Genitourinary case study

Case Study.
Patient Setting:
A 28 year old female presents to the clinic with 2 days history of frequency, burning and pain upon urination, increased lower abdominal pain and vaginal discharge over the past week.

complains of urinary symptoms similar to those of previous urinary tract infection(UTIs) which started approximately 2 days ago; also experiencing severe lower abdominal pain and noted brown fouls smelling discharge after having unprotected intercourse with her formal boyfriend.

Reccurent UTIs(3 this year);gonorrhea X2, chlamydia X 1; gravida IV para III

Past surgical History
Tubal Ligation 2 years ago

Family/social history
Family: Single; history of multiple male sexual partners; currently lives with new boyfriend and 3 children.
Social: Denies smoking, alcohol and drug use.

Medication history
Trimethoprim (TOM)/ Sulfamethoxazole (SMX) rash

Last pap 6 months ago. Denies breast discharge. Positive for urine lookin dark.

Physical Exam
BP 100/80, HR 80, RR 16, T 99.7, wt 120lb, Ht 5’0″

Gen: female in moderate distress.
Cardio: Regular rate and rhythm normal S1 and S2.
Chest: WNL
Abd: Soft, tender, increase suprapubic tenderness.
GU: Cervical motion tenderness, adnexal tenderness, foul smelling vaginal drainage.
Rectal: WNL.
Neuro: WNL

Laboratory and diagnostic testing
Lkc differential: Neutrophils 68%, Bands 7%, lymphs 13%, monos 8%, EOS 2%.,
UA: Starw colored. sp gr , ph 8.0, protein neg, ketones neg, bacteria-many, Lkcs 15, RBC 0-1
urine gram stain- Gram negative rods
Vaginal discharge culture: Gram negative diplococci, Neisseria gonorrhoeae, sensitivities pending. Positive monoclonal AB for Chlamydia, KOH preparation, wet preparation and VDRL negative.

Assignment 2 Grading Criteria

The submission included a general introduction to the priority diagnosis.

Subjective Data

The submission included the patient’s interpretation of current medical problem. It included chief complaint, history of present illness, current medications and reason prescribed, past medical history, family history, and review of systems.

Objective Data

The submission included the measurements and observations obtained by the nurse practitioner. It included head to toe physical examination as well as laboratory and diagnostic testing results.


The submission included at least three priority diagnoses. Each diagnosis was supported by documentation in subjective and objective notes and free of essential omissions. All diagnoses were documented using acceptable terminologies and current ICD-10 codes.

Plan of Care

Plan included diagnostic and therapeutic (pharmacologic and non-pharmacologic) management as well as education and counseling provided. The plan was supported by evidence/guidelines, and the follow-up plans were noted.

Evaluation of Priority Diagnosis

The plan chose the priority diagnosis for the patient and differentiated the disorder from normal development. Discussed the physical and psychological demands the disorder places on the patient and family and key concepts to discuss with them. Identified key interdisciplinary team personnel needed and how this team will provide care to achieve optimal disorder management and outcomes.

Facilitators and Barriers

The submission interpreted facilitators and barriers to optimal disorder management and outcomes and strategies to overcome the identified barriers.


The submission included what should be taken away from this assignment.

The submission was free of grammatical, spelling, or punctuation errors. Citations and references were written in correct APA Style.
Utilized proper format with coversheet, header.


Topic: Critical Ethical Issues In Health Care

Order Description

Type: Individual Project
Unit: Critical Ethical Issues in Health Care
Deliverable Length: 3–4 pages with references

Assignment Objectives:

Explain the theoretical basis of ethical behavior and explain the basic elements of normative ethical theory to justify behaviors or situations confronting leaders and managers in decision-making processes.

An Appalachian patient in your health care facility wishes to stop treatment for his stage 4 bone cancer. His family is adamant that he continue the treatments. There have been multiple incidents where the family have verbally abused the nursing staff for consenting to the patient’s wishes. You decide to convene the ethics committee. Discuss this in a paper of 3–4 pages, including the following:

•Using the ethical decision-making frameworks of your choice, how will you lead this committee?
•Who would you include in the committee?

Review the following resources for more information: Attached


American College of Healthcare Executives. (2017). About ACHE: Ethics toolkit. Retrieved from

Bonde, S., & Firenze. P. (2013, May). A framework for making ethical decisions. Retrieved from

Santa Clara University. (2015, August 1). A framework for ethical decision making. Retrieved from