NR293 Case Study Sexually Transmitted Infections
Scenario
You are the nurse in a walk-in clinic. A.P. is being seen this morning for a 2-day history of
diffuse, severe abdominal pain. She has complaints of nausea without vomiting; she denies
vaginal bleeding or discharge. A.P. reports having unprotected sex with several partners recently,
two of whom had penile discharge. Her last menstrual period ended 3 days ago. She has no
known drug allergies and denies previous medical or psychiatric problems. Vital signs are
108/60, 110, 20, 100.6° F (38.1° C). Physical examination reveals that her abdomen is very
tender. The slightest touch of her abdomen causes her to wince with pain. Bowel sounds are
normal. Pelvic examination reveals purulent material pooled in the vaginal vault, which appears
to be coming from the cervix. A sample of the vaginal drainage is obtained and sent for culture.
The result of a pregnancy test is negative; a rapid diagnostic test for chlamydial infection has a
positive result.
1. Which of these assessment findings are significant and why?
2. What medical interventions can you anticipate?
3. What should you teach A.P. about chlamydial infection?
4. How would you provide emotional support to A.P. at this time?
Case Study Progress
The physician has the option of treating A.P. by one of two different methods. First, the physician
could prescribe treatment over a period of 1 week. A.P. would be given the first dose of
doxycycline (Monodox) 100mg PO, and then she would be prescribed the same dose to be taken
PO bid for 7 days. Second, the physician could prescribe a one-time dose of azithromycin
(Zithromax) 1g PO, which could be administered in the clinic.
5. Which choice is best for A.P.? Explain your reasoning.
6. You tell A.P. that chlamydial infection is a sexually transmitted infection (STI) that is
mandated to be reported to the public health department. What is the purpose of reporting
Scenario
You are the nurse in a walk-in clinic. A.P. is being seen this morning for a 2-day history of
diffuse, severe abdominal pain. She has complaints of nausea without vomiting; she denies
vaginal bleeding or discharge. A.P. reports having unprotected sex with several partners recently,
two of whom had penile discharge. Her last menstrual period ended 3 days ago. She has no
known drug allergies and denies previous medical or psychiatric problems. Vital signs are
108/60, 110, 20, 100.6° F (38.1° C). Physical examination reveals that her abdomen is very
tender. The slightest touch of her abdomen causes her to wince with pain. Bowel sounds are
normal. Pelvic examination reveals purulent material pooled in the vaginal vault, which appears
to be coming from the cervix. A sample of the vaginal drainage is obtained and sent for culture.
The result of a pregnancy test is negative; a rapid diagnostic test for chlamydial infection has a
positive result.
1. Which of these assessment findings are significant and why?
2. What medical interventions can you anticipate?
3. What should you teach A.P. about chlamydial infection?
4. How would you provide emotional support to A.P. at this time?
Case Study Progress
The physician has the option of treating A.P. by one of two different methods. First, the physician
could prescribe treatment over a period of 1 week. A.P. would be given the first dose of
doxycycline (Monodox) 100mg PO, and then she would be prescribed the same dose to be taken
PO bid for 7 days. Second, the physician could prescribe a one-time dose of azithromycin
(Zithromax) 1g PO, which could be administered in the clinic.
5. Which choice is best for A.P.? Explain your reasoning.
6. You tell A.P. that chlamydial infection is a sexually transmitted infection (STI) that is
mandated to be reported to the public health department. What is the purpose of reporting
