Primary Nursing Diagnosis

Risk for infection related to invasion or proliferation of microorganisms

OUTCOMES. Immune status; Knowledge: Infection control; Risk control; Risk detection; Nutritional status; Risk control: Sexually transmitted disease; Tissue integrity: Skin and mucous membranes

INTERVENTIONS. Medication administration; Medication management; Perineal care; Surveillance; Bathing; Teaching: Sexuality; Teaching: Disease process

^ PLANNING AND IMPLEMENTATION Collaborative

Once vaginitis is diagnosed, the primary treatment is pharmacologic. Patients are told to stop using any douches and feminine hygiene sprays, to observe good nutrition, and to maintain healthy exercise patterns.

Pharmacologic Highlights

Medication or Drug Class

Dosage

Description

Rationale

Antifungals

Varies with drug; given as a vaginal cream or suppository or PO

Miconazole nitrate, clotrimazole, nystatin, terconazole, buto-conazole, fluconazole

Treat vaginal candidiasis

Metronidazole

Single 2-g dose PO for patient and sexual partner; 500 mg bid for 7 days for bacterial vaginosis

Antibacterial

Disrupts susceptible microorganisms and acts as a bactericidal drug; used to treat trichomoniasis or bacterial vaginosis

Other Drugs: Bacterial vaginosis may also be treated with metronidazole vaginal gel, oral clindamycin, and clindamycin vaginal cream.

Independent

Encourage the patient to get adequate rest and nutrition. Encourage the patient to use appropriate hygiene techniques by wiping from front to back after urinating or defecating. Teach the patient to avoid wearing tight-fitting clothing (pantyhose, tight pants or jeans) and to wear cotton underwear rather than synthetics. Explain to patients that the risk of getting vaginal infections increases if one has sex with more than one person. Teach the patient to abstain from sexual intercourse until the infection is resolved. If the patient has Trichomonas, her partner needs treatment as well. Teach the patient that the inflammation caused by the Trichomonas increases her susceptibility to HIV

The pain and itching from vaginitis may be quite intense until the medication is effective. Some women find that by applying wet compresses and then using a hair dryer on a cool setting several times a day provides some relief of itching. Other women find that a cool sitz bath provides comfort. For yeast infections, tepid sodium bicarbonate baths and applying cornstarch to dry the area may increase comfort during treatment. Be informed about which sexually transmitted diseases need to be reported to the local health department.

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