Sexual Risk Assessment Mary Jane

Sexual Risk Assessment

Mary Jane is a thirty years of age, white female who is 5, 7, brown hair, green eyes, 122 pounds. Mary Jane is in the office today reporting sexual dissatisfaction with her partner. Mary Jane has noticed a change in her vaginal discharge with an odor. She is experiencing lower back pain. She states she has an alcohol dependency, and drinks quite heavily on a daily bases to the point she is comatose.

Mary Jane lives at home with her elderly mother. Mary Jane's parents are divorced and she only sees her father on holidays. She is having deteriorating peer relationships and she dropout out of school at the age of 14. Family medical problems include bowel cancer, diabetes, reflux disease, heart disease, and depression..

Mary Jane's last reported sexual intercourse was March 21, 2010 with her male partner, there was no method of protection used during this sexual engagement. She states she has had over twenty partners over the past year . Do to her alcohol dependency she cannot provide information on these partners, as they were random partners she would pick up in the bars . She has never used protection during sexual intercourse because she is allergic to latex, and doesn't like the feeling of condoms. She has been treated in the past for vaginal bacterial infections with antibiotics . Do to Mary Jane's past risky sexual encounters, clinical recommendation is to screen for pregnancy, Chlamydia, gonorrhea, HIV, and syphilis infections, along with a Hepatitis B & C. screening.. A cytology will be performed by a pap smear to rule out cervical cancer since and other abnormalities . Mary Jane engages in risky sexual behavior, and is complaining of sexual dissatisfaction with her male partner . This has been going on for over six months, and she doesn't understand what is causing this issue . She complains of burning sensation before and after intercourse . Her menstrual cycle has been light, but normal . She hasn't had a pap smear since she was eighteen years of age.

Mary Jane states the last time she had vaginal oral sex was this morning with her partner, she states she doesn't and hasn't had anal sex. She states she doesn't perform oral sex on her partners, only receives from her partner ( s). She has engaged in sexual with multiple partners at that same time, with none of the parties using protection. Mary Jane has had sex with multiple men during her lifetime. She states all are from the U.S. And none from overseas, best of her recollection. Mary Jane has never used any form of birth control or other forms of contraception's. Mary Jane does believe one of her partners must have had some sort of disease or infection because of her vaginal bacterial infections . Mary Jane has never been paid for sex, or to receive any form of sex.

Mary Jane's last menstrual cycle was February 20, 2010. She was tested for pregnancy, which was negative. She has had several vaginal bacterial infections, with the latest one being in January 2010, she was treated with antibiotic. Then for another vaginal bacterial infections in March 2010, which she forgot to take all her antibiotics, do to her drinking . Because Mary Jane has a history of vaginal bacterial infections, and sleeps with multiple partners without protection, forgetting to take all the antibiotic that is prescribed to her, she is and her partners are spreading this infection among partners. Because Mary Jane drinks heavily on a daily bases, this prolongs the recovery period when combined with certain antibiotics. Long-term consumption of alcohol also stimulates the production of metabolic enzymes, which in turn, reduces the quality of antibiotic in the body hence, increases the need for more dosage.

Mary Jane's laboratory results show there is an elevated white blood count, with CBC with differential within normal limits. Proton and INR were normal. Pregnancy was negative. UA showed occasional bacteria, but normal otherwise. Drug screen was normal, and EKG showed sinus bradycardia, rate of 59 beats per minute. Renal and hepatic functions were within normal limits.

There are four sexual response cycles, marked by physiological and psychological changes. The first stages is excitement, which Mary Jane is not getting with her partners, which is triggered by psychological or physical stimulation, and is marked by emotional changes, and increased heart rate, and vaginal swelling. Second stage is plateau, Mary Jane states she doesn't have this stimulation. The third stage is orgasm, which Mary Jane doesn't getting during intercourse, or she doesn't remember because she in under the influence of alcohol. The final phase, resolution, involves a rush of blood away from the vagina, and shrinking of breasts and nipples, and a reduction in heart rate, respiration, and blood pressure. She claims not to have this last phase. However, it differs depending on who much alcohol she has consumed before sexual intercourse.

Mary Jane, doesn't understand why alcohol is the cause of her sexual dissatisfaction, and the vaginal bacterial infections . She states it is her age, and/or her partner's performance. She states she loves being sexually active, just not being dissatisfied . She states she is under a lot of stress because she recently lost her job do to her daily drinking binges. She has lower back pain from her vaginal bacterial infections, and vaginal soreness from having sexual with multiple partners on a regular bases .

Mary Jane has never had surgery of any sort. She is under weight for her height, and age, and noted because of alcohol addiction. She states she does experiment with marijuana on an occasion to see if it will help her with an orgasm, and to relax her from her daily stress of not having a job. She currently takes four Ibuprofen for her back pain on a daily bases . If she can find pain medication on the street to take, she will take a Percocet., Vicodin, or Valium . She suffers from seasonal allergies, and only takes over the counter Sudafed. There are no IV drugs present. She doesn't smoke, however consumes larges quantities of alcohol on a daily bases. Three or four bottles of wine, fifth of Jim Beam, fifth of vodka, or fifth of scotch, just depends on what she can gets her hands on from friends, and what others are willing to buy her in the bars . Mary Jane, usually drinks at least a fifth of alcohol per day. This is destroying her liver, although the lab results didn't show this at this present time.