2. Karen is age 40 and has been married for 22 years. Karenstarted having menstrual cycles at age 12 and had her first childat age 16. She has four children ages 16 to 24. Karen’s menstrualperiods have always been “heavy” but regular between 28 and 31 daysapart. Over the last 6 months she has been experiencing severemenstrual bleeding with progressively worsening back pain andcramping. Karen was seen by her family doctor and a CBC revealed ahemoglobin of 8.9. She was referred to an OB/GYN who afterextensive diagnostic testing and a physical examination determinedthat she should recommend a complete hysterectomy. (LearningObjectives 1, 2, 4, and 5) a. What common reproductive concern isthe probable cause of Karen’s symptoms including severemenorrhagia, progressively worsening dysmenorrhea, and anemia? b.What diagnostic tests do you think the OB/GYN ordered beforeconcluding that a complete hysterectomy was in order? c. Discussthe nursing management that Karen will need in order to assist herin understanding the physiologic and psychological conditions shewill experience after her surgical menopause.
Case Studies, Chapter 5, Sexually Transmitted Infections 1.Becky, age 17, has just been diagnosed with chlamydia. The doctorat the adolescent health clinic has asked the nurse to reinforce adiscussion on chlamydia and the prevention of other STIs withBecky. The nurse collects the proper educational materials andstarts reviewing them with Becky. Becky tells the nurse this isn’tthe first time she has had chlamydia, but she says she isn’tconcerned about the infection and knows the medication will cureit. She has had several partners in the past few months and isn’tsure who gave chlamydia to her. (Learning Objectives 2, 3, 4, and5) a. What techniques would you use to educate Becky about thedangers of chlamydia and other STIs? b. How would you discussprevention of STIs with Becky? 2. Kelly is a sexually active19-year-old college student at a local community college. She hasbeen coming to the health department for birth control since shewas 16 and is well known to the nursing staff. Kelly comes to seeyou today for a refill on her birth control pills and reportsintense vaginal itching, burning, profuse watery, foul-smellingdischarge, and burning while urinating. She has been treated forfour different STIs in the last 2 years. Kelly tells you that shehas an active sex life seeing “three to four different guys amonth.” Kelly further states, “Thank goodness I am on the pill. Icouldn’t handle a baby right now.” Kelly is seen by the physicianand it is determined that she has gonorrhea and a UTI. She is givenprescriptions for antibiotics and referred to you for clienteducation. (Learning Objectives 1, 2, 3, 4, and 5) a. Based onKelly’s history and present infection, what teaching–learning needscan you identify? b. What other gynecologic and/or reproductiveconditions is Kelly at risk for developing? c. What risk reductionstrategies would you present to Kelly? How would you approach thetopic with her?
