Question

Design a pamphlet for women regarding health assessment and screening methods. The pamphlet should explain each method, why it is performed, what it entails, and the schedule for its performance. Self-assessment techniques such as BSE and VSE should be fully explained and illustrated in the pamphlet.

Answer 1

As a woman, there’s a lot she can do to prevent health problems, including maintaining or improving your health and preventing disease to help her live a healthy life.By scheduling a preventive visit with the doctor, physician will likely consider the personal risk factors, and lifestyle, then make recommendations for the preventive health screenings that are right for an individual.

• Well-woman visit (physical exam)

Annual preventive care visits are recommended and are covered under the Affordable Care Act; discuss with your health care provider. To screen for diseases; assess risk for future problems; discuss lifestyle habits; and keep vaccinations up to date.

• Thyroid test

Routine screening is typically not recommended for healthy, nonpregnant adults; however, some organizations recommend considering screening people 60 years and older, as well as women planning to get pregnant and anyone at increased risk for hypothyroidism. Discuss with your health care provider. To identify an under- or overactive thyroid, both of which are very treatable and either of which can lead to more serious conditions if left untreated.

• Bone health

Bone mineral density test At least once beginning at age 65; earlier depending on your risk factors for osteoporosis. There are no obvious signs of osteoporosis until you fracture a bone. Bone density screenings identify problems early, enabling you to start treatment and prevent further bone loss.

• Breast health

1. Mammogram - Every 1-2 years starting between ages 40 and 50 (guidelines vary; talk to your health care provider about your risks and benefits). Continue annual or biennial screenings at least through age 74, and beyond that guidelines vary. Age alone should not be the reason to discontinue screenings. To identify possible early signs of breast cancer.
2. Clinical breast exam About every 3 years for women in their 20s and 30s, and every year for women 40 and over; some medical organizations no longer recommend clinical breast exams, so talk with your health care provider. A good clinical breast exam may help identify breast cancer relatively early.
3. In addition to your preventive Breast Clinical Exam (BCE) and mammogram,it’s a good idea to do breast self-exams on a regular basis.  The best time to do a breast self-exam is five to seven days after the last day of your menstrual period. During this time, breasts are least likely to be lumpy or tender. If one ,no longer have any periods or are pregnant, they can choose a day of the month — such as the 1st or the 15th — to do the self-exam. Try to perform the exam at the same time every month. Two-step breast self-exam (BSE), It’s not hard to do a breast exam. Make sure to follow each step described below.

• Step 1 –Lie down and place your right arm behind your head.

The exam is done while lying down, not standing up. This is because when lying down the breast tissue spreads evenly over the chest wall and is as thin as possible, making it much easier to feel all the breast tissue. Use the finger pads of the 3 middle fingers on your left hand to feel for lumps in the right breast. Use overlapping dime-sized circular motions of the finger pads to feel the breast tissue. Use 3 different levels of pressure to feel all the breast tissue. Light pressure is needed to feel the tissue closest to the skin; medium pressure to feel a little deeper; and firm pressure to feel the tissue closest to the chest and ribs. It is normal to feel a firm ridge in the lower curve of each breast, but you should tell your doctor if you feel anything else out of the ordinary. If you’re not sure how hard to press, talk with your doctor or nurse. Use each pressure level to feel the breast tissue before moving on to the next spot. Move around the breast in an up and down pattern starting at an imaginary line drawn straight down your side from the underarm and moving across the breast to the middle of the chest bone (sternum or breastbone). Be sure to check the entire breast area going down until you feel only ribs and up to the neck or collar bone (clavicle). There is some evidence to suggest that the up-and-down pattern (sometimes called the vertical pattern) is the most effective pattern for covering the entire breast, without missing any breast tissue. Repeat the exam on your left breast, putting your left arm behind your head and using the finger pads of your right hand to do the exam.

• Step 2 – In front of a mirror

While standing in front of a mirror with your hands pressing firmly down on your hips, look at your breasts for any changes of size, shape, contour, or dimpling, or redness or scaliness of the nipple or breast skin. (The pressing down on the hips position contracts the chest wall muscles and enhances any breast changes.) Examine each underarm while sitting up or standing and with your arm only slightly raised so you can easily feel in this area. Raising your arm straight up tightens the tissue in this area and makes it harder to examine. Always talk to your doctor about any changes or concerns.These self-exams should not take the place of clinical exams, but they may give you extra information that you can discuss with your doctor.

