What Should the Nurse Do?
Sarah, a 25-year-old female, presents to the clinic reporting symptoms of lower abdominal pain, dysuria, and vaginal discharge. She discloses a recent change in sexual partners and inconsistent condom use. Sarah's medical history indicates no known allergies, but she mentions a previous diagnosis of chlamydia treated six months ago. Current vital signs reveal a slightly elevated temperature of 99.8°F. Diagnostics include positive nucleic acid amplification test for Chlamydia and N. gonorrhoeae.
1
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What specific verbal and nonverbal cues did Sarah provide during the initial assessment that indicated the possibility of a recurrent sexually transmitted infection?
2
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In addition to antibiotic therapy, what educational interventions would you recommend to Sarah regarding safe sex practices, and how would you tailor these interventions to her individual needs?
Mark, a 45-year-old male, presents to the emergency department with a chief complaint of ED. He reports recent onset of difficulty achieving and maintaining an erection, causing distress in his intimate relationship. Mark has a history of hypertension and is currently taking antihypertensive medication. Vital signs reveal blood pressure within the normal range, but Mark appears anxious and visibly uncomfortable discussing his symptoms. He mentions occasional chest discomfort during exertion but has not sought medical attention for it.
3
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Given Mark's history of hypertension and occasional chest discomfort, how would you further analyze these cardiovascular cues to understand their potential impact on his erectile function?
4
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As a nurse, what specific actions would you take to facilitate further diagnostic evaluations for Mark's potential cardiovascular risks associated with ED?
David, a 60-year-old male, presents to the urology clinic with complaints of urinary frequency, urgency, and difficulty initiating a stream. He reports occasional nocturia and a sensation of incomplete emptying of the bladder. David's medical history includes hypertension and a family history of prostate cancer. Vital signs are within normal limits, but a DRE reveals an enlarged and firm prostate. A PSA test is ordered, and the result indicates a significantly elevated PSA level.
5
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What specific cues in David's case initially prompted you to consider the possibility of a prostate disorder, and how did you differentiate these cues from common age-related urinary changes?
6
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As a nurse, what specific actions would you take to ensure David's understanding of the diagnostic procedures and support him through the potential diagnosis of a prostate disorder?
Emily, a 35-year-old female, presents to the breast health clinic with a chief complaint of a palpable lump in her left breast. She reports discovering the lump during a routine self-breast examination. Emily has no prior history of breast issues, and her family history is negative for breast cancer. On further inquiry, Emily mentions occasional breast tenderness and notes changes in the appearance of her left nipple. Her vital signs are stable, and a physical examination reveals a firm, nonmobile mass in the upper outer quadrant of the left breast, with nipple retraction.
7
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What specific cues in Emily's case initially prompted you to consider the possibility of a breast disorder, and how did you differentiate these cues from normal breast changes?
8
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Given Emily's age, medical history, and symptoms, what potential risk factors for breast disorders should be considered in the analysis of her case?