A plan of wellness for women across the lifespan
As a nurse practitioner you will develop a plan of wellness for women across the lifespan, inclusive of adolescence, child-bearing years, and beyond. Follow the case of Mary below and develop a wellness plan for each life phase. For each age, include the well visit content, immunizations, preventive screenings and at least one education related to age in life.
At age 18 Mary is healthy. What are her well visit and screening needs?
At age 40 Mary is early in rheumatoid arthritis. She has two teenage children and is sexually active. What are her well visit and screening needs?
At age 65 Mary is disabled due to severe rheumatoid arthritis. What are her well visit and screening needs? What additional concerns and recommendations will you have for her as a disabled woman? How can you demonstrate and advocate for policies/practices that promote social justice and health equity for Mary’s needs?
Provide evidence-based sources.
- Immunizations:
- Meningococcal booster (if not previously received).
- Influenza (annual).
- HPV vaccine (if not completed).
- Tdap booster (if not within the past 10 years).
- Preventive Screenings:
- Blood pressure measurement.
- Pelvic exam and Pap smear (if sexually active).
- Screening for sexually transmitted infections (STIs), if sexually active.
- Cholesterol screening (if risk factors present).
- Mental health screening.
- Education:
- Safe sexual practices and contraception.
- Substance use prevention and harm reduction.
- Healthy lifestyle choices (diet, exercise, stress management).
2. Mary at Age 40 (Childbearing Years/Middle Adulthood)
- Well Visit Content:
- Review of medical history, including rheumatoid arthritis management.
- Assessment of physical and mental health.
- Discussion of lifestyle habits and stress management.
- Assessment of sexual health and family planning.
- Discussion of menopausal symptoms (if applicable).
- Review of rheumatoid arthritis symptoms and medication management.
- Immunizations:
- Influenza (annual).
- Tdap booster (if not within the past 10 years).
- Pneumococcal vaccine (if recommended due to RA).
- Preventive Screenings:
- Blood pressure measurement.
- Mammogram (annual or biennial, depending on guidelines).
- Cervical cancer screening (Pap smear and/or HPV testing, depending on guidelines).
- Cholesterol screening.
- Diabetes screening.
- Colon cancer screening (age 45, depending on guidelines).
- Bone density screening (if risk factors present, especially with RA).
- Rheumatoid arthritis disease activity monitoring.
- Education:
- Management of rheumatoid arthritis, including medication adherence and joint protection.
- Menopause management (if applicable).
- Healthy lifestyle choices for chronic disease prevention.
- Teenage parenting skills and support.
3. Mary at Age 65 (Older Adulthood)
- Well Visit Content:
- Comprehensive geriatric assessment, including functional status and cognitive assessment.
- Review of medical history, including rheumatoid arthritis management.
- Assessment of physical and mental health.
- Discussion of fall prevention and home safety.
- Assessment of medication management and potential drug interactions.
- Discussion of advance care planning.
- Immunizations:
- Influenza (annual).
- Pneumococcal vaccine.
- Zoster vaccine.
- Tdap booster (if not within the past 10 years).
- Preventive Screenings:
- Blood pressure measurement.
- Mammogram (depending on guidelines).
- Cervical cancer screening (depending on guidelines).
- Colon cancer screening (depending on guidelines).
- Bone density screening.
- Vision and hearing screening.
- Cognitive assessment.
- Fall risk assessment.
- Additional Concerns and Recommendations for a Disabled Woman:
- Assessment of accessibility needs (home, transportation, healthcare facilities).
- Referral to occupational therapy and physical therapy for adaptive equipment and strategies.
- Assessment of social support and access to community resources.
- Discussion of pain management and strategies for coping with chronic pain.
- Monitoring for depression and anxiety, which are common in individuals with chronic illness and disability.
- Assessment of caregiver support.
- Demonstrating and Advocating for Social Justice and Health Equity:
- Advocate for accessible healthcare facilities and transportation.
- Support policies that provide affordable and accessible healthcare for individuals with disabilities.
- Educate healthcare providers and the community about the needs of individuals with disabilities.
- Promote the use of assistive technology and adaptive equipment.
- Support legislation that protects the rights of individuals with disabilities.
- Advocate for policies that improve access to home and community based services.
- Work with community based organizations that provide support for disabled people.
Mary's Wellness Plan Across the Lifespan
1. Mary at Age 18 (Adolescence/Early Adulthood)
- Well Visit Content:
- Review of medical history, including family history.
- Assessment of physical and mental health.
- Discussion of lifestyle habits (diet, exercise, substance use).
- Assessment of sexual health, including contraception and STI prevention.
- Mental health screening for depression, anxiety, and substance use.
- Discussion of healthy relationships and violence prevention