• Colorectal health

Colonoscopy -(and/or other screening tests for colorectal cancer, such as fecal occult blood testing, flexible sigmoidoscopy and CT colonography) Starting at age 50. You may need to be screened earlier if you have a family history of colorectal cancer. Time frames for screening, as well as risks and benefits, vary for different screening methods. Talk to your health care provider about which test is best for you. To identify (and remove) precancerous polyps or early cancers.

• Diabetes

Fasting plasma glucose test (also called blood glucose test)- Screening guidelines generally recommend every 3 years starting at age 45, except for adults with increased risk for diabetes who may be tested regularly starting at any age. That includes adults who are overweight or obese or have another risk factor, including: blood pressure higher than 140/90 (or taking blood pressure medicine); family history of diabetes; high cholesterol; history of cardiovascular disease, physical inactivity; high-risk race or ethnicity; or gave birth to a baby weighing 9 pounds or more or had gestational diabetes. To provide an early warning sign of high blood sugar levels, which could mean an increased risk for diabetes.

• Eye, ear and teeth health

Eye exam-At least once from age 20-29; at least 2 exams from age 30-39. At age 40, get a baseline eye disease screening, with follow-ups as recommended. Starting at age 65, eye exams every 1-2 years. To test your vision and screen for glaucoma and macular degeneration, two common, often age-related conditions.

Hearing test -Currently, there are no recommendations for regular hearing screenings, but if you have a hearing problem, ask your health care provider for a screening. To make sure you're hearing all life has to offer.

Dental exam and cleaning- Regularly, usually every 6-12 months, or as recommended by your dentist or dental hygienist.To remove plaque and bacteria that could lead to tooth and gum disease; to check for tongue and mouth cancer. Problems with your teeth can indicate osteoporosis.

• Heart and lung health

Blood pressure screening-

Beginning at age 18, at least every 2 years. Several screenings, both in and out of the clinical setting, may be recommended before a diagnosis is made. If your blood pressure is 120/80 mm Hg or higher or you have other heart disease risks, more frequent screening may be recommended. The only way to identify hypertension is with blood pressure screenings.

Cholesterol screening-

Begin screening at age 20 for women at increased risk for coronary heart disease (CHD). Risk factors include diabetes, smoking,obesity,hypertension, personal history of CHD oratherosclerosis or family history of cardiovascular disease. Screenings are recommended every 5 years for those with levels close to needing treatment, possibly longer for those with less risk of needing therapy. Screening is less important in older people because lipid levels are less likely to increase after age 65.Treating cholesterol abnormalities can help reduce your risk of heart disease.

Lung cancer screening-

Annually with low-dose computed tomography for adults aged 55 to 80 who have a 30 pack-year smoking history and or have quit within the past 15 years. To identify early signs of lung cancer.

Reproductive/sexual health.

Pap test and HPV test (human papillomavirus)-

Pap test every 3 years for women ages 21-29; for women 30-65, Pap test and HPV test every 5 years or Pap test alone every 3 years. Women at average risk should not be screened more than once every 3 years. Testing may be stopped at age 65 or 70 for women who have 3 or more normal Pap tests in a row and no abnormal test results in 10 years. If you have had your cervix and uterus removed, ask your health care provider if you need to continue screening.Pap tests screen for abnormalities that could indicate pre- or early cervical cancer; HPV helps identify women at risk for developing cervical cancer.

Chlamydia test-

Yearly until age 25 if sexually active; for older women, get tested if you are at increased risk for infection, such as if you have new or multiple sexual partners. Allows for early treatment and reducing spread of chlamydia.

Gonorrhea test-

Yearly until age 25 if sexually active; for older women, get tested if you are at increased risk for infection, such as if you have new or multiple sexual partners. Allows for early treatment and reducing spread of gonorrhea.

HIV test and other sexually transmitted infection tests-

All sexually active women and their partners should be tested for HIV and other STIs before starting sexual activity. Prevention education and risk assessment for HIV should continue annually, with additional screening based on risk. All pregnant women should be screened for HIV at the start of pregnancy, with retesting during pregnancy based on risk factors. Helps prevent spread of HIV and other STDs, many of which can only be detected through testing.

