Patient Case Study Scenarios for Professor Jeremy Barthels MA279/BSC2347 Section 01 Human Anatomy and Physiology II - 2015 Spring Quarter
Introduction
The paper discusses three patients' case studies of the reproductive system utilizing appropriate medical terminology, various cultural, religious, and societal perspectives and issues. The paper further identified health care team members’ values and morals that are odds or conflicts with each patient case that affect professionalism interaction with the patients.
Unwed Early 20-Year-Old Female Muslim Patient For the 20-year-old female Muslim patient with excessive cramping and bleeding during menstrual cycle, it is important for care team to understand menstrual cramps with bleeding and discuss treatment regiment with patient. Menstrual cramps are pains in the lowest part of the torso (pelvis) a few days before, during, or after a menstrual period. The pain tends to be most intense about 24 hours after periods begin and to subside after 2 to 3 days. The pain is usually cramping or sharp, comes, and goes, but it may be a dull, constant ache. It sometimes extends to the lower back and legs. It is however, normal for occasional cramps and spotting (bleeding) during menstruation. Many women also have a headache, nausea (sometimes with vomiting), and constipation or diarrhea. They may need to urinate frequently. Symptoms of premenstrual syndrome (such as irritability, nervousness, depression, fatigue, and abdominal bloating) may persist during part or all of the menstrual period. Sometimes menstrual blood contains clots. The clots, which may appear bright red or dark, may contain tissue and fluid from the lining of the uterus, as well as blood. Menstrual cramps may be primary dysmenorrheal (no identifiable cause) usually starts during adolescence or secondary dysmenorrheal (cause from another disorder) which starts during adulthood. Because the female Muslim patient reported excessive cramping and bleeding during her menstrual cycle, she must be evaluated for the presence of primary and secondary dysmnorrhea. Primary dysmenorrhea may be caused by release of substances called prostaglandins during menstruation. Prostaglandin may cause the uterus to contract (as occurs during labor), reducing blood flow to the uterus. These contractions can cause pain and discomfort. Prostaglandins also make nerve endings in the uterus more sensitive to pain. Lack of exercise and anxiety about menstrual periods may also contribute to the pain. While Secondary dysmenorrhea is commonly caused by endometriosis: Tissue that normally occurs only in the lining of the uterus (endometrial tissue) appears outside the uterus. Endometriosis is the most common cause of secondary dysmenorrhea. Health care practitioners or care team must ask about the pain and the medical history, including the menstrual history. Practitioners then do a physical examination. What they find during the history and physical examination may suggest a cause of the cramps and the tests that may need to be done Practitioners also ask the woman how old she was when symptoms began and what other symptoms she has. She is asked to describe the pain, including how severe it is, what relieves or worsens symptoms, and how symptoms interfere with her daily activities. Whether she has pelvic pain unrelated to periods is also important. The woman is asked whether she has or has had disorders and other conditions that can cause cramps, including use of certain drugs (such as birth control pills) or an IUD. During pelvic examination, Doctors check the vagina, vulva, cervix, uterus, and the area around the ovaries for abnormalities, including polyps and fibroids. Concerns related to this scenario is the fact that Muslim women prefer to have same gender doctors and nurses in order to follow rules of modesty in regard to the opposite sex. Muslim women cover their
