NR 602 Week 6 Combined Assignments

NR 602 Week 6 Combined Assignments

NR 602 Week 6 Combined Assignments

Hello Class,

During this week we will have combined assignments, ranging from chapter readings, a quiz and your Women’s Health Grand Rounds Presentation. The discussion this week will focus on women’s health concerns: Breast, Cervix, Ovaries/Oviducts and Pelvic Floor Disorders.  Please see below for an outline.

Assignments:

• Week 6: Website Exploration- Use the links provided to explore important information from valuable women’s health websites
• Week 6: Lessons – read lecture(s) The lecture will include topics and questions that will appear on the graded exams
• Reading assignments: Refer to week 6 Reading in the modules
• Week 6: Quiz: graded and worth 20 points, covers weeks 6  material,  due Sunday 11:59PM Mountain time
• Clinical hours– continue entering your hours into Elogs
• Grand Rounds– your Women’s Health Grand Rounds assignment is due. Please see the rubric and guidelines under Course Resources.
  • By Wednesday, 11:59 p.m. (MT) Record and copy link to presentation into the discussion with three questions on your topic to initiate a discussion and keep it going.
  • ByFriday, 11:59 p.m. (MT) Post to a minimum of two peer’s initial discussion by responding substantively to all questions posts and citing related research to support.
  • By Sunday, 11:59 p.m. (MT) Summarize your grand rounds presentation by posting a summary to your initial post in the discussion. Summarize the discussion questions you posted as well as conclusions from the collective group discussion. Include evidence-based references at the bottom of the summary.
• APEA practice questions- Complete assigned practice questions in myQbank

Program Outcomes that will be covered for this week include:

Integrate current evidence based clinical practice guidelines in the care of childbearing and childrearing families. (PO 5)

Construct an evidence based reproductive health management plan. (PO 5)

Dr. Smith

DeCherney, A., Nathan, L., Laufer, N., & Roman, A. (2014). Current diagnosis & treatment Obstetrics & Gynecology (11^th ed.). New York, NY: McGraw-Hill. Retrieved from link to ebook (Links to an external site.)Links to an external site.

• The Breast
• Benign Disorders of the Uterine Cervix (Cervical Infection- Acute and Chronic Cervicitis)
• Benign Disorders of the Ovaries and Oviducts (Endometriomas, Polycystic Ovarian Syndrome, Fibroma)
• Pelvic Infections (Sexual Transmitted Diseases and Pelvic Infections)

Katsiki, N., Georgiadou, E., & Hatzitolios, A. I. (2009). The role of insulin-sensitizing agents in the treatment of polycystic ovary syndrome. Drugs, 69(11), 1417-31. link to article (Links to an external site.)Links to an external site.

Shafti, V., & Shahbazi, S. (2016). Comparing Sexual Function and Quality of Life in Polycystic Ovary Syndrome and Healthy Women. Journal Of Family & Reproductive Health, 10(2), 92-98. link to article (Links to an external site.)Links to an external site.

Week 6 lesson section 1

Polycystic Ovary Syndrome (PCOS)

PCOS is a fairly common endocrine disorder typically affecting women of childbearing age, producing chronic anovulatory menstrual cycles. Obesity and the clinical presence of ovarian cysts are typical, and there are signs of hyperandrogenism, that is, facial hair and excess hair, infertility, male-pattern baldness, and acne. Most patients will also have high insulin levels and insulin resistance, predisposing them to type 2 diabetes mellitus. While the exact cause of PCOS is not known, it is thought to have a genetic component. It is vital for the diagnosis and management of PCOS to occur early in the teenage years as the disorder will have profound effects on the young patient.

Menstrual irregularities are common, including amenorrhea and irregular menses from the chronic anovulation. Elevated levels of luteinizing hormone (LH) may be seen in addition to low levels of follicle-stimulating hormone (FSH). The increase in LH is thought to produce a hyperandrogenism state. The diagnosis is made from the patient’s clinical presentation and the results of laboratory studies, as well as a pelvic ultrasound.

Treatment is aimed at symptom relief and the prevention of significant sequelae, such as malignant conditions or the development of type 2 diabetes mellitus. Lifestyle modification is the primary focus, followed by an appropriate medical regimen. Weight loss is imperative. The use of oral contraceptives and spironolactone has been shown to alleviate symptoms. Metformin and other insulin-sensitizing antidiabetic agents are also useful in preventing type 2 diabetes mellitus. Consultation with a fertility practice may also be indicated (ACOG, 2009, 2010a, 2010b, 2014).

Uterine Fibroids (Leiomyomas)

Another common benign disorder of the uterus is leiomyomas, or classic uterine fibroids. These benign neoplasms are very common and typically occur in women older than thirty-five years of age. The incidence rate is one in every four or five women. In the majority of cases, leiomyomas are asymptomatic and may only be diagnosed when a woman presents with menorrhagia, rectal pressure or pain, urinary frequency, or in some cases iron-deficiency anemia from excessive blood loss. Leiomyomas originate from myometrial cells and commonly are estrogen dependent. Oral contraceptives may stimulate the growth of leiomyomas. Sometimes, leiomyomas outgrow their blood supply and degenerate and may also regress following the onset of menopause. However, some cases of leiomyomas progress, and surgery is required to remove them; the patient may sometimes require a hysterectomy (ACOG, 2008, 2010a, 2010b, 2011, 2014).

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Bartholin’s Cysts

Bartholin glands are two glands positioned posterolaterally inside the introitus. Each of their respective ducts empties into the introitus to provide lubrication during sexual arousal. Bartholin glands are about 8-10 mm in size and in relation to position, they are situated at the distal ends of the labia majora, hidden beneath the perineal skin. They are not normally palpable.

Common signs and symptoms present as persistent enlargement of Bartholin glands, dyspareunia, and pain in the local area. Bartholin’s cysts that are chronic may require surgical excision.

If they become blocked from a noninfectious process, management can be as simple has having the patient take sitz baths to encourage spontaneous expulsion of the retained mucus or to needle-aspirate and drain the glands and then ensure the patient takes sitz baths to promote comfort and healing.

If an infectious process occurs, aspiration may be attempted but an incision and drainage is usually required.

Infectious processes that commonly cause such cysts are chlamydia, gonorrhea, staphylococcal infection, and anaerobic infection. Bartholin glands may also be slightly enlarged, causing no symptoms in the patient. A cyst can also resolve spontaneously.