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M6 13-005
Exam 8: Reproductive System; Infection of the Female Reproductive System
| Term | Definition |
|---|---|
| Vaginitis | Inflammation of the vagina |
| Vaginitis: Etiology | Common vaginal infection caused by: E. Coli Staphylococcal Organisms Streptococcal Organisms |
| Vaginitis: Pathophysiology | If Pt changes perineal pads or tampons infrequently: Vaginal tract and groin become irritated. Creates a medium suitable for organism growth. |
| Vaginitis: Types | Simple (bacterial) Vaginitis Senile/atrophic Vaginitis |
| Simple Vaginitis: Causative Organisms | E. Coli Trichomonas vaginalis Gardnerella bacillus Candida albicans |
| Senile/ Atrophic Vaginitis: Causative Factors | Decreased levels of estrogen causes the vagina to atrophy. Occurs in women post-menopause. Naturally occurs as women ages. |
| Vaginitis: Clinical Manifestations | Pruritis burning Edema of surrounding tissue Dysuria Exudate (yellow, white, grayish white, or curd) |
| Exudate for Tichomoniases Vaginalis | Diffusely foamy (bubbly) |
| Exudate for Candida Albicans | Thick and cheese like |
| Vaginitis: Assessment | Menstrual Hx Birth Control Methods Current Medications Family Hx of DM Hx of vaginal infections or STI Sexual Hx |
| Vaginitis: Diagnostic Tests | Direct Visualization Culture of Organism Bi-manual Examination |
| Vaginitis: Medical Management | Douching Creams, ointments, suppositories (depends on cause) Oral Meds Refrain from intercourse or use condom For senile/ atrophic vaginitis, estrogen, vaginal suppositories and ointments may be prescribed |
| Vaginitis: Goals of Treatment | Cure the infection Prevent Reinfection Prevent Complications Prevent infection of sexual partner(s) |
| Vaginitis: Patient Teaching | Wash hands b&a vaginal applications Use Meds at night and remain recumbent for more than 30 minutes Discourage douching Heat may be applied to area as sitz bath, perineal irrigations & douches Sexual partner should also be treated Change pads/tampon |
| Vaginitis: Prognosis | Good with proper treatment |
| A female client with a history of diabetes mellitus is at risk for developing vaginitis due to what occurrence? | Presence of glucose in the urine |
| Cervicitis | Infection of the cervix |
| Cervicitis: Causes | Vaginal infection or STI Childbirth or abortion in which lacerations occured |
| Cervicitis: Clinical Manifestations | Backaches Whitish exudate Pink-tinged menstrual discharge Dyspareunia |
| Cervicitis: Treatment | Specific to causative organism Untreated, can spread to other pelvic organs Vaginal suppositories, ointments and creams Oral medications Sexual partners need to be treated as well |
| Oral Medications for Cervicitis | Azithromycin (Zithromax) Doxycycline (Vibramycin) |
| Cervicitis: Patient Teaching | Personal hygiene/warm tub baths to decrease discomfort and odor. Avoid intercourse. Wash hands before and after vaginal applications. Use vaginal meds at bedtime and remain recumbent for more than 30 mins |
| An STI caused by herpes type 2 can cause | Cervicitis |
| 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. |
| Pelvic Inflammatory Disease (PID): Pathophysiology | When cervical mucus is altered or destroyed, bacteria ascend into the uterine cavity and other reproductive structures. Causes adhesions and can lead to sterility. |
| Pelvic Inflammatory Disease (PID): Causes | Insertion of biopsy curette or irrigation catheter Abortion Pelvic Surgery Sexual Intercourse Pregnancy |
| Pelvic Inflammatory Disease (PID): Causative Organisms | Neisseria gonnorrhoeae Strptococci Staphylococci Chlamydiae Tubercle bacilli |
| Pelvic Inflammatory Disease (PID): Clinical Manifestations | Elevation in temperature Chills Severe ABD pain Malaise N/V Malodorous purulent vaginal exudate |
| Pelvic Inflammatory Disease (PID): Assessment | Assess severity of disorder Occurrences (Primary or recurrent) Sexual Hx Recent pelvic examinations or precedures |
| Pelvic Inflammatory Disease (PID): Diagnostic Tests | Gram Stain of Secretion C&S of secretions Laproscopic Visualization Vaginal US Leukocyte and erythrocyte sedimenation rate (ESR) |
