Scenario
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 but they never have sex when he is having a flare-up so she is not sure how she could have gotten it from him.
The first priority for this client
In this scenario, the first and most important step is to make the client feel relaxed. Secondly, once she is calm, an examination should be conducted to find out the cause of the rush. Next is to check the characteristics of the rash, whether there is some discharge or it is reddish (WHO, 2019). After that, confirm whether other parts of the skin have been infected. Lastly, the swabbing of virginal discharge and scrapping of skin cells are done to examine if there could be any fungal infection.
What factual information should the nurse provide about the spread of this disease between flare-ups?
Inform the client that this STI is caused by the herpes simplex virus. It is transmitted through unprotected anal, oral, or vaginal sex. Contact with an infected area during the flare-up of the diseases through either kissing or vaginal sex can spread HSV-1 and HSV-2.
The client is confused as of 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?
The patient should be made to understand that Syphilis can easily be cured in its early stages. A person with a secondary, primary, or latent condition can be healed with a single intramuscular injection of Benzathine penicillin G. Furthermore, early treatment will effectively prevent damage by the bacterium. If it is not handled in the early stages it can cause disability and death (Williamson & Chen, 2020). Consequently, it is good to know that over-the-counter drugs cannot cure it.
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?
Inform the client there are no over-the-counter drugs that can cure syphilis. It is also advisable to let them know that penicillin is important and it only works more effectively in the early stages. Otherwise, in the later phases, longer periods of use of penicillin to cure syphilis will be required. Unknown duration latent syphilis treatment is done using three doses of long-acting Benzathine penicillin G (Unemo et al, 2017). Therefore, inform the patient that treatment depends on the time the bacteria have been in the body.
What in data collection indicates that the client is at high risk for HIV?
Fever, chills, and the sore throats that she had is an indication that she may have had HIV. The confession that she had been a sex worker is an indication that the client was at high risk for HIV.
References
Unemo, M., Bradshaw, C. S., Hocking, J. S., de Vries, H., Francis, S. C., Mabey, D., Marrazzo, J. M., Sonder, G., Schwebke, J. R., Hoornenborg, E., Peeling, R. W., Philip, S. S., Low, N., & Fairley, C. K. (2017). Sexually transmitted infections: Challenges ahead. The Lancet. Infectious diseases, 17(8), e235–e279.
Williamson, D. A., & Chen, M. Y. (2020). Emerging and reemerging sexually transmitted infections. New England Journal of Medicine, 382(21), 2023-2032. Web.
WHO, (2019) Sexually transmitted infections (STIs).