Sample Answer for NURS 6501 Knowledge Check Women’s and Men’s Health, Infections, and Hematologic Disorders Included After Question
In this exercise, you will complete a 5-essay type question Knowledge Check to gauge your understanding of this module’s content.
Possible topics covered in this Knowledge Check include:
- Sexually transmitted diseases
- Prostate
- Epididymitis
- Factors that affect fertility
- Reproductive health
- Alterations and fertility
- Anemia
- ITP and TTP
- DIC
- Thrombocytopeni
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
BY DAY 7 OF WEEK 10
Complete the Knowledge Check by Day 7 of Week 10.
A Sample Answer For the Assignment: NURS 6501 Knowledge Check Women’s and Men’s Health, Infections, and Hematologic Disorders
Title: NURS 6501 Knowledge Check Women’s and Men’s Health, Infections, and Hematologic Disorders
Question 1
Scenario 1: Polycystic Ovarian Syndrome (PCOS)A 29-year-old female presents to the clinic with a complaint of hirsutism and irregular menses. She describes irregular and infrequent menses (five or six per year) since menarche at 11 years of age. She began to develop dark, coarse facial hair when she was 13 years of age, but her parents did not seek treatment or medical opinion at that time. The symptoms worsened after she gained weight in college. She got married 3 years ago and has been trying to get pregnant for the last 2 years without success. Height 66 inches and weight 198. BMI 32 kg.m2. Moderate hirsutism without virilization noted. Laboratory data reveal CMP within normal limits (WNL), CBC with manual differential (WNL), TSH 0.9 IU/L SI units (normal 0.4-4.0 IU/L SI units), a total testosterone of 65 ng/dl (normal 2.4-47 ng/dl), and glycated hemoglobin level of 6.1% (normal value ≤5.6%). Based on this information, the APRN diagnoses the patient with polycystic ovarian syndrome (PCOS) and refers her to the Women’s Health APRN for further workup and management. Question1. What is the pathogenesis of PCOS? |
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Question 2
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Scenario 1: Polycystic Ovarian Syndrome (PCOS)A 29-year-old female presents to the clinic with a complaint of hirsutism and irregular menses. She describes irregular and infrequent menses (five or six per year) since menarche at 11 years of age. She began to develop dark, coarse facial hair when she was 13 years of age, but her parents did not seek treatment or medical opinion at that time. The symptoms worsened after she gained weight in college. She got married 3 years ago and has been trying to get pregnant for the last 2 years without success. Height 66 inches and weight 198. BMI 32 kg.m2. Moderate hirsutism without virilization noted. Laboratory data reveal CMP within normal limits (WNL), CBC with manual differential (WNL), TSH 0.9 IU/L SI units (normal 0.4-4.0 IU/L SI units), a total testosterone of 65 ng/dl (normal 2.4-47 ng/dl), and glycated hemoglobin level of 6.1% (normal value ≤5.6%). Based on this information, the APRN diagnoses the patient with polycystic ovarian syndrome (PCOS) and refers her to the Women’s Health APRN for further workup and management. QuestionHow does PCOS affect a woman’s fertility or infertility? |
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Question 3
Scenario 2: Pelvic Inflammatory Disease (PID)A 30-year-old female comes to the clinic with a complaint of abdominal pain, foul smelling vaginal discharge, and fever and chills for the past 5 days. She denies nausea, vomiting, or difficulties with bowels. Last bowel movement this morning and was normal for her. Nothing has helped with the pain despite taking ibuprofen 200 mg orally several times a day. She describes the pain as sharp and localizes the pain to her lower abdomen. Past medical history noncontributory. GYN/Social history + for having had unprotected sex while at a fraternity party. Physical exam: thin, Ill appearing anxious looking white female who is moving around on the exam table and unable to find a comfortable position. Temperature 101.6F orally, pulse 120, respirations 22 and regular. Review of systems negative except for chief complaint. Focused assessment of abdomen demonstrated moderate pain to palpation left and right lower quadrants. Upper quadrants soft and non-tender. Bowel sounds diminished in bilateral lower quadrants. Pelvic exam demonstrated + adnexal tenderness, + cervical motion tenderness and copious amounts of greenish thick secretions. The APRN diagnoses the patient as having pelvic inflammatory disease (PID). Question:1. What is the pathophysiology of PID? |
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HH is a 68 yo M who has been admitted to the medical ward with community-acquired pneumonia for the past 3 days. His PMH is significant for COPD, HTN, hyperlipidemia, and diabetes. He remains on empiric antibiotics, which include ceftriaxone 1 g IV qday (day 3) and azithromycin 500 mg IV qday (day 3). Since admission, his clinical status has improved, with decreased oxygen requirements. He is not tolerating a diet at this time with complaints of nausea and vomiting.
