Midterm Exam - NR 6552 Advanced Nurse Practice in Reproductive Health Care Practicum - Walden Latest 2023 / 2024 Why do we screen for TYPE 2 DIABETES but not TYPE 1?
-TYPE 1 DIABETES
Screening for type 1 diabetes is not recommended for the following
reasons: patients typically present with an acute onset of
symptoms, no established cutoff value is available for antibody tests, no accepted treatment exists for patients who are asymptomatic, and no medication is available to prevent the disease in persons genetically predisposed to type 1 diabetes
-TYPE 2 DIABETES
Screening is recommended for type 2 diabetes because reliable tests are available, and lifestyle changes and medications reduce progression and adverse sequelae of the disease, even in persons who are initially asymptomatic.
CERVICAL CANCER AND SCREENING
-Pap-test 21-65 (cervical cancer screen) New screening interval was recently updated from annually to once every three years if normal Co-testing with HPV via PAP every 5 years for ages 30-65. 1 / 3
Diabetes in women (pregnant and nonpregnant) -(USPSTF) recently updated recommendations and suggests screening individuals 40 to 70 years of age who are overweight or obese.Persons with abnormal results should be referred for intensive behavioral counseling interventions focusing on physical activity and a healthy diet. Clinicians should consider screening certain individuals at higher risk. repeat screening every 3 years and a fasting blood glucose yearly.PREGNANT WOMEN-Glucose test is done between 24-28 weeks. The test may be performed earlier if high glucose levels are in the urine or if they had Gestational DM in previous pregnancies.Colorectal Cancer Screening -USPSTF recommends screening all adults ages 5-75 years old. Early screening in women if a first degree relative had colorectal cancer at a young age. If they have inflammatory bowel disease, or rare genetics such as familial adenomatous polyposis or nonpolyposis Use of the Rectovaginal examination -Perform with the patient laying in a supine lithotomy position (lithotomy means with legs up in stirrups). Used in a person who has a retroflexed or retroverted uterus. allows palpitation to depth of 2.5 cm's more than transvaginal ultrasound. This is very uncomfortably and usually omitted unless very necessary. 2 / 3
Types and Sizes of speculums
-There are three main types of cervical speculum: pediatric,
Pederson and Graves. They come in plastic and medal.The Pediatric Speculum (smallest most narrow) Shorter in length, the pediatric speculum is intended for use in patients who have never had sexual intercourse and therefore have narrower vaginal canals The Pederson Speculum Flat and narrow, the Pederson speculum is a vaginal speculum used during OB/GYN examinations when women have narrow vaginal canals. This condition can be caused by traumatic injuries and the resulting scar tissue, but is also found in elderly women and women who have never had sexual intercourse. Using this narrow speculum type can eliminate some of the discomfort of a pelvic exam. (Also used in menopausal women, transgender men on testosterone, transgender women with neovagina.The Graves Speculum (resembles a duck’s mouth in appearance) The Graves speculum is the most common variety used by OB/GYNs. This vaginal speculum is commonly available in multiple
sizes: small, medium and large. Used in Sexually Active Women.
Normal vs Abnormal Pap smears -Checks for cervical intraepithelial neoplasia.-Normal results show negative for cell changes to cervix.-Abnormal shows positive for cell changes to cervix
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