Nursing/ 2nd stage Maternity N. Lecturer: Mryam Y.

Gynecological Infection/ Examination

Terms Related to Gynecology
1. Amenorrhea: The absence or cessation of the menstrual period
2. Dysmenorrhea: Pain associated with the menstrual period
3. Dyspareunia: Pain in the vagina or pelvis experienced by a woman during intercourse.
4. Dysplasia: The growth of abnormal cells, Precancerous condition.
5. Menorrhagia: Excessive bleeding during the menstrual period
In the number of days or amount of blood or both , Also called dysfunctional uterine bleeding (DUB)
6. Metrorrhagia: Bleeding between menstrual periods

The Pap Test

1. Consists of a ctology evaluation , Used for:
a. Early detection of cervical cancer
b. Detection of abnormal (atypical) cells of cervix
c. Detection of cancer of endometrium

Gynecological Infections Includes:

I- Local Infections II- Pelvic Inflammatory Diseases (PID's)
Local Infections: Doesn't effect on fertility
Vulvovaginitis:
- Is an inflammation or infection of the vulva & vagina.
- The most common symptom and Signs:
Strong-smelling vaginal discharge Itching Burning sensation Dysuria Dyspareunia
Infection around labia and perineal area Erythema Edema
- Causes:
- Bacteria: most common cause (Gardnella) - Yeast (Candida albicans)
- Viruses(Herpes) - STD,s (Trichomonas) - Parasites(Pinworms, Scabies)
- Environmental factors (poor hygiene, allergens, tight clothing, chemical irritant)
Gardenella Infection:
- Bacterial infections - Occasional Burning - little redness
- Vaginal discharge  gray , foul-smelling (fish-like), minimal amount
Treatment: Any antibiotic can work e.g. Flagyl (500% tid for 7 days)
Candida Infection:
- Symptoms & Signs:
1) Discharge: Milky whitish, thick (cheese-like) 2) Severe itching 3) Burning
 4) Dysuria 5) Dyspareunia 6) Erythema 7) Edema

- Treatment:
1) Nystatin 2) Clotrimazole
Trichomoniasis : - STD
- Symptoms & Signs:
1) Vaginal discharge: heavy, yellowish/greenish, foul-smelling 2) dysuria/ dyspareunia
3) Strawberry appearance of cervix (hemorrhagic spots around cervix 4) Edema
- Treatment:
7 days (1 course of antibiotics)  Both woman and Husband
In pregnant: Vaginal tablets 5gms for 5 days
II- Pelvic Inflammatory Diseases (PID's)

- Infections involving the upper organs of the genital tract (Endometrium, fallopian tubes, ovaries..etc)
- It is usually caused by gonorrhea or chlamydia and other mixed bacteria. The pathogens enter the uterus
through the infected cervix. Can be acute or chronic.

- Risk Factors:
1) Sexually active woman (young) 2) Recent IUD placement 3) History of STD
4) Post-operatively following pelvic surgery (C/S, D&C ) 5) Infection somewhere else in body
- Causes
- STD’s (most common) - Vaginal flora overgrowth
- Infection of pelvic structures - Cervical mucus changes

- Symptoms:
1) Fever 2) Lower abdominal pain 3) Yellow or green vaginal discharge
4) Dysuria 5) Dyspareunia 6) Sick appearance 7) Tachypnea 8) Increased pulse rate + Palpitation
Diagnosis: Diagnosis based on:
- Clinical history - Physical exam - Ultrasound (US) - Lab tests - Laparoscope
- Treatment:
1) Hospital admission 2) Hydration 3) Painkillers 4 ) Husband treatment
5) Triple antibiotics (effective for all types of bacteria :Augmentin Cephalosporin)

- Nursing considerations
1- Frequent assessment : 2- Pain control 3- Patient Education
- Complications - Mild analgesics
- Improvement of infection - Heating pad
- Comfort Positioning → Semi-fowler’