A 33-year-old Caucasian female presents with concerns about a four-month history of diffuse musculoskeletal pain and stiffness associated with fatigue and dry eyes. The pain varies with the weather and is worse in the morning.

Compare and contrast the roles of the Nurse Practitioner, Nurse Educator, Nurse Informaticist and Nurse Administrator in advanced practice nursing pertaining to clinical practice, primary care, education, administration and research.
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A 33-year-old Caucasian female presents with concerns about a four-month history of diffuse musculoskeletal pain and stiffness associated with fatigue and dry eyes. The pain varies with the weather and is worse in the morning.

Endocrine and musculoskeletal conditions, especially when left untreated, can have a significant impact on women’s health. Many of these conditions present unique challenges for women, making risk assessments and routine screenings an important part of primary care. As an advanced practice nurse, you must identify signs and symptoms of these conditions and educate at-risk patients so they can also monitor themselves. For this Discussion, consider how you would diagnose, treat, and educate the patients in the following three case studies:

Case Study 1

A 33-year-old Caucasian female presents with concerns about a four-month history of diffuse musculoskeletal pain and stiffness associated with fatigue and dry eyes. The pain varies with the weather and is worse in the morning. Her menstrual periods are irregular and she has frequent dyspareunia. Physical exam is remarkable for pain at different points all over the body, including neck, back, chest, elbows, hips, buttocks, and knees

Case Study 2

A 28-year-old Latina obese female presents to the clinic with increasing body hair and irregular menses. She now has coarse body hair on her chest and upper back. Her menstrual periods used to be fairly regular, but now she can skip three or four months before her next menstrual cycle. She has never been pregnant. She has one male sex partner.

Case Study 3

A 28-year-old Caucasian female comes to clinic concerned about three episodes of urinary incontinence associated with difficulty walking. The first two episodes resolved spontaneously after a couple of days without residuals, but this current episode has lasted a week. Today she began to have some blurred vision. Physical exam is remarkable for mild edema of the optic disc and difficulty with heel-to-toe walking. Deep tendon reflexes are 2+ and there is no extremity weakness.

To prepare:

Review Chapter 8 of the Tharpe et al. text and the McSweeney et al. article in this week’s Learning Resources.

Review and select one of the three provided case studies. Analyze the patient information.

Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.

Reflect on the appropriate clinical guidelines. Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.

Consider strategies for educating patients on the treatment and management of the disorder you identified as your primary diagnosis.

By Day 3

Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the 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 patients on the disorder.


 

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