Question

Ashley White, an 18-year-old college freshman, visits the campus health clinic today for complaint of a headache that she has had for 4 days. Ashley lives in the dorm and is majoring in English. She has recently been dating a junior named Tyler who she met through her roommate. Ashley is an only child and is a little homesick. Beth Mitchell is the RN who is assisting Ashley today in the clinic. Beth is 32 years old and has been working at the campus health clinic for 3 years. During the visit, Ashley tells her that she is concerned that she might have a sexually transmitted infection (STI) because she has started being intimate with Tyler.

• How would you approach this situation?
• When you are completing your nursing assessment, what types of questions would be relevant and important to obtain for the doctor in this scenario?
• What type of model provides an approach that nurses can use to assess sexuality in patients?
• Once ordered, what labs could be obtained to determine infection?

Answer 1

ANSWER 1:

Clinicians need to continue to develop their approach and communication skills with their adolescent patients.This article will discuss communication skills needed to work with youth :

• The health care provider must deliver information in such a way as to allow the patient to participate in their own care to the limit of their capabilities developmentally, physically and emotionally, whether they have a short term, chronic or life-threatening condition
• Confidentiality is the cornerstone of any therapeutic relationship with youth. Without clarifying the limits of confidentiality you may well get incorrect or incomplete information during your history taking.
• spending time with the adolescent and his/her parent speeds up information gathering in a busy office or clinic;
• This approach starts with nonthreatening, open-ended, nonjudgmental questions and progresses to more sensitive areas such as sexuality,

ANSWER 2 :

QUESTIONS THAT WOULD BE RELEVANT TO ASK:

• Do you have any concerns about your physical/sexual development?

• Are you dating? How long have you been together?

• Have you ever had sex? Are you sexually active now? How often do you have sex?

• What was your age when you first had sex?

• Have you used protection for sexually transmitted diseases or birth control?

• Have you ever been pregnant?

• Have you ever been forced to have sex?

ANSWER 3 :

The model used to assess the sexuality in patient is:

PLISSIT and SEXOLOGICAL APPROACH.

• Permission
• limited information
• specific suggestion
• intensive therapy

a sexological approach to education, the model defines 10 key components posited to be essential aspects of healthy human sexuality:

• talking about sex,
• culture and sexual identity,
• sexual anatomy and functioning,
• sexual health care and safer sex,
• challenges to sexual health,
• body image,
• masturbation and fantasy
• , positive sexuality, intimacy and relationships, and spirituality.

ANSWER 4 :

LAB TEST NEEDED TO DETECT INFECTION:

• Blood tests. Blood tests can confirm the diagnosis of HIV or later stages of syphilis.
• Urine samples. Some STIs can be confirmed with a urine sample.
• Fluid samples. If you have open genital sores, your doctor may test fluid and samples from the sores to diagnose the type of infection.
• The one STI screening test suggested for everyone ages 13 to 64 is a blood or saliva test for human immunodeficiency virus (HIV), the virus that causes AIDS.
• . Experts recommend that all sexually active women under age 25 be tested for chlamydia infection. The chlamydia test uses a sample of urine or vaginal fluid you can collect yourself.