University:
West Coast University
Course:
NURS 664 | Primary Care Women's Health: Theory, Pharmacology and Practice
Academic year:

2022
Views:

405

Pages:

2
Author:

Zoie Hudson

IHuman-case Case 2 - Juliana A Mirabelles complaint "I have been having burning when I pee. I was worries that I had another bladder infection, but these symptoms are a little different that the symptoms I had with my last UTI. History of present illness Juliana 25 y/o F no PMH c/o 3d hx of dysuria. Reports burning pain upon initiation, urinary frequency, alleviated w/ soaking in warm water, yellow vaginal discharge, vaginal spotting. Previous UTI "feels" different than current sx. Sexually active w/ multiple partners, no barrier contraceptive. Past STD were negative, partners' STD statuses unknown. She denies any fever, chills, chest pain, SOB, nausea, vomiting or abdominal pain. The patient stated the pain is worse at the beginning of urination. Patient denies having any treatment for her symptoms. Management Plan by Ingrid Pradere on case Case 2 - Juliana A Mirabelles V5.2 PC PL-Chamberlain Cervicitis-Bases for diagnosis: Reported discharge, sexually active without condom use, urinary symptoms, mucopurulent discharge from cervical os, cervix friable appearance, and positive culture for gonorrhea. Patients must be educated that cervicitis is a preventable, sexually transmitted infection (STI) and that the most effective way to prevent the transmission of the infective agents is to avoid sexual intercourse without protection or infected partners My plan for Juliana is to treat her cervicitis. Patient should be treated with one time dose of ceftriaxone 500 mg intramuscularly and Azithromycin 1g orally in a single dose Both given as a one-time dose Education: Ms. Campbell will need to contact all recent sexual partners, at least those she has had intercourse in the last 60 days, to inform them of her STD status and recommend that they get tested and treated. She should be educated on the importance of safe sex practices, such as condom use and STD testing before intercourse with new partners, It is recommended that she have a PAP smear to further determine if the cervicitis was caused by the gonorrhea infection of by something else. She should complete the STD screening for HIV and syphilis. She should abstain from sexual intercourse for at least 7 days after treatment and have a follow-up in a week to determine if the infection is gone. It is recommended she receive the HPV vaccine as she is 25 years old. She should follow-up in three months for a recheck vaginal culture to ensure there is no reinfection. She should be educated about chlamydia being a known coinfection with gonorrhea but not present with symptoms. Clinician should explain any side effects of medication and know what to do if they occur. Explain what medication she is given and why.