NRNP 6552 Week 5 Case Study; Reproductive Health Challenges in Adolescents

Week 5 Case Study XXXXXXX Master of Science in Nursing, Walden University NRNP-6552: Advanced Nursing Practice Reproductive Health Dr. Dr. Indira Maurer Dec. 29, 2025 Week 5 Case Study Introduction Case #4. Stephanie. History of Present Illness (HPI): Stephanie is a 15-year-old female G0 who presents to the office with her mother. She c/o heavy bleeding during her periods, anxiety, and mood swings, which had been occurring for the past 4 months. Her symptoms usually occur a few days before the onset of her menses and improve by day 3. She uses 2 pads every 1-2 hours and sometimes needs to double up on the pads. She also c/o severe bloating, pelvic pain, and back pain during her periods. She has missed numerous days of school due to her symptoms, and lacks interest in usual daily activities, staying in bed all day. Around 2 months ago, she was seen by an adolescent psychiatrist and was diagnosed with major depression and started on sertraline 50mg once daily. She has refused to take the medication because she rejects the diagnosis of depression. She states that she knows she is not depressed and is angry that nobody believes her. Data Template Outline Subject ive data. Outline Objective findings. Identify diagnostic tests, procedures, laboratory work indicated. Distinguis h at least three differenti al diagnoses. Identify appropri ate medicatio ns, treatmen ts or other interventi ons associate d with each differenti al diagnosis 370840151804. Explain key Social Determin ants of Heath (SDoH) for your chosen case. Describe collaborati ve care referrals and patient education needs for your chosen case. 15-year- old female G0 who presents to the office with her mother. She c/o heavy bleedin g during her periods, anxiety, and mood swings, which had been occurrin g for the past 4 months. Her sympto ms usually occur a few days before the onset of her menses and improve by day 3. She uses 2 pads every 1- 2 hours OB- GYN History: Menarche age 12, cycle length was 5- 7 days- frequency every 28 days- 3 pads per day, until the past 4 months. LMP: 1 week ago. Contraceptio n history: None Social history: Lives with her parents. She is an only child. Denies ETOH, smoking, or recreational drug use. Sexually active once (vaginal) - 1 year ago with same partner- none since. Participates in sports: basketball Family history: Mother alive and well, Father with diabetes Review of Systems Lab testing for hormones (estrogens, LH, FSH, and testosterone) would be beneficial to evaluate potential hormone imbalance and to identify a specific diagnosis. CBC w/ diff to search for evidence of infection or a neoplastic concern UA to exclude UTI Despite the lack of cervical and vaginal discharge, it would still be prudent to order Chlamydia trachomatis and Neisseria gonorrhoeae screening due since it is both a clinical and public health concern (Yusuf & Trent, 2023). 1. Dysmenor rhea (Primary)- the onset of her symptoms is 3 years post menarche and associated symptoms of anxiety,