Guidelines for Nurse Practitioners in Gynecologic Settings

Heidi Collins Fantasia, PhD, RN, WHNP-BC, FNAP, FAAN, is an associate professor and department chair 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 100 publications, including peer-reviewed manuscripts, books, book chapters, and editorials that focus on various aspects of women's and gender related 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 previously served on the Board of Directors for the National Association of Nurse Practitioners in Women's Health from 2019-2021 and is the current editor of the journal Nursing for Women's Health. She is a Distinguished Practitioner and Fellow in the National Academies of Practice and a Fellow in the American Academy of Nursing. 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, FNAP, is Dean and Professor of the College of Nursing at Prairie View A&M University, Houston, Texas. Formally Dr Harris was 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 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 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, the Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN), and is a Distinguished Practitioner and Fellow in the National Academics of Practice. Currently, Dr. Harris is a member of the board of directors and secretary for National Association of Nurse Practitioners in Women's Health and is 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, FNAP, FAAN, is a professor, Research Director for Department of Nursing, and Frances A. Matsuda Chair in Women's Health at the School of Nursing at the University of Hawaii at Manoa. She has been a board-certified women's health nurse practitioner since 2000, and has practiced in multiple settings, including 10 years 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 as well as an Associate Member at the University of Hawaii Cancer Center. She is a member of the CDC, Adult/Child Combined Immunization Workgroup and a nursing leader at the Society of Adolescent Health and Medicine. Prior to her move to Hawaii, 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 cancer prevention (with a particular focus on HPV associated cancers), adolescent and young adult vaccination, and adolescent health. Her work has enhanced care delivery associated with human papillomavirus (HPV) vaccination, HPV-associated cancer screening, and comprehensive adolescent health, including elucidating the importance of sexual and gender minority-affirming care on health outcomes. She has authored numerous national webinars/presentations and nearly 100 publications. Dr. Fontenot is a Distinguished Practitioner and Fellow in the National Academies of Practice and Fellow in the American Academy of Nursing. She is a member of numerous professional organizations including Sigma Theta Tau International and the National Association of Nurse Practitioners in Women's Health. 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


Acknowledgments


Springer Publishing ConnectTM Resources


PART I: WOMEN'S HEALTH: SPECIAL TOPICS


Chapter 1. Well-Patient Initial/Annual Gynecologic Exam


Chapter 2. Safe Practices for Clinicians


Chapter 3. Complementary and Alternative Therapies


Chapter 4. Substance Use and Misuse


Chapter 5. Weight Management


Chapter 6. Guidelines for Assessing Individuals Who Have Experienced Abuse, Violence, and Sexual Assault


Chapter 7. Special Populations


Chapter 8. Emotional and Mental Health


Chapter 9. Pharmacology and Women's Health


Chapter 10. Telehealth and Gynecologic Healthcare


PART II: GUIDELINES FOR CONTRACEPTION AND PRECONCEPTION CARE


Chapter 11. Methods of Contraception and Family Planning





Barrier Methods

Contraceptive Spermicides and Condoms

Emergency Contraception

Hormonal Contraception

Intrauterine Devices

Natural Family Planning

Sterilization



Chapter 12. Preconception Care


PART III: GUIDELINES FOR MANAGING WOMEN'S HEALTH CONDITIONS


Chapter 13. Breast Conditions





Breast Cancer Screening Guidelines

Abnormal Breast Discharge

Breast Mass

Mastalgia/Breast Pain



Chapter 14. Human Papillomavirus and Management of Cervical Abnormalities





Cervicitis

Human Papillomavirus

Routine Screening for Cervical Cancer



Chapter 15. Genitourinary Tract Conditions





Interstitial Cystitis/Bladder Pain Syndrome

Urinary Tract Infection



Chapter 16. Infertility


Chapter 17. Pelvic Floor Dysfunction


Chapter 18. Medical Abortion





Overview of Medical Abortion

Postabortion Care: Medical and Surgical

Postabortion Complications



Chapter 19. Menstrual Disorders





Abnormal Uterine Bleeding

Amenorrhea

Dysmenorrhea

Premenstrual Syndrome



Chapter 20. Gynecologic and Pelvic Conditions





Abdominal Pain (Generalized)

