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I need some assistance with these assignment. treatment of gonorrhoea Thank you in advance for the help!
I need some assistance with these assignment. treatment of gonorrhoea Thank you in advance for the help! Once on board, the pt who was from Romania explained in good English that she has been having lower Abdo/ pelvic/ vaginal pain whilst urinating from the past week, she has also noticed that she had a creamy colored discharge Per Vaginal (PV), This has an odor to it. She also explained that she had had no Per Vaginal Bleeding (PVB), and did not believe that she was pregnant even though she did practice unprotected sex with her new boyfriend. Before this, she had had several casual sexual relationships, again those were unprotected. Her last menstrual cycle was two weeks ago and was normal. The patient has not taken any analgesia during this time. no reason was given for this. She is not registered with a G.P at present due to a recently moving into the area from another part of the UK. The pt’s breathing was calm and she did not look flushed or was she warm to touch and appeared well perfused. She has not had any episodes like this before. Her urine was in normal color, according to her and she has noticed no haematuria. The pain was described as sharp and burning when urinating. She has also mentioned that she has had a sore throat for the past three days. PC: Lower Abdo/ pelvic/ vaginal pain on urination. Vaginal discharge HPC: Lower abdominal/ vaginal pain on urination for the past week. No history of trauma. PMH: Nil. No known allergies. DHx: Nil. SHx: Lives alone in flat. Barmaid Smoker- 15 cigarettes a day. Social drinker- 10-12 unit’s a week. Romanian lived in the UK for one year, very good English. Sexual Hx: Sexually active since nineteen. Multiple sexual partners in the past few years. Safe sex was not practiced. Hx of previous partners is not known. Engage in Vaginal sex only. No use of foreign bodies (FB), in the vagina. FHx: Boyfriend. The family lives in Romania. No known gynecological problems. Respiratory system: RR 16BPM. No DIB/ SOB Complete sentences in one breathe Clear bilateral air entry in all lobes Cardio Vascular system: Radial pulse in both arms of 85 regulars. SpO2 99%. BP 110/75 sitting. Cap refill <.2 secs. Neurological system: GCS 15. FAST negative. Pupils were equal and reactive to light. Gastrointestinal system: Abdo soft. No nausea. No vomiting. No constipation. No diarrhea. No abdominal distension. No guarding. No rebound tenderness. No history of trauma. No pain on palpation. No Per Rectum Bleeding, (PRB). Normal daily bowel movements. Ptosis sign negative. Roving's sign negative. Gynecological system. Not pregnant. No PVB. No swelling to labia. No previous pregnancies. No reddening of the affected area. Last menstrual cycle normal. Cream colored discharge. Discharge has a strong odor. Vaginal pain on urination. Urological system: No dysuria. No haematuria. No polyuria. No referred pain in the back. No change in color. Other observations: Temp 37.0 Normal fluid intake. No reduction in appetite. Pain score 7/8 on urination. No odors on breath Good pallor. Tonsils not enlarged or reddening to back of the throat. No problems swallowing. Differential Diagnosis: Lower abdominal/ pelvic pain: Acute bowel obstruction. Acute mesenteric infarction. Appendicitis/ ruptured appendix. Cancer. Chlamydia. Crohn's disease. Ectopic pregnancy. Endometriosis. Gonorrhea. Muscular wall pain. Ovarian cysts. Pelvic Inflammatory Disease, (PID). Renal colic. Urinary Tract Infection, (UTI). Vaginal discharge: Allergens. Bacterial vaginosis. Cervical polyps. Chlamydia. Post conization or cauterization. Gonorrhea. Hormonal changes. Inadequate personal hygiene. Infection from FB. Trichomoniasis. Vulvovaginal candidiasis. Pain on urination: Chlamydia.
