Women’s Health or GU
A 21-year-old female patient presents to the office for an annual exam. She has had normal, regular menstrual cycles since she was 14 but she has not had a menstrual cycle in over 6 months. A pregnancy test is negative. The FNP wants to order blood work to determine the cause of her secondary amenorrhea. When the patient hears that if all is normal the treatment will be giving progestins to initiate a menstrual cycle, she tells the FNP that she cannot do that because she does not believe in birth control pills. The FNP tries to advise the patient that it is not birth control pills, but a hormone to assist in regulating her periods and the patient leaves the office crying. What does the FNP do now to help this patient?
OR
A 65-year-old male presents to your clinic with frequent urination. He complains of painless, frequent urination approximately every 45 minutes to an hour for the past 5 months. He states he hates visiting doctors because they always try to find something wrong with him. His wife made him this appointment, but he thinks his problem is just because he is getting older. He denies any pain on urination or any blood in the urine. He also denies any difficult voiding. No foul odor is in the urine or discharge from the penis. He has tried to reduce his liquid consumption, but it has not made much of a difference. He denies any pelvic pain or rectal pain. He has not had any labs done in the past 5 years. Also, he has not had a physical done in 10 years. Physical exam reveals an African American male in no apparent distress. The abdomen is soft, nontender, no masses or distensions on palp. No hepatosplenomegaly. DRE (Digital Rectal Examination) reveals an enlarged, firm, smooth, symmetrical prostate. Provide the most likely diagnosis based on the HPI and PE. In addition, provide your interpretation of the cues found in the assessment. List at least 3 possible differential diagnoses and justify your rationale. Develop therapeutic plan options based on quality, evidence-based clinical guidelines.
Length: A minimum of 250 words, not including references
Citations: At least one high-level scholarly reference in APA from within the last 5 years.
