Comprehensive Woman’s Wellness Case Study Paper
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Write My Essay For MeSUBJECTIVE DATA (S): (information the patient/caregiver tells you)
Initials: Patient not provided
Age: 37 years old
Race: Caucasian
Gender: Female
Marital Status: Not specified
Name of Informant: Patient herself
CHIEF COMPLAINT (CC): “The reason for my health care visit today is that I don’t feel like my baby is lying right for delivery.” Comprehensive Woman’s Wellness Case Study Paper
HISTORY OF PRESENT ILLNESS (HPI):
Location: The patient feels the baby is not positioned correctly for delivery.
Quality: Not mentioned.
Severity: Not mentioned.
Timing: Patient is at 34 2/7 weeks gestation. The concern arose during the current pregnancy.
Setting: Patient has been seeing a midwife at home, but decided to come to the healthcare facility.
Alleviating and Aggravating Factors: The patient believes that being at home with a midwife and not knowing the baby’s position is a potential risk.
Associated Signs and Symptoms: No other symptoms mentioned. Patient has had five living children, all delivered at home with a midwife.
PAST MEDICAL HISTORY (PMH):
Allergies: None reported.
Current Medications: Not provided.
Age/Health Status: 37 years old, current health status not specified.
Immunization Status: Not provided.
Previous Screening Tests Result: Not provided.
Childhood Illnesses: Not provided.
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Major Adult Illnesses: No history of heart disease, hypertension, kidney disease, thyroid disease, cancer, seizures/epilepsy, congenital abnormalities, or recurrent miscarriages. Patient has a sister with Type 2 Diabetes.
Injuries: Not provided.
Hospitalizations: Not provided.
Surgeries: Not provided.
FAMILY HISTORY (FH):
Family members: Patient does have a sister with Type 2 Diabetes.
Conditions queried: No information provided.
SOCIAL HISTORY (SH):
Important Life Events: Not specified.
Marital Status: Not specified.
Occupational History: Not provided.
Military Service: Not provided.
Level of Education: Not specified.
Lifestyle and Health Habits: Patient mentions having all previous children delivered at home with a midwife. No information provided on exercise, diet, safety measures, living arrangements, hobbies, travel, religious preferences, or habits related to drug, alcohol, and tobacco use.
Resources: No information provided on resources to pay for care, insurance, worries about the cost of care, or history of postponing care.
Reproductive Hx: LMP 05/16/2023, Due Date 02/20/2024. Pregnant with Gravida 7, Parity 5. No information on nursing/lactating, contraceptive use, types of intercourse, gender sexual preference, or sexual concerns. Patient has a negative blood type and receives Rhogam after childbirth. Comprehensive Woman’s Wellness Case Study Paper
REVIEW OF SYSTEMS (ROS):
- Constitutional symptoms:
The patient reports no general weakness, fatigue, or malaise.
No unintentional weight loss or weight gain mentioned.
- Eyes: No issues with vision, including blurriness, double vision, or eye pain.
- Head, Ears, nose, mouth, and throat:
No headaches or migraines reported.
No hearing loss, tinnitus, or ear pain.
No nasal congestion, nosebleeds, or changes in sense of smell.
No sore throat, difficulty swallowing, or voice changes.
- Cardiovascular:
No chest pain, palpitations, or shortness of breath on exertion.
No history of heart disease mentioned.
Blood pressure reported as 108/74.
- Respiratory:
No shortness of breath or difficulty breathing.
No cough, wheezing, or chest pain reported.
No history of respiratory infections or chronic respiratory conditions mentioned.
- Gastrointestinal:
No abdominal pain, bloating, or discomfort reported.
No changes in appetite or weight.
No nausea, vomiting, diarrhea, or constipation mentioned.
- Genitourinary:
No urinary frequency, urgency, or dysuria reported.
No changes in urinary habits or color.
No history of kidney disease mentioned.
- Musculoskeletal:
No joint pain, stiffness, or swelling reported.
No muscle pain or weakness mentioned.
No history of arthritis or other musculoskeletal conditions
- Integumentary (skin and/or breast):
No unusual changes, lumps, or masses in the breast tissue reported.
No skin discoloration, redness, or swelling mentioned.
