28 YEARS OLD DYSURIA AND VAGINAL DISCHARGE WEEK#7 NUR 602 i-HUMAN CASE STUDY 2026

1. Case Introduction & Patient Overview This iHuman case study centers on Kristina Hart, a 28-year-old woman who presents to an outpatient women's health clinic reporting urinary painthat has persistedforthreedays.Theencounterrequirestheadvancedpractice nursing (APN) student to conduct a systematic genitourinary and gynecological assessment, generate a clinically sound differential diagnosis, and apply current evidence-based guidelines to formulate a safe, patient-centered management strategy. A central competency tested by this case is the ability to distinguish sexually transmitted infections (STIs) from other common causes of dysuria — particularly uncomplicated bacterial cystitis — and to recognize pelvic examination findings that redirect the clinical impression toward STI-related cervicitis. The case also challenges the student to address sexual health counseling, mandatory public health reporting, and health maintenance screening in a compassionate, non-judgmental manner. Patient Demographics Patient Name Kristina Hart Age 28 years old Sex Female (she/her) Height / Weight 5'2" (157 cm) / 132 lb (60.0 kg) BMI 24.2 kg/m² (Normal range) Encounter Setting Outpatient Primary Care / Women's Health Clinic Case Assignment Week 7 — NR 602, Chamberlain University Chief Complaint "Pain when I pee" — Dysuria x 3 days Insurance Not specified — confirm at check-in Learning Objectives By completing this case, the NR 602 student will be able to: 1. Apply the OLDCARTS mnemonic to construct a comprehensive genitourinary history for a woman of reproductive age. 2. Distinguish the physical examination features of STI-related cervicitis from those of uncomplicated urinary tract infection. 3. Prioritize and interpret diagnostic studies appropriate to this clinical presentation. 4. Construct a ranked differential diagnosis with supporting and refuting evidence for each condition. 5. Apply current Centers for Disease Control and Prevention (CDC) guidelines to prescribe evidence-based antibiotic therapy for cervicitis. 6. Deliver culturally sensitive sexual health counseling and initiate expedited partner therapy (EPT) where appropriate. 7. Identify reportable STI conditions and describe mandatory public health reporting obligations. NR 602 — Primary Care of the Childbearing Family | Week 7 iHuman Case Study | Kristina Hart II. Chief Complaint & History of Present Illness Chief Complaint In the patient's own words: "It hurts when I pee — like a burning feeling. I also noticed some discharge that looks yellow and kind of thick. It started a few days ago." History of Present Illness — OLDCARTS Framework Element Clinical Details Onset Symptoms began approximately 3 days prior to today's visit; onset was gradual and has not improved. Location Burning discomfort localized to the urethra during urination; associated yellow vaginal discharge noted in the vaginal vault and at the cervical os. Duration Continuous for 3 days; present throughout the day with every void. Character Burning, painful urination (dysuria); urinary urgency; yellow, creamy vaginal discharge described as non-malodorous. Aggravating Factors Voiding; reports that sexual intercourse worsens discomfort. Relieving Factors Warm sitz baths provide limited temporary relief; drinking water does not fully resolve symptoms. Timing Symptoms are persistent and have not resolved or significantly improved since onset. Severity Patient rates discomfort as 5/10 on the numeric pain rating scale; symptoms are interfering with daily activities and work attendance. Narrative History of Present Illness Kristina Hart is a 28-year-old woman presenting for evaluation of a 3-day history of dysuria, urinary urgency, and vaginal discharge. She describes the urinary pain as a burning sensation that occurs with every void and has not decreased since it began. She noticed a yellow, creamy, non-malodorous vaginal discharge approximately simultaneously with the onset of urinary symptoms. She has attempted symptomatic relief with warm sitz baths, which provide brief but incomplete relief. She is sexually active and reports more than one male sexual partner over the preceding several months. She uses an oral contraceptive pill (OCP) for pregnancy prevention but does not routinely use barrier contraception such as condoms.SheisnotawareofanyrecentSTIdiagnosesinherselforhercurrentpartners,thoughsheacknowledges she has not undergone recent STI testing. She denies fever, chills, rigors, nausea, vomiting, flank pain, lower back pain, hematuria, genital sores or ulcers, abdominal cramping, or rectal symptoms. Her last menstrual period occurred approximately two and a half weeks prior to this visit. Menstrual cycles are regular, and she denies any intermenstrual or post-coital bleeding. She denies any recent antibiotic use.