Vaginal Self Examination (VSE)

Vaginal self-examination or VSE is a way that a woman can get to know what is normal for her own body simply by using a hand mirror. The best time to perform a VSE is in between menstrual periods. To perform a VSE, a woman simply needs to disrobe from the waist down, sit down or lay down in a well-lit area, and hold a mirror in front of her genital area. Some things a woman should note while examining her genital area include:

• the color of the tissues of the vagina
• the color, consistency and odor (if any) of vaginal discharge
• any lesions, bumps, raised areas
• redness, tenderness or irritation

When done on a fairly regular basis, a vaginal self-examination can help a woman get to know what is normal for her, and to identify problems more easily when they occur. Odd coloration, sores, smelly discharge, bumps or changes from previous exams should be brought to the attention of a medical professional. A vaginal self-examination can be a helpful tool for women, but it cannot replace a pelvic exam with her health care provider or a Pap test.

Procedure for VSE:

Take off your clothes below the waist. Have the mirror and flashlight where you can easily reach them. Wash your hands. Sit on the floor, a bed, or a couch and support your back with pillows. Bend your knees, place your feet near your bottom, lean slightly backward, and spread your knees apart so your genital area can be seen.

Hold or prop the mirror in front of your genital area. Look at the:
Outer and inner fleshy lips of the vulva (called the labia).
Bump of tissue covered by a hood of skin at the front of the labia (called the clitoris). Opening of the urethra where urine drains from your body.
Opening of the vagina.
Opening of the anus.
Have the light reflect off the mirror so you can clearly see your vaginal area. Then use your fingers to spread apart the vaginal lips. Adjust the light and mirror until you can see into the vagina. You should be able to see the reddish pink walls of the vagina, which have small folds or ridges known as rugae.

Look at your vaginal discharge. A normal discharge usually is clear to cloudy white, smells slightly acidic (like vinegar), may be thick or thin, and changes a little throughout the menstrual cycle.
Relax your pelvic and belly muscles as much as you can during the vaginal self-examination. You should have little or no discomfort from the examination, unless you have a vaginal infection or an open sore.

• Skin health

Skin exams-

Talk to your health care provider about what’s right for you. If you have risk factors for skin cancer, your health care provider may recommend periodic skin exams. To track worrisome moles and identify skin cancer early.

• Immunizations

Influenza (flu) vaccine-

Annually for everyone 6 months and older. Protects against major strains of flu viruses.

Hepatitis A- Given in 2 doses, 6-18 months apart, to children 1 year of age and to adults at risk or who want protection from hepatitis A. May be given in combination with hepatitis B vaccine (in 3 doses). Protects against hepatitis A, a serious liver disease that can cause flu-like illness, jaundice and severe stomach pains and diarrhea.

Hepatitis B- Given to children at birth in 3 doses at 0, 1 and 6 months. Also given to children or adults who weren't vaccinated and are at risk for hepatitis B, such as health care workers. Protects against hepatitis B, a serious liver disease that can develop into a chronic infection.

Herpes zoster- Once only at age 60 or older. Shingles prevention (even if you have had shingles before).

Human papillomavirus (HPV)- Age 11-12; or 13-26 if not previously vaccinated; 3 doses at 0-, 2- and 6-month intervals; no booster necessary. Protects against four common types of HPV, including the two most likely to cause cervical cancer.

MMR (measles, mumps, rubella)- One dose for adults born in 1957 or later who weren't vaccinated as a child, unless advised otherwise by your health care provider. Protects against measles, mumps and rubella.

Meningococcal (meningitis)- College freshmen, military recruits and other at-risk people; discuss with your health care provider. Protects against some types of meningococcal disease (meningitis).

Pneumonia- Once only at age 65 or older. It may be recommended for younger adults with chronic heart, lung or liver disease; asthma; alcoholism; diabetes; or those who smoke. Protects against pneumonia.

Tetanus, diphtheria, pertussis (Td/Tdap)- Every 10 years. Protects against tetanus, diphtheria and pertussis.

Varicella (chicken pox)- Given in 2 doses at 0- and 4- to 8-week intervals to those 19 or older who have not been vaccinated or had chicken pox. Protects against chicken pox, a usually mild but highly contagious childhood disease, which can be serious in infants and adults.