NRNP 6552 Week 8 Case Study Discussion: Case Study: Dysfunctional Uterine Bleeding

Week 8

Case Study

Case Study: Dysfunctional Uterine Bleeding

Gretchen Abernathy is a 38-year-old G2 P2 Caucasian female who presents to the clinic with complaints of frequent menstrual bleeding. Her menstrual calendar shows bleeding frequency 17-36 days, lasting 5-10 days in duration and on her heaviest day she needs to change her super tampon every 2 hours. She relates this has been getting worse since stopping her OCP’s when she had a bilateral tubal ligation 4 months after having her second child 9 months ago. She is upset as no one told her that weight gain could happen after and relates she has gained 27 lbs. since her surgery. She states that all this bleeding is making her tired and she cannot keep herself awake. Gretchen’s mother told her she probably just had “low iron” and if she took vitamins, she would feel better.

ORDER A CUSTOMIZED, PLAGIARISM-FREE NRNP 6552 Week 8 Case Study Discussion: Case Study: Dysfunctional Uterine Bleeding HERE

Thanks for stopping by this assessment. We can assist you in completing it and other subsequent ones. Our expert writers will comprehensively review instructions, synthesize external evidence sources, and customize an A-grade paper for YOU!!!

· HEENT: wnl, hair dry, neck supple without adenopathy

· CV: RSR without murmur or gallop

· Lungs: clear to p&a.

· Abd soft, non-tender, BS all 4 quadrant.

· VVBSU: WNL

· Cervix: firm, smooth, parous, w/o CMT

· Uterus: mid mobile non tender, approximately 10 cm

· Adnexa: without masses or tenderness

· Extremities: negative homan’s, reflexes 2+ = bilaterally, no edema

QUESTIONS:

1. What testing do you want to order?

2. What is your differential diagnosis?

ANSWERS:

PLEASE ADD THE ANSWERS TO YOUR NOTE

The results of the testing are as follows:

a. CBC: hgb 10.8 hct 32.1 platelets 210

b. TSH 6.8, free T4 0.6

c. Hcg negative

d. Ferritin 10

e. Prolactin 16

f. PT, PTT, fibrinogen – all within normal limits

g. FSH – 21

h. LH – 21

i. Progesterone 10

j. Pelvic ultrasound uterus normal size 82 mm x 5 mm x 4.8 mm with a 2 mm

endometrial stripe. No masses noted

2. Diagnosis is dub related to hypothyroidism causing anovulation.

QUESTION:

What are the next steps?

ANSWERS:

PLEASE ADD ANSWERS TO YOUR NOTE

COMMON HEALTH CONDITIONS WITH IMPLICATIONS FOR WOMEN

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.

For this Case Study Discussion, you will propose a differential diagnosis with a minimum of 3 possible conditions or diseases. You will prioritize these diagnoses and explain which you would recommend.

RESOURCES

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

LEARNING RESOURCES

Required Readings

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

Chapter 17, “Breast Conditions” (pp. 337-349)

Chapter 32, “Anatomy and Physiologic Adaptations of Normal Pregnancy” (pp. 677–673)

Chapter 19, “Pregnancy Diagnosis, Decision-Making support, and Resolution” (pp. 367-379

GENERAL GUIDELINES FOR HEALTH SCREENINGS

American Academy of Family Practice (AAFP). (2020). Browse AAFP clinical recommendationsLinks to an external site.. https://www.aafp.org/home.html

American Cancer Society, Inc. (ACS). (2020). Cancer A-ZLinks to an external site.. https://www.cancer.org/

Note: As you review this resource, select the “Cancer A-Z” topic in the navigation to review information and Resources about for Cancer: Breast, Colon, Lung, Prostate, Skin.

American College of Obstetricians and Gynecologists (ACOG). (2020). Clinical topicsLinks to an external site.. https://www.acog.org/

Note: As you review this source, make sure to navigate to the “Topics” section in the navigation to review the clinical topics.