Ht: 5’8” Wt: 89 kg
Allergies: Penicillin (rash)
A Sample Answer 2 For the Assignment: NURS 6501 Knowledge Check Women’s and Men’s Health, Infections, and Hematologic Disorders
Title: NURS 6501 Knowledge Check Women’s and Men’s Health, Infections, and Hematologic Disorders
Community-acquired pneumonia remains the single most common cause of death from infectious diseases in the elderly population. Adults aged over 65 years are a rapidly expanding cohort with growth rates more than twice that of younger populations with an expected 20% of the world’s population reaching elderly status by 2050, the burden of CAP will be even more significant in the coming years. Moreover, the annual incidence of CAP in elderly patients is estimated to be 25–44 cases per 1000 persons (Stupak et al., 2009). In the above case study patient is an elderly 68yrs old who has been admitted to the medical ward with community-acquired pneumonia for the past 3 days with his PMH is significant for COPD, HTN, hyperlipidemia, and diabetes who remains on empiric antibiotics, which include ceftriaxone 1 g IV qday (day 3) and azithromycin 500 mg IV qday (day 3). Since admission, his clinical status has improved, with decreased oxygen requirements however he is not tolerating a diet at this time with complaints of nausea and vomiting. Therefore, the following treatment and health needs are important.
Patient’s Health needs
- Treatment and need for longer hospitalization stay with longer IV ABX treatment
Mr. HH is 68ys old elderly patient and he is at risk of infection for a longer period. To prevent the spread of infection, he might need more than 7days of IV ABX treatment even though he is improving. Moreover, he is not tolerating the diet currently and complains of nausea and vomiting. Therefore, he may require a longer hospitalization stay with a longer duration of parenteral IV ABX therapy before switching to an oral antibiotic along with antiemetic medication. The oral course of ABX can be started once his nausea/vomiting stop and able to tolerate the diet. Moreover, Pharmacists should evaluate medication choices, check for allergies and interactions, and educate patients about side effects and the importance of compliance.
Need for treatment of his co-morbidities
Mr. HH has other significant co-morbidities like COPD, HTN, hyperlipidemia, and diabetes and should be treated with a bronchodilator and steroids for COPD, anti-hypertensive for HTN, Statin and Cholesterol for hyperlipidemia and Metformin or insulin for diabetes along with treatment of community-acquired pneumonia.
Need for hydration and nutritional diet
Particular attention should also be paid to nutritional status, fluid administration, functional status, and comorbidity stabilizing therapy in this group of frail patients (Simonetti et al., 2014).
Mr. HH is an elderly patient and risk of malnutrition since he is not tolerating his diet and complain of nausea and vomiting. Continuous iv fluids should be given for hydration and a nutritionist Consult should be done and parenteral nutrition should be started according to the needs of the patient.
Need for financial support
The patient’s financial status for treatment should be assessed by the case manager. If a Patient has Medicare or Medicaid, it will be covered by insurance but if the patient does not have insurance or financial support then the hospital should provide financial support via a charity fund or a discount should be given if possible.
Need for physical and psychological support
Physical support should be given by providing physical and occupational therapy to increase the activity of daily living, breathing exercises, and self-care. Help patient to maintain hygiene throughout the hospital stay. Similarly, emotional support should be provided by allowing him to express his feeling and allowing family time for emotional support that prevents depression.
