14 Apr Talla is a 16-year-old who has come into the clinic because she has not had a menstrual period in 5 months
Case Scenario 1: Talla is a 16-year-old who has come into the clinic because she has not had a menstrual period in 5 months. She reports she started menstruating at 13 years old. She denies being sexually active.
• What more should you know about Talla? • What diagnostic tests should you order and why? • How should you manage this condition?
Case Scenario 2: Elizabeth is a 14-year-old female who has sickle cell disease and exercise-induced asthma. Her asthma has been well managed so far but she is interested in trying out for the volleyball team. She came to the clinic today for a sport physical and clearance.
• What more should you know about Elizabeth? • Assuming you can clear Elizabeth for volleyball, what type of anticipatory guidance
would she and her family need? Include specific instructions for sickle cell crisis and asthma exacerbation prevention.
• What part of the sports physical exam should the APRN focus on given Elizabeth’s medical history?
Case Scenario 3: Mrs. Lim brings in two of her children 3-year-old Lily and 5 year old Liam with complaints of a rash. Lily is not in any discomfort and her mother denies she has had any fever. Most of the painless flesh colored lesions are located on her abdomen and are dome shaped in appearance. However, she has one lesion on her left lower arm that appears to be draining. You notice Lily has a café au lait spot to her left lower back. Liam on the other hand has an itchy rash on his face. You notice Liam has small red sores about 1 cm around his mouth and nose with areas of yellow crusting where these have burst. Their mother wants to know if it is okay to send them to attend preschool/school.
• What other information would you want to know about Lily and Liam? • How should you manage Lily and Liam? · What anticipatory guidance regarding
spread of infection? • When it is okay for each child to return to preschool/school?
Case Scenario 4: Sandy is a 16 year old who comes in for complaints of vaginal itching and thick white discharge x3 days. She also reports unprotected vaginal intercourse with a new consensual male partner in the past 2 weeks. She is not on any birth control.
• What other relevant questions should you ask Sandy? • What diagnostic studies would you order today for Sandy? • What patient education is important to include for this patient?
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