Cardiovascular and neurologic conditions are among the leading causes of death and hospitalization of women in the United States (Centers for Disease Control and Prevention, 2008a).
As an advanced practice nurse, you must routinely monitor patients at risk of these conditions and recommend the appropriate health screenings and preventive services.
When assessing patients for these conditions, it is important to keep in mind that while some female patients might present with typical signs and symptoms, others might present with atypical signs and symptoms that are unique to women.
For this Discussion, consider signs and symptoms presented by the women in the following case studies and develop differential diagnoses:
Case Study 1:
A 48-year-old overweight African American female is in the clinic for a wellness visit. A routine fasting lipid panel returned with the following results:
Total cholesterol: 305 mmol/L
Low-density lipoprotein (LDL): 180 mg/dl
High-density lipoprotein (HDL): 30 mg/dl
Triglycerides: 165 mg/dl
Case Study 2:
You are seeing a 63-year-old African American female for a two-week history of intermittent chest pain. The pain varies in intensity and resolves with rest. She does not believe it has increased over time. She is a nonsmoker with a history of hypertension treated with Lisinopril 10 mg once daily. She had an exercise stress test one year ago that was within normal limits. Her physical exam findings are as follows: HR–90, BP–150/92, R–22, O2Sat 98% RA; lungs: clear to auscultation bilaterally; cardiovascular: apical pulse of 90 RRR, no rubs, murmurs, or gallops. Chest wall mildly tender to palpation that reproduces her complaint of pain. Extremities include no clubbing, cyanosis, or edema. The remainder of the exam is within normal limits.
Case Study 3:
A 32-year-old Asian American female is in the clinic for a history of recurrent headaches for the past year, occurring monthly, lasting up to 12–18 hours. The headaches are sometimes associated with photophobia, nausea, and vomiting. She takes either acetaminophen or ibuprofen for relief that is not always successful. She uses Ortho Tricyclin for birth control. Her physical exam is within normal limits.
To prepare:
Review Chapter 8 of the Tharpe et al. text and the McSweeney et al. article in this week’s Learning Resources.
Discuss all three case studies provided seperately.
Analyze the patients information.
Consider a differential diagnosis for each patient in the case studies.
Think about the most likely diagnosis for each patient.
Reflect on the appropriate clinical guidelines.
Think about a treatment and management plan for each patient.
Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.
Consider strategies for educating each patient on the treatment and management of the disorder you identified as your primary diagnosis.
Discuss the differential diagnosis for each patient in the in all three cases.
Explain which is the most likely diagnosis for each patient and why.
Then, based on the appropriate clinical guidelines, explain a treatment and management plan for the patient, including proper dosages for any recommended treatments.
Finally, explain strategies for educating each patient on the disorder.
Readings:
Tharpe, N. L., Farley, C., & Jordan, R. G. (2013). Clinical practice guidelines for midwifery & Women’s health (4th ed.). Burlington, MA: Jones & Bartlett Publishers.
Chapter 8, “Primary Care in Women’s Health” (pp. 431–560)
This chapter explores health promotion and disease prevention in women’s health. It also describes the presentation, assessment, diagnosis, and management of various systemic conditions, including cardiovascular and neurologic conditions.
McSweeney, J. C., Pettey, C. M., Souder, E., & Rhoads, S. (2011). Disparities in Women’s cardiovascular health. Journal of Obstetric, Gynecologic & Neonatal Nursing, 40(3), 362–371.
Retrieved from the Walden Library databases.
This article explores health disparities in cardiovascular disease, including gender and racial disparities related to the diagnosis, treatment, and outcomes of patients with this disease.
Department of Health and Human Services, National Institutes of Health, & National Heart, Lung, and Blood Institute. (n.d.). Women’s Health Initiative: WHI background and overview. Retrieved March 20, 2013, from http://www.nhlbi.nih.gov/whi/background.htm
This website outlines details of the Women’s Health Initiative (WHI) and introduces the various health issues addressed by the WHI.
