Nursing 5333 Family Nursing 1; Martha STD Diagnostic Reasoning Case Study.

Nursing 5333 Family Nursing 1; Martha STD Diagnostic Reasoning Case Study. STD Case Study Subjective: Martha is a 26-year-old female who reports vaginal burning for 3 days. She says that she can barely focus on other things because of the burning. She also reports a copious foul smelling vaginal discharge. Her last pap smear was at age 21 and was negative. She has not received the HPV vaccine series. Martha denies previous episodes and states that she is otherwise healthy. She denies fever, chills, nausea, vomiting or diarrhea. She is sexually active and has been sexually active with males since age 15. She states that she has had 2 relationships in the past year. Last intercourse was last week. She admits to dyspareunia and burning with urination. She denies use of vaginal sprays, douches, or powders or the use of new soaps detergent or clothing. She wears a thong regularly. Past Medical History: Tonsillectomy at the age of 7. Currently on no medications or herbal/vitamin supplements Family History: Mom with diabetes; Dad COPD; Brother healthy Social History: Martha is a college graduate and lives alone in an apartment. She feels safe and has a good relationship with her boyfriend. Martha works as a teacher and feels financially secure. She does not smoke and denies drug abuse. She drinks socially on the weekends with 1-2 glasses of wine. NKDA Allergies: Spring Allergy Objective Vital signs: Martha is afebrile. Her B/P is 110/70. Pulse is 64 and regular. Respirations are 18. She is 5 feet 3 inches tall and weighs 120 lbs. General: Martha is pleasant and cooperative but anxious about the visit Cardiac: Regular rate and rhythm without murmurs Respiratory: Lungs are clear Abdomen: Soft, nontender, nondistended, and without organomegaly Pelvic Exam: Inguinal lymph nodes are without swelling or tenderness; vaginal mucosa is moist, pink, and mildly swollen. There is a fishy odor; copious discharge in the introitus. The cervix is pink and friable. There is a negative chandelier sign. PH is mildly alkaline and wet prep indicates trichomads. 3 Differential 1 Trichomoniasis Differential 2 Chlamydia Bacterial Infection Differential 3 Candidal Vulvovaginitis Epidemiology (short synopsis) for each Who, Where, When Kissinger et al. (2022) identify that trichomoniasis is one of the most dominant non-viral sexually transmitted infections (STI), afflicting approximately 3.7 million men and women in the U.S as of 2015. AfricanAmericans are four times more likely to be infected than other races (Kissinger et al., 2022). CDC reports that it is the most prevalent and reported STI in the U.S. among people aged 24 years and over (Centers for Disease Control and Prevention, 2022). CDC reported 1,579,885 cases of chlamydia in 2020 (Centers for Disease Control and Prevention, 2022). 61% or two-thirds of the cases were reported in adolescents and young adults (Centers for Disease Control and Prevention, 2022). CDC project that candidal vaginitis is the second most prevalent type of vaginitis after bacterial vaginosis in the U.S (Centers for Disease Control and Prevention, 2022). Yearly, around 1.4 million American women visit outpatient centers to treat the infection (Centers for Disease Control and Prevention, 2022).