Response 1 (Joan Wambui)

Development of gynecologic patient histories requires practitioners to recognize the various elements that are necessary to construct a history that is accurate and relevant. This effort requires consideration of the chief complaint and multiple other elements, including effective communication with various populations including those in the LGBTQ+ community, to ensure a productive screening and subsequent examination. The assignment Respond to your colleagues’ posts on two different days and introduce a perspective that they may not have considered and list any additional health maintenance guideline questions that might be relevant. Use the Learning Resources and/or the best available evidence from current literature to support your explanation. Colleague’s Post A lot of diseases in this world usually affect both sexes and even though this is the case, women tend to face a lot of barriers when it comes to seeking healthcare (Onarheim et al., 2016). This is why a gynecological history is just as important as any physical health screening as not only does it concentrate on a woman’s reproductive health but also on different screenings which are individualized to the patient (ACOG, 2020). This individualization is based on certain factors which include the patient’s age, pregnancy status, health status, psychosocial well-being, risk factors, reproductive needs, and immunizations (ACOG, 2020). Another component to consider includes a person’s sexual orientation. This should never be assumed as 4.5% of the population in the United states identify themselves as lesbians, gay, bisexuals, transgender, or queer and also face a lot of barriers in healthcare (Aisner, Zappas & Marks, 2020). This particular group of individuals should also be taken into consideration as they are prone to discrimination and violence therefore increasing their risk of psychiatric disorders, suicide and also substance abuse (ODPHP, 2020). Questions included in screening this population should include how they would like to be addressed, the number of partners, their relationship status and if they feel safe in the relationship, and whether they abuse any drugs. These questions can help the provider know which screening tools to use such as using the patient health questionair-9 for depression individuals at risk for depression, using CAGE questionnaire, BSTAD, & TAPS for substance abuse, HIV/ STI risk assessment for individuals with multiple partners, and intimate partner violence for those who verbalize safety issues and substance abuse issues in their relationships (Aisner, Zappas & Marks, 2020). In terms of health guidelines, as advance practitioners our priority when taking care of women should always focus on the health risk factors and the age of the patient. Examples of health maintenance guidelines include screening for cervical cancer every 3 years with cytology testing for patients who are 21-65 years old and every 5 years with co-testing for those women who are over 30- 65 years of age (AHRQ, 2014). Other screening considerations in women should include breast cancer screening with mammogram every 2 years for women 50- 74 years and individualized decision to screen for women 40-49 year of age, osteoporosis screening for women who are 65 years and older using bone density scan, and behavioral management, counseling and dietary modifications when obesity is a health issue based on the individual’s body mass index (AHRQ, 2014). With vaccinations being an important component in prevention of common diseases, women are recommended to receive 2 doses of the Shingrix vaccination 2-6 months apart after the age of 50 years (CDC, 2020). Another vaccination that they should receive which is related to reproductive health is Human papillomavirus (HPV). If the age of vaccination is between 9-14, these individuals should receive two doses of Gardasil and if over 15 years, 3 doses are recommended (CDC, 2020). References Agency for Healthcare Research and Quality. (2014). Guidelines to Clinical Preventative Services, 2014. Retrieved from https://www.ahrq.gov/prevention/guidelines/guide/index.html Aisner, A. J., Zappas, M., & Marks, A., (2020). Primary Care for Lesbians, Gay, Bisexual, Trasngender, & Queer/ Questioning (LGBTQ) Patients. The Journal for Nurse Practitioners, 16 (4), 281-285. Retrieved from https://doi-org.ezp.waldenulibrary.org/10.1016/j.nurpra.2019.12.011 American College of Obstetrician and Gynecologists (ACOG). (2020). Well-Woman Health Care. Retrieved from https://www.womenspreventivehealth.org/wp-content/uploads/Well-Woman-Preventive-Visits.pdf Centers for Disease Control and Prevention. (2020). Retrieved from https://www.cdc.gov/vaccines/schedules/index.html Office of Disease Prevention Health Promotion (ODPHP). (2020). Lesbian, gay, bisexual, and transgender health. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/lesbian-gay-bisexual-and-transgender-health Onarheim, K. H., Iversen, J. H., & Bloom, D. E. (2016). Economic benefits of investing in Women’s health: A systematic review. PLoS One, 11(3) doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1371/journal.pone.0150120 Sources within 5 years

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