Postmenopausal Bleeding Evaluation

Postmenopausal Bleeding Evaluation

Weekly Clinical Experience 3

Describe your clinical experience for this week.

• Did you face any challenges, any success? If so, what were they?

• Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnosis with rationales.

• Mention the health promotion intervention for this patient.

• What did you learn from this week’s clinical experience that can beneficial for you as an advanced practice nurse?

• Support your plan of care with the current peer-reviewed research guideline.

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources WITHIN 5 YEARS

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APA

Postmenopausal Bleeding Evaluation

Challenges and Successes

This week in my clinical rotation, I encountered a range of cases, with a particularly complex case involving a 52-year-old female patient presenting with postmenopausal bleeding. The challenge was distinguishing between benign and malignant causes while ensuring the patient received appropriate diagnostic workup and counseling. Success came from effectively educating the patient about her condition, explaining the necessary tests, and reassuring her about the next steps. This experience reinforced the importance of patient-centered communication and shared decision-making in women’s health.

Patient Assessment

Chief Complaint:
The patient reported light vaginal bleeding occurring intermittently over the past two weeks. She denied pelvic pain, abnormal vaginal discharge, or recent trauma.

Signs and Symptoms (S&S):

• Postmenopausal bleeding (intermittent, light spotting)
• No dysuria, fever, or foul-smelling discharge
• No unintended weight loss or constitutional symptoms

Physical Exam:

• Abdomen: Non-tender, no palpable masses
• Pelvic Exam: Slightly atrophic vaginal mucosa, no visible cervical lesions
• Bimanual Exam: No adnexal tenderness or palpable masses

Plan of Care:

1. Diagnostic Testing:
   • Transvaginal Ultrasound (TVUS): Assess endometrial thickness (a thickness >4 mm raises concern for malignancy) (ACOG, 2021).
   • Endometrial Biopsy: If the TVUS shows increased endometrial thickness, a biopsy is necessary to rule out endometrial hyperplasia or carcinoma.
   • Pap Smear and HPV Testing: To screen for cervical dysplasia or malignancy.
   • CBC and Coagulation Panel: To evaluate anemia and…