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Ericka Echezarreta

Weekly Clinical Experience 5

This week’s clinical experience was very productive and successful. I saw a patient for a well woman annual exam who states she has been trying to conceive for about a month, currently on prenatal vitamins. Otherwise, she is doing well with no complaints. Her vitals are stable. She has not been able to see her primary care physician.

A well woman exam refers to a preventive breast and gynecological exam that is done annually. It is very crucial in the early diagnosis of disorders and preventive care (Brown & Conry, 2017). Well woman checks help prevent breast diseases and other disorders such as cervical cancer. They also reduce the risk of women experiencing unwanted pregnancies and developing sexually transmitted diseases.

The assessment of the patient involved asking the patient several questions about her lifestyle and health. This involved asking the patient about the medicines she takes, whether she has any surgeries or long-term conditions or whether she uses illicit drugs, drinks caffeine, drinks alcohol, or smokes cigarettes. Other questions asked were how frequent she has sex, her birth control history, if she had sex outside her marriage, and if she has had STIs (Sexually transmitted diseases). It was also important to know whether the patient has missed periods or had irregular periods and whether she has conceived before.

Several tests were ordered for this patient. A pap smear was done to rule out cervix disorders such as cervical cancer or abnormal cells on the cervix. The test also helps to detect sexually transmitted diseases because STIs can prevent a woman from getting pregnant (Barbieri, 2019). A complete blood count (CBC) was carried out to diagnose disorders such as leukemia, anemia, and infection as well as check the overall health of the patient. A CMP (comprehensive metabolic panel) was also conducted to provide vital information about the metabolism and chemical balance of the patient’s body. Other tests ordered include lipid panel, hemoglobin A1C, Vitamin D test, and Thyroid-stimulating hormone (TSH) test. A lipid panel refers to a blood test that measures the level of fatty substances and fats. It measures lipids such as triglycerides and cholesterol. A hemoglobin A1C test was essential to check the average levels of blood sugar over the previous three months (Barbieri, 2019).Other tests performed were vitamin D test to rule out bone disorders and TSH test to detect thyroid disorders and check if the thyroid gland is functioning properly.

Some of the causes of infertility in women include issues with ovulation such as thyroid disorders, and hormonal balances, and issues with the uterus such as fibroids, adhesions, and polyps (Barbieri, 2019). It can also be caused by fallopian tube problems such as pelvic inflammatory disease and issues with egg quality and number. An ovum requires the right number of chromosomes to fertilize and develop into a baby or fetus. The patient was diagnosed with ovulation problems.

There are several treatment options for female infertility. The type of treatment given to a patient is determined by the cause of infertility (Hanson et al., 2017). The patient was given fertility drugs to trigger ovulation and restore her fertility. The patient was educated on lifestyle changes because her reproductive health is determined by her overall health.She was advised to exercise regularly to maintain fitness and the normal weight of her body. The patient was also advised to avoid smoking.

From this week’s clinical experience, I have learned how to conduct a well woman annual exam. I have also learned that a well woman exam primarily includes a pap smear, a pelvic examination, and a breast examination. However, it may also include other assessments or procedures.

References

Barbieri, R. L. (2019). Female infertility. In Yen and Jaffe’s Reproductive Endocrinology (pp. 556-581). Elsevier.

Brown, H. L., & Conry, J. (2017). The Well-Woman Task Force. The Well-Woman Visit, 65, 5.

Hanson, B., Johnstone, E., Dorais, J., Silver, B., Peterson, C. M., & Hotaling, J. (2017). Female infertility, infertility-associated diagnoses, and comorbidities: a review. Journal of assisted reproduction and genetics, 34(2), 167-177.