HealthyPeople 2030. (2020). Healthy People 2030 FrameworkLinks to an external site.. https://www.healthypeople.gov/2020/About-Healthy-People/Development-Healthy-People-2030/Framework

U.S. Preventive Services Task Force (USPTFS). (2017, September). Search and Filter All Recommendation TopicsLinks to an external site.. https://www.uspreventiveservicestaskforce.org/uspstf/topic_search_results?topic_status=P&searchterm=

FNP RESOURCES

Centers for Disease Control and Prevention. (CDC). (n.d.). Disease & conditionsLinks to an external site.. https://www.cdc.gov/DiseasesConditions/

The American Association of Nurse Practitioners (AANP). (2020). AANP practice: Clinical Resources, Business, acumen and opportunities for professional recognitionLinks to an external site.. https://www.aanp.org/practice

GERIATRIC RESOURCES

Nicholas, J. A., & Hall, W. J. (2011). Screening and preventive services for older adultsLinks to an external site.. The Mount Sinai Journal of Medicine, New York, 78(4), 498–508. https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.1002/msj.20275

Document: Focused SOAP Note Template Download Focused SOAP Note Template(Word document)

Document: General Guidelines for Health Screenings Matrix Template Download General Guidelines for Health Screenings Matrix Template(Word document)

Required Media

Common Health Conditions

Dr. Anne Salomone reviews and discusses the topics found in Weeks 7 & 8 (40 mins).

Optional Resources

Note: In Weeks 1-10, these resources are optional for your review. In Week 11, you will be required to review each of the PowerPoint slides from the text Gynecologic Health Care (4th ed.).

Chapter 17, “Breast Conditions Download Breast Conditions”

Chapter 32, “Anatomy and Physiologic Adaptations of Normal Pregnancy Download Anatomy and Physiologic Adaptations of Normal Pregnancy”

Chapter 19, “Pregnancy Diagnosis, Decision-Making support, and Resolution Download Pregnancy Diagnosis, Decision-Making support, and Resolution”

To prepare:

By Day 1 of this week, you will be assigned to a specific 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 as well as Weeks 5 and 6 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 Discussion. Based on the case study scenario provided, complete a SOAP note and critically analyze this and focus your attention on the diagnostic tests.

BY DAY 3

Based on your assigned case study, post a Focused SOAP NOTE with the following:

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 first priority in conducting your assessment.

Explain which diagnostic tests and treatment options you would recommend for your patient and explain your reasoning.

Your differential diagnosis, what you believe the most important diagnosis is and why, additional diagnostic tests and treatments and rationales are what this assignment and grading is focused on. Your critical thinking for this assignment

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 your colleagues suggested and why. Use your learning resources and/or evidence from the literature to support your position.

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 Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!

NRNP_6552_Week8_Case_Study_Discussion_Rubric

Criteria Ratings Pts
This criterion is linked to a Learning OutcomeMain 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.
44 to >39.16 pts

Excellent Point range: 90–100

Thoroughly responds to the discussion question(s)… Post includes appropriate 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.

39.16 to >34.76 pts

Good Point range: 80–89

Responds to most of the discussion question(s).. Post includes appropriate 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.

34.76 to >30.36 pts

Fair Point range: 70–79

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.

30.36 to >0 pts

Poor Point range: 0–69

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.

44 pts

This criterion is linked to a Learning OutcomeMain Posting:

Writing
6 to >5.34 pts

Excellent Point range: 90–100

ORDER A CUSTOMIZED, PLAGIARISM-FREE NRNP 6552 Week 8 Case Study Discussion: Case Study: Dysfunctional Uterine Bleeding HERE

Written clearly and concisely… Contains no grammatical or spelling errors… Further adheres to current APA manual writing rules and style.

5.34 to >4.74 pts

Good Point range: 80–89

Written concisely… May contain one to two grammatical or spelling errors… Adheres to current APA manual writing rules and style.

