· You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts.
· All replies must be constructive and use literature where possible.
RESPONSE 1 – Case study 2
Case 2
Toxic shock syndrome is characterized by a fever, low blood pressure, a body rash, and organ damage. TSS caused by S. aureus is generally secondary to localized infection and TSS caused by S. pyogenes is the consequences of an invasive infection. Staphylococcal TSS is further subdivided into menstrual and non-menstrual illness. S. aureus is a common bacterium that is responsible for several diseases and conditions including skin boils, acne and some severe forms of food poisoning. Other symptoms of TSS include myalgias, headache, pharyngitis which may progress to organ dysfunction (Schuiling & Likis, 2022). Early signs include generalized erythematous and macular rash, pitting edema, etc. Acute phases include desquamation of the fingers, palms, toes, and soles. Alterations to the mucous membrane of the mouth such as strawberry tongue. The Pelvic exam may reveal hyperemic vaginal mucosa and vulvar and vaginal tenderness (Schuiling & Likis, 2022). Differential diagnosis based on the disease presentation for O.R can include J02.9 Acute pharyngitis, unspecified due to the presentation of TSS leading to possible organ dysfunction; R65.21 Severe sepsis with septic shock due to the manifestation of fever, low blood pressure, and organ dysfunction; B09 unspecified viral infection characterized by skin and mucous membrane lesions due to the early signs of generalized erythematous and macular rash, pitting edema, desquamation of fingers, palms, toes, and soles.
Patient education can include educating women on the signs and symptoms of TSS and steps on preventing the occurrence by frequently changing tampons, alternating pad with tampons, avoiding overnight tampon use, and removing barrier contraception within 24 hours, also educating women who’s had TSS to not use barrier contraceptives methods, tampons, or menstrual cups (Schuiling & Likis, 2022). Pharmacologic management can include antibiotics such as PCN for 14 days, also vasopressin for patients who are in shock and not improving on fluids alone. Also, IV immunoglobulin to neutralize toxin activity. Non pharmacologic can include hand washing, alternating pads with tampons, and not using tampons overnight (Schuiling & Likis, 2022).
Health assessment involves more than just the physical aspects, it also includes the mental aspects as well. Assessing someone’s overall mental well-being will help in relieving mental pressures as well as physical pressures because someone who is mentally exhausted will show signs of physical exhaustion too. So by asking those important questions regarding mental health such as how’s your sleeping pattern or stress level will help the clinician learn about their mental status and present mental health. Personality and behavioral changes along with understanding the underlying causes for the changes are important in health assessments (Rhoads & Peterson, 2021).
Different family development involves stages such as going from being single to dating and getting married, and also learning to coexist with each other. Next is the talk about starting a family and preparing the home for children. Now growing a home and incorporating rules in teaching the children right from wrong and putting them through school. Now when the children leave home and start their lives the parents are left to grow and once again learn with one another, and plan for their retirement and future goals. Family function in health care I believe involves teaching the children through the adult about the positive side of healthcare and the importance of doctor visits, and improving your health.
RESPONSE 2 – Case study 3
Sexually Transmitted Infections
Gonorrhea
Infections spread through sexual contact are called sexually transmitted infections (STIs) or sexually transmitted diseases (STDs). Chlamydia, Gonorrhea, Syphilis, Herpes, and Human Papillomavirus (HPV) are examples of these conditions. Gonorrhea is an infection caused by Neisseria gonorrhea, an aerobic gram-negative diplococcus. Gonorrhea is primarily transmitted via genital contact, although transmission from the mouth and anus is also possible. Clinical symptoms typically don't show up for 2 to 10 days following infection exposure. The condition's pathophysiology includes infection of the mucous membranes of the reproductive tract. Gonorrhea induces localized infection at the anatomic site of inoculation, typically urethra, cervix, pharynx, or anus in adults, but dissemination can occur. Feminine infertility and ectopic pregnancies have been linked to pelvic inflammatory disease (PID) caused by the condition. Female patients with gonococcal urogenital infections who have symptoms may complain of vaginal discharge, dysuria, or pelvic pain (Springer & Salen, 2022). Gonorrhea infection in the rectum can progress to show symptoms such rectal pain, bleeding, discharge, and proctitis if left untreated. Rarely, Gonorrhea can cause vasculitis, tenosynovitis, arthritis, and fever/septicemia as systemic manifestations.
