Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and possible differential diagnosis.

Dear writer, I need a clinical discussion for an FNP clinical OB-GYN class I am currently taking. I am shadowing an OB-GYN doctor. You may come up with a clinical case of someone with Mastitis. Remember I am shadowing the doctor. I will attach the class book to use as reference and i will also provide a sample of a classmate clinical week experience to guide you. You are to answer this questions within the clinical week discussion.Describe your clinical experience for this week.Did you face any challenges, any success? If so, what were they?Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and possible differential diagnosis.What did you learn from this week’s clinical experience that can beneficial for you as an advanced practice nurse?Support your plan of care with the current peer-reviewed research guideline.Classmate sample clinical week experience;I had another great week of clinical. I cannot think of any unusual challenges that I faced this week. Of course every day it can be a challenge coming up with the appropriate plan of care for a patient. My preceptor has me developing the plan of care for most of our patients, provided they are not too complex. I find that is the best way for me to learn. I feel successful whenever I develop a plan of care independently, which is happening more often. One patient I was able to come up with a plan of care for independently came in for a chief complaint of “painful periods”.The patient was 23 years old and reported that she has had “the worst periods ever” during her last three menses. She reports that she had been on combined oral contraceptive pills since she was 16 years old. She stopped them four months ago since she was no longer in a relationship and wanted to live a healthier life. She says she felt that the pills mess with her body’s natural process. The patient reports that after stopping the pills she lost five pounds and feels better for the most part. However, several days before her menses begins and for the first two days of menstruation she says the pain is so bad she just wants to stay in bed. She tried taking ibuprofen and acetaminophen which were somewhat helpful. She was worried something was wrong with her and is concerned she has fibroids or endometriosis. She was not sure of the start date for her last menstrual period, but believes it was about two weeks ago. She also reports some nausea, diarrhea, gas, and bloating around the time of her menses.I did a full physical exam including an internal and external pelvic exam. All of the findings were normal. There were no masses palpated during bimanual palpation and no tenderness during palpation of the lower abdomen. Sexually transmitted infection testing was offered to the patient, but she declined it stating that she had testing a year ago and has not had any new partners in two years.The primary diagnosis for this patient was dysmenorrhea. Differential diagnoses include endometriosis, uterine fibroids, adenomyosis, adhesions, and pelvic inflammatory disease (Bechmann et al., 2017, pp. 295-296). A transvaginal ultrasound was ordered for this patient in order to safely rule out secondary causes of dysmenorrhea.I educated the patient that combined oral contraceptives are helpful in decreasing symptoms of dysmenorrhea and that is likely why her symptoms started after stopping the pills. We discussed whether she would like to go back on the birth control pills and she decided she would like to try natural options first. Education was provided that exercise and reduced stress levels can be helpful. In addition, appropriate hydration and fiber intake can help alleviate some symptoms. Decreasing consumption of salt, caffeine, and chocolate may be beneficial. I also told her about trying topical heat therapy and transcutaneous electrical nerve stimulation or TENS therapy for pain relief (Burns et al., 2017, p. 969). The patient was told to call the office if she changes her mind about pharmacological options for dysmenorrhea. My preceptor told her that she would receive a phone call from her with the ultrasound results about a week after she has it done.This week’s clinical is helping me to become more independent in developing my plan of care. This particular experience was helpful in determining complementary and alternative therapies that could be offered to a patient with dysmenorrhea. It is important to be aware of nonpharmacological options to offer our patients whenever possible. ReferencesBechmann, C.R., Ling, W. F., Herbert, N. W., Laube, W. D., Smith, P. R., Casanova, R., & Weiss, M.P. (2014). Obstetrics and gynecology (7th ed.). Philadelphia, PA: Lippincott, Williams, & Wilkins.Burns, C. E., Dunn, A. M, Brady, M. A., Starr, N. B., Blosser, C. G., & Garzon, D.L. (2017). Pediatric primary care. (6th ed.). St. Louis, MO: Elsevier.