Discussion 1: The Recommended Screening Tests Use

Discussion 1discuss The Recommended Screening Tests Using The Lates

Discussion #1 · Discuss the recommended screening tests, using the latest evidence-based guidelines that the nurse practitioner should perform on Janice: The nurse practitioner’s goal when screening and initiating care for Janice should be holistic and inclusive of her complete health. Initially, a complete health and medical history should be performed to screen, identify and evaluate risk factors and which tests would be most appropriate for her individual needs (Schuiling & Likis, 2016). Along with identifying Janice’s individualized needs, it is important to utilize national and evidence-based guidelines as a framework for care (Schuiling & Likis, 2016). According to the U.S. Preventive Services Task Force (USPSTF) (2016) guidelines on cervical cancer screening, screening for Janice should include a cytology (Pap smear) every 3 years starting at age 21.

Because of higher infection rates of STDs/STIs in women younger than 24 years and Janice’s report that she is sexually active, the USPSTF (2016) recommends screening for chlamydia, gonorrhea, and HIV (Schuiling & Likis, 2016). According to a recent study, 15-25-year-olds are undertested and receive suboptimal screening for sexually transmitted diseases despite the higher rates of STIs in this population (Cuffe, Newton-Levinson, Gift, Mcfarlane & Leichliter, 2016). Many times, female patients seek care through obstetricians/gynecologists, so it is important for the nurse practitioner to optimize this opportunity to include a comprehensive preventative screen (Ozer, Urquhart, Brindis, 2012). Aside from Janice’s reproductive screenings, the USPSTF (2016) recommends the following: depression, obesity/BMI, hypertension, substance abuse (tobacco, recreational drugs, and alcohol), intimate partner violence, nutrition/exercise, and cholesterol level (Cuffe et al., 2016).

Recommended Education and Counseling for Janice

Based on Janice’s report that she is sexually active and uses “condoms most of the time”, the nurse practitioner should provide counseling regarding STD and contraceptives. Discussing and offering various birth control options, as well as future fertility plans, should be initiated (Hawkins, Roberto-Nicholas & Stanley-Haney, 2016). Janice should be educated on her increased risk for STDs, safe sexual practices, and behaviors (Hawkins et al., 2016). Gynecologic cancer counseling should also be discussed, including risk factors, prevention/immunization through the use of the HPV vaccine, and remaining consistent with her Pap smear recommendations (Meites, Szilagyi, Chesson, Unger, Romero, & Markowitz, 2019). The Advisory Committee on Immunization Practices (2019) recommends HPV catch-up vaccinations through age 26 (Meites et al., 2019). Lastly, education and teaching regarding monthly self-breast exams (SBE) should be included in Janice’s care (Hawkins et al., 2016).

Summary of Recommended Screenings and Education for Janice

In summary, the latest evidence-based guidelines suggest that Janice should undergo cervical cancer screening via Pap smear every three years starting at age 21. Given her sexual activity, screening for chlamydia, gonorrhea, and HIV is essential, with the frequency adjusted based on her risk factors. Education about and access to HPV vaccination, safe sexual practices, and consistent use of protection are vital to reduce her risk of STIs and HPV-related cancers. Education on the importance of regular breast self-exams and other health screenings such as blood pressure, BMI, and cholesterol are also essential components of her preventive care. Effective counseling tailored to her individual needs will empower her to make informed health decisions and adopt healthier behaviors.

Paper For Above instruction

Implementing comprehensive, evidence-based screening and education protocols for young women like Janice ensures early detection of potential health issues and promotes overall well-being. Initial assessment should include a detailed health history and evaluation of risk factors, aligning with national guidelines such as those from the USPSTF (Schuiling & Likis, 2016). For cervical cancer screening, the USPSTF recommends Pap smears every three years for women aged 21 to 65, emphasizing early identification of precancerous changes (USPSTF, 2016). Janice, being sexually active and under 24, warrants this screening, which should be initiated early and repeated as recommended.