| Pelvic Inflammatory Disease (PID): Medical Management | Goal: Control and eradicate infection, prevent systemic spreading Systemic antibiotics intravenously or intramuscularly. Corticosteroids no intercourse for 3 weeks Sexual partner evaluated and treated Pain control |
| Pelvic Inflammatory Disease (PID): Meds | Cefoxitin (Mefoxin) Doxycycline (Vibromycin) |
| Pelvic Inflammatory Disease (PID): Nursing Interventions | Client is usually hospitalized Observe standard precautions Assess Pain and administer analgesics as ordered Monitor VS Provide fluids and monitor fluid status Palliative measures for comfort Support client with positve, non-judgemental attitude F |
| Pelvic Inflammatory Disease (PID): Pt teaching | low grade fever persists or purulent vaginal discharge occurs call provider Understand significance of PID Compliance with medication therapy Importnece of hand washing and personal hygiene, sexual partner evaluated/treated. Painful intercourse after |
| Pelvic Inflammatory Disease (PID): Prognosis | Good with adequate treatment Can lead to complications such as infertility |
| Toxic Shock Syndrome (TSS) | Acute bacterial infection caused by stphylococcus aureus |
| Toxic Shock Syndrome (TSS): | Most common in menstruating women using tampons. Can occur in non menstruating women Greatest risk are those who insert with fingers and not applicator |
| Toxic Shock Syndrome (TSS): Cause | When a tampon is left in place for too long, bacteria flourish and release toxins into the bloodstream |
| Toxic Shock Syndrome (TSS): Clinical Manifestations | Begins with flu-like symptoms (first 24 hours) Elevated temperature Vomiting Dizziness Headache Diarrhea Myalgia Sore throat Red macular palmar or diffuse rash followed by desquamation of the skin |
| Toxic Shock Syndrome (TSS): Assessment | Tampon usage and time between changes Other TSS symptoms (fatigue, headache, myalgia, sore throat) Eythematous rash on palms ans soles Edema and signs of shock. Desquamation |
| Toxic Shock Syndrome (TSS): Diagnostic Tests | No definitive test Cervical/vaginal smear Blood, urine and throat cultures Labs |
| Toxic Shock Syndrome (TSS): Labs | Leukocytosis Thrombocytopenia Elevated levels of : bilirubin, BUN, Creatinine, SGPT, SGOT, CPK |
| Toxic Shock Syndrome (TSS): Medical Management | ABx based on C&S Parental Fluids Correct Electrolyte imbalances Monitor renal labs (BUN & Creatinine) Monitor LFTs, SGPt and SGOT |
| Toxic Shock Syndrome (TSS): Nusring interventions | Bed Rest Administer ABx moniot VS and fluid status |
| Toxic Shock Syndrome (TSS): Patient Teaching | Advise client not to use super absorbent tampons Obsers S/S of TSS Alternate tampons with pads Inspect tampon for defects before insertion Change tampons frequently (every 4 hours) |
| Toxic Shock Syndrome (TSS): Prognosis | Dependent upon severity of disease and time medical management are instituted Rare disease that can be fatal |
| Antifungals | Used to treat vaginitis and cervitis caused by Candida Albicans (yeast infections) |
| Antifungals: Predisposing factors | Broad-spectrum antibiotic therapy Immunodeficiency disorders |
| Antifungals: Generic/Trade names | Butonazole (Femstat 3) Clotrimazole (Gyne-Lotimin 3 or Mycelex-7) Miconazole (Monistat) Tioconazole (Vagistat) Fluconazole (Diflucan) |
| Antifungals: Action | Inhibits growth of fungi by interfering with DNA replication |
| Antifungals: Common Adverse Effects | Vulvovaginal burning and itching Pelvic cramps and rash Uticaria Stining Contact Dermatitis |
| Anitfungals: Nursing implications | Wash hands and don gloves Observe for adverse effects Ensure adequate perineal hygiene |
| Antifungals: Patient Teaching | Apply and insert creams/vaginal tablets at bedtime and remain in recumbent position for at least 30 minutes Keep the area cleansed and dry If using Diflucan (flucanazole) prophylactically, do not take until there are signs of a yeast infection |
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jtzuetrong
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