No history of breast pain, nipple discharge, or changes in breast size reported.
No history of skin lesions, moles, or unusual growths mentioned.
No itching, tenderness, or changes in the texture of the skin reported.
- Neurologic:
No history of seizures or epilepsy.
No changes in sensation, coordination, or balance reported.
No history of strokes or neurological disorders mentioned.
- Psychiatric:
No history of psychiatric illnesses mentioned.
No symptoms of depression, anxiety, or other mood disorders reported.
- Endocrine:
No history of thyroid disease or diabetes mentioned.
No symptoms of hormonal imbalance reported.
- Hematologic/lymphatic:
No history of bleeding disorders mentioned.
No easy bruising or prolonged bleeding reported.
- Allergic/immunologic:
No known drug allergies reported.
No history of recurrent infections mentioned.
Rhogam mentioned as part of the patient’s history for negative blood type after childbirth.
OBJECTIVE DATA:
A concise report of physical exam findings. Systems (there are 12 systems for examination):
- Constitutional (VS: Temp, BP, pulse, height and weight); Comprehensive Woman’s Wellness Case Study Paper
Vital Signs: Temperature within normal range, Blood Pressure 108/74, Pulse rate within normal limits.
General Appearance: The patient appears well-nourished, in no acute distress, and oriented to person, place, and time.
Height: Not provided.
Weight: 173 lbs.
- Eyes
Pupils are equal, round, and reactive to light.
Extraocular movements are intact.
No signs of ptosis or nystagmus.
Conjunctiva and sclera are clear.
- Ear, nose, throat
Ears: Bilateral canals are clear, tympanic membranes intact.
Nose: No nasal congestion, discharge, or epistaxis.
Throat: Oropharynx is clear with no signs of erythema or exudate.
- Cardiovascular
Regular heart rate with no murmurs, rubs, or gallops.
Peripheral pulses are palpable and equal bilaterally.
No signs of jugular venous distention.
- Respiratory
Respiratory rate within normal limits.
Clear breath sounds bilaterally.
No wheezing, crackles, or respiratory distress.
- Gastrointestinal
Abdomen is soft and non-tender on palpation.
Bowel sounds present in all quadrants.
No organomegaly or masses palpated.
- Genitourinary
No urinary frequency, urgency, or dysuria reported.
External genitalia appear normal with no signs of inflammation.
- Musculoskeletal
Full range of motion in all extremities.
No joint swelling, redness, or deformities observed.
- Integument/lymphatic pertaining to each location
Skin: No lesions, rashes, or abnormalities noted on visual inspection.
Breast: No palpable masses, tenderness, or nipple discharge reported.
- Neurologic
Alert and oriented to person, place, and time.
Cranial nerves intact.
No focal neurological deficits reported.
- Psychiatric
No apparent signs of acute psychiatric distress.
Mood and affect appear within normal limits.
- Hematologic/immunologic
No signs of bleeding or bruising observed.
No reported history of immunologic disorders.
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RESULTS OF DIAGNOSTIC TESTING:
- Blood Pressure (BP): BP: 108/74 mmHg (within normal limits).
- Laboratory Testing:
Type and Screen: Not specified.
Complete Blood Count (CBC): Not specified.
- Obstetric Ultrasound (US):
Ordered for the patient to assess the fetal position and the possibility of external cephalic version.
To be performed in 2 weeks to determine if the baby has turned head down.
- Rhogam Administration:
Patient reports being Rh-negative and receives Rhogam after childbirth.
Not administered during the current visit.
- Follow-up Plan:
Patient instructed to follow up in 2 weeks for the obstetric ultrasound.
Evaluation for possible external cephalic version based on ultrasound results.
- Immunization History:
Rhogam mentioned for Rh-negative status after childbirth.
No other immunization history provided.
