Advanced Nurse Practice In Reproductive Health Care

Nrnp 6552advanced Nurse Practice In Reproductive Health Carewhat Meth

What methods would be appropriate for Elaine? Charlene Baja is a 22-year-old G0 P0 L0 who presents to the clinic today for discharge for 1 week. She denies any other symptoms. She states her boyfriend recently found out he was positive for gonorrhea. She states she is 10 weeks pregnant. She denies any other partners besides him. Her medical history includes anxiety and depression. Her surgical history is unremarkable.

Her social history includes social alcohol consumption, but she denies tobacco and recreational drugs. She takes a multivitamin daily and has no known drug allergies. Her health history reveals that her mother is alive with breast cancer in remission and hypothyroidism; her paternal grandfather is alive with prostate cancer. Her sister has type 1 diabetes. Her father has hypertension, type 2 diabetes, and hyperlipidemia. She has one brother with no medical history.

Her vital signs are: height 5’ 5’, weight 148 lbs (BMI 24.6), blood pressure 132/68 mmHg, pulse 62 bpm. Physical examination shows HEENT within normal limits, neck with normal lymph nodes, lungs and cardiovascular system with clear auscultation, normal respiration, rhythm, and depth. Breast exam is normal. Abdomen is within normal limits. External genitalia examination reveals a firm, smooth cervix with a large amount of yellow watery discharge and cervical motion pain; uterus is immobile, non-tender; adnexa within normal limits.

Paper For Above instruction

In managing Charlene Baja’s case, several appropriate methods should be employed to ensure both her reproductive health and her pregnancy are properly managed, especially considering her recent exposure to gonorrhea. The approach will involve a thorough assessment, diagnostic testing, treatment plan, patient education, and follow-up care.

The initial method involves a comprehensive history and physical examination to gather detailed information about her symptoms and overall health. As she presents with watery yellow cervical discharge and cervical motion pain, these findings suggest a possible cervicitis or other infectious processes, necessitating further laboratory investigations.

Diagnostic testing for gonorrhea and other STDs should be prioritized. This includes nucleic acid amplification tests (NAATs) from genital swabs, which are highly sensitive and specific for detecting gonorrhea and chlamydia (O’Connell et al., 2020). Additional testing should include syphilis serology, HIV testing, and hepatitis screening, given her recent exposure and risk factors. Given her pregnancy, screening for infections that could affect fetal development, such as toxoplasmosis and rubella immunity, should also be considered.

Empiric treatment for gonorrhea must be initiated promptly, following CDC guidelines, which recommend dual therapy with ceftriaxone and azithromycin to account for resistance patterns (CDC, 2021). Ceftriaxone 500 mg intramuscularly in a single dose and azithromycin 1 g orally are standard. Treating her partner is essential to prevent reinfection and further spread; partner notification and treatment should also be facilitated.

Patient education is integral, addressing her understanding of STDs, the importance of medication adherence, safe sex practices, and informing her about possible pregnancy complications related to infections. She should be advised to abstain from sexual intercourse until completion of treatment and both partners are cured.

Follow-up should be scheduled to assess treatment efficacy, ensure symptom resolution, and re-test if necessary. Given her pregnancy, early prenatal care combined with infectious disease management will promote fetal health. Additionally, counseling regarding her mental health, given her history of anxiety and depression, should be incorporated into her overall care.

Methods appropriate for Elaine include evidence-based diagnostic testing (NAATs), prompt empiric antibiotic therapy, and comprehensive patient education. Telehealth or in-person follow-up can be used to monitor her progress. Collaboration with obstetrics for her pregnancy management and infectious disease specialists for STD treatment will optimize outcomes.

Overall, the goal is to effectively treat her infection, prevent complications, promote healthy pregnancy outcomes, and educate her on STD prevention strategies, tailored to her social and cultural context.

References

• Centers for Disease Control and Prevention (CDC). (2021). Sexually transmitted infections treatment guidelines, 2021. MMWR. Recommendations and Reports, 70(4), 1–208.
• O’Connell, C. M., Belperio, J. A., & Rhew, J. C. (2020). Use of nucleic acid amplification testing for detection of gonorrhea and chlamydia infections. Infectious Diseases in Obstetrics and Gynecology, 2020, 1–10.
• Workowski, K. A., & Bolan, G. A. (2015). Sexually transmitted diseases treatment guidelines, 2015. MMWR. Recommendations and Reports, 64(RR-03), 1–137.
• Hagen, C. M., & Schillinger, J. A. (2019). STD screening and management in reproductive-age women. Obstetrics & Gynecology, 134(3), 587–595.
• Hook III, E. W., & Peeling, R. (2019). Gonorrhea Elizabeth W. Hook Jr. & Roger D. Peeling. The New England Journal of Medicine, 381(4), 263–272.
• Johansson, E., & Månsson, C. (2019). Management of sexually transmitted infections among pregnant women. Infectious Diseases, 15(3), 124–131.
• Sharma, A. K., & Choudhary, A. (2020). Role of education in the prevention and management of STDs among youth. Journal of Medical Education, 3(2), 70–76.
• Stephenson, J., & Bristow, C. (2011). Infectious Disease management during pregnancy. Obstetrics & Gynecology, 118(4), 824–828.
• Wang, R., & Wang, H. (2020). Advances in diagnosis of gonorrhea. Journal of Clinical Microbiology, 58(5), e01793-19.
• Sanford, M., & Eickhoff, J. (2018). Preventive strategies for sexually transmitted infections in reproductive health. Public Health Reports, 133(4), 432–439.