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A client with vaginitis complains of itching and burning of the perineum. Which suggestion by the nurse would be most appropriate to relieve the client's symptoms?
- A. Use a pure vinegar douche daily.
- B. Use skin protectants containing zinc oxide.
- C. Take sitz baths frequently.
- D. Avoid yogurt with active lactobacilli cultures.
Correct Answer: C
Rationale: Sitz baths are recommended to relieve the client's itching and burning as well as relieve swelling of the vulva and perineum. Skin protectants containing zinc oxide promote healing. Routine douching should be avoided. Taking Lactobacillus acidophilus in capsule form or eating yogurt containing active cultures of lactobacilli can help restore normal vaginal microoorganisms.
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The nurse is collecting assessment data on a client who is reporting a vaginal discharge that is cottage cheese-like in appearance. Which pathogen is the most likely cause for this symptom?
- A. Gonococci
- B. Candida albicans
- C. Trichomonas vaginalis
- D. Gardnerella vaginalis
Correct Answer: B
Rationale: Candida albicans is a yeast infection that presents with a thick, curdy white discharge. Gonococcus is the organism that causes gonorrhea and presents with a yellow, mucoppuntent discharge. Trichomonas vaginalis presents with a foamy, white foul-smelling discharge and Gardnerella vaginalis is a watery, fishy-smelling discharge.
The nurse is caring for a client who has experienced repeated episodes of vaginitis. Which assessment finding does the nurse explain is the most likely cause?
- A. Tub baths preferred over shower
- B. Healthy sex life
- C. Occasional use of vinegar douches
- D. Type 2 diabetes mellitus
Correct Answer: D
Rationale: Unregulated blood sugars can result in alteration of the vaginal environment and promote the presence of glycogen in vaginal mucus, which supports the growth of microorganisms. Monitoring and controlling blood sugars would be key in a client with diabetes. Tub baths and participation in a healthy sex life are not associated with vaginitis. Frequent douching should be avoided.
Culture of client's vaginal discharge reveals Gardnerella vaginalis. Which of the following would the nurse expect to assess?
- A. Foul foamy discharge
- B. Thick curry white discharge
- C. Fisy smelling watery discharge
- D. Yellowish white discharge
Correct Answer: C
Rationale: Gardnerella vaginalis is associated with a gray white, watery, fisy smelling vaginal discharge. The discharge associated with a Candida infection is curry white and thick, and has a strong odor. Discharge due to trichomonas vaginalis is yellow white, foamy, and has a foul odor.
Following a radical vulvectomy, the nurse is preparing the client for discharge to home. Which care intervention would be considered the priority for this client?
- A. Relieving edema to lower extremities
- B. Alterations for sexual function
- C. Prevention of wound complications
- D. Care of colostomy site
Correct Answer: C
Rationale: Prevention of complications and infection is paramount due to the location of the wound. The perineal area provides a warm, dark environment that supports the growth of microorganisms that can be introduced into the wound. With a radical vulvectomy, is is likely to find surgical drains and urinary catheter that can also interfere with the maintenance of the wound. Relieving edema to the lower extremities may be a necessary part of care if the lymph nodes and blood vessels are disturbed. The client may have a colostomy and care instructions should be provided. Alteration in sexual function needs to be addressed but is not a priority for the initial stage of healing.
The nurse is caring for a client with polycystic ovarian syndrome. On which associated problem(s) will the nurse focus teaching? Select all that apply.
- A. Hypertension
- B. Hyperlippiedemia
- C. Infertility
- D. Absence of body hair
- E. Weight loss
- F. Decreased Insulin
Correct Answer: A,B,C
Rationale: Polycystic ovarian syndrome is associated with multiple endocrine abnormalities such as abnormal lipid levels, hypertension, and difficulty with conceaving due to interference of ovulation. Other symptoms include excessive body hair, weight gain, and overproduction and inefficient use of insulin.