Health Promotion Throughout the Life Span.

“I have been experiencing irregular bleeding for three weeks.”

ORDER CUSTOM, PLAGIARISM-FREE PAPER

Mrs. N.R. is a 61-year-old white female G1T1A0 who presents to the Ob/Gyn clinic today with the chief complaint of irregular vaginal bleeding for three weeks. The patient appears to be in no distress. On 05/24/2017, she went to her primary care provider who has now referred her to this clinic. She states that she first noticed these symptoms when she was using the bathroom at her daughter’s house. She is very concerned because her LMP was six years ago at age 55. She describes her vaginal bleeding as “spotting, ” and she is now wearing one to two feminine panty liners per day. Mrs. N.R. claims the spotting is at times bright red in color and sometimes brown in color. She is unaware of any actions that aggravate or relieves her symptoms. She reports no abdominal pain or cramping. She rates her symptoms 1/10. The spotting is intermittent. Mrs. N.R. claims that her symptoms may last for a few minutes or may last a few hours. She reports the spotting develops throughout the day and night. She also reports intentionally losing 80 pounds within the past two years. Her original weight was 420 lbs, and her current weight is 339 lbs. She is losing her weight through diet by eliminating carbs and consuming more vegetables and lean meats. The patient and her husband have not been sexually active for the past 15 years. Her last pap smear was in February 2015, and it was negative. She claims she has never been diagnosed with an abnormal pap smear. Her last routine mammogram was in February 2015. The patient has an HMO insurance plan. She and the office staff claims that Human, the insurance company, must make the approval for diagnostic testing before any procedures can be performed.

Patient provided the HPI as follows:

O- Onset of symptoms started three weeks ago

L- Vaginal

D- Symptoms are intermittent and has lasted three weeks.

C- Reports spotting and sometimes she notices bright red in color and at other times brown in color

A- Nothing aggravates or alleviates her symptoms

R- Reports no abdominal pain or cramping

T- Spotting occurs the morning, day, and night.

T- No treatments so far.

S- Rates symptoms 1/10.

All women who live past the age of 50 will experience menopause. The final stage of reproduction in a female’s life is menopause. Menopause is defined as amenorrhea following 12 months after the females last menstrual cycle (Buttaro, Trybulski, Bailey, and Sandberg-Cook, 2013). The practitioner needs to recognize that postmenopausal spotting or bleeding is considered to be not normal (Buttaro et al., 2013). An encounter with a female who presents abnormal bleeding after menopause should entail a complete history and physical examination, laboratory examination, and treatment plan (Hawkins, Roberto-Nichols, and Stanley-Haney, 2016). Based on these recommendations, a comprehensive history was taken, the patient received a complete physical exam, a CBC was ordered to rule out anemia, and endometrial biopsy is ordered to rule out endometrial cancer.