Question

A 25-year-old female client presents to the clinic for evaluation of itching and discomfort in the genital area, accompanied by painful urination. The client states that the symptoms started about a week ago and have been getting progressively worse. During the interview, the client states that she had a urinary infection a few months ago. She is sexually active. Upon physical examination, the nurse notes mild reddening of the vaginal walls and a foul-smelling discharge. The nurse asks the client what form of contraception she uses. The client tells the nurse that she has been using a diaphragm for about a year, but she is not totally sure she is using it correctly. She still has difficulty inserting and removing it, and, at times, she feels it inside. The nurse practitioner (NP) she saw at the time told her she wasn’t supposed to feel it if it was positioned correctly. Along with the diaphragm, she requests her partner to use a condom as well for added protection. She has an appointment to go back to the NP for a follow-up. The client stated that she gets yearly Pap smears because her mother had cervical cancer.

Questions:

8. To complete an accurate nursing history, what additional data does the nurse need to obtain?

9. The nurse develops a teaching plan for this client. What information needs to be included?

Answer 1

8.Ask the additional questions like

A.Any history of post coital bleeding or abnormal vaginal bleeding

B.whether she uses any lubricants like petroleum jelly with the diaphragm because petroleum can weaken latex

C.History of a normal pelvic pain or back pain to rule out pelvic inflammatory disease.

D.whether she had history of pregnancy or not.

E.Allergy of sensitivity to silicon or spermicide

Teaching plan for this client:

1.she should be educated as device fitting by a trained clinician and fit should be rechecked after a women gives birth or loos or gain weight

2.Wash diaphragm with mild sopa and water after each use and allow to air dry it

3.wash the hands before insertion of diaphragm

4.Check the placement of diaphragm after insertion

5.if the diaphragm does not cover your cervix or cannot feel your cervix at all the dome is not on right place

6.Do note douche while the diaphragm is applied

7.Do not use diaphragm more than 24 hours to prevent infection