Despite the common perception that medicine is becoming specialty driven, there are many reasons for primary care providers to offer women’s health procedures in an office setting. Women feel more comfortable having procedures done by prov- ers whom they already know and trust. Continuity of care is still valued by patients, who trust their primary care providers to work with them as collaborators in the decision-making process. Women have found that their options for care have become limited, not by their own decision, but by the lack of training of their p- vider. In rural areas, the barriers of time, expense, and travel often prevent many women from obtaining necessary care; yet many of the procedures that these women are requesting are relatively easy to learn. Positive experiences are shared by women who then refer friends and family by word of mouth. This book has been designed to assist not only the clinician performing the pro- dures covered, but also the office staff with setting up the equipment tray prior to p- forming the procedure and with preparing office documents and coding information needed to complete the procedure. Most procedures covered can be done with a mi- mum investment in equipment and require minimal training.
This manual-style reference presents the clinical skills needed to assess health and provide care to women of all of ages, with systematic reviews of all aspects of female mental and bodily health. The authors and contributors comprehensively cover female reproduction, anatomy, and physiology as examined at the cellular level. Also discussed are developmental, psychological, and sociocultural dimensions of women. Offering an integrated approach to women's health care, the authors delineate the roles and functions of various health care providers serving female patients, including physician's assistants, nurse midwives, and nurse practitioners. The chapters present assessment strategies that are on the leading edge of the expanded role of the advanced practice clinician. The chapter authors provide full, in-depth discussions of each assessment skill and technique as well as an understanding of the rationale behind each assessment. Key Topics Discussed: Health assessment: physical examinations, assessment of pregnant women, and assessment and clinical evaluation of obesity in women Female Reproduction: anatomy, physiology, and the reproductive cycle Contraceptive devices: the diaphragm, intrauterine contraception, and contraceptive implants Assessment of women at risk: domestic violence, STIs, and sexual assault Assessment of the infertile woman: initial evaluations, donor insemination, and more
Helps readers understand the principles of health care and management for diverse types of delivery systems and the role of ob-gyns and other providers in hospital and office practice.
This is the only truly comprehensive advanced text for the assessment of women's health, written for such primary care providers as nurse practitioners, physician assistants, and certified nurses;midwives. It encompasses both foundational and cutting-edge physical and psychosocial information in a clear and concise outline format, and is unique in its presentation of more advanced techniques and procedures not addressed in standard graduate assessment texts. Keeping pace with the expanding scope of advanced practice, the third edition provides several completely new chapters authored by renowned specialists, expanded chapters, and updates. This includes new information on contraception, domestic violence, health history of special populations, lesbian health, evaluation of the pelvic floor, aging and menopause, bleeding irregularities, infertility, skin aesthetics, pelvic pain, and health guidelines. With an integrated approach to treatment, the authors delineate the expanded roles of advanced health care providers, including guidance for situations when a practitioner must decide whether to act independently, co-manage, consult, or refer. The authors provide in-depth descriptions enhanced by plentiful tables and figures of each assessment skill and technique along with its underlying rationale. Basic techniques are augmented by the inclusion of possible alterations for a particular procedure. On a continuum from simple to complex, the text is divided into 11 units that cover basic women's health assessment down to the cellular level, health history, prenatal assessment, investigative procedures including sonohysteroscopy and simple cystometrogram, and several chapters on specific women's health concerns. A special chapter on urinary incontinence includes diagnosis of bladder dysfunction. Sample assessment forms are integrated throughout, as are comprehensive lists of equipment required for each procedure along with information on patient preparation and follow-up. New to the Third Edition: Updated assessment guidelines New chapters on lesbian health, dysfunctional uterine bleeding, polycystic ovarian syndrome, skin aesthetics, and pelvic pain Information on new contraception devices New information on domestic violence, health history of special populations, and vaginal microscopy Cervical cancer screening, menopause assessment, and osteoporosis screening Expanded information on evaluation of the pelvic floor Expanded information on aging and menopause Updates on infertility and information on BRCA gene testing Key Features: Provides detailed descriptions of advanced assessment techniques enhanced with plentiful tables and figures Presents the rationale for all assessments and procedures Delineates clinical procedures on the leading edge of the expanded role of the advanced practice clinician Includes unique chapters about selection and insertion of the vaginal pessary, intrauterine insemination procedure, and donor insemination Covers such advanced skills as vulvar exam and biopsy, endometrial biopsy, acrochordonectomy, polypectomy, and colposcopy
This comprehensive, case-based title takes a practical approach to treating the pregnant patient by illustrating common and less common issues that arise during pregnancy. Outlining how difficult it often is to discern normal changes from pathological changes in the pregnant patient, Medical Problems During Pregnancy addresses not only this core dilemma but also a full array of specific, challenging issues to consider when pregnant patients present with conditions like epilepsy, hypertension, cardiac arrhythmias and renal disease – disorders requiring medication despite some risks. Although standard best practices generally determine medication use, the practicality of medication at various stages of pregnancy is highly variable. Medical Problems During Pregnancy outlines key points to consider when prescribing medication and additionally offers a range of practical suggestions that can greatly improve the physician-patient interaction. A unique and invaluable addition to the literature, Medical Problems During Pregnancy will be of great interest to practicing obstetricians, primary care clinicians, family practice physicians, nurse practitioners, and other allied health professionals.
