Assessing Client Sexual Health History Discussion Paper
Question
The public health nurse is assessing a 35-year-old male client at a sexual health clinic. He arrives to the clinic alone with complaints of night sweats, headache, muscle ache, sore throat, and chills.
Which of the findings below that place the client at high risk for contracting a sexually transmitted infection.
Sexual Health History:
Client says he slept with multiple partners of both sexes in the last 5 months; unprotected sex “most of the time.” He says that he never had oral sex, only vaginal or rectal intercourse. He has a history of chlamydia and was treated appropriately. The only reason he came today is because he got a call from public health last week stating that he was exposed to a HIV+ client who remained anonymous. Vital signs: P 88, RR 18, BP 128/77, T 38.7 C (101.7 F), pulse oximetry reading 99% on room air. Assessing Client Sexual Health History Discussion Paper
Expert Answer
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Step 1/12
Review chief complaints and health history to identify potential STI risk factors
Explanation:
The public health nurse should review the client’s chief complaints and health history to identify any potential risk factors for sexually transmitted infections (STIs). The client’s complaints of night sweats, headache, muscle ache, sore throat, and chills can be associated with STIs, including HIV. The nurse should also pay attention to the client’s sexual health history, which includes multiple partners, unprotected sex, and a history of chlamydia.
Step 2/12
Assess for additional symptoms and risk of other infections
Explanation:
The nurse should perform a comprehensive assessment of the client’s symptoms, including asking about any additional symptoms that may be associated with STIs. The nurse should also assess the client’s risk for other infections, such as pneumonia or influenza, which can present with similar symptoms.
Step 3/12
Assess vital signs to identify signs of infection or STIs
Explanation:
The nurse should assess the client’s vital signs, including heart rate, respiratory rate, blood pressure, and temperature. Elevated temperature and heart rate may indicate an infection, while elevated blood pressure can be associated with some STIs, such as syphilis.
Step 4/12
Assess oxygen saturation for respiratory or cardiovascular problems
Explanation:
The nurse should assess the client’s oxygen saturation using pulse oximetry. Low oxygen saturation can indicate respiratory or cardiovascular problems, which can be associated with some STIs.
Step 5/12
Review previous STI history to identify patterns of risky behavior
Explanation:
The nurse should review the client’s previous STI history to identify any patterns of risky behavior or recurrent infections. This can help the nurse determine appropriate testing and treatment options.
Step 6/12
Assess potential exposure to STIs and HIV
Explanation:
The nurse should ask the client about potential exposure to STIs, including any recent sexual partners who may be infected. The client’s exposure to an anonymous HIV-positive partner is a significant risk factor for HIV infection.
Step 7/12
Determine appropriate testing for STIs based on client’s history and symptoms
Explanation:
Based on the client’s sexual health history, symptoms, and potential exposure to STIs, the nurse should determine appropriate testing for STIs. This may include testing for HIV, chlamydia, gonorrhea, syphilis, and other infections. Assessing Client Sexual Health History Discussion Paper
Step 8/12
Provide education on safe sex practices and regular STI testing
Explanation:
The nurse should provide the client with education on safe sex practices, including the use of condoms to prevent STIs. The nurse should also educate the client on the importance of regular STI testing and treatment.
Step 9/12
Develop a treatment plan based on diagnosis and test results
Explanation:
Based on the client’s test results and diagnosis, the nurse should develop a treatment plan that addresses the client’s specific needs. This may include medication, referrals for further testing or treatment, and follow-up appointments.
Step 10/12
Provide emotional support and resources for additional support
Explanation:
The nurse should provide emotional support to the client, who may be experiencing anxiety or distress related to their potential STI diagnosis. The nurse should also provide resources for additional support, such as counseling or support groups.
Step 11/12
Schedule follow-up appointments for continued monitoring and care
Explanation:
The nurse should schedule a follow-up appointment with the client to monitor their progress and ensure that they are receiving appropriate care. The nurse should also encourage the client to return for regular STI testing and treatment.
Step 12/12
Document all assessments, interventions, and education in medical record for continuity of care.
Explanation:
The nurse should document all assessments, interventions, and education provided to the client in their medical record. Accurate documentation is important for continuity of care and communication between healthcare providers.
Final answer
Based on the client’s sexual health history, symptoms, and potential exposure to STIs, the public health nurse should assess for additional symptoms, assess vital signs and oxygen saturation, review the client’s previous STI history, assess for potential exposure to STIs, determine appropriate testing, provide education on safe sex practices, develop a treatment plan, provide emotional support and resources, schedule a follow-up appointment, and document all assessments, interventions, and education provided in the client’s medical record. The client’s history of multiple partners, unprotected sex, and exposure to an anonymous HIV-positive partner place him at high risk for contracting STIs, including HIV. Assessing Client Sexual Health History Discussion Paper