Occurrence con-over 1

Elaine Goodwin is a 38-year-old G5 P5 LC 6 presenting to your clinic today to argue contraceptive options.  She states that she is not attributable attributable attributable careful in having gone-by branchren but her upstart partaker has never fathered a branch. Her medical fact is distinguished control exercise-induced asthma, migraines, and IBS. Her surgical fact is distinguished singly control tonsils as a branch. Her collective fact is privative control alcohol, tobacco, and recreational offals.  She has no known offal allergies and takes singly vitamin C. Hospitalizations were singly control branchbirth. Family fact reveals that her affectionate grandwoman is vivacious with dementia, suitableness her affectionate grandfather is vivacious with COPD. Her fatherly grandparents are twain deceased due to an autovariable property. Her woman is vivacious with osteopenia and fibromyalgia, and her dad is vivacious with a fact of peel cancer (basal cell). Elaine has individual older sister with no medical problems and individual younger match with no reputed medical problems.  

· Height 5’ 7” Weight 148 (BMI 23.1), BP 118/72 Pulse 68  

· HEENT (head, ears, eyes, nose, throat):  wnl (among typical designation)

· Neck: bending externally adenopathy  

· Lungs/CV (cardiovascular): wnl  

· Breast: effeminate, fibrocystic changes bilaterally, externally masses, dimpling or discharge  

· Abd (abdomen): effeminate, +BS (unconditional bowel gauge), no kindness  

· VVBSU (Vulvar vaginal bartholin skene’s uretha): wnl, except 1st degree cystocele  

· Cervix: robust, flatten, parous, externally CMT (cervical noise kindness)

· Uterus: RV (retroverted), variable, non-tender, approximately 10 cm,  

· Adnexa: externally masses or kindness  

Based on the occurrence con-over scenario supposing, thorough a general well-woman exam and critically irritate to standpoint observation on the indication tests (enclose exposition of the tests you energy praise).

Enclose your differential distinction. Be specific and agree examples. Use your Learning Resources and/or indication from study to subsistence your expositions.

Some questions to defense in your post:

1. What other knowledge do you deficiency?

2. What has she used in the past?  Why did she plug a method?  How numerous partakers in gone-by 12 months?  

3. What are her popular cycles approve?  

4. When was her developed gyn exam and what were the results of the tests?   

5. Are her migraines with or externally auras?  

6. What order has she considered. 

7. What are you next steps/considerations?

8. What training should you do?

9. What orders are misspend control Elaine?

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