4.74 to >4.14 pts

Fair Point range: 70–79

Written somewhat concisely… May contain more than two spelling or grammatical errors… Contains some APA formatting errors.

4.14 to >0 pts

Poor Point range: 0–69

Not written clearly or concisely… Contains more than two spelling or grammatical errors… Does not adhere to current APA manual writing rules and style.

6 pts
This criterion is linked to a Learning OutcomeMain Posting:

Timely and full participation

10 to >8.9 pts

Excellent Point range: 90–100

Meets requirements for timely, full, and active participation… Posts main discussion by due date.

8.9 to >7.9 pts

Good Point range: 80–89

Posts main discussion by due date… Meets requirements for full participation.

7.9 to >6.9 pts

Fair Point range: 70–79

Posts main discussion by due date.

6.9 to >0 pts

Poor Point range: 0–69

Does not meet requirements for full participation… Does not post main discussion by due date.

10 pts

This criterion is linked to a Learning OutcomeFirst Response:

Post to colleague’s main post that is reflective and justified with credible sources.
9 to >8.01 pts

Excellent Point range: 90–100

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.

8.01 to >7.11 pts

Good Point range: 80–89

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

7.11 to >6.21 pts

Fair Point range: 70–79

Response is on topic, may have some depth.

6.21 to >0 pts

Poor Point range: 0–69

Response may not be on topic, lacks depth.

9 pts
This criterion is linked to a Learning OutcomeFirst Response:

Writing

6 to >5.34 pts

Excellent Point range: 90–100

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.

5.34 to >4.74 pts

Good Point range: 80–89

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.

4.74 to >4.14 pts

Fair Point range: 70–79

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.

4.14 to >0 pts

Poor Point range: 0–69

Responses posted in the discussion lack effective communication… Response to faculty questions are missing… No credible sources are cited.
6 pts

This criterion is linked to a Learning OutcomeFirst Response:

Timely and full participation
5 to >4.45 pts

Excellent Point range: 90–100

Meets requirements for timely, full, and active participation… Posts by due date.

4.45 to >3.95 pts

Good Point range: 80–89

Meets requirements for full participation… Posts by due date.

3.95 to >3.45 pts

Fair Point range: 70–79

Posts by due date.

3.45 to >0 pts

Poor Point range: 0–69

Does not meet requirements for full participation… Does not post by due date.

5 pts

This criterion is linked to a Learning OutcomeSecond Response:

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

9 to >8.01 pts

Excellent Point range: 90–100

8.01 to >7.11 pts

Good Point range: 80–89

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

7.11 to >6.21 pts

Fair Point range: 70–79

Response is on topic, may have some depth.

6.21 to >0 pts

Poor Point range: 0–69

Response may not be on topic, lacks depth.

9 pts
This criterion is linked to a Learning OutcomeSecond Response:

Writing

6 to >5.34 pts

Excellent Point range: 90–100

5.34 to >4.74 pts

Good Point range: 80–89

4.74 to >4.14 pts

Fair Point range: 70–79

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.

4.14 to >0 pts

Poor Point range: 0–69

Responses posted in the discussion lack effective communication… Response to faculty questions are missing… No credible sources are cited.

6 pts

This criterion is linked to a Learning OutcomeSecond Response:

Timely and full participation

5 to >4.45 pts

Excellent Point range: 90–100

Meets requirements for timely, full, and active participation… Posts by due date.

4.45 to >3.95 pts

GoodPoint range: 80–89

Meets requirements for full participation… Posts by due date.

3.95 to >3.45 pts

Fair Point range: 70–79

Posts by due date.

3.45 to >0 pts

Poor Point range: 0–69

Does not meet requirements for full participation… Does not post by due date.

5 pts

Total Points: 100

NRNP 6552 Week 8 Case Study Discussion: Case Study: Dysfunctional Uterine Bleeding