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infections of the fe
female reproductive tract infections
| Question | Answer |
|---|---|
| normal acidity of the vaginal secreitons is a natual defense against infection, but if infected by certain pathogenic organizms, an infection results, | vaginitis |
| most common organisms | E. coli, trichomonas vaginalis, candida albicans (fungus) |
| other organixms | Garderella bacillus, staphylococcal and streptococcal organisms |
| patho 1. 2. 3. | 1.seen in women with diabetes, 2. stress malnutrition, aging, intercourse 3. Factors that influence the development of a vaginal infection |
| include: | glucose/glycogen in urine, change in vag ph/flora, hormonal change during menstrual,, pregnancy, steroids, long term use of birht controlpills, systemic antibiotics, compromised immunity diseease |
| Types of vaginites | Bacteria Simplel Vaginitis, Atrophic (Senile), Bacterial |
| Bacteria Simpel Vaginitis describe it punk | non specific Vaginits, increased discharge, erythema or edema not significant, sexually transmitted possible |
| Atrophic | Occurs in post menopausal women, low estrogen causes vulva and vagina to atrophy and become susceptible to infection |
| Bacterial | milk like discharge with odor, T. Vaginalis: profuse, foamy discharge... C. albicans: thick, cheese like discharge |
| S/S Vaginitits | Yellow, white grayish white exudate, perineal prurits, burning, edema, possible discomfort in lower abd, dysuriaif urinary meatusitis, painful intercourse |
| DX | visual exam, Culture, bi manual exam, |
| TX | Goals, cure infection prevent re infection revent complications, prevent infetio of sexual partners, local application of vaginal suppositories, ointments, creams, douch it douch |
| Nursing INterventions | take at bedtime, remain recumbent for 30 min after insertion, refrain from intercourse or use condom, handswash pre and post application, perineal irrigation or sitz may be ordered, TX of sexual partners |
| one of the most common diseases of the reproductive system | Cervicitis- inflammation or infectio of the cervicx |
| caused by: | vaginal infecton or STD: Chlamydia, Gonorrhea, Herpes II, Trichomoniasis, Occurs quite often after child birth or abortions in which lacerations occur |
| S/s | leukorrhea, menstrual irretularies, dyspareunia, backaches |
| tx | specific causative oganism, local application of suppositories, ointments, and creams, personal hygien warm tub baths to minimize odor and discomfort |
| PID | any acute, subacute, recurrent, or chronic infection of the cervix, ovaries, fallopian tubes, or uterus that has extended to the connective tissues lying b/w the broad ligaments |
| cause and transmission of Pelic Inflammatory Disease | INfecton enters the pelvic organs through the vagina, peritoneum, lymph glands, or blood stream |
| , PID may follow: | insertion of biopsy curette or irrigation cathetter, abortion, pelvic surgery, sexual intercourse, infection during pregnancy, |
| Organisms of PID | Gonococcus (neisseria gonorrhea), Streptococcus, Staphylococcus, Chlamydia, Tubercle bacilli |
| S/S | Malodorous purulent discharge, backache, pelvic and or severe abd pain, fever, chills, malaise, nausea, vomition, |
| A women with PID is more likely to have what type of pregnancy? | ectopic pregnancy |
| DX of PID | Gram's stains of scertions, C&S of vag dc to determine causative orgnism, laparoscopy: confirm extent of infectio, ultrasound to dx abscesses, leukocyte count ESR |
| TX modalities of PID | Goal is to control and eradicate the infecton and prevent the spread to toher body systems, systemic ABX IV or IM to destroy causative bacteria (unless caused by Herpes. Sitsz baths for pain, douche and sexual intercourse aavoid diurng active diseas |
| nursing interventions | Monitor VS and progeress of tx, provide fluids, change peri pads, personal hygeine, postive non judgemental attitude |
