Pp03l042_infection Of Female Repro

Infections of the Female Reproductive Tract

Terminal Learning Objective: 

Given a scenario of a patient with an infection of the female reproductive system

Enabling Learning Objectives: A. Describe the etiology/ pathophysiology, assessment, diagnosis, medical and nursing management of infections of the female reproductive system

Vaginitis:

Vaginitis:  

Definition – inflammation of the vagina Causes: – E. coli – Staphylococcal and streptococcal organisms – T. vaginalis – Candida albicans (fungus) – Gardnerella

Vaginitis:    

Commonly occurs during pregnancy After antibiotic therapy Diabetes Vaginitis may persist for years

Vaginitis:  Other factors

– – – – – –

Presence of glucose or glycogen in the urine Vaginal pH Hormonal changes Long term use of birth control pills Use of systemic antibiotics Compromised immunity

Vaginitis: 

Types of Vaginitis: – Bacterial Vaginosis – Atrophic (Senile) Vaginitis

Vaginitis: 

Signs and symptoms – Yellow, white, or grayish white exudate. – Perineal pruritis – discomfort in lower abdominal region – Dysuria – Painful intercourse

Vaginitis: 

Diagnosis – – –



Visual exam Culture Bimanual exam

Treatment – Vaginal suppositories, ointments, and creams – Douching frequently prescribed

Vaginitis:

Vaginitis: 

Nursing Interventions – Seek Tx with s/s of infection – Medications – Hygiene – Tx sexual partners – Refrain or us condom

Cervicitis

Cervicitis Definition – inflammation or infection of the cervix  One of the most common diseases  Causes 

– – – –

Vaginal infections or STDs Lacerations r/t childbirth or abortions Frequent douching Forgotten tampon

Cervicitis 

Signs and symptoms – – – –

Leukorrhea Menstrual irregularities Dyspareunia Backaches

Cervicitis 

Treatment – – – –

Specific to causative organism Suppositories, ointments, and creams Personal hygiene & warm tub baths Electrocautery or conization (if severe)

Pelvic Inflammatory Disease (PID)

Pelvic Inflammatory Disease (PID) 

Definition: Any acute, subacute, recurrent, or chronic infection of the cervix, ovaries, fallopian tubes, or uterus that has extended to the connective tissues lying between the broad ligaments

Pelvic Inflammatory Disease (PID) 

Infection enters the pelvic organs through – – –

Vagina, peritoneum Lymph glands Blood stream

Pelvic Inflammatory Disease (PID) 

Signs and symptoms – Foul smelling vaginal discharge – Backache – Pelvic, abdominal pain – Fever, chills, malaise – Nausea, vomiting – Menorrhagia – Dysmenorrhea – Dyspareunia

Pelvic Inflammatory Disease (PID) 

Diagnosis – – – – –

Gram’s stains of secretions Culture and sensitivity Laparoscopy Ultrasound Leukocyte count, ESR

Pelvic Inflammatory Disease (PID) 

Treatment modalities – – – –

Bedrest Systemic antibiotics Sitz baths to relieve pain Douches and sexual intercourse avoided

Pelvic Inflammatory Disease (PID) 

Nursing Interventions – – – – –

Monitor Avoid dehydration Palliative measures Patient support Discharge planning

Toxic Shock Syndrome

Toxic Shock Syndrome (TSS) Definition – acute bacterial infection  Menstruating and using tampons  Cause – Bacterium Staphylococcus aureus  May be seen in men and in nonmenstruating women 

Toxic Shock Syndrome (TSS) 

Signs and symptoms – Flu-like signs and symptoms first 24 hours – Between days 2-4 of menses: » High fever, chills » Nausea, vomiting, diarrhea » Myalgia » Hypotension » Septic shock » Hyperemia

Toxic Shock Syndrome (TSS) Red, macular palmar or diffuse rash » Decreased urine output. » Increased BUN » Disorientation. » Pulmonary edema »

Toxic Shock Syndrome (TSS) 

Diagnosis – – –

Vaginal smear Elevated BUN, creatinine, bilirubin levels ALT, AST, CPK depression

Toxic Shock Syndrome (TSS) 

Treatment modalities – – – – – –

IV antibiotics Analgesics IV fluids Antiemetics. Oxygen Adrenergic drug

Toxic Shock Syndrome (TSS) 

Nursing Interventions – – –

Bedrest Monitor Patient teaching

CHECK ON LEARNING: 

Why is vaginitis common in women with diabetes?

ANSWER 

Because of the increase of glucose in the urine. The glucose can breed the monilial fungus due to the high carbohydrate content of glucose.

QUESTIONS