

31 (31%) – 34 (34%)

Responds to some of the discussion question(s).

Post contains incomplete or vague diagnoses or explanations of appropriate diagnostic tests and treatment options.

Is somewhat lacking in synthesis of knowledge gained from the course readings for the module and current credible sources.

Post is cited with fewer than 2 credible references.

Poor
Point range: 0–69

0 (0%) – 30 (30%)

Does not respond to the discussion question(s).

Post contains incomplete diagnoses or explanations of appropriate diagnostic tests and treatment options, or diagnoses and/or explanations are missing.

Lacks synthesis gained from the course readings for the module and current credible sources.

Contains only 1 or no credible references.

Main Posting:

Writing–

Excellent
Point range: 90–100

6 (6%) – 6 (6%)

Written clearly and concisely.

Contains no grammatical or spelling errors.

Further adheres to current APA manual writing rules and style.

Good
Point range: 80–89

5 (5%) – 5 (5%)

Written concisely.

May contain one to two grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

Fair
Point range: 70–79

4 (4%) – 4 (4%)

Written somewhat concisely.

May contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

Poor
Point range: 0–69

0 (0%) – 3 (3%)

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Posting:

Timely and full participation–

Excellent
Point range: 90–100

9 (9%) – 10 (10%)

Meets requirements for timely, full, and active participation.

Posts main discussion by due date.

Good
Point range: 80–89

8 (8%) – 8 (8%)

Posts main discussion by due date.

Meets requirements for full participation.

Fair
Point range: 70–79

7 (7%) – 7 (7%)

Posts main discussion by due date.

Poor
Point range: 0–69

0 (0%) – 6 (6%)

Does not meet requirements for full participation.

Does not post main discussion by due date.

First Response:

Post to colleague’s main post that is reflective and justified with credible sources.–

Excellent
Point range: 90–100

9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

Good
Point range: 80–89

8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

Fair
Point range: 70–79

7 (7%) – 7 (7%)

Response is on topic, may have some depth.

Poor
Point range: 0–69

0 (0%) – 6 (6%)

Response may not be on topic, lacks depth.

First Response:
Writing–

Excellent
Point range: 90–100

6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in Standard, Edited English.

Good
Point range: 80–89

5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in Standard, Edited English.

Fair
Point range: 70–79

4 (4%) – 4 (4%)

Response posed in the discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

Poor
Point range: 0–69

0 (0%) – 3 (3%)

Responses posted in the discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

First Response:
Timely and full participation–

Excellent
Point range: 90–100

5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

Good
Point range: 80–89

4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

Fair
Point range: 70–79

3 (3%) – 3 (3%)

Posts by due date.

Poor
Point range: 0–69

0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.

Second Response:
Post to colleague’s main post that is reflective and justified with credible sources.–

Excellent
Point range: 90–100

9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

Good
Point range: 80–89

8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

Fair
Point range: 70–79

7 (7%) – 7 (7%)

Response is on topic, may have some depth.

Poor
Point range: 0–69

0 (0%) – 6 (6%)

Response may not be on topic, lacks depth.

Second Response:
Writing–

Excellent
Point range: 90–100

6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in Standard, Edited English.

Good
Point range: 80–89

5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in Standard, Edited English.

Fair
Point range: 70–79

4 (4%) – 4 (4%)

Response posed in the discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

Poor
Point range: 0–69

0 (0%) – 3 (3%)

Responses posted in the discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

Second Response:
Timely and full participation–

Excellent
Point range: 90–100

5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

Good
Point range: 80–89

4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

Fair
Point range: 70–79

3 (3%) – 3 (3%)

Posts by due date.

Poor
Point range: 0–69

0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.