- Janice, a 21 year-old healthy female, presents to her nurse practitioner for her yearly check-up. She is sexually active with her boyfriend and uses condoms most of the time. She has never had a pelvic exam before.
- Discuss the recommended screening tests, using the latest evidence based guidelines that the nurse practitioner should perform on Janice.
- Discuss the recommended education and counseling that should be included in Janice’s care?
Expert Solution Preview
Introduction: This scenario presents a 21 year-old female patient, who is sexually active with her boyfriend, and has no history of pelvic exam. As medical professionals, it is important to follow evidence-based guidelines in recommending screening tests and providing education and counseling to patients.
1. The nurse practitioner should perform the following screening tests on Janice:
– Annual cervical cancer screening with Pap test or HPV test starting at age 21 years
– Screening for sexually transmitted infections (STIs) including chlamydia and gonorrhea, since she is sexually active
– Screening for HIV according to the Centers for Disease Control and Prevention (CDC) guidelines
– Screening for syphilis if high risk factors are present
– Breast cancer screening with mammogram starting at age 50 years, unless family history or other risk factors are present
2. Recommended education and counseling that should be included in Janice’s care:
– Educate Janice about the importance of using condoms regularly to prevent STIs
– Discuss the benefits and risks of hormonal contraception, if Janice expresses interest in using it
– Counsel Janice to quit smoking if she is a smoker, since smoking increases the risk of cervical cancer
– Educate Janice about the signs and symptoms of STIs and encourage her to seek medical attention if any symptoms occur
– Discuss the importance of regular pelvic exams and Pap tests in detecting cervical cancer early.
