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Infect Female Repro

MAMC exam 8 infections of the female reproductive tract

vaginitis inflammation of the vagina
etiology & pathophysiology of simple vaginitis common viral infection patient changes pads/tampons infrequently
types of vaginitis simple (bacterial) senile/atrophic
causative organisms of simple organisms e. coli trichomonas vaginalis gardnerella bacillus candida albicans
causative factors of senile/atrophic vaginitis decreased levels of estrogen causes vagina to atrophy occurs in post-menopause naturally occurs as woman ages
clinical manifestations of vaginitis pruritis burning edema of surrounding tissue dysuria yellow, white, grayish white, curdlike exudate
diagnostic tests for vaginitis direct visualization, culture of organism, bimanual examination
assessment of vaginitis menstrual history birth control methods current meds family history of DM history of vaginal infections or STI sexual history
medical management of vaginitis douching vaginal creams/ointments/suppositories oral meds refrain from sexual intercourse or use condom for senile/atrophic, estrogen/vaginal suppositories & ointments may be prescribed
goals of vaginitis treatment cure infection prevent reinfection prevent complications prevent infection of sexual partner(s)
patient teaching for vaginitis wash hands vaginal meds at HS & remain recumbent >30 min discourage douching (unless prescribed) heat partner should also be treated change pads/tampons frequently
prognosis for vaginitis good with proper treatment
cervicitis infection of cervix
causes of cervicitis vaginal infection or STI childbirth or abortion in which lacerations occured
clinical manifestations of cervicitis backaches, whitish exudate, pink-tinged menstrual discharge, dyspareunia
treatment for cervicitis specific to causative organism untreated can spread vaginal suppositories, ointments, creams oral meds: azithromycin (Zithromax) doxycycline (Vibramycin) partner needs to be treated as well
patient teaching for cervicitis personal hygiene/warm tub baths avoid intercourse wash hands use vaginal meds at bedtime & remain recombent >30 min
pelvic inflammatory disease (PID) any infection that involves the cervix, uterus, fallopian tubes, ovaries and may extend to connective tissue lying between the broad ligaments
pathophysiology of PID when cervical mucus is altered or destroyed, bacteria ascend into the uterine cavity & other reproductive structures
PID causes adhesions that can lead to sterility
causes of PID insertion of biopsy curette or irrigation catheter, aborption, pelvic surgery, sexual intercourse, pregnancy
causative organisms of PID neisseria gonnorrhoeae, streptococci, chlamydiae, tubercle bacilli
clinical manifestations of PID elevated temperature chills severe ABD pain malaise N/V malodorous purulent vaginal exudate
assessment of PID assess severity of disorder occurrences (primary or recurrent) sexual history recent pelvic exams or procedures
diagnostic tests for PID gram stain of secretions culture & sensitivity laparoscopic visualization vaginal ultrasound leukocyte & ESR
medical management for PID goal is to control and eradicate infection, prevent spreading systemic antibiotics IV/IM -cefoxitin (Mefoxin) -doxycycline (Vibromycin) corticosteroids no intercourse 3 weeks partner must be evaluated & treated pain control, rest, adequate fluid
nursing interventions for PID client usually hospitalized observe standard precautions assess pain & administer analgesics as ordered monitor VS provide fluids comfort measures fowlers position
prognosis for PID good with adequate treatment can lead to complications such as infertility
patient teaching/discharge planning for PID low grade fever, purulent vaginal discharge understanding PID compliance hygiene & hand washing intercourse avoided until provider says
the client who has a history of many pelvic inflammatory infections often seeks medical care for ________ infertility
toxic shock syndrom (TSS) actute bacterial infection caused by staphylococcus aureus
TSS most commonly seen in menstruating women using tampons
women at greatest risk for TSS those who insert tampons with fingers & not inserters
how TSS develops when a tampon left in place for too long, bacteria flourish & release toxins into bloodstream
t/f non-menstruating women can develop TSS true
clinical manifestations of TSS flu-like symptoms, fever, V/D, dizziness, headache, myalgia, sore throat, erythematous rash, desquatmation, decreased urinary output, elevated BUN, disorientation, hypotension, signs of septic shock, pulmonary edema, inflammation of mucous membranes
assessment of TSS tampons? other symptoms assess palms & soles assess for edema & signs of shock
diagnostic tests for TSS no definitive test cervical/vaginal smear blood, urine, throat cultures labs:leukocytosis, thrombocytopenia, BUN, bilirubin, creatinine, SGPT, SGOT, CPK antiobiotics parenteral fluids correct imbalances monitor labs
nursing interventions for TSS bed rest administer antiobiotics monitor VS & fluid status
patient teaching for TSS don't use super absorbent tampons alternate tampons with pads inspect tampon for defects change tampons Q4Hours use inserter wash hands ovserve for S&S of TSS
prognosis for TSS dependent on severity of disease & time of medical management are instituted rare disease that can be fatal
first significant sign of TSS the client will exhibit is _______ sudden high fever & flu-like symptoms
use of antifungals treat vaginitis & cervicitis caused by Candida albicans (yeast infection)
predisposing factors for antifungals broad-spectrum antibiotic therapy immunodeficiency disorder
generic names for antifungals butonAZOLE clotrimAZOLE miconAZOLE tioconAZOLE fluconAZOLE
trade names for antifungals Femstat 3 Gyne-Lotrimin 3/Mycelex-7 Monistat Vagistat Diflucan
action of antifungals inhibits growth of fungi by interfering with DNA replication
common adverse effects of antifungals vulvovaginal burning & itching pelvic cramps & rash urticaria stinging contact dermatitis
nursing implications for antifungals wash hands & don gloves observe for adverse effects ensure adequate perineal hygiene
patient teaching for antifungals follow directions on package wash hands before & after insertion apply/insert creams/vaginal tablets at HS & remain recumbent >30 min keep area dry & cleansed if using Diflucan (flucanzole) prophylactically, do not take until signs of yeast infection
Created by: ealongo