Vaginitis: Trichomoniasis Complications – Not life threatening Medical Management – Metronidazole (Flagyl) Anti-bacterial Anti-protozoal – Both partners!
Nursing process of Patients with Vulvovaginal infection Assessment – Examine – Do not douche Observe the area for: – Erytherma – Edema – Excoriation – Discharge
Nursing process of Patients with Vulvovaginal infection Describe symptoms – Odor – Itching – Burning – Dysuria Prep vaginal smear Test pH of discharge
Nursing process Patients w/ Vulvovaginal infection Assess though questions factors that might contribute to the infections – Physical /chemical factors Constant moisture from tight or synthetic clothing Perfumes and powders Soaps & Bubble baths Poor hygiene Feminine hygiene products
Nursing process Patients w/ Vulvovaginal infection – Psychogenic factors Stress Fear Abuse – Medical conditions DM Antibiotics Sex partners
Nursing process Patients w/ Vulvovaginal infection Diagnosis – Discomfort related to burning, odor or itching from the infectious process – Anxiety related to stressful symptoms – Risk for infection or spread of infection – Deficient knowledge about proper hygiene and preventive measures
Nursing process Patients w/ Vulvovaginal infection Nursing Interventions – Admin. meds – Sitz baths – Cornstarch powder – Educate patient – Douching discouraged – Loose fitting underwear = good – Tight, synthetic, non-absorbent, heat-retaining underwear = bad
Pelvic Inflammatory Disease Etiology AKA: Pelvic Infection PID is an inflammation of the pelvic cavity Begins with cervicitis uterus, fallopian tubes, ovaries, pelvic peritoneum &/or pelvic vascular system Usually caused by bacteria – Gonorrheal and Chlamydial organisms Most common STD but… – Not always STD
PID: Medical management Brood spectrum Antibiotics Treat Partners Treatment at home – mild Intensive therapy / Hospital – Rest – IV fluids IV antibiotics
PID: Nursing Interventions Activity – Bed rest Position – Semi-fowler’s Vital signs Assess – Drainage Administer – Analgesics / Antibiotics Pain relief – Heat to abd.
Endometriosis Etiology “A benign lesion or lesions with cells similar to those lining the uterus grow aberrantly in the pelvic cavity outside the uterus.” Chronic pelvic pain & infertility
Endometriosis Pathophysiology Misplaced endometrial tissue responds to hormone changes During menstruation, the extopic tissue bleeds, mostly into areas having no outlets pain and adhesions Causes lesions, cysts and or scar tissue
Endometriosis Clinical manifestations Dysmenorrhea Dyspareunia Pelvic pain Depression Loss of work Relationship difficulty Infertility
Endometriosis Medical managements NSAIDS Oral contraceptives – Side effects: fluid retention weight gain Nausea Surgery Pregnancy
Endometriosis: Nursing process Assessment – Hx & PE focus on specific symptoms, effects of meds, reproductive plans Diagnosis, Planning and Goals – Relief of pain, Dysmenorrhea, dyspareunia – Avoidance of infertility Nursing Interventions – Dispel myths and encourage the patient to seek care if dysmenorrhea or dyspareunia occurs Evaluations/Expected patient outcomes