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Genital Urinary System Female Reproductive System Part 2.

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Presentation on theme: "Genital Urinary System Female Reproductive System Part 2."— Presentation transcript:

1 Genital Urinary System Female Reproductive System Part 2

2 Vaginitis Pathophysiology Vaginitis = inflammation of the vagina Normally pH ( ) – Maintained by Lactobacillus acidophilus, suppress the growth of anaerobes produces lactic acid  –  pH Produces hydrogen peroxide

3 Vaginitis Pathophysiology –  risk if… Stress Illness Alt. pH Pathogen – Candida,Trichomonas or other bacteria invade the vagina.

4 Vaginitis: Clinical manifestations Vaginal discharge + – Itching – Odor – Redness – Burning – Edema – Aggravated by voiding – Urethritis (possibly)

5 Vaginitis: Candidiasis Candidiasis / Vulvovaginal Candidiasis Fungal or yeast infection Asymptomatic  symptomatic – Use of antibiotics   bacteria   protective organisms – Pg – DM – HIV – Corticosteroid – Oral contraceptives

6 Vaginitis: Candidiasis Clinical manifestations Vaginal discharge – Color White, cottage cheese like – The pH if the discharge is < 4.5 Pruritus – Itching

7 Vaginitis: Candidiasis Medical Management Anti-fungal agents – Miconazole (Monistat) – Without prescription

8 Bacterial Vaginitis Overgrowth of anaerobic bacteria normally found in the vagina Absence of lactobacilli

9 Characterized by: – Fish-like odor –  vaginal pH –  discharge Gray –yellowish white No discomfort

10 Medical Management – Metronidazole (Flagyl) PO Bid x 1wk – Clindamycin (Cleocin) Vaginal cream

11 Vaginitis: Trichomoniasis “TRICK” STD – Sexually transmitted Vaginitis Asymptomatic carrier

12 Vaginitis: Trichomoniasis Clinical manifestations Vaginal discharge – Frothy – Yellow-green – Malodorous – Irritating Cervical erythema Multiple small Petechiae pH > 4.5

13 Vaginitis: Trichomoniasis Complications – Not life threatening Medical Management – Metronidazole (Flagyl) Anti-bacterial Anti-protozoal – Both partners!

14 Nursing process of Patients with Vulvovaginal infection Assessment – Examine – Do not douche Observe the area for: – Erytherma – Edema – Excoriation – Discharge

15 Nursing process of Patients with Vulvovaginal infection Describe symptoms – Odor – Itching – Burning – Dysuria Prep vaginal smear Test pH of discharge

16 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

17 Nursing process Patients w/ Vulvovaginal infection – Psychogenic factors Stress Fear Abuse – Medical conditions DM Antibiotics Sex partners

18 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

19 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

20 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

21 PID Pathophysiology Enters through vagina  Cervical canal  Colonizes  Uterus  Fallopian tubes & ovaries  Pelvis

22 PID Risk factors Early age 1 st intercourse  # sexual partners Sex with a partner with an STD Hx of STD’s Previous pelvic infection Invasive procedure

23 PID: Clinical manifestation Vaginal discharge Dyspareunia Lower abd. pelvic pain Tenderness after menses. Pain  while voiding Other S&S: – Fever – Gen. malaise – N/V – H/A

24 PID: Complications Peritonitis Abscesses Strictures / adhesions – chronic pelvic pain

25 PID: Complications Fallopian tube obstruction – Ectopic pregnancy – Occlude tubes  sterility

26 PID:Complications Bacteremia  – septic shock Thrombophlebitis  – embolization

27 PID: Medical management Brood spectrum Antibiotics Treat Partners Treatment at home – mild Intensive therapy / Hospital – Rest – IV fluids IV antibiotics

28 PID: Nursing Interventions Activity – Bed rest Position – Semi-fowler’s Vital signs Assess – Drainage Administer – Analgesics / Antibiotics Pain relief – Heat to abd.

29 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

30 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

31 Endometriosis Clinical manifestations Dysmenorrhea Dyspareunia Pelvic pain Depression Loss of work Relationship difficulty Infertility

32 Endometriosis Assessment & diagnostic findings Health hx Pelvic exam Laparoscopy exam

33 Endometriosis Medical managements NSAIDS Oral contraceptives – Side effects: fluid retention weight gain Nausea Surgery Pregnancy

34 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


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