Abx use DM poor hygiene menopause frequent douching Allergies HIV infection

Abx use dm poor hygiene menopause frequent douching

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Abx use, DM, poor hygiene, menopause, frequent douching Allergies, HIV infection, intercourse with an infected partner, low estrogen levels, oral-genital contact, pregnancy, premenarche, synthetic clothing, tight undergarments, oral contraceptives Vaginitis Group of conditions that cause vulvovaginal symptoms MCC- bacterial vaginosis S/S- itching, irritation, burning, abnormal discharge Table 57-1 p. 1688 Sitz bath with cool water to help with irritation 20
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Provide topical vaginal estrogen therapy Candidiasis Fungal or yeast infection - 75% of women get at least one in their lifetime, 3+/yr: look for immunosuppressive disease (diabetes or autoimmune disorder) Oral contraceptive use increases risk Cause is alteration of internal environment S/S- discharge that causes pruritus and irritation- can be watery or thick like cottage cheese, symptoms are worse before the period and hard to treat during pregnancy, do not use OTC to treat b/c you do not know what you are treating Diagnosis- spores and hyphae on microscopic exam/ pH 4.5 or less Treatment- miconazole, nystatin, clotrimazole, fluconazole Bacterial Vaginosis Overgrowth of anaerobic bacteria, Gardnerella vaginalis and no lactobacilli present During pregnancy can cause low birth weight / premature delivery R/F- douching, smoking, multiple partners, other STDs S/S – heavy discharge gray-yellowish white, fishlike odor, pH greater than 4.7, burning w urination Diagnosis- whiff test and clue cells Treatment- metronidazole (flagyl) PO BID for 7 days and/or clindamycin cream/suppositories If untreated endometriosis & pelvic infections Trichomoniasis Caused by Trichomonas vaginalis -- asymptomatic in 75-85% of women that have it Increases changes of cervical neoplasia, post op infections, pregnancy problems, PID and infertility S/S- thin, frothy, yellow to yellow-green discharge, odor and irritation Diagnosis- microscopic assessment of smear and “strawberry spots” , pH greater than 4.5 Treatment- metronidazole or tinidazole 1x 1-2g PO once or PO TID for 1 week- NO ETOH Nursing Care Determine probable cause Physical or chemical factors Psychogenic factors Medical conditions Use of medications New or multiple sex partners Educate patient of ways to prevent further infections based on cause -- do not have unprotected sex, avoid bubble baths & frequent douching, good hygiene, wear cotton underwear, proper hand hygiene before and after adminstering meds, lay down 30 min after insertion, some sepage is normal -- may want to use a pad, avoid OTC medications Fistulas: management (rectocele can have a douche) Structural Disorders Fistulas of the Vagina: (opening between 2 internal organs or between an internal & external opening) Congenital, other countries from external labor complications Clinical Manifestation- depends on defect Diagnosis- symptoms/methylene blue dye/ indigo carmine instilled in the bladder and if it appears in the
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