Will need minimum of 150 words for each response, APA Style, double spaced, times new roman, font 12, and and Include: (1 reference for each response within years 2015-2018) with intext citations.
Pelvic pain can be caused by many reasons such as ovarian cysts, urinary tract infections, appendicitis, sexually transmitted infections, pelvic inflammatory disease (PID)…In this discussion, I will address PID as the cause of pelvic pain. PID is an infection or inflammation of the upper genital tract in women (Shen et al., 2016). For PID, it is considered acute if the symptoms last 30 days or less (Ferri, 2018). The condition is chronic if the symptoms last more than 30 days. PID is a sequela of sexually transmitted infections, so it is commonly diagnosed in young and sexually active women. Patients usually complain of lower abdominal pain, abnormal vaginal discharge/ bleeding, postcoital bleeding, dysuria, dyspareunia, or fever (Ferri, 2018). If a patient also complains of nausea and vomiting, we need to rule out peritonitis. Since the disease can cause infertility, ectopy pregnancy and can permanently damage other organs such as the uterus, ovaries, fallopian tubes, the patient needs to be referred to a gynecologist immediately to have a proper treatment (Shen et al., 2016). Some women may not have any symptoms, so we need to do a thorough history and physical examination, as well as offer STI screenings to avoid underdiagnosis. We can order basic labs and imaging studies such as urinalysis and urine culture, CBC, CMP, CRP, ESR, and ultrasound pelvic/transvaginal so that the patient can have them done before seeing the gynecologist. An endometrial biopsy or laparoscopy can be done by the gynecologist to confirm the diagnosis of PID (Ferri, 2018).
To write a referral to a specialist, we first need to include our information (name, address, phone, fax, email) and the specialist’s information. Second, the reason for consult/referral, the patient’s biographical data, chief complaint, history of present illness, past medical history, allergies, current medications, family history, social history, vital signs, review of system, and physical examination need to be addressed. Also, we need to include labs and imaging studies, treatment plan, diagnosis, and recommendations. After the patient has been seen and treated by the gynecologist, we are responsible for advising the patient to come back to see us for follow-ups. Since PID can be recurrent, the patient needs to be tested for gonorrhea and chlamydia three to six months after the treatment (Ferri, 2018). Her sexual partner needs to be treated as well to prevent her from being re-infected. Untreated gonorrhea and chlamydia can cause PID; therefore, it is essential for NPs to screen female patients aged less than 25 and those at increased risk for these infections to reduce the incidence of PID (Kreisel, Torrone, Bernstein, Hong, & Gorwitz, 2017). We also need to offer HIV and other STI screenings to all women with PID.