| DC Planning | Contact MD for fever, purulent discharge, teach significance of PID, compliance with med therapy, handwashing and personal hygiene, importance of sexual partners being examined and treated to avoid recurrence, avoid sexual activity until advised byMD |
| Toxic Shock Syndrome (TSS | acute bacterial infection caused by Staphylococcus aureus and usually occuring in women who are menstruating and using tampons . if a tampon is left in too long bacteri aprofliferate and release toxins into the blood stream. |
| S/S | also non menstruating women, flu-24 hrs, 2-4 dayss ofmenses (sudden fever, chills, NVD), Myalgia, hypotension, septic shock symptoms, hyperemia, rash, desquamation, decreased urine output, increase BUN, PE, AMS |
| DX of TSS | Vaginal smear with staph aureus, elevated BUN, reatinine, bilirubin levels, ALT> AST> CPK> |
| TX of TSS | IV ABX with C&S, Analgesics, IV fluids to maintain proper fluid balance, Antiemetics Oxygen for respiratory distress, Severe hypotension is treated with an intravenious adrenergicf drug such as Dopamine, lab data to eval fluid imbalance |
| Nursing interventions | bedrest, Monior VS and fluid status, pt teaching |
| Pt teaching for TSS | Avoid superabsorbent tampons, Alternate tampons with pads, changing tampons often (q4 hr), Insert tampons carefully, avoid laceratons, handwashing, seek medical attention if sudden fever when menstruating |
| why is vaginitis common in women with diabetes? | due to the increase of lgucose in the urin,theglucose can breed the moniial fungus due to the huygh carbohydrate content of glucose |
| Antifungals | Infections of the skin or mucous membranes may be treated with topical or vaginal prepartations, Deep seated or systemic onfections require oral or parenteral therapy |
| Action of Antifungals | fungicidal/fungisatic susceptible fungi by affecting the permeability of the fungal cell membrane or protein synthesis within the fungal cell itself |
| example of topical antifungal | butoconalzole, clotrimazole, miconazole nitrate, trioconazole ointment, nystatin terconazole, amphotecerin B |
| Trade and Generic names: butoconazole, clotrimazole | Femstat creame, mycelex-7, gyne-lotrimin, femcare |
| miconazole nitrate | monistat 7, monistat 3 |
| tioconazole ointment | vagistat 1 |
| nystatin | mycostatin |
| terconazole | terazol 7 terazol 3 |
| topical nystatin | nilstat, mycostating, O-V statin |
| topical amphotericin B | Fungizone-ream, lotion, ointment |
| Hypersensitivity, liver failure, kidny failure | contraindicaitons to antifungals |
| precautions | systemic antifungals with depressed bone marrow reserve, amphotecerin B cause renal impairment |
| adverse effects | rash, urticaria, pruritus, |
| nursing implications | Assess for s/s of infection throughout, skin and mucous membranes, skin irritation may indicate need to dc med |
| implementation of antifungals | consult physician for cleansing techinique before applying medication, wear gloves during application, do not use occlusive dressings unless specified by physician |
| pt teaching for antifungals | proper use of med, continue therapy for full course, advise pt to report increased skin irritation or lack of therapeutic response to health care professional |
| evaluation of TX with antifungals | resolution of s/s of infection, lenghth oftime for complete resolution dpeends on organism and site of infection, deepp seated fungal infections may require prolonged therapy (weeks-months), recurrent fungal infections - serious systemic ilness |
| Anti - Infectives | TX for Gonorrhea, Syphilis, HIV |
| Gonorrhea: | penicilin resistant strains of N. gonorrhoeae, pienicillin, the former drug of choice for treatement of gonorrhea, has been changed to ceftriaxone (rocephin) |
| anti infectives for yeast infections are antifungals such as? | butoconazole, clotrimazole, miconazole nitrate, tioconozaole , nystatin terconazole, topical nnystain, topical amphotericin B |
| what strong antifungal may cause renal damage and is therefore a last choice for treatment? | Amphotericin B |
Created by:
redhawk101
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