Sexually active 17-year-old

J.S.  is a sexually active 17-year-old that lives with her parents and two younger sisters. She does not confide in her parents or sisters about many aspects of her life, especially her sexual activity. J.S. would rather discusses her sexual activity with her friends from school, who also are sexually active. The school nurse recently visited J.S’s health class to discuss the topic of sexually transmitted infections (STIs), which has caused J.S. to think a lot about her situation since the class discussion. She has an appointment tomorrow for an annual gynecologic examination.
Case Study
Once J.S. gets into the exam room, she tells the nurse during her history intake that she is sexually active and comments that her boyfriend has been experiencing a “discharge from his penis” and is concerned that “I may have some disease.” She denies any vaginal discharge, odor, itching, or painful intercourse. Upon examination, a vaginal discharge is noted, and the provider obtains specimens for C. trachomatis, Gonorrhea, Candida, and Bacterial Vaginosis diagnostic testing.
Questions:

-What other objective physical assessment data would the provider want to obtain during the examination?
-What should the provider’s priorities of care for J.S. be during this visit?
-For EACH of the following, 1) C. trachomatis, 2) Gonorrhea, and 3) Bacterial Vaginosis, 4) Candida what diagnostic test would need to be obtained to make a diagnosis?
-For EACH of the following, 1) C. trachomatis, 2) Gonorrhea, 3) Candida, and 4) Bacterial Vaginosis, if any of the diagnostic tests are positive what does this finding indicate and what plan of care/pharmacologic agents would J. S. need for EACH diagnosis?
-If J. S. has a positive gonorrhea or chlamydia culture what are the common complications associated with these conditions if it is not effectively treated? Discuss potential short term and long-term risks.
-Discuss J.S.’s priority teaching needs for STI, contraception, and medication regimens given to treat each of the following, 1) C. trachomatis, 2) Gonorrhea, 3) Candida, and 4) Bacterial Vaginosis.

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