Gloria Smart is a 75-year-old female who presents to your office today for regular gyn care. You read her medical history and note she received a cardiac stent at age 55, has mild hypertension, and is on Zocor, Plavix, and lisinopril. Surgical history is remarkable for tonsils as a child and bunion surgery. She works full time, by choice, because it “makes me feel young.” She is up to date with colonoscopies. Gyn history normal pap history, last DXA within normal limits, normal mammogram. BMI is 26. First menses age 14 and menopause age 54. She works out at her local gym 5 days a week. Social history is negative for tobacco and recreational drugs. She has an occasional glass of wine. She has never married and has been with her current partner for 2 years and will be getting married in 2 months. She has never been pregnant, and her partner has never had a child.Decision Point OneGloria relates as you start to talk to her that she and her fiancé have been talking about it, and they would like to have a child. She read an article about a woman in Canada who was 80 and about another one in India who was 78. She wants a referral and some guidance.What would you do in this situation? Is it right to dismiss her desire, or should you facilitate it? How do you see your role here ? What is your differential diagnosis? • Why did you make this diagnosis decision?• What is your treatment plan?• What evidence-based research can you provide to support your decision (choice for differential diagnosis and plan/intervention)?• What resources did you use to meet your best practice guidelines?What ethical dilemmas and/or other issues do you need to consider?Address the ethical dilemmas and/or other issues for your case study:• Ethical issues• Psychological issues• Physical issues• Financial issuesWhat would you do in this situation? Is it right to dismiss her desire, or should you facilitate it? a write brief summary, continue to post the differential diagnosis decision you or your group decided on. Why did you make this decision? What is your treatment plan? What evidence-based research can you provide to support your decision?What resources did you use to meet your best practice guidelines?Make sure to provide evidence from the literature to support your discussion post.
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