Trichomonas Vaginalis Infection in Reproductive-Aged Women Essay

Week 10 Lab Assignment – Assessing the Genitalia and Rectum

In the subjective portion, using the LOCATES pneumonic, the additional information that should be included in the documentation include any associated symptoms such as lower back pain or flank pain, any abnormal vaginal discharge or bleeding, changes in urine color, or the presence of pus or blood in urine, and any discomfort or pain during sexual intercourse (dyspareunia). The patient’s history of being sexually active should be explored further to include the number of sexual partners that the patient and her partner have, if any, their use or lack thereof of condoms to protect against sexually transmitted diseases, and her last menstrual period and use of menstrual products more so tampons that are associated with increased frequency of urinary tract infections caused by bacteria, notably Escherichia coli (Lawati et al., 2024). The dysuria should also be further characterized to differentiate it from the burning sensation associated with Trichomonas vaginalis, which could be confused with dysuria (Pinto et al., 2023). The patient’s daily fluid and nutritional intake should also be documented to assess for other causes of dysuria and increased urine frequency, such as kidney stones leading to recurrent urinary tract infections (Lawati et al., 2024). Trichomonas Vaginalis Infection in Reproductive-Aged Women Essay Finally, the dysuria’s severity and the timing of the symptoms should be documented to help develop plausible differential diagnoses and patient treatment plans. Also, the kind of treatments, if any, that she received for the past year for her symptoms should be evaluated and documented, including the number of episodes that she has had for her symptoms.

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In the objective portion, the patient’s comprehensive abdominal examination should be included in the documentation because of the history of flank pains to assess her kidneys. The palpation for the kidneys should be done, and her back should be percussed at the costo-vertebral angle for tenderness that could indicate the presence of pyelonephritis of kidney disease (Lawati et al., 2024). Also, the suprapubic area should be assessed for masses or enlarged bladder that could indicate acute urine retention. Trichomonas Vaginalis Infection in Reproductive-Aged Women Essay The assessment is supported by subjective and objective information such as increased urinary frequency, dysuria, flank pain, and suprapubic tenderness, which support the diagnosis of urinary tract infection (Lawati et al., 2024). Also, the history of being sexually active with a new partner warrants the assessment for any sexually transmitted infection (STI) (Lawati et al., 2024). The diagnostics indicated in the episodic SOAP note are appropriate in leading to a definitive diagnosis and ruling out sexually transmitted infection. However, collecting urine for microscopic, culture, and sensitivity testing would help better identify the causative microorganism causing the urinary tract infection and the antibiotic regimens that the bacteria best responds to. Trichomonas Vaginalis Infection in Reproductive-Aged Women Essay

The three possible conditions that should be considered in this care include urinary tract infection, sexually transmitted infection, Trichomonas vaginalis, and Chlamydia or gonococcus cervicitis (Pinto et al., 2023). Chlamydia trachomatis is the most common cause of bacterial sexually transmitted infections and, hence, one of the leading differential diagnoses for this patient (Li et al., 2023). Further, the increased frequency and dysuria would be common among women with Trichomonas vaginalis which is common among women who are 30 years old and is more common among women who smoke cigarettes and have concurrent bacterial vaginosis (Pinto et al., 2023). Therefore, I would accept the list of differential diagnoses listed in the episodic SOAP note since they are supported by evidence from the subjective and objective portions of the SOAP note. Also, the assessment findings are salient and evidence-based, with a considerate list of diagnostics that will help narrow the differential diagnosis list to find a definitive diagnosis for the patient. Trichomonas Vaginalis Infection in Reproductive-Aged Women Essay

References

Lawati, A. H., Blair, M. B., & Larnard, J. (2024). Urinary tract infections: Core curriculum 2024. American Journal of Kidney Diseases, 83(1), 90–100. https://doi.org/10.1053/j.ajkd.2023.08.009

Li, T., Liu, Z., Zhang, D., Liao, Q., Fan, S., Hao, M., Hong, Y., Huang, X., Wang, H., Xiong, Z., Xu, H., Xue, F., Xue, M., Yang, X., & Zhang, J. (2023). Prevalence of and risk factors for Chlamydia in female outpatients with genital tract infections: a nationwide multi-center, cross-sectional study in China. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1182108

Pinto, G. V., Bolpet, N. A., Martin, L. F., Moco, P. N., Ramos, A. R. B., Silva, C. M., Duarte, C. RT. M., Tristao, R. A., Silva, G. M., & Marconi, C. (2023). Factors associated with Trichomonas vaginalis infection in reproductive-aged women attending cervical screening in southeast of Brazil. The Brazilian Journal of Infectious Diseases, 27(4), 102794. Trichomonas Vaginalis Infection in Reproductive-Aged Women Essay

Using evidence-based resources from your search, answer the following questions and support your answers using current evidence from the literature.
• Analyze the subjective portion of the note. List additional information that should be included in the documentation.
• Analyze the objective portion of the note. List additional information that should be included in the documentation. Trichomonas Vaginalis Infection in Reproductive-Aged Women Essay
• Is the assessment supported by the subjective and objective information? Why or why not?
• Would diagnostics be appropriate for this case, and how would the results be used to make a diagnosis?
• Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature. Trichomonas Vaginalis Infection in Reproductive-Aged Women Essay