A female patient shows mucopurulent cervical drainage, fever of 102°F, adnexal tenderness, and a distended/rigid abdomen. What is the appropriate management?

The appropriate management in this scenario is to call surgery and arrange for an exploratory laparotomy (ex lap) and pelvic abscess drainage due to the presence of signs that are highly suggestive of acute pelvic inflammatory disease or a possible ruptured appendix or ectopic pregnancy, which can cause serious complications.

The patient's symptoms, including mucopurulent cervical drainage, fever, adnexal tenderness, and a distended and rigid abdomen, indicate a significant degree of inflammation and possibly infection within the pelvic region that may have progressed to a point where surgical intervention is necessary. A distended and rigid abdomen typically suggests either significant intra-abdominal pathology or the possibility of peritonitis, which warrants urgent surgical evaluation.

In situations where there’s a concern for the presence of an abscess, especially with systemic symptoms like fever, immediate surgical consultation is crucial. Delay in surgical evaluation and intervention can lead to worsening of the patient's condition, including sepsis or further spread of infection.

In contrast, prescribing oral antibiotics may not provide the timely intervention needed for an acute abdomen scenario, and monitoring without definitive intervention could lead to deterioration. A pelvic ultrasound may help visualize some abnormalities but is not definitive for management in an acute setting where immediate surgical evaluation is indicated.