ASSESSMENT (A):
- Fetal Malpresentation (ICD-10 Code: O32.1X0): The primary concern in the patient’s case is the breech presentation of the baby at 34 2/7 weeks gestation. This represents a critical issue for delivery planning. The potential complications associated with breech presentation like increased risk of birth trauma and the need for a cesarean section, necessitate a thorough diagnostic evaluation. The plan includes an obstetric ultrasound (US) in 2 weeks to confirm fetal position and assess the feasibility of an external cephalic version. The rationale for further investigation is twofold. It is imperative to confirm the exact fetal presentation to determine optimal delivery strategy. If the baby remains in a breech position, the healthcare team can proactively plan for a safe delivery method. This would involve a cesarean section. Secondly, an external cephalic version may be considered as an intervention to manually turn the baby into a head-down position (Mendez, 2020). This intervention can increase the likelihood of a successful vaginal delivery. It would therefore reduce the need for surgical interventions. The diagnosis of fetal malpresentation is pending further evaluation with the obstetric ultrasound, and the patient will be actively involved in discussions surrounding the potential interventions and the overall birth plan.
- Rh-Negative Status (ICD-10 Code: O36.9XX0): The patient reports a negative blood type and receives Rhogam after childbirth. This is a well-known condition, but it requires ongoing monitoring and intervention. The patient’s history suggests the need for Rhogam administration postpartum to prevent Rh incompatibility issues in future pregnancies (Shah et al., 2023).
- Family History of Type 2 Diabetes (ICD-10 Code: Z84.9): The patient’s sister has Type 2 Diabetes. While not an acute problem, it is important for ongoing health maintenance and risk assessment. The patient should be counseled on diabetes risk factors and encouraged to maintain a healthy lifestyle to reduce the risk of developing diabetes (Vounzoulaki et al., 2020).
- General Obstetric Care (ICD-10 Code: Z34.XX): The patient is currently in the third trimester of pregnancy. Routine obstetric care is essential to monitor fetal development, maternal health, and plan for a safe delivery. This includes regular check-ups, monitoring blood pressure, weight, and ordering necessary tests such as the Type and Screen and CBC. The patient’s history of home births with a midwife introduces the need for careful evaluation and coordination of care (Dotters-Katz & Hughes, 2020)Comprehensive Woman’s Wellness Case Study Paper.
Status of Diagnoses:
- Fetal Malpresentation: Pending further evaluation with an obstetric ultrasound in 2 weeks.
- Rh-Negative Status: Well-controlled with the planned administration of Rhogam postpartum.
- Family History of Type 2 Diabetes: Chronic health problem; requires ongoing health maintenance and lifestyle management.
- General Obstetric Care: Acute self-limited problem during pregnancy, with ongoing monitoring and management until delivery.
PLAN (P): The comprehensive plan for the patient, a 37-year-old Caucasian woman at 34 2/7 weeks gestation, involves a multifaceted approach to address her specific concerns and ensure optimal maternal and fetal health. The treatment plan is designed to be discussed with the patient, taking into account her preferences, cultural background, and the collaborative nature of healthcare decision-making.
- Laboratory Tests:
Type and Screen: To be performed today. This test is crucial for identifying any blood type or Rh incompatibility issues that may impact the pregnancy.
Complete Blood Count (CBC): Ordered today to assess for any potential hematological concerns that may affect the health of the patient and the developing fetus.
- Consultation Requested and Justification:
Obstetric Ultrasound (US): Scheduled in 2 weeks to assess fetal position. The patient’s concern about the baby not being head down necessitates a detailed evaluation to plan for a safe delivery. Consultation with a radiologist or obstetric sonographer will provide valuable information for decision-making.
- Medications Prescribed (Name, Dose, Route, Amount, Refills):
Rhogam: Not prescribed during the current visit but will be administered postpartum. The dose and administration route will be determined based on the specific clinical circumstances after childbirth.
Additional Medications: None prescribed at this time. The patient does not report any acute medical issues or complications that require immediate pharmacological intervention. Comprehensive Woman’s Wellness Case Study Paper
- Appliances Prescribed:
None at this time: The patient does not present with conditions requiring specific appliances. Further assessment during routine check-ups will guide any additional recommendations.
- Lifestyle Modifications:
Activity Modification: No strict limitations on physical activity are prescribed at this time. The patient is advised to maintain regular, moderate physical activity unless otherwise contraindicated based on future diagnostic findings.
Dietary Recommendations: General dietary guidelines for a healthy pregnancy are discussed, including the importance of a balanced diet, adequate hydration, and the avoidance of known risk factors.
