Nursing Pathophysiology

Draft study notes: bacterial vaginosis

Diagnosis (3 of or gram stain)

1. White vaginal discharge coating the vaginal wall,
2. A ph of above 4.5
3. Whiff test/ fishy odor
4. Clue cells- coccoid bacteria

Treatment

Symptomatic- treat

Asymptomatic- only pg women preparing for termination

First choice: Metronidazole oral 500 mg, metronidazole gel, > similar effectiveness

-alcohol (avoid during and one day after completion) use may lead to disulfiram-like reactions

clindamycin cream> less effective than met, oil-based hence weaken latex condoms and diaphragms,

probiotics- controversial with no reliable evidence

treatment of both partners- no evidence to support use hence not recommeneded

Pregnant women: associated with premature rapture of membranes, preterm labor, and postpartum endometriosis >screen when pg dgx is made. Use oral metronidazole recommended as opposed to topical

Relapse and reinfection: (3 episodes with 12 months)

Suppressive therapy- met gel (0.75%) for 4-6 months

Vaginal boric acid 600 mg for 21 days + metronidazole for seven days