Prescribing Cases Module Six Case One Complaint: A 19-year-o

Prescribing Cases Module Six Case One Complaint: A 19-year-old… Prescribing Cases Module SixCase OneComplaint:A 19-year-old woman comes in for her annual women’s health examination and oral contraception refill. She has no physical complaints. She admits to being sexually active with her male partner of 1 month.History:The patient has been sexually active since the age of 14. At age 15, she contracted chlamydia and received treatment. She did not return for follow-up after her antibiotic treatment. Her preferred method of contraception is combined oral contraceptives. She does not like to use condoms, because they ruin sexual spontaneity. She is allergic to doxycycline. Currently, she does not have medical insurance.Physical Exam:Vital Signs: T 98.6°F, HR 80, BP 100/60 mm Hg, weight 100 pounds, and height 5’2″.Physical examination reveals external genitalia are without lesions, erythema, visible discharge, or the presence of nits or lice. Cervical speculum examination reveals a vaginal vault that is pink with rugae and clear discharge. Cervix is anterior, midline, and pink, without lesions or visible discharge. Swab of the endocervix is sent for gonorrhea and chlamydia screening.Laboratory Results:Laboratory results are positive for chlamydia, but negative for gonorrhea. Urine pregnancy test is negative.1. What is the pharmacologic management plan for a patient with chlamydia?2. What education does the patient need about this treatment?3. What is your plan for follow-up for this treatment?Case TwoComplaint: “I twisted my right ankle, and it hurts when I walk.”History:Tom, a 26-year-old runner, came in to the office today complaining of constant pain in the right ankle. While running his usual route, he accidentally stepped on a branch lying in his path, twisting his ankle inward. He denies hearing a “pop.” He was able to walk, or limp, the remaining quarter mile back to his home, where he immediately elevated and iced the ankle for 30 minutes. He took two acetaminophen 325 mg, showered and dressed for work, and drove to his place of employment. He continued to experience significant pain in the ankle, which is worse when walking. His foot became swollen. Since his job in a sporting goods store requires that he be on his feet most of the day, he was unable to continue his normal workday, and made a same-day appointment to be seen. He has no chronicdiseases, takes no medication. He sprained the ankle last year but was able to manage that injury at home with acetaminophen.Assessment:A 26-year-old, otherwise healthy male presents limping into the examination room, holding his right shoe in his hand. He grimaces with partial weight-bearing of the affected foot. He has local ecchymosis and 1+ edema over the anterolateral ligaments of the right ankle. Capillary refill, pulses, and sensation of the foot and toes are intact. There is no lateral or anterior instability of the joint or tendons. X-rays of the ankle and foot are negative for fracture or dislocation. He has a grade I lateral ankle sprain.1. What medication would be appropriate to prescribed for this pain?2. What education is required for the medication you chose? Health Science Science Nursing NURS 730

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