Question

Case Study, Chapter 27, Assessing Female Genitalia, Anus, and Rectum

A 25-year-old female client presents to the clinic for evaluation of itching and discomfort in the genital area, accompanied by painful urination. The client states that the symptoms started about a week ago and have been getting progressively worse. During the interview, the client states that she had a urinary infection a few months ago. She is sexually active. Upon physical examination, the nurse notes mild reddening of the vaginal walls and a foul-smelling discharge. The nurse asks the client what form of contraception she uses. The client tells the nurse that she has been using a diaphragm for about a year, but she is not totally sure she is using it correctly. She still has difficulty inserting and removing it, and, at times, she feels it inside. The nurse practitioner (NP) she saw at the time told her she wasn’t supposed to feel it if it was positioned correctly. Along with the diaphragm, she requests her partner to use a condom as well for added protection. She has an appointment to go back to the NP for a follow-up. The client stated that she gets yearly Pap smears because her mother had cervical cancer. (Learning Objectives: 2, 3)

Questions:

a. To complete an accurate nursing history, what data does the nurse need to obtain?

b. The nurse develops a teaching plan for this client. What information needs to be included?

Answer 1

a. Urine culture, Blood picture, Post voidal catheterisayion test, WBCs & RBCs in urine. Pap smear test. antibiotic sensitivity culture of urine. Internal vaginal scan. Analysing the location of pain helps in differentiating the infection of kidney or bladder. Any back pain?

b. to teach on contraceptive method other than diaphrgm method. Antibiotics treatment for UTI. Betadine wash of the genital areas. Cleaning procedure of rectal & genital areas.

Encourage frequent voiding of urine to empty the bladder, Avoid urinary irritants.