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