- Patient Education and Responsibilities:
Obstetric Education: The patient will receive education on the importance of regular prenatal care, the significance of the upcoming ultrasound, and the potential interventions for breech presentation.
Self-Monitoring: Encouraged to monitor any changes in fetal movement and report promptly. Education on recognizing signs of preterm labor and when to seek emergency care.
- Patient Counseling Related to Lab/Diagnostic Results, Impression, or Recommendations:
Type and Screen and CBC Results: The patient will be informed of the results during the next visit, with a thorough explanation of the findings and any necessary interventions.
- Family Education:
Diabetes Risk Education: The patient’s sister has Type 2 Diabetes, prompting education on diabetes risk factors, lifestyle modifications, and the importance of regular health screenings.
- Coordination of Care:
Midwife Collaboration: Coordination with the patient’s midwife is crucial for maintaining continuity of care. The midwife will be informed of the laboratory results and the plan for the upcoming obstetric ultrasound.
Radiology/OB Sonography Collaboration: Coordination with the radiology department or obstetric sonography unit for scheduling and performing the obstetric ultrasound.
- Follow-up:
Obstetric Ultrasound Follow-up: The patient is scheduled for a follow-up in 2 weeks for the obstetric ultrasound to assess fetal presentation.
Routine Obstetric Care Follow-up: Regular check-ups will continue throughout the remainder of the pregnancy, with the frequency determined by the clinical findings and any emerging issues.
PRN Follow-up: The patient is encouraged to seek follow-up care or contact the healthcare provider PRN in case of any concerning symptoms or changes in health status.
Reflection on Domestic Violence and Implications for Care
The comprehensive care plan for the 37-year-old Amish patient becomes more challenging by factors pertaining to domestic violence. Even though the patient did not mention any history of domestic violence, it is still essential to consider the potential implications and how they can affect the treatment approach. Comprehensive Woman’s Wellness Case Study Paper
- Cultural Sensitivity and Awareness: It is imperative to understand the cultural background of the patient in order to address possible domestic violence-related concerns. The Amish culture are renowned to place an emphasis on family and community values. However, there are instances when it can be difficult to identify and deal with domestic abuse due to cultural norms. Healthcare professionals should handle this matter delicately. They should consider the cultural setting and any possible obstacles to disclosure.
- Screening for Domestic Violence: Routine screening is essential to prenatal care because domestic violence affects women of all cultural origins. A thorough assessment that includes sensitive and specific inquiries on the patient’s safety should be part of the care plan. The utilization of standardized screening instruments, like the HITS (Hurt, Insult, Threaten, Scream) questionnaire, can promote transparent communication and detect any indications of domestic violence.
- Implications for the Care Plan: The care plan is significantly impacted if domestic violence is suspected or reported. The mother’s safety and well-being, as well as the unborn child’s, take precedence. The following factors could change the treatment plan:
- Safety Planning: Preparation for safety is critical if there is evidence of domestic abuse. Collaborate with the patient to develop a personalized safety plan. The plan may include determining a safe location, coming up with a code word or signal for when an emergency arises, and giving them information about nearby resources like shelters and hotlines.
- Referral to Support Services: In cases of domestic violence, the plan of care should involve referral to support services. This may include connecting the patient with local domestic violence shelters, counseling services, and legal resources. Establishing a network of support is crucial for empowering the patient to make informed decisions about her safety.
- Engaging in Open Communication: Create a safe and non-judgmental environment for the patient to discuss her experiences. Encourage open communication and active listening, ensuring the patient feels heard and supported. Building trust is essential for fostering an ongoing relationship that allows for continued monitoring and intervention. Comprehensive Woman’s Wellness Case Study Paper
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- Collaboration with Multidisciplinary Team: In cases of domestic violence, collaboration with a multidisciplinary team is essential. This may involve partnering with social workers, psychologists, and legal professionals to address the complex psychosocial aspects of domestic violence. Coordination with these professionals can provide comprehensive support for the patient’s physical and emotional well-being.
