Respond to your peers
- Juliete Misas.
Evaluation & Management Plan post
- “In 2015, 52 million pelvic examinations were performed in the United States 1. The pelvic examination has long been considered a fundamental component of the well-woman visit, and many women and gynecologic care providers view this visit as an opportunity to discuss sexual and reproductive health issues” (The utility of and indications for routine pelvic examination. ACOG. n.d.). The gynecological examination is an important part of routine care for women. It is important to education our patients as to why this examination is so important and warranted especially after becoming sexually active. As a nurse practitioner encountering a young adolescence who has newly become sexually active it is important to educate the patient as to why this exam is so important as well as to what to expect from the examination before beginning. The patient should understand the examination is composed of four parts. The examination will include an inspection of the external genitalia, speculum examination of the vagina and cervix, bimanual examination and sometimes a rectal or rectovaginal examination. Knowing what to expect before beginning the examination may help ease the patients’ nerves.
Obtaining a patient’s gynecological history is important because is helps identify areas of concern for the nurse practitioner to further explore. The most popular birth control methods are long-acting reversible methods that include implantable devices and intrauterine devices. Less effective and popular methods include injections, birth control pills, patch, ring, diaphragm, male and female condoms, spermicide, fertility calendar. Barriers for success with birth control include social behavioral, mental health, substance abuse and issues with domestic violence.
Patient education on patient adverse effects and side effects are important. Patient’s concern with weight gain while using Oral contraceptive methods is a very valid concern. “If a woman taking oral contraceptive pills complains of the adverse effects typically associated with this method including nausea, abdominal bloating, hair changes, weight gain, leg pain, cramps and swelling, changing the pill to a lower estrogen dose or one with a less androgenic progestin formula will often relive the problem” (Hektor et al., pg. 673, 2019). Even though, birth control options are the patient choice and optional if the patient is unsure of which method she will choice the nurse practitioner can encourage the patient to practice safe intercourse method in the mean time via condom use.
References
Hektor, D. L. M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2019). Primary care: The art and science of advanced practice nursing. F.A. Davis Company.
The utility of and indications for routine pelvic examination. ACOG. (n.d.). Retrieved October 5, 2021, from https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/10/the-utility-of-and-indications-for-routine-pelvic-examination.
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