The treatment comprises of a dual therapy that includes doxycycline 100 mg twice daily for seven days along with a single 1 gm intramuscular dose of ceftriaxone (Dlugasch, L., & Story, 2021). After starting antibiotic therapy, patients should wait at least a week before engaging in any sexual activity. Patients with Gonorrhea infection are more likely to acquire other STIs, such as HIV; therefore, it is important to provide counseling on the use of condoms and other safe sex practices. They should be encouraged to get tested and treated if they have symptoms or have had sexual contact with someone who has the infection. All patients should be encouraged to practice safe sex, maintain fastidious hygiene, insist that partners seek treatment, and keep follow-up appointments with healthcare providers.
Chlamydia
Chlamydia is a sexually transmitted disease caused by Chlamydia trachomatis, an intracellular parasitic bacterium. The cervix, urethra, and rectum are the reproductive mucosal surfaces that are susceptible to infection by C. trachomatis. The bacteria can also infect the eyes, throat, and the lungs. Feminine infertility and ectopic pregnancies are linked to pelvic inflammatory disease (PID), which occurs when this condition affects the reproductive site of the woman. The clinical symptoms of Chlamydia infection include mucopurulent endocervical discharge, cervical friability, intermenstrual or postcoital bleeding, dysuria, dyspareunia, rectal pain, and abdominal pain (Mohseni et al., 2021). The treatment of choice for chlamydia is a single dose of Azithromycin 1-gram oral tablet, or Doxycycline 100 mg oral tablets twice a day for seven days (Dlugasch, L., & Story, 2021). Treatment is required for the patient's sex partner. After a single dosage of treatment or until the entire seven-day course has been finished, patients should refrain from sexual activity for seven days. To prevent reinfection, abstinence should be maintained until the patient's sex partner has received treatment. Patients should be educated on the importance of following up in three months for testing, as reinfection is very common. Patients should be educated on safe sex, including using condoms during sexual intercourse.
Syphilis
Syphilis is a condition caused by Treponema pallidum, a spiral-shaped spirochete bacterium that lives in warm environments. The bacteria enter the bloodstream to infect various organs, including the brain, heart, and bones. Syphilis is spread through skin or mucous membrane contact with infected chancres. Lesions infected with Syphilis allow an easy opportunity to acquire other STIs. Syphilis has different stages with its own clinical manifestations. The first or primary stages clinical manifestations of Syphilis include a painless sore (called a chancre) at the site of infection, while the secondary stage of Syphilis causes a rash, fever, and swollen lymph nodes. Tertiary stage of Syphilis can cause serious problems such as cardiovascular disease, neurosyphilis disease and blindness (Tudor et al., 2022).
The treatment of choice for Syphilis involves the use Benzathine Penicillin 2.4-million-unit intramuscular single dose. Patients must undergo post-treatment clinical evaluations at 6, 12, and 24-months following treatment. It is vital that patients understand the importance of maintaining a follow up appointment for re-evaluation of Syphilis. If left untreated, the organism has significant morbidity and mortality. Syphilis can be reduced by educating patients about safe sex behaviors, such as using condoms. Additionally, they should be encouraged to have regular screenings for STIs if they are going to continue being sexually active.
Herpes Simplex
Genital herpes is a sexually transmitted disease responsible for causing herpes simplex virus (HSV) 1 and 2. Oral herpes is more commonly associated with HSV-1, a linear dsDNA virus that is a member of the Alphaherpesviridae subfamily (Saleh et al., 2022). The disease is transmitted via patient’s saliva, for example, shared drinkware or cosmetics, or mouth to mouth contact. Genital herpes is more commonly associated with HSV-2 and is mainly transmitted through sexual intercourse. Physical contact with an infected person, even just kissing or having sex, is enough to spread the virus. This virus infects people when it enters their bodies through cuts or scratches. Once the virus enters the body, it goes to the sensory nerve ganglia, where it lies dormant until a suitable stimulus awakens it. When the virus is reactivated, it spreads back to the original infection site. It is important to note that HSV-1 infection does not usually cause symptoms in women. When symptoms do occur, there is a wide range of clinical presentations including oral herpes, HSV folliculitis, herpes gladiatorum, herpetic whitlow, ocular HSV infection, herpes encephalitis, Kaposi varicelliform eruption, and severe or chronic HSV-1 infection (Saleh et al., 2022). HSV-2 manifests itself clinically may present as a primary infection with painful genital ulcers, sores, crusts, tender lymphadenopathy, and dysuria. The affected area may also feel itchy, burning, or tingly. The traditional signs include skin and mucous membrane lesions that are macular or papular and advance to vesicles and pustules, which can last up to three weeks.
