week 10 clinical decision making assignmnet

• Which anticipatory guidelines will you consult (if any) for this particular disease process?
• How will a proactive/anticipatory approach to diagnosing, treating, and managing this disease process affect your consideration of the following:
• Prevention of the progression of the disease or comorbid issues
• Empowerment of self-management for the patient
• Anticipatory guidance such as labs, vaccines, testing (Digital rectal exams, mammography, Pap smears, colonoscopy, etc.)
• Patient education and referral to interdisciplinary professionals (specialists, nutrition, rehab, physical therapy, support groups, etc.)

****NO INTRODUCTION OR CONCLUSION NEEDED****

Mikita Spencer, 23-year-old female, arrives for her appointment to discuss her irregular menstrual periods. During assessment of the patient, you notice that she has gained 12 pounds since her visit three months ago, hirsutism, and acne vulgaris. Ms. Spencer states that she never knows when her period will come. She sometimes goes for months without a period. She states that she is sexually active but has never really bothered with birth control because she doesnt think that she can get pregnant.

Dana Carlyle, a 28-year-old female, is being seen with a complaint of long-standing abdominal pain. Ms. Carlyle states, Every month I literally dread my period. If Im lucky, I only miss work and life for 4 or 5 days. The cramps are excruciating. The rest of the month I never know when Im going to have a painful day. My friends, family, and my husband try to understand, but I would be frustrated with me if I were them. And sex… Sex hurts almost every time we try. Its just not fair. We want to have children, but Im starting to feel like there is no hope. Can you help me?

Kirkland Barnette, a 36-year-old male, who arrives for his appointment with a complaint of something going on down there. Mr. Barnette states that he thinks he might have hemorrhoids, or it could be something else. Upon examination of his anal area and perineum you see a collection of growths that appear to be verruca form.

Jing Zhou, a 52-year-old female, arrives for her appointment to discuss a group of symptoms that she is experiencing. Mrs. Zhou is concerned that she might be pregnant or that something else concerning may be happening. Her urine HCG test was negative. So, you continue with your history and exam. Mrs. Zhou states that her last menstrual period was 13 months ago, and she has had so many issues in the last year: trouble sleeping, problems regulating her temperature, vaginal dryness, and irritability.

Sebastian Oliver, a 59-year-old male, reports for his appointment to discuss his urinary problems. Mr. Oliver states that over the last several months he has had pain on and off in his lower abdomen and at times on his perineum between his testicles and anus. However, his most concerning problem has been pain with ejaculation, in addition to problems in trying to urinate.

The disease processes for week ten are as follows:

• Endometriosis
• Chronic Prostatitis
• Menopause
• Polycystic Ovary Syndrome (PCOS)
• Genital Warts.