Sti Case Study

You are the nurse in a walk-in clinic.
AP is being seen this morning for a 2-day

history of diffuse, severe abdominal pain. She has complaints of nausea without
vomiting. She denies vaginal bleeding or discharge. AP reports having
unprotected sex with several partners recently. Two of these partners had penile
discharge. Her last menstrual period ended 3 days ago. She has no known drug
allergies and denies PMH or psychiatric problems. Vital signs are 108/60; HR 110;
Temp 100.6F. Physical examination reveals that her abdomen is very tender. The
slightest touch to her abdomen causes great discomfort. Bowel sounds are
normal. Pelvic examination reveal purulent material pooled in the vaginal vault,
which appears to be coming from the cervix. A sample of the vaginal drainage is
obtained and sent for culture. The result of a pregnancy test is negative. A rapid
diagnostic chlamydia test is positive.
1.) Which of these assessment findings are significant and why?
These findings are consistent with an infection, and if it goes untreated the infection can
progress into something worse
2.) What medical interventions can you anticipate?
Antibiotics, pain medication, blood testing, sample testing, contact tracing
3.) What should you teach AP about chlamydial infection?
I would tell AP that chlamydia is a common STI that is treatable. If not treated quickly
and properly, it can cause permanent damage to her reproductive system
4.) How would you provide emotional support to AP at this time?
I would remind her that this is a common infection, and she can anonymously report to
her partners that they should get tested
Case study progresses
The physician has the option of treating AP by one of two different methods.
First, the physician could prescribe treatment with doxycycline (monodox0
100mg PO bid X 7 days OR the physician could provide a one-time dose of 1
gram azithromycin.
5.) Which choice is best for AP? What is your reasoning?
I would ask AP which she would prefer to take, and remind her that she needs to
abstain from sexual activity for 7 days after the single dose, or until the week dose is
completely finished.
6.) You tell AP that chlamydial infection is sexually transmitted that is mandated
to be reported to the Department of Public Health. What is the purpose of
reporting this?
It can spread quickly through sex, so in theory the spread can be stopped if sexual
activity is halted
7.) Based on the information in this case study, what other risk assessment
questions should you ask AP?
Any drug use, how many sexual partners she has, if condoms are being used, if she
has regular exams, or chronic illnesses
8.) you ask whether someone has talked with AP about "safe sex". She laughs
and she tells you she knows there is nothing safe about sex. Undaunted, she tells
you that she always uses condoms if "she doesn't know the guy". How will you
respond?
I would tell her that condoms should be used all the time to prevent unwanted
pregnancy and help prevent STIs
8.) You ask AP if she has been tested for HIV. She says "no". She does not know
anyone with AIDS and does not have sex with gay men. What is your response?
HIV and AIDS is not subject soley to the gay population, and it can be spread through
body fluids.
9.) You ask her whether she would like to be tested for HIV as it is free and
confidential. She agrees. What additional counseling with you provider her
regarding this test?
A person should be tested every time they have a new partner, a recent STI, or with
injectable drug use
10.) You make an appointment for AP to return to the clinic in 1 week for her HIV
test results. Describe the instructions you will give to AP before she leaves the
clinic.
Before she leaves, remind her that she must abstain from sexual activity until the
antibiotic course is completed, and to report to her partners about the infection and they
should be tested
Case study progresses
AP returns to the clinic in 1 week for her HIV test results, which are negative.

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Sti Case Study

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You are the nurse in a walk-in clinic.

AP is being seen this morning for a 2-day

1.) Which of these assessment findings are significant and why?

2.) What medical interventions can you anticipate?

Antibiotics, pain medication, blood testing, sample testing, contact tracing

3.) What should you teach AP about chlamydial infection?

4.) How would you provide emotional support to AP at this time?

Case study progresses

5.) Which choice is best for AP? What is your reasoning?

Case study progresses

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