- Documentation and Reporting: It is essential to accurately and thoroughly document any suspected or revealed domestic abuse. Incorporate details regarding the patient’s declarations, detected signs, and any interventions made within the medical record. Healthcare professionals should follow the proper reporting processes, if mandated by local laws and regulations, in order to protect the patient and any vulnerable parties involved.
- Ongoing Monitoring and Follow-up: When domestic violence is identified, continual monitoring and follow-up become essential components of the treatment approach. Regular check-ups should include evaluations of the patient’s safety, mental health, and compliance with safety plans. It is crucial to develop a supportive and trustworthy relationship with the patient for long-term engagement in care.
Conclusion
In conclusion, an extensive and comprehensive strategy must be implemented to address domestic abuse in the context of prenatal care. A care plan that prioritizes the safety and well-being of the pregnant patient and her unborn child first must include cultural awareness, open communication, and teamwork with a multidisciplinary team. The strategy should be flexible, centered on giving the patient the tools and resources she needs to make educated decisions about her own safety while also offering continuing support.
Reference
Dotters-Katz, S. K., & Hughes, B. L. (2020). Considerations for obstetric care during the COVID-19 pandemic. American journal of perinatology, 37(08), 773-779. https://doi.org/10.1055/s-0040-1710051
Mendez, M. D. (2020). Fetal Malpresentation. Illustrated Obstetrics and Gynecology Problems, 230.
Shah, P., Pawar, S. H., Naik, S. N., Sivjyothi, T., Rao, A., & Kakkar, A. (2023). A Real-world Prospective Study to Evaluate the Geographical Distribution, Isoimmunization Rate, and Utilization of Prophylactic Treatment of Rh-negative Pregnant Women in India (RhYTHM Study). Journal of South Asian Federation of Obstetrics and Gynaecology, 15(5), 594-600. https://www.jsafog.com/doi/JSAFOG/pdf/10.5005/jp-journals-10006-2304
Vounzoulaki, E., Khunti, K., Abner, S. C., Tan, B. K., Davies, M. J., & Gillies, C. L. (2020). Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis. Bmj, 369. https://doi.org/10.1136/bmj.m1361 Comprehensive Woman’s Wellness Case Study Paper
COMPREHENSIVE WELL-WOMAN/OBSTETRIC PAPER
For a wide variety of medical conditions, early detection of the problem enables timely and more effective treatment. Annual well-woman
exams are among the best tools available for health care professionals to identify potential diseases and medical conditions in women.
Advanced nurse practitioners can play an active role in these important visits. This role can include a physical examination as well as collection of details about such factors as nutrition habits, sexual activity, stress, and more. By participating in comprehensive well-woman exams, advanced nurse practitioners can help patients engage in preventative health.
For this Assignment, you will complete your well-woman exam using a focused note format in which you will gather patient information, relevant diagnostic and treatment information and reflect on health promotion and disease prevention in light of patient factors, such as age, ethnic group, past medical history (PMH), socio-economic status, cultural background, etc.
Assignment:
Write an 8- to 10-page Comprehensive Well-Woman that addresses the following:
- Age, race and ethnicity, and partner status of the patient
- Current health status, including chief concern or complaint of the patient
- Contraception method (if any)
- Patient history, including medical history, family medical history, gynecologic history, obstetric history, and personal social history (as appropriate to current problem)
- Review of systems
- Physical exam
- Labs, tests, and other diagnostics
- Differential diagnoses
- Management plan, including diagnosis, treatment, patient education, and follow-up care
- Provide evidence-based guidelines to support treatment plan. Note: Use your Learning Resources and evidence from scholarly sources from your personal search to support your treatment plan of care.
Reflection
Reflect on some additional factors for your patient: Comprehensive Woman’s Wellness Case Study Paper
- What are implications if you have observed or know of some domestic violence? Would this change your plan of care? If so, how?
Use your Learning Resources and evidence from scholarly sources from your personal search to support your reflection.