Recommended Treatment
- In the presence of comorbid illness (chronic heart disease excluding hypertension; chronic lung disease – COPD and asthma; chronic liver disease; chronic alcohol use disorder; diabetes mellitus; smoking; splenectomy; HIV or other immunosuppression), a respiratory fluoroquinolone (high-dose levofloxacin, moxifloxacin, gemifloxacin) or a combination of oral beta-lactam (high dose amoxicillin or amoxicillin-clavulanate, cefuroxime, cefpodoxime) and macrolide is recommended (Regunath & Oba, 2022).
- For patients with a CURB 65 score of greater than or equal to 2, inpatient management is recommended. A respiratory fluoroquinolone monotherapy or combination therapy with beta-lactam (cefotaxime, ceftriaxone, ampicillin-sulbactam, or ertapenem) and macrolide are recommended options for nonintensive care settings (Regunath & Oba, 2022).
- The pneumonia severity index score can be used to assess the severity and need for more hospitalization in patients with community-acquired pneumonia
- Diagnostic tests like chest X-ray, CT, or MRI can be done to identify infiltration or effusion
- A complete blood count with differentials, serum electrolytes, and renal and liver function tests are indicated for confirming evidence of inflammation and assessing severity.
- A chest x-ray will be needed to identify an infiltrate or effusion, which, if present, will improve diagnostic accuracy.
- Blood and sputum cultures should be collected, preferably before the institution of antimicrobial therapy, but without delay in treatment.
- Urine for Legionella and pneumococcal antigens must be considered as they aid in diagnosis when cultures are negative.
- Influenza testing is recommended during the winter season. If available, testing for respiratory viruses on nasopharyngeal swabs by molecular methods can be considered. CURB 65 (confusion, urea greater than or equal to 20 mg/dL, respiratory rate greater than or equal to 30/min, blood pressure systolic less than 90 mmHg or diastolic less than 60 mmHg),
- Pneumonia Severity Index (PSI) are tools for severity assessment to determine the treatment setting, such as outpatient versus inpatient, but accuracy is limited when used alone or in the absence of effective clinical judgment.
- Serology for tularemia, endemic mycoses, or psittacican be sent in the presence of epidemiologic clues
Education Strategy
The interpersonal level communication helps to use the community volunteer to alert the surrounding people about health hygiene, the impact of community-acquired pneumonia, treatment, antibiotic therapy, diagnosis, tests, and other health care services. Which can be conveyed even by conducting small-group educational programs. Moreover, elderly patients like HH should be provided education on the following topic:
The following education strategy for the Community-acquired Pneumonia
- Staying compliance with medication helps in full recovery
- Vaccination
- All adults 65 years and older and those considered at risk for pneumonia must receive the pneumococcal vaccination. There are two vaccines available: PPSV 23 and PCV 13.
- For all unvaccinated adults 65 years or older, first vaccinate with PCV 13, followed by PPSV 23 at least a year later for immune-competent patients and at least eight weeks or more apart for patients who are immune-compromised or asplenic.
- Influenza vaccination is recommended for all adult patients at risk for complications from influenza. Inactivated flu shots (trivalent or quadrivalent, egg-based or recombinant) are usually recommended for adults.
- Cessation of smoking: – Smoking is injurious to health and will damage the lungs by deteriorating their health condition. Educate patient on smoking cessation therapy and offer therapy like nicotine treatment
- Hand Hygiene and mask
Proper hand hygiene and the use of a face mask while traveling in crowded places helps to prevent the transmission of disease and encouraged to wash hand with soap water or hand sanitizer
- Diet and exercise: – Eating a well balanced diet like protein-rich food, and green leafy vegetables help to increase the immune system and prevent infection as well as malnutrition. Breathing exercise helps to improve respiration
- Follow up with PCP to monitor the health status
Reference
Regunath H, Oba Y. Community-Acquired Pneumonia. [Updated 2022 Nov 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430749/
Stupka, J. E., Mortensen, E. M., Anzueto, A., & Restrepo, M. I. (2009). Community-acquired pneumonia in elderly patients. Aging health, 5(6), 763–774. https://doi.org/10.2217/ahe.09.74Links to an external site.
Simonetti, A. F., Viasus, D., Garcia-Vidal, C., & Carratalà, J. (2014). Management of community-acquired pneumonia in older adults. Therapeutic advances in infectious disease, 2(1), 3–16. https://doi.org/10.1177/2049936113518041