Reproductive Interventions

Purpose

To treat clients with STIs with a nonjudgmental attitude within the scope of practice of the LPN while functioning on a team of professionals.

Competency

Identify nursing interventions for clients with disorders of the reproductive system.

Instructions

Read the case studies below and answer the questions. Make sure you cite any sources using APA format.

Scenario # 1

You are working in a community health clinic on a team that has an LPN, RN, and nurse practitioner. Your first client of the day is a tearful young woman who states that she has had a painful rash to her genital area for the past couple of days. She came to the clinic today because the rash is getting progressively worse. Her vital signs are: 100.5 (PO), 114, 28, 145/88 Pain: 9 on a 1-10 scale. The client shares with you that her boyfriend has herpes. They never have sex when he is having a flare-up, so she is not sure how she could have gotten it from him.

Question # 1: What should be the first priority for this client? Explain your answer. (5-10 sentences)

Question # 2: The RN provides teaching to the client, but the client has some follow-up questions. As the LPN you reinforce the teaching about how herpes is spread. What factual information should the nurse provide about the spread of this disease between flare-ups? (2-3 sentences)

Scenario # 2

You are working in a primary care office with a physician’s assistant (PA) and RN. A client comes in for a follow-up visit. He states that he was called to come in because of an “abnormal lab report.” You print the labs for the PA, and you see that the client had a sore on his penis that was scraped and sent to the lab. The scrapings are positive for syphilis. You also see in the notes that the client had to be called repeatedly to come to the office. At first, he was unwilling to return because he stated he “feels fine.”

Question # 3: The client is confused about why he needs to name his sexual partners. What factual information can the nurse give to explain the need for all of his sexual partners to be treated as soon as possible? (5-10 sentences)

Question # 4: The PA orders a single dose of Benzathine Penicillin G 2.4 million units IM. The client questions why he just cannot take some pills. What explanation will you provide to the client? (5-10 sentences)

Scenario # 3

You are working in a primary care office with a physician. You are instructed to collect data on a client, including vital signs and chief complaint. The client states that she is a sex worker and has had chills, fevers, and sore throats on and off for several weeks. The physician orders a rapid HIV test.

Question # 5: What in your data collection indicates that the client is at high risk for HIV? (2-3 sentences)

Format

• Standard American English (correct grammar, punctuation, etc.)
• Logical, original, and insightful
• Professional organization, style, and mechanics in APA format
• Submit document through Grammarly to correct errors before submission.

Resources

APA Online Guide

Question #1: The first priority for this client should be to alleviate her pain and discomfort. Given her symptoms of a painful rash in the genital area, along with her elevated temperature and increased heart rate, it’s crucial to address her immediate physical distress. Pain management and symptom relief will not only improve her comfort but also allow for a more thorough assessment and diagnosis. Additionally, considering her history of potential exposure to herpes from her boyfriend, there’s a need to assess the extent of the infection and provide appropriate treatment promptly. A compassionate and supportive approach is essential to help the client feel at ease and encourage open communication about her concerns and medical history, facilitating effective care delivery.

Question #2: As the LPN reinforcing the teaching about herpes spread, it’s important to provide factual information to the client. The RN may have already mentioned that herpes can be transmitted even when the partner doesn’t have visible symptoms (asymptomatic shedding). You can further explain that herpes simplex virus (HSV) can be transmitted through skin-to-skin contact, including genital-to-genital, oral-to-genital, and genital-to-oral contact, regardless of whether the infected person is experiencing a flare-up. This emphasizes the importance of consistent barrier methods, such as condoms, to reduce the risk of transmission, even when there are no visible symptoms present.

Question #3: The nurse can explain to the client that naming his sexual partners is crucial for several reasons. Firstly, it’s necessary for the treatment and prevention of further spread of syphilis. Informing sexual partners allows them to seek timely testing and treatment if needed, which is essential for their health and to prevent the infection from spreading within the community. Additionally, identifying and treating sexual partners helps interrupt the transmission cycle of the disease, contributing to public health efforts in controlling sexually transmitted infections. By emphasizing the importance of partner notification, the nurse can convey the client’s role in promoting both his own well-being and that of his sexual contacts.

Question #4: The client may question why he needs an injection of Benzathine Penicillin G instead of oral medication. In response, it’s important to explain the rationale behind the treatment choice. Benzathine Penicillin G is the preferred treatment for syphilis because it provides sustained therapeutic levels of the antibiotic in the body, ensuring effective eradication of the infection. Unlike oral antibiotics, which may require multiple doses and have lower tissue penetration, a single dose of Benzathine Penicillin G is convenient for the client and ensures compliance with the treatment regimen. Moreover, it offers the advantage of treating both early and latent syphilis effectively, reducing the risk of complications and transmission. Ensuring that the client understands the rationale for the treatment modality can promote adherence and optimize treatment outcomes.

Question #5: The data collection indicates that the client is at high risk for HIV based on several factors. Firstly, her occupation as a sex worker puts her at increased exposure to sexually transmitted infections, including HIV. Secondly, her presenting symptoms of chills, fevers, and sore throats, along with a history of these symptoms persisting for several weeks, raise concerns about possible HIV seroconversion illness. Additionally, the physician’s decision to order a rapid HIV test reflects the need to promptly assess her HIV status due to her high-risk behavior and symptoms suggestive of acute HIV infection. Collectively, these findings underscore the importance of comprehensive HIV screening and risk reduction counseling for the client.

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