Acute and Chronic Pelvic Pain

Bartholin's Cyst, Bartholinitis

Dysesthetic Vulvodynia

Endometriosis

Pelvic Mass

Uterine Leiomyomata (Fibroids)

Vulvar Conditions

Vulvar Dermatology



Chapter 21. Perimenopause and Postmenopause





General Care Measures

Hormone Therapy

Atrophic Vaginitis

Osteoporosis



Chapter 22. Polycystic Ovary Syndrome


Chapter 23. Sexual Dysfunction


Chapter 24. Sexually Transmitted Infections





Chancroid

Chlamydia trachomatis Infection

Condylomata Acuminata (Genital Warts)

Genital Herpes Simplex

Gonorrhea

Granuloma Inguinale

Hepatitis

HIV/AIDS

Lymphogranuloma Venereum

Molluscum Contagiosum

Pediculosis (Lice)

Pelvic Inflammatory Disease

Scabies

Syphilis

Trichomoniasis



Chapter 25. Vaginitis and Vaginosis





Normal Vaginal Flora

Bacterial Vaginosis

Candidiasis

Tips for Microscopic Examination



PART IV: CASE STUDIES AND EDUCATION TEMPLATES


Chapter 26. Case Studies





Case Studies 1A and 1B: Contraception (Chapter 11)

Case Studies 2A and 2B: Preconception Care (Chapter 12)

Case Studies 3A and 3B: Breast Conditions (Chapter 13)

Case Studies 4A and 4B: HPV and Cervical Abnormalities (Chapter 14)

Case Studies 5A and 5B: Genitourinary Tract Conditions (Chapter 15)

Case Studies 6A and 6B: Infertility (Chapter 16)

Case Studies 7A and 7B: Pelvic Floor Dysfunction (Chapter 17)

Case Studies 8A and 8B: Medical Abortion (Chapter 18)

Case Studies 9A and 9B: Menstrual Disorders (Chapter 19)

Case Studies 10A and 10B: Gynecologic Conditions (Chapter 20)

Case Studies 11A and 11B: Perimenopause and Postmenopause (Chapter 21)

Case Studies 12A and 12B: Polycystic Ovary Syndrome (Chapter 22)

Case Studies 13A and 13B: Sexual Dysfunction (Chapter 23)

Case Studies 14A and 14B: Sexually Transmitted Infections (Chapter 24)

Case Studies 15A and 15B: Vaginitis and Vaginosis (Chapter 25)



Chapter 27. "For Your Information": Education Templates for Electronic Records





Bacterial Vaginosis

Candidiasis (Monilia) Yeast Infection

Care After Abortion

Cervical Cap (FemCap)

Chlamydia trachomatis

Contraceptive Implant

Contraceptive Patch

Contraceptive Vaginal Ring

Cystitis (UTI)

Diaphragm

Genital Herpes Simplex

Genital Warts (Condylomata Acuminata)

Gonorrhea

Hormone Therapy

Intrauterine Device

Lice (Pediculosis)

Osteoporosis

Polycystic Ovary Syndrome

Preconception Care

Premenstrual Syndrome

Scabies

Smoking Cessation

Stress or Urge Urinary Incontinence

Syphilis

Trichomoniasis

Vaginal Contraceptive Sponge



APPENDIX A: Abuse Assessment Screen


APPENDIX B: Danger Assessment: Women with Male or Female Partners


APPENDIX C: HIV Risk Assessment





HIV Testing

HIV Prevention



APPENDIX D: Women and Heart Disease: Risk Factor Assessment


APPENDIX E: Endometrial Biopsy


APPENDIX F: Differential Diagnosis of Vaginitis and Vaginosis


APPENDIX G: Body Mass Conversion Table


APPENDIX H: Post Sexual Assault Care


Bibliographies


Index