Primary Nursing Diagnosis

Pain related to infectious process

OUTCOMES. Pain control; Pain level; Comfort level

INTERVENTIONS. Medication administration; Pain management; Heat/cold application; Analgesic administration


Without treatment, this disease process can be lethal for women. The goal is to rid the patient of infection and preserve fertility if possible. Because no single antibiotic is active against all possible pathogens, the Centers for Disease Control and Prevention (CDC) recommends combination

708 Pelvic Inflammatory Disease regimens. These regimens vary if the patient is hospitalized or treated on an outpatient basis. Usually, the treatment is with broad-spectrum antibiotics. Both the affected woman and her sexual partner(s) should be treated with antibiotics. Women with PID are usually treated as outpatients, but if they become acutely ill, they may require hospitalization. The hospitalized patient with PID usually is placed on bedrest in a semi-Fowler position to promote vaginal drainage. Priority should be given to timely administration of intravenous (IV) antibiotics to maintain therapeutic blood levels. IV fluids may be initiated to prevent or correct dehydration and acidosis. If an ileus or abdominal distension is present, a nasogastric tube is usually inserted to decompress the gastrointestinal tract. Urinary catheterization is contraindicated to avoid the spread of the disease process; tampons are also contraindicated. If the woman has an IUD, it is removed immediately.

If antibiotic therapy is not successful and the patient has an abscess, hydrosalpinx (distension of the fallopian tube by fluid), or some type of obstruction, a hysterectomy with bilateral salp-ingo-oophorectomy (removal of ovaries and fallopian tubes) may be done. A laparotomy may be done to incise adhesions and to drain an abscess. Signs of peritonitis, such as abdominal rigidity, distension, and guarding, need to be reported immediately so that medical or surgical intervention can be initiated. If the patient is poorly nourished, a dietary consultation is indicated.

Analgesics are prescribed to manage the pain that accompanies PID. Comfort measures can include the use of heat applied to the abdomen or, if they are approved by the physician, warm douches to improve circulation to the area. (See other interventions for pain in the following section.)



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