NSG 6430 iHuman Case Study – Ectopic Pregnancy

NSG 6430 iHuman Case Study – Ectopic Pregnancy

NSG 6430 iHuman Case Study – Ectopic Pregnancy Assignment

Discuss the questions that would be important to include when interviewing a patient with this issue.
Some interview questions that should be asked for a patient with pelvic pain and vaginal bleeding are as follows:

How severe is you vaginal bleeding?
Are you on your period?
Could you be pregnant, or have you ever been pregnant? Are you sexually active?
When did your vaginal bleeding start and for how long have you been bleeding?
Are you passing any clots?

Is this bleeding abnormal for you?
How many tampons do you go through?
When did your pelvic pain start?
How sever is your pelvic pain from 0-10?
Does the pelvic pain radiate anywhere else, like to your shoulder or thigh?
Where exactly is your pelvic pain located, only on one side or both sides?
Any way you could have an STD or history of STD? For example, gonorrhea or chlamydia?
Do you have a history of ectopic pregnancies? NSG 6430 iHuman Case Study – Ectopic Pregnancy Assignment.
Do you have a history of ovarian cysts? Or pelvic inflammatory disease? Or cancer?
Does your pelvic pain feel deep or superficial?
Have you had any history of abdominal or pelvic surgery?
Are you a smoker?
Have you had multiple sex partners?
Are you on any birth control, and if so what type?
When was your last menstrual period?
Have you experienced any fever or chills? NSG 6430 iHuman Case Study – Ectopic Pregnancy Assignment

Sample Solution for NSG 6430 iHuman Case Study – Ectopic Pregnancy Assignment

These questions are good to ask in order to aid in the diagnoses process for pelvic abnormalities, cancer or ectopic pregnancy and to rule out any potential life threatening disorders. In addition, it is important to question the patient about previous abdominal surgeries or pelvic surgeries because this could increase that chances of an ectopic pregnancy. Also, the practitioner should ask about birth control methods, the use of progesterone only intrauterine devices can cause vaginal bleeding and an increase risk of ectopic pregnancy.

Furthermore, questioning about the history of pelvic inflammatory disease is very important because this is the most common risk factor for the occurrence of an ectopic pregnancy. Also, questions about smoking and location, intensity and description of pain can aid in the diagnosis process as well. Moreover, a history of cervicitis, for example gonorrhea or chlamydia can be a cause for this patients’ symptoms as well and also it is a common risk factor for ectopic pregnancy. Therefore, this line of questioning allows a better understanding of the patient’s history for the practitioner, so that they can provide the best care possible for the patient (Schuiling & Likis, 2017). NSG 6430 iHuman Case Study – Ectopic Pregnancy Assignment.

Describe the clinical findings that may be present in a patient with this issue.

Clinical findings that are present in this patient do point towards her diagnosis of ectopic pregnancy. For example, this patient is sexually active and has a history of gonorrhea and chlamydia, multiple sexual partners, smoking and previous abdominal surgery, these are common risk factors for the development of an ectopic pregnancy. Also, upon physical examination, this patient has deep left lower pelvic pain and cramping upon movement with abnormal vaginal bleeding. Also, she is inconsistent with birth control methods and is sexually active (Schuiling & Likis, 2017). Other clinical findings that the practitioner may see are nausea and vomiting and feeling faint or dizzy an have pain radiating to shoulder (The American College of Obstetrics and Gynecology, 2018). NSG 6430 iHuman Case Study – Ectopic Pregnancy

Are there any diagnostic studies that should be ordered on this patient? Why?

Yes, there are diagnostic tests that should be ordered for this patient. These consist of a CBC, urinalysis, HCG plasma, liver function test, blood type and screen, obstetric ultrasound and progesterone level. The patent has heavy abnormal vaginal bleeding, in this case a CBC should be drawn to obtain popper blood counts not only for internal bleeding from a rupture but also a white cell count for any infection. Also, the HCG plasma must be ordered to identify positive pregnancy, this also may aid in ruling out other alternate diagnosis. An obstetric ultrasound is imperative for this diagnosis to enable a visual of the ectopic pregnancy to confirm its presence.