The treatment of choice for HSV include acyclovir, valacyclovir, or famciclovir. Usually, Valacyclovir is prescribed 1,000 mg oral tablets once a day for seven days, and for episodic treatment, Valacyclovir 500 mg oral tablets once a day, prophylactically are prescribed (Dlugasch, L., & Story, 2021). During the HSV-1 infection, the patient should be educated on washing hands and avoiding close contact with others. Patients with HSV-1 should be educated on how to avoid inflicting the disease on others through practices like using condoms and other barrier methods during sexual activity and limiting close physical contact with people who are experiencing active outbreaks. Patients should also be educated on Abstain from sexual activity during periods of known active viral shedding.
Human Papillomavirus (HPV)
Human Papillomavirus (HPV) is considered the most common STI. Although sexual contact is the primary transmission mode, the virus can also be spread through direct skin contact. Once the virus enters the body, it multiplies abnormally in the skin and mucous membrane cells. In most cases, HPV-related warts manifest as tender, small bumps on the skin or mucous membranes. Clinical manifestations of HPV are bleeding/spotting outside of menses, pelvic or genital pain, pain/bleeding during intercourse, and/or palpable lesions felt on the cervix (Luria & Cardozo-Favarato, 2022). In its early stages, HPV-caused cervical cancer may not show any symptoms; however, abnormal vaginal bleeding, pelvic pain, and weight loss can all occur later.
Treatment options and follow-up care for cervical cancer caused by human papillomavirus form part of patient education. There are many different treatment options for cutaneous warts, including surgery, cryotherapy, irritating or immunomodulating drugs, and laser excision. If the patient is immunocompetent, anogenital and oropharyngeal warts can be treated similarly to cutaneous warts. Further surgery, chemotherapy, and/or radiation may be necessary if the patient develops a malignancy such as squamous cell carcinoma or endocervical adenocarcinoma. Since HPV is sexually transmitted, educating patients about safe sex, condom use, and avoiding many sex partners is one of the greatest approaches to reduce the morbidity of this virus. To check for cervical dysplasia and the presence of HPV, these women should be urged to have a Pap smear. More significantly, patients should be informed that they should refrain from sexual activity while they receive treatment for or until the lesions have disappeared if they have genital warts.
Our best line of defense against sexually transmitted illnesses is antibiotics. For the treatment of a STI, there is no effective alternative or non-pharmacological therapy. The best supplementary STI treatments, or those that work in addition to regular medical care, focus on patient education and prevention. Among the strategies include monogamy, condom use, refraining from dangerous sexual behavior, and taking medications as prescribed. Some believe that the use of carotenes, zinc, and vitamins A and C can that boost immunity and act as a preventative measure.
An effective health assessment incorporates not only physiological parameters; please suggest other parameters that should be considered and included on health assessments to reach maximal health potential on individuals.
In addition to a patient's physiological measurements, it is important to evaluate their economic, social, and educational factors that could affect their health. The risk of the illness is increased by social factors like smoking, having several sexual partners, engaging in unprotected intercourse, having sex with other women, and having multiple partners. The likelihood of the disorder also rises with poorer socioeconomic level. Low levels of education may have an impact on income, and when combined with a lack of disease awareness, they raise the possibility of making unwise health decision.
Name the different family developmental stages and give examples of each one.
Families progress through stages in a particular way over time after each member successfully completes the chores associated with that stage. When a person enters adulthood without parental financial, emotional, or social support, they have reached the first stage of independence. The second step is coupling or marriage, in which two individuals who are in love join together through matrimony or other forms of commitment and create their own family structure. The third stage of parenting is when a couple decides it's time to have children and start a family of their own. Stage four is known as launching adult children, that is when children eventually leave the home,.
Describe family structure and function and the relationship with health care.
Family functioning is one of the key ideas studied in current health literature with regard to the role of family in sickness and how illness effects the family system. A healthy family structure is supportive, resilient, and able to adapt to changes and stressors. A healthy family functions with clear roles and responsibilities, open communication, and a positive and nurturing environment. A healthy family also has access to healthcare resources and can advocate for their needs. Throughout the medical process, family members can frequently offer valuable advice and support. Their interest in the well-being of a loved one can significantly contribute to the promotion of health and the avoidance of illness
