Which patient in the gynecology clinic should the nurse see first?
1. 22-year-old, using tampons, T=102°F, P=122, BP=70/55
2. 15-year-old, no menses for past four months
3. 18-year-old seeking information on contraception methods
4. 31-year-old, reports increasing dyspareunia
Correct Answer: 1
Rationale 1: A patient using tampons who is febrile, tachycardic, and hypotensive might have toxic shock syndrome. Hypotension is life-threatening; this patient should be seen immediately.
Rationale 2: Secondary amenorrhea can be caused by pregnancy. Teen pregnancy is a high risk, but no indication is given that the patient is exhibiting a life-threatening condition.
Rationale 3: Unplanned pregnancy and sexually transmitted infections can be problematic in the future, but this patient exhibits no signs or symptoms of a life-threatening condition at this time.
Rationale 4: Although this patient might have endometriosis, dyspareunia is not a life-threatening condition.
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