Advanced Practice in Primary Care: Women’s Health

by | Apr 11, 2025 | healthcare

 

1. Develop advanced practice care plans to help manage the delivery of health care to women (EOPSLO# 3, 5, 6, 7).
2. Utilize relevant evidence-based research findings in the clinical management of women’s health issues (EOPSLO# 1, 3, 4).
3. Integrate legal, ethical, socioeconomic, psychosocial, and cultural factors in the delivery of health care to women’s health clients (EOPSLO# 3, 6, 8 and 9).
6. Communicate practice knowledge effectively both orally and in writing (EOPSLO# 4 and 5).
7. Demonstrates information literacy skills in complex decision-making (EOPSLO# 1, 5).

Instructions: Please choose one women’s health condition learned in the course. Once the health condition is chosen, you are to write a three-to-five-page paper in APA format 7th edition with the following sections and level 2 headings:
Introduction
-Brief overview of women’s health
-Introduce the disease condition chosen
-Importance of understanding the condition
Presentation of Condition
-Describe the condition chosen and its pathophysiology.
-What signs/symptoms are identified in the patient that can be found?

 

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.


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God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

 

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.

Advanced Practice Care Plan: Endometriosis Management

Introduction

Women’s health encompasses a broad spectrum of physiological and psychological experiences, demanding a holistic and individualized approach to care. Advanced practice registered nurses (APRNs), particularly those specializing in women’s health, play a crucial role in managing complex conditions and promoting well-being across the lifespan. Endometriosis, a chronic and often debilitating condition, significantly impacts women’s quality of life. This paper will delve into the pathophysiology, clinical presentation, evidence-based management, and the integration of legal, ethical, and sociocultural considerations in the care of women with endometriosis. Understanding this condition is paramount for APRNs to provide comprehensive and effective care, minimizing morbidity and enhancing patient outcomes.

Advanced Practice Care Plan: Endometriosis Management

Introduction

Women’s health encompasses a broad spectrum of physiological and psychological experiences, demanding a holistic and individualized approach to care. Advanced practice registered nurses (APRNs), particularly those specializing in women’s health, play a crucial role in managing complex conditions and promoting well-being across the lifespan. Endometriosis, a chronic and often debilitating condition, significantly impacts women’s quality of life. This paper will delve into the pathophysiology, clinical presentation, evidence-based management, and the integration of legal, ethical, and sociocultural considerations in the care of women with endometriosis. Understanding this condition is paramount for APRNs to provide comprehensive and effective care, minimizing morbidity and enhancing patient outcomes.

Presentation of Condition

Description and Pathophysiology

Endometriosis is defined by the presence of endometrial tissue outside the uterine cavity. This ectopic tissue, while histologically similar to eutopic endometrium, responds to hormonal fluctuations, leading to inflammation, bleeding, and the formation of adhesions. Common locations include the ovaries, fallopian tubes, pelvic peritoneum, and rectovaginal septum.

The exact pathogenesis remains unclear, but several theories exist:

  • Retrograde Menstruation: The most widely accepted theory suggests that menstrual blood flows backward through the fallopian tubes into the pelvic cavity, depositing endometrial cells.
  • Coelomic Metaplasia: This theory proposes that cells lining the pelvic cavity transform into endometrial tissue.
  • Induction Theory: This theory posits that substances from the endometrium induce the formation of ectopic endometrial tissue.
  • Lymphatic or Hematogenous Spread: Endometrial cells may spread through the lymphatic or circulatory system to distant sites.
  • Genetic Predisposition: Familial clustering suggests a genetic component.

Regardless of the origin, the ectopic tissue responds to estrogen, causing inflammation, pain, and the formation of adhesions. Over time, these lesions can lead to pelvic organ distortion, infertility, and chronic pain.

Signs and Symptoms

The clinical presentation of endometriosis varies significantly. Some women are asymptomatic, while others experience severe symptoms. Common signs and symptoms include:

  • Pelvic Pain: This is the hallmark symptom, often described as chronic and cyclical, worsening during menstruation (dysmenorrhea).
  • Dyspareunia: Pain during or after sexual intercourse.
  • Infertility: Endometriosis can distort pelvic anatomy and impair ovulation or fertilization.
  • Heavy or Irregular Menstrual Bleeding (Menorrhagia/Metrorrhagia): Due to the hormonal response of ectopic tissue.
  • Bowel or Bladder Symptoms: Dyschezia (painful bowel movements) or dysuria (painful urination) may occur if endometriosis involves the bowel or bladder.
  • Fatigue: Chronic pain and inflammation can lead to fatigue and decreased energy levels.
  • Nausea and Vomiting: Occur during menstruation due to increased prostaglandins.
  • Pain Radiating to the Lower Back or Legs: Due to nerve involvement.
  • Presence of Endometriomas: Ovarian cysts filled with old blood.

