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Infect Female Repro
MAMC exam 8 infections of the female reproductive tract
| Question | Answer |
|---|---|
| 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
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