Question Answered step-by-step Vaginal Itching Subjective: Martha is a 25 y/o female who reports… Vaginal Itching Subjective: Martha is a 25 y/o female who reports vaginal itching for 3 days. She says that she can barely focus on other things because of the itching. She also reports a copious, white vaginal discharge. Her last Pap smear was at age 21 and was negative. She has not received the HPV vaccine series. Denies previous episodes and states that she is otherwise healthy. Denies fever, chills, nausea vomiting or diarrhea. She is sexually active and has been with females and males since she was 15 years old. She states that recently she has been exclusively with females and has only had 2 relationships in the past year. She states that she still feels somewhat confused about her sexual preferences. She admits to dyspareunia and burning with urination. Denies use of vaginal sprays, douches, or powders or the use of new soaps, detergent, or clothing. Admits to eating sweets often. Admits to wearing a thong regularly. PMHx: Tonsillectomy at age 7 y/oFH: Diabetes and COPDSH: College graduate; lives with her widowed mother. She feels safe and has a good relationship with her mother but has not disclosed her sexual preferences to her mother. Worries about their financial status. They are currently renting their apt from a friend. Denies smoking and substance abuse.Meds: DeniesAllergies: None Objective: Afebrile, B/P 110/70, P 64, R 12, Ht: 5 ft 3 in, Wt: 120, BMI: 21.3General: Pleasant and cooperative but somewhat anxiousCardiac: RRR w/o m,r,gResp: CTAABD: Soft, NT, BS x 4, neg HSMPelvic Exam: Inguinal lymph nodes w/o tenderness or swelling; vaginal mucosa moist, pink and mildly swollen. No foul odor. White, thick discharge at the introitus. Cervix pink non friable, neg CMT. Neg Chandelier sign. PH 4.0. The wet prep indicates pseudohyphae.What are your differential diagnoses and why? Would you consider another diagnostic testing for Martha and why? What would your treatment plan be? When should she next have a Pap smear, and why? Should that exam include an HPV test? What would your recommendations be regarding the HPV vaccine for a woman of her age and health history? Health Science Science Nursing NURS MISC Share QuestionEmailCopy link Comments (0)