A nurse in a gynecology office is caring for a client who reports vaginal itching and discharge in the last week.
The discharge is described as thick and “smelly.”. The client reports pain with urination and sexual intercourse.
The discharge became worse after their menstrual period this month.
The client has been treated for STIs in the past and is currently sexually active in a new relationship.
The provider has been notified, and a vaginal swab for culture and nucleic acid amplification testing (NAAT) has been performed.
Based on the information found in the client’s medical record, which of the following prescriptions should the nurse anticipate receiving from the provider?
Instruct the client to avoid alcohol for 72 hr after treatment.
Administer metronidazole 2 g PO x 1 dose.
Perform an oatmeal sitz bath.
Have the client douche every morning and night.
Recommend the client’s partner receive treatment.
The Correct Answer is B
Choice A rationale
Instructing the client to avoid alcohol for 72 hr after treatment is a common instruction given when a client is prescribed certain medications, such as metronidazole, due to the potential for a disulfiram-like reaction. However, this choice does not directly address the client’s symptoms of vaginal itching and discharge.
Choice B rationale
The client’s symptoms are indicative of Bacterial Vaginosis (BV), a common vaginal infection in women of reproductive age. Metronidazole is a medication commonly used to treat this infection. A single dose of 2 g orally is a typical treatment regimen.
Choice C rationale
An oatmeal sitz bath can help soothe irritated skin and reduce inflammation, but it does not treat the underlying cause of the client’s symptoms.
Choice D rationale
Douching is generally not recommended as it can disrupt the normal balance of bacteria in the vagina and can lead to further complications.
Choice E rationale
Recommending the client’s partner receive treatment is important in cases of sexually transmitted infections to prevent reinfection. However, this choice does not directly address the client’s immediate need for treatment.
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Related Questions
Correct Answer is C
Explanation
The correct answer is Choice C.
Choice A rationale: Inserting an IV catheter is important for potential fluid and medication administration, but it is not the immediate priority action.
Choice B rationale: Administering glucocorticoids is important for fetal lung maturity in case of preterm birth, but it is not the immediate priority upon admission.
Choice C rationale: Applying an external fetal monitor is the priority action. It allows for continuous monitoring of the fetal heart rate and uterine activity to assess the well-being of the fetus and detect any signs of distress.
Choice D rationale: Monitoring vaginal bleeding is important for managing placenta previa, but it is not the immediate priority. Continuous fetal monitoring takes precedence to ensure fetal safety.
Correct Answer is D
Explanation
Choice A rationale
Tubal ligation does not decrease menstrual flow. It is a surgical procedure that blocks or seals the fallopian tubes, preventing eggs from reaching the uterus for implantation.
Choice B rationale
Tubal ligation does not reduce menstrual pain. It prevents pregnancy but does not have an effect on the menstrual cycle or associated symptoms.
Choice C rationale
The timing of the procedure in relation to the menstrual cycle is not a significant factor in tubal ligation. The procedure can be performed at any time as long as pregnancy is not present.
Choice D rationale
It is crucial to emphasize that tubal ligation is considered a permanent form of birth control. While reversal procedures exist, they are not always successful and should not be relied upon. Therefore, the decision to undergo tubal ligation should be made with the understanding that it is typically irreversible.
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