solved

Question
Answered step-by-step
Asked by vgil1987
Case 1 Case 2 Case 3
Chief Complaint
(CC)    “I have pain during intercourse and urination”
History of Present Illness (HPI)   A 19-year-old female reports to you that she has “sores” on and in her vagina for the last three months.
Drug Hx   She tries to practice safe sex but has a steady boyfriend and figures she doesn’t need to be so careful since she is on the birth control pill
Family Hx    
Subjective
    states “I have sores and bumps on the inner creases of my thighs and pelvic area”. “There is yellowish discharge from the sores that comes and goes”
Objective Data
 VS   temperature: 100.2°F; pulse 92; respirations 18; BP 122/78; weight 156 lbs, 25 lbs overweight; height 5′3″
 General   patient appears to have good hygiene; minimal makeup, pierced ears, no tattoos; well nourished (slightly overweight); no obvious distress noted
 HEENT   Atraumatic, normocephalic, PERRLA, EOMI, conjunctiva and sclera clear; nares patent, nasopharynx clear, good dentition. Piercing in her right nostril and lower lip.
 
Lungs   within normal limits, appropriate lung sounds auscultated, clear and equal bilaterally
 
Card   S1S2 without rub or gallop
Breast  

• INSPECTION: no dimpling or abnormalities noted upon inspection
• PALPATION: Left breast no abnormalities noted. Right breast: denies tenderness, pain, no abnormalities noted.

Lymph   Inguinal Lymph nodes: tenderness bilaterally, numerous, 1 cm in size
Abd   tender during palpation; the left lower quadrant was very tender during palpation; patient denies nausea or vomiting
GU   labia major and minor: numerous ulcerations, too many to count; some ulcerations enter the vaginal introitus; no ulcerations in the vagina mucosa; cervix is clear, some greenish discharge; bimanual exam reveals tenderness in left lower quadrant; able to palpate the left ovary; unable to palpate the right ovary; no tenderness; uterus is normal in size, slight tenderness with cervical mobility
Integument    
MS   Muscles are smooth, firm, symmetrical. Full ROM. No pain or tenderness on palpation.
Neuro   No obvious deficits and CN grossly intact II-XII

 

What other subjective data would you obtain?
What other objective findings would you look for?
What diagnostic exams do you want to order?
Name 3 differential diagnoses based on this patient presenting symptoms?
Give rationales for your each differential diagnosis.
What teachings will you provide?
SCIENCE
HEALTH SCIENCE
NURSING
NUR 123

******CLICK ORDER NOW BELOW AND OUR WRITERS WILL WRITE AN ANSWER TO THIS ASSIGNMENT OR ANY OTHER ASSIGNMENT, DISCUSSION, ESSAY, HOMEWORK OR QUESTION YOU MAY HAVE. OUR PAPERS ARE PLAGIARISM FREE*******."