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Case study

 

You are a provider working at an outpatient health department and Sean Brown a 17-year-old Hispanic male was referred to your office from a needle exchange program with a report of a presumptive positive from a site that uses the “Rapid-Rapid HIV testing” algorithm. His mother, who knew he had a history of unprotected sex, escorted him to the HIV testing site because he had a rash on his body. He had received an HIV test a month previously at an agency in another state, but had not returned for results because they moved. He also reported that he had a scant penile discharge two weeks ago, but that had resolved, however he still complained of some meatal irritation and itching. He smokes about 7 cigarettes a day and denies illicit drug use. He states he dropped out of school at the age of 16. When his mother steps out of the room, he does admit to being sexually active at 15 years of age and feels that he may have had between 40 to 50 partners, males and females. He currently has a boyfriend for 2 months but continues to have sexual encounters with other partners.

 

Given this patient’s social and sexual history, what would be the focus of your physical exam?
What kind of findings might you find on examination?
Keeping in mind that this patient was just diagnosed as presumptive HIV positive at a counseling and testing site, which laboratory tests would you request?
Per your previous Shadow Health concept labs, what types of communication would you use in the education and counseling that you would provide this patient?

pls  add references

 

course book

ickley, L. S. (2021). Bates’ pocket guide to physical examination and history taking. Wolters  Kluwer.

SCIENCE
HEALTH SCIENCE
NURSING
NUR 706

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