Guidelines for Nurse Practitioners in Gynecologic Settings

Heidi Collins Fantasia, PhD, RN, WHNP-BC, is an associate professor in the Zuckerberg College of Health Sciences, Solomont School of Nursing at the University of Massachusetts Lowell, and has been a board-certified women's health nurse practitioner since 1997. She has practiced clinically in a variety of settings including obstetrics/gynecology, primary care, and a Title X public health clinic. She is the author of more than 80 publications, including peer-reviewed manuscripts, books, and book chapters that focus on various aspects of women's health throughout the life span. Her research interests include the intersection of violence and the reproductive health of women, including violence screening, women's experiences of violence, issues surrounding sexual consent and coercion, and human trafficking. Dr. Fantasia is on the Board of Directors for the National Association of Nurse Practitioners in Women's Health and is a Distinguished Practitioner and Fellow in the National Academies of Practice. She is a member of the Editorial Advisory Board for the Journal of Obstetric, Gynecologic, and Neonatal Nursing and previously served on the Editorial Advisory Board for the journal Nursing for Women's Health. Dr. Fantasia received a bachelor of science in nursing from Salem State College in Salem, Massachusetts, and master's and doctoral degrees from Boston College in Chestnut Hill, Massachusetts. She completed a postdoctoral fellowship at Boston College prior to joining the faculty at the University of Massachusetts. Allyssa L. Harris, PhD, RN, WHNP-BC, is an associate professor and program director for the Women's Health Nurse Practitioner program at the William F. Connell School of Nursing at Boston College. Dr. Harris has been a board-certified women's health nurse practitioner since 1996 and has practiced clinically in a variety of settings, including federally qualified community health centers and family planning agencies. She currently provides care to patients at Health Quarters, Inc., in Beverly, Massachusetts. She has authored numerous data-based and clinical publications. Dr. Harris' program of research centers on reducing adolescent sexual risk behaviors. In particular, she is focused on understanding the role of parent-adolescent sexual communication and media influences on sexual risk behaviors. She has received awards for Education from the New England Regional Black Nurses Association and the Inspiration in Women's Health award from the National Association of Nurse Practitioners in Women's Health. She is a member of the Honor Society of Nursing, Sigma Theta Tau International, the National Association of Nurse Practitioners in Women's Health, and the Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN). Dr. Harris is the president of the Boston College Chapter of Sigma Theta Tau, and a member of the Editorial Advisory Board and a column editor for the journal Nursing for Women's Health. Dr. Harris received her associate degree in nursing from Gardner-Webb College, Boiling Springs, North Carolina, and her bachelor's, master's, and doctoral degrees from Boston College. Holly B. Fontenot, PhD, RN, WHNP-BC, FAAN, is an associate professor at the William F. Connell School of Nursing at Boston College and has been a board-certified women's health nurse practitioner since 2000. She has practiced in multiple settings, but for the past 10 years she has maintained clinical privileges at the Sidney Borum Jr. Health Center, a program of Fenway Health. Fenway Health is a federally funded health center that focuses on providing quality/competent care for sexual and gender minority persons. Dr. Fontenot is also Adjunct Faculty at The Fenway Institute, an internationally recognized research institute, and an educational consultant for the STD/HIV Prevention Training Center at the Boston Department of Public Health. Dr. Fontenot was the Program Director for the Boston College Women's Health Nurse Practitioner program for over 10 years. Her nationally funded program of research focuses on enhancing care delivery associated with human papillomavirus (HPV) vaccination, sexually transmitted infections (STI)/HIV prevention, and elucidating the importance of sexual and gender minority-affirming care on health outcomes. She has authored numerous national webinars/presentations and publications. Dr. Fontenot is a Distinguished Practitioner and Fellow in the National Academies of Practice and has held leadership positions in both nursing and multidisciplinary national health societies. Dr. Fontenot received her bachelor of science from the Georgia Baptist College of Nursing at Mercer University and her master's and doctoral degrees from Boston College.