The progesterone level is important because serum progesterone levels are generally lower in a non-viable or an ectopic pregnancy. For example, a progesterone level of 5 ng/ml or less is strongly associated with pregnancy failure, whereas if the pregnancy is viable then the progesterone level is usually around 20 ng/ml (US national Library of Medicine National Institute of Health, 2018).
List the primary diagnosis and three differential diagnoses for this patient. NSG 6430 iHuman Case Study – Ectopic Pregnancy Assignment.

Explain your reasoning for each.

Primary diagnosis- Ectopic Pregnancy

Differential- 1. Ovarian cyst 2. Abortion 3. Tubo-ovarian abscess

The reasoning for the primary diagnosis of ectopic pregnancy (unruptured) is because this patient has many signs of this diagnosis. For example, unilateral pelvic pain, vaginal bleeding, missed period and progesterone levels and HCG levels identifying pregnancy. (US national Library of Medicine National Institute of Health, 2018). Also, the diagnostic tests performed showed strong evidence of an ectopic pregnancy.
The reason for the differential diagnosis of ovarian cyst is because this patient showed signs of unilateral pelvic pain minstrel irregularities and exacerbation with physical activity. Also, other signs of an ovarian cyst include, dyspareunia and deep pain radiating to lower back and thigh (Schuiling & Likis, 2017). This patient did exhibit pain to the left upper thigh. Furthermore, the reasoning for the differential diagnosis of abortion is because this patient had active heavy vaginal bleeding with crampy like pelvic pain (Schuiling & Likis, 2017). Also, the patients diagnostic hormonal test showed presence of pregnancy. Lastly, the reason for the differential diagnosis of Tubo-ovarian abscess is that this patient showed pelvic pain and tenderness unilaterally. Other signs include, abdominal discomfort and distension with fever or chills (Schuiling & Likis, 2017). NSG 6430 iHuman Case Study – Ectopic Pregnancy

Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups.
According to the diagnostics and lab results this patent is stable and hemodynamically intact and does not have a ruptured ectopic pregnancy. Also, this patient’s HCG level is under 2000 mlU/ml. Therefore, this patent needs to be started on methotrexate IM therapy and a continuation of monitoring for possible rupture if medication treatment fails and for hemodynamic stability. This patent needs to be referred to a specialist for continuation of motoring and to oversee treatment. Also, this patient may need to be referred to an OBGYN surgical specialist for possible surgical option if needed. The patent should be educated on the importance of treatment of an ectopic pregnancy and how this issue must be taken seriously, and she needs to be treated right away, for this could be life threating if ignored (American Academy of Family Physicians, 2018). NSG 6430 iHuman Case Study – Ectopic Pregnancy Assignment.

References

American Academy of Family Physicians (2018). Diagnosis and Management of Ectopic
Pregnancy Retrieved from https://www.aafp.org/afp/2014/0701/p34.pdf

Schuiling, K. D. & Likis, F. E (2017). Women’s Gynecologic Health, 3rd Edition. [South

University]. Retrieved from https://digitalbookshelf.southuniversity.edu/#/books/undefined/

The American College of Obstetrics and Gynecology (2018). Ectopic Pregnancy retrieved from
https://www.acog.org/Patients/FAQs/Ectopic-Pregnancy
US national Library of Medicine National Institute of Health (2018). Diagnosis and management
of ectopic pregnancy retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3213855/

Week 1 Assignment 3: SOAP Note

Each week, you are required to enter your patient encounters into eMedley. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using the SOAP Note template. The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox. When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

By Wednesday, May 24, 2017, enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG 6430_W1_A3_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

Submit your document to the W1 Assignment 3 Dropbox by Wednesday, May 24.

