Purpose
To treat clients with STIs with a nonjudgmental attitude within the scope of practice of the LPN while functioning on a team of professionals.
Competency
Identify nursing interventions for clients with disorders of the reproductive system.
Instructions
Read the case studies below and answer the questions. Make sure you cite any sources using APA format.
Scenario # 1
You are working in a community health clinic on a team that has an LPN, RN, and nurse practitioner. Your first client of the day is a tearful young woman who states that she has had a painful rash to her genital area for the past couple of days. She came to the clinic today because the rash is getting progressively worse. Her vital signs are: 100.5 (PO), 114, 28, 145/88 Pain: 9 on a 1-10 scale. The client shares with you that her boyfriend has herpes. They never have sex when he is having a flare-up, so she is not sure how she could have gotten it from him.
Question # 1: What should be the first priority for this client? Explain your answer. (5-10 sentences)
Question # 2: The RN provides teaching to the client, but the client has some follow-up questions. As the LPN you reinforce the teaching about how herpes is spread. What factual information should the nurse provide about the spread of this disease between flare-ups?
(2-3 sentences)
Scenario # 2
You are working in a primary care office with a physician’s assistant (PA) and RN. A client comes in for a follow-up visit. He states that he was called to come in because of an “abnormal lab report.” You print the labs for the PA, and you see that the client had a sore on his penis that was scraped and sent to the lab. The scrapings are positive for syphilis. You also see in the notes that the client had to be called repeatedly to come to the office. At first, he was unwilling to return because he stated he “feels fine.”
Question # 3: The client is confused about why he needs to name his sexual partners. What factual information can the nurse give to explain the need for all of his sexual partners to be treated as soon as possible? (5-10 sentences)
Question # 4: The PA orders a single dose of Benzathine Penicillin G 2.4 million units IM. The client questions why he just cannot take some pills. What explanation will you provide to the client? (5-10 sentences)
Scenario # 3
You are working in a primary care office with a physician. You are instructed to collect data on a client, including vital signs and chief complaint. The client states that she is a sex worker and has had chills, fevers, and sore throats on and off for several weeks. The physician orders a rapid HIV test.
Question # 5: What in your data collection indicates that the client is at high risk for HIV? (2-3 sentences)
Format
- Standard American English (correct grammar, punctuation, etc.)
- Professional organization, style, and mechanics in APA format
- APA format and in-text citation
- References – must contain professional references, published within the past 5 years
Question #1: The first priority for this client is to alleviate her pain and discomfort while assessing and diagnosing the cause of her symptoms. Given her presentation with a painful rash in the genital area, it’s crucial to address her pain, discomfort, and any potential infection promptly. Since she has disclosed that her boyfriend has herpes, it raises concerns about possible transmission, which needs to be investigated further. Additionally, assessing for any signs of systemic infection, such as fever, is essential to determine the severity of the condition and the need for immediate intervention. Therefore, providing analgesia, conducting a thorough assessment, and initiating appropriate diagnostic measures should be the primary focus at this time (Gulanick & Myers, 2019).
Question #2: The nurse should provide factual information about the spread of herpes between flare-ups to reinforce the client’s understanding. Between flare-ups, herpes can still be transmitted through asymptomatic shedding of the virus from the infected partner’s genital area. Even when there are no visible sores or symptoms present, the virus can still be active and contagious, making it possible to transmit the infection to sexual partners. Therefore, it’s crucial for the client to understand that herpes can be spread even when her boyfriend is not experiencing visible symptoms (CDC, 2021).
Question #3: The nurse can explain to the client that naming his sexual partners is essential to prevent further spread of syphilis and to ensure that all individuals at risk receive timely treatment. Syphilis is a sexually transmitted infection that can have serious consequences if left untreated, including neurological and cardiovascular complications. By identifying and treating all sexual partners, the client not only protects their health but also contributes to public health efforts to control the spread of syphilis within the community. Emphasizing the importance of confidentiality and non-judgmental support can help facilitate open communication and cooperation from the client (Centers for Disease Control and Prevention, 2021).
Question #4: The nurse can explain to the client that Benzathine Penicillin G is the recommended treatment for syphilis because it provides prolonged therapeutic levels of the antibiotic in the bloodstream, effectively treating the infection. Unlike oral antibiotics, which may require multiple doses and have a higher risk of non-adherence, a single dose of Benzathine Penicillin G is convenient and ensures complete treatment. Additionally, this regimen helps to prevent the development of antibiotic resistance and ensures successful eradication of the syphilis bacteria. It’s important to reassure the client that this treatment approach is the most effective and safest option for managing his condition (Workowski et al., 2015).
Question #5: The client’s occupation as a sex worker and the presence of symptoms such as chills, fevers, and sore throats for several weeks indicate a high risk for HIV. Sex workers are often exposed to multiple sexual partners, increasing their risk of contracting sexually transmitted infections, including HIV. The presence of persistent symptoms suggestive of acute retroviral syndrome, such as fever and sore throat, further raises concerns for recent HIV infection. Therefore, conducting a rapid HIV test is appropriate to assess the client’s HIV status and provide timely interventions if needed (Centers for Disease Control and Prevention, 2021).
References:
Centers for Disease Control and Prevention. (2021). Sexually Transmitted Diseases Treatment Guidelines, 2021. MMWR. Recommendations and Reports, 70(4), 1–187. https://www.cdc.gov/std/treatment-guidelines/default.htm
Gulanick, M., & Myers, J. L. (2019). Nursing care plans: Diagnoses, interventions, and outcomes. Elsevier Health Sciences.
Workowski, K. A., Bolan, G. A., & Centers for Disease Control and Prevention. (2015). Sexually transmitted diseases treatment guidelines, 2015. MMWR. Recommendations and Reports, 64(RR-03), 1–137. https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6403a1.htm