N.L., a 17-year-old student, has come to your clinic seeking treatment. N.L. is reporting pain and burning on urination, as well as pain during intercourse. She states that she is infrequently sexually active with her 17-year-old boyfriend and is also seeking a form of birth control. She has not used any form of birth control in the past and neither has her boyfriend. She also reports having a yellowish vaginal discharge and has been wearing a panty liner to deal with this. Upon examination, N.L. says she has some abdominal tenderness but denies that she has had any tenderness before this time. N.L. is screened for chlamydia and gonorrhea. She denies having had sex with any other partners but does admit that she and her boyfriend had a fight and broke up temporarily about a month ago. They got back together about a week later. She does not know if he had any other sexual contacts during their period of separation. N.L. is concerned that she has contracted an STI and states, “I’ll die of embarrassment!”
The following questions will guide your development of a nursing care plan for this case study.
1. What other information should be elicited from N.L.?
2. What other STIs will N.L. most likely be tested for in addition to chlamydia and gonorrhea?
3. Write three nursing diagnoses and goals for N.L.
4. List the medications that N.L. will be most likely to receive to treat a chlamydial infection.
5. List some complications that N.L. may experience if she does not receive treatment for an active chlamydial or gonorrheal infection.
6. What information will you include when you counsel N.L. regarding sexual activity and forms of birth control? (See Chapter 61, Infertility and Contraceptive Methods for additional information.)