Week 2 Assignment 2: Interactive MedU Case

For this assignment, you will complete a MedU case study based on the course objectives and weekly content. MedU cases emphasize core learning objectives for an evidence-based primary care curriculum. Throughout your nurse practitioner program, you will use the MedU case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

After you complete the MedU case study for the week, please print the summary of your case session and submit it as a PDF file to the W2 Assignment 2 Dropbox. Note that the summary of your case session has your name on the top right-hand corner. You need to submit this document as evidence that you have completed the case.

The MedU assignments are highly interactive and a dynamic way to enhance your learning. Material from the MedU cases will be present in the weekly quizzes, the midterm exam, and the final exam. You must have all MedU assignments completed in order to successfully pass the course.

Click here for information on how to access and navigate MedU.

This week, complete the case entitled “Case #1: 45-year-old female annual exam – Mrs. Payne.”

Submission Details:

Submit your work in a 2- to 3-page Microsoft Word document.

Name your file SU_NSG 6430_W2_A2_LastName_FirstInitial.pdf.

Submit your file to the W2 Assignment 2 Dropbox by Monday, May 29,. NSG 6430 Discussion and Assignment Essay Papers

Week 2 Assignment 3: SOAP Note

Each week, you are required to enter your patient encounters into eMedley. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using the SOAP Note template. The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox. When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

By Wednesday, May 31, 2017, enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG 6430_W2_A3_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

Submit your document to the W2 Assignment 3 Dropbox by Wednesday, May 31.

Week 3 assignment 2

Assignment 2: Interactive MedU Case

For this assignment, you will complete a MedU case study based on the course objectives and weekly content. MedU cases emphasize core learning objectives for an evidence-based primary care curriculum. Throughout your nurse practitioner program, you will use the MedU case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

After you complete the MedU case study for the week, please print the summary of your case session and submit it as a PDF file to the W3 Assignment 2 Dropbox. Note that the summary of your case session has your name on the top right-hand corner. You need to submit this document as evidence that you have completed the case.

The MedU assignments are highly interactive and a dynamic way to enhance your learning. Material from the MedU cases will be present in the weekly quizzes, the midterm exam, and the final exam. You must have all MedU assignments completed in order to successfully pass the course.

Click here for information on how to access and navigate MedU.

This week, complete the case titled “Case #12: 16-year-old female with vaginal bleeding and UCG – Savannah Bauer.”

Submission Details:

Submit your work in a 2- to 3-page Microsoft Word document.

Name your file SU_NSG 6430_W3_A2_LastName_FirstInitial.pdf.

Submit your file to the W3 Assignment 2 Dropbox by Monday, June 5. NSG 6430 Discussion and Assignment Essay Papers.

Week 3 assignment 3

Assignment 3: SOAP Note

Each week, you are required to enter your patient encounters into eMedley. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using the SOAP Note template. The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox. When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

By Wednesday, June 7, 2017, enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG 6430_W3_A3_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

Submit your document to the W3 Assignment 3 Dropbox by Wednesday, June 7. NSG 6430 Discussion and Assignment Essay Papers.

Week 4 assignment 2

Assignment 2: SOAP Note

Each week, you are required to enter your patient encounters into eMedley. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using the SOAP Note template. The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox. When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

By Wednesday, June 14, 2017, enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG 6430_W4_A2_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

Submit your document to the W4 Assignment 2 Dropbox by Wednesday, June 14.

Week 5 assignment 1

Assignment 1: SOAP Note

Each week, you are required to enter your patient encounters into eMedley. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using the SOAP Note template. The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox. When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

By Wednesday, June 21, 2017, enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG 6430_W5_A1_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

Submit your document to the W5 Assignment 1 Dropbox by Wednesday, June 21. NSG 6430 Discussion and Assignment Essay Papers.

Week 6 assignment 2

Assignment 2: SOAP Note

Each week, you are required to enter your patient encounters into eMedley. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using the SOAP Note template. The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox. When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

By Wednesday, June 28, 2017, enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG 6430_W6_A2_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

Submit your document to the W6 Assignment 2 Dropbox by Wednesday, June 28.

