Assessment 1: Young adult gynecology
Subjective Data is K.S., a 22-year-old Latin female who came to the clinic for her annual gynecological exam after having an abnormal pap smear October 1, 2015. The patient is a single mother of one who works as a homemaker, has a high school level of education, and lives extended family members such as cousins, aunts, and uncles. She denies a history of alcohol or drug abuse. Her current method of birth control is male condoms on occasion.
History of present illness is the following: K.S. was seen last month for positive HPV result. She admits to having multiple sex partners within the last six months, discomfort to her vaginal area, vaginal odor ,and white thick discharge for one week. She denies a history of candida, STIs, or having sexual contact with anyone who has Hepatitis B, Hepatitis C, HIV, and/or AIDS. K.S. states that she has had vaginitis in the past and has used Gynazole for treatment. Upon assessment, the APN asked K.S. if she uses any perfume infused bathing products, antibacterial soaps, and her bathing pattern. The patient admits to using Bath & Body Works bathing soaps,
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Avoid douche, bathes, antibacterial soaps, or use of OTC vaginal hygiene products to vagina area. K.S. will be given pamphlets and verbal education on the use protection during sexual intercourse while receiving free male condoms or female condoms. Additionally, the APN will educate on abstinence. The patient will be given instructions on how to call her healthcare provider if symptoms persist or worsen (Evidence-Based, 2015). She will also receive instruction on the need to follow up six-months for HPV and three to four weeks for chlamydia/STI testing (Chlamydial Infections, 2015). The APN and K.S. will need to report her results of chlamydia today to the Florida Department of Health to ensure that all other sexual partners are informed of infection to seek