Charli Souza Main Post
COLLAPSE
A 28 year old female with an offensive and fishy-smelling, abnormal vaginal discharge is characteristic for bacterial vaginosis. BV is not always associated with sexual intercourse as it can be from a a change in the pH or normal bacteria in the vagina (Fenstermacher & Hudson, 2016). Douching, tampon use, or new/multiple sex partners can all be causes of BV. In order to evaluate this patient, I would first assess the vaginal discharge during a pelvic examination. There are a few diagnostic tests that can be done to diagnose this. According to Fenstermacher and Hudson (2016) there are 4 diagnostic tests that can be done in which 3 out of the 4 must be present to diagnose BV. First the pH can be tested. A pH that is greater than 4.5 may indicate BV. Another diagnostic test is to simply assess the vaginal discharge. Discharge that is copious, thin, grey-white that coats the vagina indicated BV (Fenstermacher & Husdon, 2016). A third diagnostic test is the positive whiff test. This test uses 10% KOH to the sample and produces a fishy odor that can be smelled. A fourth test is clue cells on wet prep that shows 20% more clue cells than epithelial cells when looks at under a microscope (Fenstermacher & Hudson, 2016). There are no NPO or fasting that must take place before examination. It would be best for the patient to be free from sexual intercourse prior to the exam.
Education that should be given to the patient is to avoid any type of douching and the use of tampons. This patient is married and has one sex partner so there is not a concern with multiple sex partners. There is also no need to treat the partner for this. Sex should be avoided during antibiotic treatment. The patient may benefit from using cotton, lose fitting underwear (Fenstermacher & Hudson, 2016).
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Fenstermacher, K., and Hudson, B. (2016). Practice guidelines for family nurse practitioners, 4th Edition. St. Louis, Missouri: Elsevier.
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