iHuman Case Study Nancy Campbell, Exams of Nursing

Download iHuman Case Study Nancy Campbell and more Exams Nursing in PDF only on Docsity! QUESTIONS AND ANSWERS iHuman Case Study Nancy Campbell TESTED AND CONFIRMED A+ ANSWERS iHuman Case Study: Nancy Campbell Name Course Date Medical History  Patient had urinary tract infection twelve months ago.  No known allergies.  No medical intolerances  No chronic health complications or major traumas.  No hospitalization or surgeries are done before.  Medications: Oral contraceptive pills. And ibuprofen is taken for headache and menstrual pains.  vaccinations are up to date. Family History  Patient’s mother has type II diabetes and the father is battling high blood pressure, hyperlipidemia and coronary artery disease (CAD). Patient has a sister older than her and is healthy. Social History  Ms. Campbell is a consultant and hence travels often. She reports to drinking two times a week and she drinks 4 or 5 drinks when she drinks. She previously used to smoke and denies other kinds of drug abuse. Patient has several sexual partners and denies using a condom but rather uses oral contraceptives. Examination Vital Signs  Temperature: 98.7 F  Weight: 135lbs  Height: 5’5”  Pulse: 66 bpm  BMI: 22.5  B/P: 116/64  Resp.: 12 General  Ms. Campbell is a healthy-appearing female who is in mild distress due to her condition. Patient is alert and well-oriented. Answers questions in the right way. Her skin is pink, intact, warm and clean with no rashes. Examination cont’d  HEENT: Head is atraumatic and normocephalic with no lesions. Normally distributed hair. Eyes: PERRLA. EOMs are intact with no sclera injection or conjunctiva. Ears: Patent canals. TMs are bilateral and appear pearly gray with light reflexes that are positive. Easily visualized landmarks. Nose: Pink nasal mucosa with normal turbinates. No case of septal deviation. Neck: Supple with full ROM. No cervical lymphadenopathy or occipital nodes. No nodules or thyromegaly. Pink and moist oral mucosa. Nonerythematous pharynx with no exudates. Teeth are healthy.  Cardiovascular: Normal S1 and S2 with normal rhythm and rate. No case of extra sounds, no murmurs, no clicks or gallops.  Respiratory: Symmetrical chest wall and lungs are bilateral and clear to auscultation. Respirations are easy and regular.  Gastrointestinal: No scars noted in the flat abdomen. Bowel sounds are audible in all the four quadrants. Abdomen non-tender, soft with no masses. No case of hepatosplenomegaly. Examination cont’d  Breast: No changes in skin color around the breasts, nipples with no retraction. Both breasts have striae at the base. No tenderness to palpitation. No masses noted.  Genitourinary: Bladder with no CVA tenderness. No case of cervical motion tenderness. No masses. Creamy discharge seen from the cervix. Cervix friable is notable.  Musculoskeletal: ROM is full and is visible in all the four extremities upon patient’s movement.  Neurological: Clear speech with a good tone. Erect posture, Balance is stable and gait is normal.  Psychiatric: Patient is well-oriented and alert. Properly dressed and keeps a good eye contact. Patient answers questions in the right way. Management Plan  Medications; Azithromycin 1000mg single dose to be taken orally and ceftriaxone 250mg IM single dose.  Non-pharmacological interventions: Patient is to abstain from sex until she is healed. She should also consider safe sex and maintain one sexual partner.  Tests ordered: Hepatitis B, HIV, screening for syphilis and PAP smear test.  Patient is advised to take a HPV vaccine. Follow-up after two weeks and repeat the tests after three to six months. Referral: Gynecologist for the PAP test. Evidence-Based Article 1  “Managing sexually transmitted infections” by Johnson-Mallard et al., (2018) is a research article that gives insights into the management of STIs. The authors give the guidelines necessary for the prevention and the management of sexually transmitted illnesses. The article updates the tips periodically based on developing science. The article provides recent updates relevant to the management of STIs. The authors focus on the treatment plans, retests and detection repeat infections and updated vaccines on HPV. In conclusion, the authors of the article state that creation of awareness on STIs is the first step of prevention and management and it is the responsibility of the advanced practice registered nurses to ensure that the public knows the STIs. The authors identify some of the best prevention and management strategies that Ms Campbell could use in managing her condition. Evidence-Based Article 2  Tang (2018) wrote “Updates on Sexually Transmitted Infections: Gonorrhea, Chlamydia, and Syphilis Testing and Treatment in the Emergency Department”. The article focusing on the relevant updates on sexually transmitted illnesses. The author focused on illnesses such as chlamydia, gonorrhea and syphilis. Updates on the testing and treatment of these illnesses are well defined in this article. The article was written to review and define the present guidelines and studies on the screening, diagnosis and treatment of STIs in the emergency department. This article entails information that Ms Campbell can use in ensuring that her illness does not reoccur and how she will be in a position to prevent herself from other sexually transmitted illnesses. Information on screening will be essential in early detection of any STI that she could be suffering from. Evidence-Based Article 5  Management of women with cervicitis is an article written by Marrazo & Martin, (2017) giving insights on cervicitis. The authors define cervicitis as the result of gonorrhea and chlamydia that are often characterized by the mentioned mucopurulent discharge, friability, cervical bleeding and cervical secretions that have elevated leukocytes. The authors have given a recommendation of the treatment options for patients and their partners. Authors mention Cefixime 400mg orally taken, azithromycin 1g single dose accompanied by ceftriaxone 250mg IM. This is a relevant article in the case of Ms. Campbell as the mentioned treatment options can be applied to treat her current diagnosis. References Buttaro, T. M., Trybulski, J., Polgar-Bailey, P., Sandberg-Cook, J. (2017). Primary care: A collaborative practice, 5th Edition. [South University]. Retrieved from https://digitalbookshelf.southuniversity.edu/#/books/ Di Tucci, C., Di Mascio, D., Schiavi, M. C., Perniola, G., Muzii, L., & Benedetti Panici, P. (2018). Pelvic inflammatory disease: Possible catches and correct management in young women. Case Reports in Obstetrics & Gynecology, 1–4. https://doi.org/10.1155/2018/5831029 Hester, E. E., & Middleman, A. B. (2019). A Clinical Conundrum: Chronic Cervicitis. Journal of pediatric and adolescent gynecology, 32(3), 342-344. Johnson-Mallard, V., Curry, K., Chandler, R., Alexander, I., Kostas-Polston, E., Orsega, S., & Woods, N. F. (2018). Managing sexually transmitted infections: Beyond the 2015 guidelines. The Nurse Practitioner, 43(8), 28-34. Marrazzo, J. & Martin, D. (2017). Management of women with cervicitis. Clinical infectious disease, 44(1), p. 102-110. DOI: 10.1086/511423 Tang, S. (2018). Updates on Sexually Transmitted Infections: Gonorrhea, Chlamydia, and Syphilis Testing and Treatment in the Emergency Department. Current Emergency and Hospital Medicine Reports, 6(3), 69-78.