M. Richards is a 33-year-old woman who comes to the urgent care center.

Case Study # 3
M. Richards is a 33-year-old woman who comes to the urgent care center. The nurse collects the following data.
Interview Data: Ms. Richards tells the nurse, “I have a really bad pain in front of my butt. It hurts so much that I can't even wipe with a tissue after I go to the bathroom. There is no way I could have a bowel movement right now.” Ms. Richards states that the pain started 2 days ago and is “much worse now.” When asked about her sexual activity, she says, “I'm with a guy, but it's not exclusive or anything. We see other people and try not to be real serious.”
Examination Data VS: BP 110/80 CR 80 RR 16 Temperature 98.8degrees Fahrenheit
HEENT: Within normal limits
CV: Within normal limits
Respiratory: Within normal limits ABD: Within normal limits External examination: Typical hair distribution, urethral meatus intact, no redness or discharge. Perineum intact. Extreme pain response to palpation of vaginal opening; edema, redness, and mass detected on right side.
Spontaneous, foul-smelling, dark yellow discharge noted with palpation over Bartholin's glands. Internal examination: Deferred because of extreme pain associated with the exam. Musculo-Skeletal: Within normal limits
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