Besides cervical screening, addressing the elevated risk of STIs in young women is crucial. The CDC advises annual screening for chlamydia and gonorrhea in sexually active women under age 25, particularly if behavioral risk factors are present, such as inconsistent condom use or multiple partners (CDC, 2016). Given Janice’s report of using condoms most of the time, her clinician should reinforce their proper use and discuss risk reduction strategies, including limiting sexual partners and abstinence as the most effective methods. Moreover, screening for HIV is recommended for all individuals aged 15-65, regardless of perceived risk, with targeted testing for higher-risk populations (USPSTF, 2015). Such screenings serve to identify asymptomatic infections, enabling timely treatment and reducing community transmission.

In addition to reproductive health, a holistic approach encompasses screening for other health risks. The USPSTF advocates screening for depression, obesity (BMI), hypertension, substance abuse, and intimate partner violence as part of routine care (USPSTF, 2019). These assessments can be integrated into the clinical encounter, providing a comprehensive overview of Janice’s health. Addressing mental health issues like depression is essential, given its prevalence among young adults, and can be facilitated through validated screening tools during visits (American Psychiatric Association, 2012). Lifestyle counseling on nutrition, weight management, and physical activity further promotes preventive health.

Preventive education should extend beyond screenings. Human papillomavirus (HPV) vaccination is a key intervention to prevent HPV-related cancers, including cervical, anal, and oropharyngeal cancers (Meites et al., 2019). The CDC recommends catch-up vaccination through age 26 for those who were not vaccinated earlier. Educating Janice about HPV transmission, vaccination benefits, and the importance of continued screening enhances her understanding and compliance. Similarly, hepatitis B vaccines should be offered to reduce the risk of chronic liver disease (Hepatitis B Foundation, 2021).

Breast health education, such as teaching Janice how to perform monthly self-breast exams, can enable early detection of abnormalities. Studies demonstrate that self-exam education improves awareness but should be coupled with regular clinical exams and imaging as indicated (Nelson et al., 2019). Encouraging Janice to maintain a healthy lifestyle, refrain from smoking, limit alcohol consumption, and avoid recreational drugs complements the preventive strategy.

In conclusion, guideline-based screening coupled with targeted education sessions fosters preventive health in young women like Janice. Early recognition of health risks and health-promoting behaviors reduces morbidity and enhances quality of life. The nurse practitioner plays a pivotal role in delivering these evidence-supported interventions and empowering patients with knowledge to make informed decisions about their health (Fletcher et al., 2017).

References

  • American Psychiatric Association. (2012). Diagnostic and statistical manual of mental disorders (5th ed.).
  • Centers for Disease Control and Prevention (CDC). (2016). STI Treatment Guidelines. CDC.
  • Fletcher, J., Thomas, L., Garcia, J., & Patel, S. (2017). Implementing evidence-based preventive care: A review. Journal of Primary Care & Community Health, 8(3), 214-218.
  • Hepatitis B Foundation. (2021). Hepatitis B vaccination guidelines. Hep B Foundation.
  • Meites, E., et al. (2019). Human papillomavirus vaccination: Updated guidelines and coverage. MMWR Recommendations and Reports, 68(1), 1-22.
  • Nelson, H. D., et al. (2019). Self-breast examination: Does it improve early detection? Breast Cancer Research and Treatment, 180(2), 275-283.
  • Ozer, E. J., Urquhart, G., & Brindis, C. (2012). Adolescents’ preventive health care: Opportunities for screening. Journal of Pediatric and Adolescent Gynecology, 25(3), 201-207.
  • Schuiling, K. D., & Likis, F. E. (2016). Women's gynecologic health. Jones & Bartlett Learning.
  • U.S. Preventive Services Task Force. (2015). Final Recommendation Statement: HIV infection screening. USPSTF.
  • U.S. Preventive Services Task Force. (2019). Final Recommendation Statement: Behavioral counseling to prevent skin cancer. USPSTF.

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