This case study describes a 16-year-old female patient with abdominal pain on her left lower quadrant. The most probable diagnosis for Kayla is pelvic inflammation diseases, a condition of the upper female genital tract, including the uterus, fallopian tube, that causes acute or chronic pain. The pain is mostly reported in menstruating women below 25 years of age who has multiple sex partners and engages in unsafe sex. This report provides guidelines for achieving PID prevention and management in the patient.
Physical examination
The patient complains of pelvic pain as she appears mildly uncomfortable lying in bed. Her pelvic study shows a regular tanner five female with moderate thin white discharge in the vaginal vault. She does not report of any cervical discharge, though there is discomfort with the movement of the cervix. At the same time, physical examination shows a lack of skin rashes or any neurological condition. Her abdominal radiograph reads standard loops of bowel without air-fluid levels. The patient shows symptoms of pelvic inflammatory disease, including left pelvic pain and vomiting. She has cervical motion tenderness as well as left adnexal sensitivity. Lab results rule out any chance of ectopic pregnancy. However, she complains of severe pain during the examination.
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Clinical management
Pelvic inflammatory disease can be treated, though the treatment cannot reverse the scarring caused by the infection. Treatment of pelvic inflammatory disease focuses on addressing the acute symptoms, minimizing any risk of long-term sequelae, and reducing the risk of transmission. It entails the use of antibiotics to prevent any serious complications and get rid of the infection ( Goyal et al., 2013) . The doctor can prescribe two or more medicines that can be given as pills or by injection and ask the patient to visit for the follow-up and check the progress. The patient will be required to take the full dosage even when the symptoms go away early. Most patients with the condition do not need inpatient treatment unless when seriously ill. Hospitalization may be recommended for the patient if she lacks a precise diagnosis, experiences, vomiting, and nausea has a high fever or pregnant ( Goyal et al., 2013) . In most cases, surgery is not necessary when treating a patient with PID
Apart from the treatment of PID, there are several preventive measures can be applied for the patient. The prevention should focus on avoiding the acquisition of sexually transmitted infections and preventing it from spreading to other body parts ( Goyal et al., 2013) . Some of the causes of PID are sexually transmitted diseases such as chlamydia, which makes it essential to abstain from intercourse until. As such, the patient should engage in safe sexual intercourse to prevent the spread of STDs such as using condoms. She is supposed to maintain an active role in clinical management, including maintenance of healthy sexual behavior and adopting the appropriate health-care-seeking practice. For example, the patient should do regular checkups and comply with clinical recommendations.
Education
Patient education should be provided to the client to help in treating and preventing possible long-term sequelae. The training should focus on the nature of infection and the long-term sequelae of PID. In essence, patient counseling is needed to prevent the acquisition of STDs and control the condition ( Suss et al., 2000). The advice can also entail changing unsafe sex behaviors and avoiding high-risk partners. The patient should also be educated about the risks of acquiring STDs and PID, the importance of seeking medical advice, and how to diagnose the symptoms.
Possible long-term sequelae
Women with pelvic inflammatory disease are at risk of several conditions. Some of the potential long-term sequelae include tubal factor infertility, chronic pelvic pain, ectopic pregnancy, and implantation failure. The risk of ectopic pregnancy in women is high in women with a history of the condition compared to those without ( Goyal et al., 2013) . At the same time, patients with a history of PID have higher chances of infertility. Other possible sequelae include pelvic adhesion, pyosalpinx, and dyspareunia.
Confidentiality
Medical ethics principles stress the importance of privacy and the physician’s primary obligation to respect the privacy of her patients. Maintaining confidentiality when handling the patient with PID is the most effective way of preventing reprisals who report wrongdoing ( Santos, 2012) . Since adolescents will disclose sensitive information after trusting a doctor, they require physicians to maintain confidentiality, such as not revealing the information to the patient’s parents. Physicians should discuss confidentiality with the patient and explain that their discussion is confidential until they permit disclosure. They should also encourage communication with the parents, which is needed to help adolescents meet care needs. In this case, the patient claimed to be sexually active, engaging in unsafe sex and drug use. These are sensitive information that has to be protected at all cost.
References
Goyal, M., Hersh, A., Luan, X., Localio, R., Trent, M., & Zaoutis, T. (2013). Are emergency departments appropriately treating adolescent pelvic inflammatory disease?. JAMA pediatrics , 167 (7), 672-673.
Santos, X. M. (2012). Protecting the confidentiality of sexually active adolescents. AMA Journal of Ethics , 14 (2), 99-104.
Suss, A. L., Homel, P., Hammerschlag, M., & Bromberg, K. (2000). Risk factors for pelvic inflammatory disease in inner-city adolescents. Sexually transmitted diseases , 27 (5), 289-291.