Week 7 assignment 2

Assignment 2: Interactive MedU Case

For this assignment, you will complete a MedU case study based on the course objectives and weekly content. MedU cases emphasize core learning objectives for an evidence-based primary care curriculum. Throughout your nurse practitioner program, you will use the MedU case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

After you complete the MedU case study for the week, please print the summary of your case session and submit it as a PDF file to the W7 Assignment 2 Dropbox. Note that the summary of your case session has your name on the top right-hand corner. You need to submit this document as evidence that you have completed the case.

The MedU assignments are highly interactive and a dynamic way to enhance your learning. Material from the MedU cases will be present in the weekly quizzes, the midterm exam, and the final exam. You must have all MedU assignments completed in order to successfully pass the course.

Click here for information on how to access and navigate MedU.

This week, complete the case titled “Case #14: 35-year-old female with missed period – Ms. Rios.”

Submission Details:

Submit your work in a 2- to 3-page Microsoft Word document.

Save your file as SU_NSG 6430_W7_A2_LastName_FirstInitial.pdf.

Submit your file to the W7 Assignment 2 Dropbox by Sunday, July 2. NSG 6430 Discussion and Assignment Essay Papers.

Week 7 assignment 3

Assignment 3: SOAP Note

Each week, you are required to enter your patient encounters into eMedley. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using the SOAP Note template The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox. When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

By Wednesday, July 5, 2017, enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG 6430_W7_A3_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

Submit your document to the W7 Assignment 3 Dropbox by Wednesday, July 5.

Week 8 assignment 2

Assignment 2: SOAP Note

Each week, you are required to enter your patient encounters into eMedley. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using the SOAP Note template. The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox. When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

By Wednesday, July 12, 2017, enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG 6430_W8_A2_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

Submit your document to the W8 Assignment 2 Dropbox by Wednesday, July 12. NSG 6430 Discussion and Assignment Essay Papers.

Week 8 assignment 3

Research Paper

For this week, you will be completing a research appraisal about a women’s health topic in which you may be interested. The purpose is to complete only a synthesis of the topic. To start, only look at studies that are specific to your women’s health topic. Your appraisal will assist in finding the most current evidence. Remember, this is only for the purpose of synthesis. Simplicity is key to a successful evaluation. Below is a way to assist you in compiling your significant articles. Your table should only contain 5 articles. Finalize your findings in 1–2 pages and submit with your evaluation table.

Submission Details:

By Tuesday, July 11, 2017, enter your table and summary

Name your document SU_NSG6330_W8_A3_LastName_FirstInitial.doc

Submit your document to the W8 Assignment 3 Dropbox by Tuesday, July 11.

In the headings for the columns, include the following:

Citation: Author, year, title

Conceptual Framework: Theoretical basis for study

Design/Method: Indicate design and describe what was done in the study

Sample/setting: Number, characteristics, attrition rate, and why

Major variables studied and their definitions: Independent/dependent variable

Measurement: What scales were used to measure the outcome variables (e.g., name of scale, author, reliability info)

Data analysis: What stats were used to answer the clinical question

Findings: Statistical findings or qualitative findings (one for every statistical test mentioned in data anlysis)

Appraisal/Worth to Practice: Strengths and limitations of the study, risk or harm if study intervention or findings implemented, and feasibility.

Week 9 – Assignment 2

Assignment 2: SOAP Note

Each week, you are required to enter your patient encounters into eMedley. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using the SOAP Note template. The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox. When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

By Wednesday, July 19, 2017, enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG 6430_W9_A2_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

Submit your document to the W9 Assignment 2 Dropbox by Wednesday, July 19.

Week 10 assignment

Assignment 1: SOAP Note

Each week, you are required to enter your patient encounters into eMedley. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using the SOAP Note template. The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

By Wednesday, July 26, 2017, enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG 6430_W10_A1_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document. NSG 6430 Discussion and Assignment Essay Papers.

Submit your document to the W10 Assignment 1 Dropbox by Wednesday, July 26.