Contributors
Preface
Acknowledgment
PART I: WOMEN'S HEALTH: SPECIAL TOPICS
1. Well-Woman Initial/Annual Gynecologic Exam
2. Safe Practices for Clinicians
3. Complementary and Alternative Therapies
4. Substance use and Abuse
5. Weight Management
6. Guidelines for Assessing Women who have Experienced Abuse and Violence
7. Care of Sexual and Gender Minority Individuals
8. Adolescent Sexual and Gynecologic Health
9. Women's Emotional and Mental Health
PART II: GUIDELINES FOR CONTRACEPTION AND PRECONCEPTION CARE
10.Methods of Contraception and Family Planning
Barrier Methods
Contraceptive Spermicides and Condoms
Emergency Contraception
Hormonal Contraception
Intrauterine Devices/Intrauterine Contraceptive Devices
Natural Family Planning
Sterilization
11.Preconception Care
PART III: GUIDELINES FOR MANAGING WOMEN'S HEALTH CONDITIONS
12.Breast Conditions
Breast Cancer Screening Guidelines
Abnormal Breast Discharge
Breast Mass
Breast Pain
13. Human Papillomavirus (HPV) and Management of Cervical Abnormalities
Cervicitis
Human Papillomavirus (HPV)
Routine Screening for Cervical Cancer
14.Genitourinary Tract Conditions
Interstitial Cystitis/Painful Bladder Syndrome
Urinary Tract Infection
15.Infertility
16.Pelvic Floor Dysfunction
Pelvic Floor Dysfunction
17.Medical Abortion
Postabortion Care: Medical and Surgical
Postabortion Complications
18.Menstrual Disorders
Abnormal Vaginal Bleeding
Amenorrhea
Dysmenorrhea
Premenstrual Syndrome
19.Miscellaneous Gynecologic Conditions
Abdominal Pain
Acute & Chronic Pelvic Pain
Bartholin's Cyst, Bartholinitis
Dysesthetic Vulvodynia
Endometriosis
Pelvic Mass
Pudendal Neuralgia
Uterine Leiomyomata
Vulvar Conditions & Dermatology
20.Perimenopause and Postmenopause
General Care Measures
Hormone Therapy
Atrophic Vaginitis
Osteoporosis
21.Polycystic Ovary Syndrome
22.Sexual Dysfunction
23 Sexually Transmitted Infections
Chancroid
Chlamydia trachomatis Infection
Condylomata Acuminata (Genital Warts)
Genital Herpes Simplex
Gonorrhea
Granuloma Inguinale
Hepatitis
HIV/AIDS
Lymphogranuloma Venereum
Molluscum Contagiosum
Pelvic Inflammatory Disease
Pubic Lice
Scabies
Syphilis
Trichomoniasis
24. Vaginosis & Vaginitis
Review of Normal Vaginal Discharge
Bacterial Vaginosis
Candidiasis
Tips for Microscopic Assessment
PART IV: APPENDICES
PDF versions of the Patient Information and Consent Forms (Appendix A) and the Patient Education Handouts (Appendix I)
APPENDIX A: Case Studies
APPENDIX B: Abuse Assessment Screen
APPENDIX C: Danger Assessment
APPENDIX D: Self-Assessment of HIV Risk
APPENDIX E: Women and Heart Disease: Risk Factor Assessment
APPENDIX F: Endometrial Biopsy
APPENDIX G: Diagnosis of Vaginitis/Vaginosis
APPENDIX H: Body Mass Conversion Table
APPENDIX I: "For Your Information": Education Templates for the EMR
Bacterial Vaginosis
Candidiasis (Monilia) Yeast Infection
Chlamydia trachomatis
Contraceptive Implant
Contraceptive Patch
Contraceptive Vaginal Ring
Cystitis (Urinary Tract Infection )
Cervical Cap
Diaphragm
Genital Herpes Simplex
Genital Warts (Condylomata Acuminata)
Gonorrhea
Hormone Therapy
Lice (Pediculosis)
Osteoporosis
Polycystic Ovary Syndrome
Postabortion Care Medical AB
Preconception Self-Care
Premenstrual Syndrome
Scabies
Smoking Cessation
Stress or Urge Incontinence (Loss of Urine)
Syphilis
Trichomoniasis
Vaginal Contraceptive Sponge
Bibliographies
Index