Pelvic inflammatory disease (PID) is a disorder that affects the reproductive tract which is characterized by a polymicrobial infection and primarily affects sexually active young women (Gradison, 2012). Diagnosis of the diseases is achieved through clinical evaluation though physicians are expected to treat it based on clinical judgement since further delays in treatment may worsen the symptoms. In the healthcare setting, nurses continually face the challenge of making care decisions presented upon them. The paper discusses the care of a 16-year-old Kayla who is experiencing the symptoms of PID.
Physical Examination
From the assessment of the patient, Kayla is experiencing signs that include lower abdominal pain, abnormal vaginal discharge, nausea and vomiting, lower back pain, and pelvic pain. From the conversation of the doctor and the nurse, they applied non-analytical decisions-making approach by relying on past experiences to make judgement. After the assessment, Dr. Robert advised the nurse to place Kayla on IV and assured the patient that more medicine will be availed to ease the pain.
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Clinical Management
Upon Kayla's assessment, she was put under clinical management to treat the infection, alleviating the symptoms, preventing further complications, and preventing the spread of the infection. The observation that informed these decisions was to cater for surgical emergencies, pregnancy, inability of the patient to tolerate oral treatments, Kayla being under the age of 19 years, severe abdominal pain, vomiting, and the patient being unable to complete oral antibiotic therapy.
Education
From the conversation of the nurse and Kayla, the patient had received counsel from the care givers. Kayla was returning for reassessment since the symptoms had not been resolved after starting treatment. It is the responsibility of caregivers to offer education to the patient which include emphasizing on the need to seek urgent medical attention when symptoms worsen, proper use of medication, and stress the need for sexual contact partners to accompany them for screening and treatment (Bjørk & Hamilton, 2011). Furthermore, the caregiver must underscore on reduction measures like use of a condom, complications of untreated PID, asymptomatic nature of some STIs, and high rate of co-infection risks when one is predisposed to STDs (Risser et al., 2017). Since prognosis of PID is highly dependent on the adolescent’s ability to seek and receive timely care, Kayla shall be advised by the nurse to conduct bi-annual screening for STIs to reduce the chances of developing another PID and consistently use a condom during sexual contact.
Possible Long-Term Sequelae
PID is a slow process of tissue destruction and scarring and absence of immediate treatment may lead to irrevocable changes in the fallopian tube morphology (Gradison, 2012). Long-term sequalae consequences include infertility, ectopic pregnancy, and chronic pelvic pain (Risser et al., 2017). The nurse seemed to have regretted not doing the correct diagnosis for Kayla when a 30-year-old female came with her husband and had struggled to get pregnant for three years.
Conclusion
Upon testing and examination, the results of the patient must be kept confidential. Even though Kayla is 16 years old, she should be checked and treated for sexually transmitted diseases without the consent of her parents which was complied with in her case. Healthcare guidelines and government laws stipulate that PID cases are not reportable. But if lab reportable infections are confirmed from diagnostic tests, partner notification should be issued and documentation kept according to agency guidelines.
References
Bjørk, I. T., & Hamilton, G. A. (2011). Clinical decision making of nurses working in hospital settings. Nursing Research and Practice , 1–8.
Gradison, M. (2012). Pelvic inflammatory disease. American Family Physician , 85 (8), 791–796.
Risser, W. L., Risser, J. M., & Risser, A. L. (2017). Current perspectives in the USA on the diagnosis and treatment of pelvic inflammatory disease in adolescents. Adolescent Health, Medicine and Therapeutics , Volume 8 , 87–94.