Patient Scenario BELOW (make up any information you need to)
37 year old Caucasian NEW OB here for her 34 2/7 weeks OB check. G7 P5 A1 L5 Patient has been seeing a midwife at her home and feels like she needed to come here d/t she doesn’t feel baby is laying right for delivery. Patient is from the Amish culture. Patient has 5 living children and has all of them at home with a midwife. LMP 05/16/2023 Due Date 02/20/2024. BP 108/74, weight 173. NKDA. Patient denies history of heart disease, HTN, Kidney disease, thyroid disease, cancer, seizures/epilepsy, congenital abnormalities, or recurrent miscarriages. Patient does have a sister with Type 2 Diabetes. FH 34, FHS 145. Patient states she is negative blood type and receives Rhogam after her children are born. At this time it appears baby is not head down and is presenting to be breech. Explained that baby still has time to turn but being at home with a midwife and not knowing is more of a risk than patient is wanting to take. Patient will follow up in 2 weeks for US for possible external cephalic version. Type and screen as well as a CBC will be ordered today. Patient has no further questions at this time.
PRAC_6552_Week10_Assignment2_Rubric
| PRAC_6552_Week10_Assignment2_Rubric | ||||||
| Criteria | Ratings | Pts | ||||
| This criterion is linked to a Learning OutcomeWrite an 8- to 10-page Comprehensive Well-Woman Exam that addresses the following: • Age, race and ethnicity, and partner status of the patient• Current health status, including chief concern or complaint of the patient• Contraception method (if any) • Patient history, including medical history, family medical history, gynecologic history, obstetric history, and personal social history (as appropriate to current problem) • Social Determinants of Health assessment• Review of systems• Physical exam• Labs, tests, and other diagnostics• Differential diagnoses• Management plan, including diagnosis, treatment, patient education, and follow-up care• Provide evidence-based guidelines to support treatment plan. |
|
45 pts | ||||
| This criterion is linked to a Learning OutcomeReflect on the following: Reflect on some additional factors for your patient: • What are the implications if your patient was pregnant or just delivered? • What are implications if you have observed or know of some domestic violence? Would this change your plan of care? If so, how? |
|
40 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. |
|
5 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation |
|
5 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. |
|
5 pts | ||||
| Total Points: 100 | ||||||
CLASS RESOURCES
- Fowler, G. C. (2019). Pfenninger and Fowler’s Procedures for Primary Care(4th ed.). Elsevier.
- Section 10, “Obstetrics”
- Chapter 162, “Dilation and Curettage” (pp. 1093–1099)
- Fanslow, J., Wise, M. R., & Marriott, J.(2019). Intimate partner violence and women’s reproductive healthLinks to an external site.. Obstetrics, Gynaecology & Reproductive Medicine, 29(12), 342–350. https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.1016/j.ogrm.2019.09.003
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- Section 10, “Obstetrics”
(Previously read in Week 2)
- Lockwood, C. J. (2019). Key points for today’s ‘well-woman’ exam: A guide for ob/gynsLinks to an external site.. Contemporary OB/GYN, 64(1), 23–29. https://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=134229869&site=ehost-live&scope=site&authtype=shib&custid=s6527200
(Previously read in Week 2)
- Document:Guidelines for Comprehensive History and Physical SOAP Note (Word document)Download Guidelines for Comprehensive History and Physical SOAP Note (Word document)Comprehensive Woman’s Wellness Case Study Paper
Clinical Guideline Resources
As you review the following resources, you may want to include a topic in the search area to gather detailed information (e.g., breast cancer screening guidelines; for the CDC – zika in pregnancy, etc.).
- American Cancer Society.Links to an external site.(n.d.). https://www.cancer.org/
- American College of Obstetricians and GynecologistsLinks to an external site.. (n.d.). https://www.acog.org/
- ANA EnterpriseLinks to an external site.. (n.d.). https://www.nursingworld.org/
- Centers for Disease Control and Prevention.Links to an external site.(n.d.). https://www.cdc.gov/
- American Association of Nurse Practitioners.Links to an external site.(2020). https://www.aanp.org/
- HealthyPeople 2030. (2020). Healthy People 2030 framework.Links to an external site.https://www.healthypeople.gov/2020/About-Healthy-People/Development-Healthy-People-2030/Framework
- S. Preventive Services Task Force.Links to an external site.(n.d.-b).Search and filter all recommendation topics.Links to an external site. https://www.uspreventiveservicestaskforce.org/uspstf/topic_search_results?topic_status=P&searchterm Comprehensive Woman’s Wellness Case Study Paper
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