Advanced Practice Care Plan

Assessment:

  • Detailed medical history, including menstrual history, pain assessment, and fertility concerns.
  • Pelvic examination to assess for tenderness, nodules, or adnexal masses.
  • Transvaginal ultrasound to visualize endometriomas or other pelvic abnormalities.
  • Laparoscopy with biopsy for definitive diagnosis and staging.
  • Assessment of psychological and emotional impact of the condition.

Diagnosis:

  • Endometriosis, based on clinical presentation and diagnostic findings.
  • Chronic pelvic pain.
  • Infertility (if applicable).
  • Potential for psychological distress (anxiety, depression).

Planning:

  • Develop an individualized treatment plan based on symptom severity, fertility desires, and patient preferences.
  • Implement evidence-based medical and surgical interventions.
  • Provide comprehensive patient education and support.
  • Coordinate care with other healthcare professionals (e.g., pain specialists, fertility specialists, mental health professionals).

Interventions:

  • Medical Management:
    • Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief.
    • Hormonal therapies (e.g., combined oral contraceptives, progestins, GnRH agonists, aromatase inhibitors) to suppress ovarian function and reduce endometrial tissue growth.
    • Danazol as a hormonal supressant.
  • Surgical Management:
    • Laparoscopic surgery to remove or ablate endometrial lesions and adhesions.
    • Hysterectomy with or without bilateral salpingo-oophorectomy (BSO) for severe cases or when fertility is not desired.
  • Pain Management:
    • Multimodal analgesia, including pharmacological and non-pharmacological approaches (e.g., physical therapy, acupuncture, relaxation techniques).
    • Referral to a pain specialist for chronic pain management.
  • Fertility Management:
    • Assisted reproductive technologies (ART) for women with infertility related to endometriosis.
    • Surgical management to improve fertility outcomes.
  • Psychological Support:
    • Counseling and support groups to address the emotional impact of the condition.
    • Cognitive-behavioral therapy (CBT) for pain management and coping skills.

Evaluation:

  • Monitor symptom improvement and treatment effectiveness.
  • Assess patient satisfaction and quality of life.
  • Evaluate fertility outcomes.
  • Provide ongoing support and education.

Integration of Legal, Ethical, Socioeconomic, Psychosocial, and Cultural Factors

  • Legal and Ethical Considerations:
    • Informed consent for medical and surgical interventions.
    • Confidentiality and privacy of patient information.
    • Addressing potential conflicts related to fertility treatments.
  • Socioeconomic Factors:
    • Assessing the impact of the condition on employment, finances, and relationships.
    • Providing resources and support for managing healthcare costs.
  • Psychosocial Factors:
    • Addressing the emotional impact of chronic pain, infertility, and sexual dysfunction.
    • Providing support for coping with the long-term nature of the condition.
  • Cultural Factors:
    • Considering cultural beliefs and practices related to menstruation, pain, and fertility.
    • Providing culturally sensitive care and education.

Evidence-Based Research

APRNs must utilize relevant evidence-based research to inform clinical decision-making. Current research supports the use of hormonal therapies and laparoscopic surgery for endometriosis management. Studies have also demonstrated the effectiveness of multimodal pain management approaches and psychological support.

Communication and Information Literacy

Effective communication is essential for building rapport with patients and providing clear and concise information about the condition and treatment options. APRNs must also demonstrate information literacy skills in accessing and evaluating research evidence to support clinical practice.

Conclusion

Endometriosis is a complex and challenging condition that requires a comprehensive and individualized approach 1 to care. APRNs play a vital role in managing this condition, integrating evidence-based research, and addressing the legal, ethical, socioeconomic, psychosocial, and cultural factors that impact women’s health. By providing holistic and patient-centered care, APRNs can improve the quality of life for women with endometriosis and promote optimal health outcomes.  

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