Women's Health for Advanced Practice Nurses

 
 

Women's Health for Advanced Practice Nurses

  • Childbirth in Black Women A reader believes that black women are more likely to die from pregnancy-related complications.
  • Vitamin D Deficiency During Pregnancy I believe that pregnant women should be taking more vitamin D. What effect does a vitamin D deficiency have on pregnancy?
  • Should a Rectal Exam Be a Routine Part of a Pelvic Examination? Is it necessary to perform a rectal exam during a routine pelvic exam? If a rectal probe is indicated, should one also test for occult blood or document that no stool was obtained?
  • Serotonin-Reuptake Inhibitors and Menopausal Hot Flashes I’ve heard that menopausal hot flashes can be treated with SSRIs such as Paxil or Prozac. Is this an appropriate indication for these medications?
  • How Should We Counsel Women About HPV Testing? We do HPV screening when we do Pap smears for women over 30 years old and for younger women if their Pap results are equivocal. How should we adapt patient counseling in light of this new practice?
  • Legal Concerns When Assisting With Clinical Research Trials I have been asked to do physical exams, interpret ECGs, and evaluate lab results to determine eligibility for participation in clinical trials funded by pharmaceutical companies. What are the risks?
  • Does the HPV Vaccine Benefit Women Who Are Already Infected With HPV? Should the new HPV vaccine be given to women with abnormal Pap smears? Does it help those who are already infected with HPV?
  • New HPV Vaccine I'm confused about who should be screened for HPV and who should be given the new vaccine. Can you please clarify?
  • FSH Levels and Menopause Will a blood sample for FSH and LH be accurate for a woman, age 50, who is on birth control pills, if it is drawn during the week of hormone-free pills?
  • Central Adiposity in Women We know that "pear-shaped" women are at less risk for heart disease than "apple-shaped" women. When weight shifts to the abdomen in menopause, does this put them at the same increased risk?
  • Fluoxetine and Premenstrual Syndrome What are the latest options for treating irritability in women with 3-5 days of premenstrual syndrome (PMS) monthly? Is fluoxetine useful if taken only 1 week per month?
  • Pap Smear Before Starting Birth Control When starting a young woman on birth control, even when she is not sexually active, how important is it to obtain a yearly Pap smear?
  • Compensation Arrangements for a Nurse Midwife I am a certified nurse midwife starting a practice with a group of physicians. I will be covering obstetrical care 24 hours/day, 7 days/week, as the only midwife on staff. What compensation is fair?
  • Depo-Provera and Hepatitis B Can depot medroxyprogesterone acetate (Depo-Provera) be given to a young woman who smokes, is hepatitis B-positive, and has multiple sexual partners?
  • Decreased Libido in Female Patients Many of the female patients I see have some type of sexual dysfunction, with most having concerns about decreased libido. No treatment has worked for very long. Do you have any suggestions?
  • Discontinuing HRT How should I advise patients who wish to discontinue hormone replacement therapy (HRT) and have concerns about hot flashes? Is there a benefit to "weaning" women off HRT?
  • Atypical Pap Test Result What is the appropriate follow-up for a patient with a Pap smear that indicates "atypical squamous cells of undetermined significance (ASCUS)"?
  • Birth Control for a Sexually Active 12-Year-Old Which form of birth control is safest for a sexually active 12-year-old? Would the vaginal ring be a good choice?
  • How Can I Make a Woman Comfortable During a Pelvic Exam? Do you have any suggestions on how to help women become more comfortable during the speculum exam, or practical hints to help locate the cervix, especially when there is anteflexion?
  • Antenatal Steroids and Pregnancy If a patient has contractions at 35 weeks, but no cervical change, and if tocolytics were not prescribed and the patient delivered a baby who developed RDS, could we be liable?