Reflect on the patient information. Consider a differential diagnosis for the patient in the case study you selected
Discussion: Assessment and Treatment of the Genitourinary, Gynecologic, and Renal Systems and Acid/Base Disorders Common emergency department complaints are vaginal bleeding, and STIs. An understanding of the differential diagnoses that might occur with pregnant and non-pregnant women is important to grasp. Advanced clinical skills that the Acute Care Nurse Practitioner must be familiar with include the auscultation of fetal heart tones, basic fetal heart monitoring, pelvic exams, and delivery of fetal demise or precipitous deliveries of viable fetuses. Pregnancy can alter the diagnostic possibilities of a patient with acute abdominal pain and change the clinical findings. Advanced pregnancy can make it even more difficult. 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. STIs may present serious health implications for infected patientsâespecially 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. 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. Case Study 3 A 21-year-old nulligravida comes to the ER, 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 38Âș 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 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 gynecological condition you identified as your primary diagnosis. By Day 3 Post an explanation of the differential diagnosis for the patient in the case study you selected. Provide a minimum of three possible diagnoses, and list them from highest priority to lowest priority. Explain which is the most likely diagnosis for the patient and why. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patient.

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