In recent years advances in laparoscopic technologies have led to renewed interest in the vaginal approach to hysterectomy, which has many proven benefits for patients. This volume, dedicated to explaining and promoting the vaginal route of hysterectomy, is written and edited by an international team of experts and provides a much-needed source of up-to-date information and instruction. Importantly, the authors caution that laparoscopic technology can provide a valuable source of assistance for the gynaecological surgeon in certain circumstances, though only in a percentage of cases. This book, beautifully illustrated with line drawings and full-colour photographs, contains step-by-step surgical techniques, enabling the surgeon to gain confidence and experience so that gradually more challenging operations can be managed successfully via the vaginal route. Acknowledged authorities from around the world take the reader through the indications and contra-indications for the vaginal approach, explain crucial preoperative assessment procedures, and offer an evidence-based elucidation of the 'why', 'when' and 'how' of vaginal hysterectomy. Specific topics considered here include: the nulliparous patient, uterine fiboids, debulking, the use of gonadtrophin-releasing hormone agonists, oophorectomy and prophylactic oophorectomy, adnexectomy for adnexal pathology, genital prolapse, the place of sacrospinous colpopexy, urethral sphincter incompetence, hormone replacement therapy, and the psychological and sexual outcomes of hysterectomy. In addition, the authors set forth the arguments for and against vaginal hysterectomy, abdominal hysterectomy, laparoscopic assistance, and transcervical resection of the endometrium. Combined with a full review of the potential complications, morbidity and mortality associated with the vaginal approach, this book provides the reader with a well-balanced, thorough and considered appraisal of vaginal hysterectomy. As the incidence of hysterectomy worldwide continues to rise, Vaginal Hysterectomy will be an indespensable reference for practising gynaecologists, surgeons, consultants and postgraduates.
The accomplishments of pioneering doctors such as John Peter Mettauer, James Marion Sims, and Nathan Bozeman are well documented. It is also no secret that these nineteenth-century gynecologists performed experimental caesarean sections, ovariotomies, and obstetric fistula repairs primarily on poor and powerless women. Medical Bondage breaks new ground by exploring how and why physicians denied these women their full humanity yet valued them as “medical superbodies” highly suited for medical experimentation. In Medical Bondage, Cooper Owens examines a wide range of scientific literature and less formal communications in which gynecologists created and disseminated medical fictions about their patients, such as their belief that black enslaved women could withstand pain better than white “ladies.” Even as they were advancing medicine, these doctors were legitimizing, for decades to come, groundless theories related to whiteness and blackness, men and women, and the inferiority of other races or nationalities. Medical Bondage moves between southern plantations and northern urban centers to reveal how nineteenth-century American ideas about race, health, and status influenced doctor-patient relationships in sites of healing like slave cabins, medical colleges, and hospitals. It also retells the story of black enslaved women and of Irish immigrant women from the perspective of these exploited groups and thus restores for us a picture of their lives.
The perfect “bridge” book between physical exam textbooks and clinical reference books Covers the essentials of the diagnostic exam procedure and the preparation of the patient record Includes overviews of each organ/region/system, followed by the definition of key presenting signs and their possible causes Unrivaled in its comprehensive coverage of differential diagnosis, organized by systems, signs, and syndromes
