Vaginitis: Causes, Symptoms & Treatments - Essay Sample

Introduction

Vaginitis is defined as vaginal inflammation, that is usually as a result of infections. The patient often experiences possible pain, itching, discharge, and even burning in the vagina (Eckert, 2006). The condition is common among women, and women ought to go through it at least once in their life. The vagina is usually a muscular canal found in a woman's body, from the cervix to the outside. The vagina usually has a lining that contains a mucous membrane. The average length of the vagina is about 6 or 7 inches (Eckert, 2006). The vaginal opening is the only part of the vagina that can be seen from the outside. The current paper discusses acute vaginitis as a condition experienced by women. Additionally, the paper explains a case of a 35yr old woman from Ethiopia, who suffers from the disease.

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Pathophysiology

The physiologic discharge said to be normal contains mucus, vaginal discharges, and exfoliated cells. The vaginal emancipation varies depending on the age, pregnancy, menstrual sequence of an individual (Eckert, 2006). Additionally, the discharge can depend on whether the person uses oral contraceptives or not.

The vaginal environment, when regular usually comprises of a mixture of Lactobacillus acidophilus together with other estragons, flora, PH and different results of pathogens and flora. Acidophilus is responsible for the production of hydrogen peroxide. The hydrogen peroxide produced is usually nonfriendly to pathogens, and thus keeps them away, which results in a favorable PH in the vagina. The PH ranges from 3.9 to around 4.3. Vaginitis is usually as a result of the availability of pathogens in the vagina, which alters the vaginal flora (Eckert, 2006). Additionally, vaginitis can be as a result of a change in the environment of the vagina, which in turn allows pathogens to survive.

The use of contraceptives, antibiotics, sexual intercourse, and stress can alter the environment of the vagina, and thus cause pathogens to survive in it. In vaginosis, scientists believe that some stimulating activities in the vagina tend to decrease the organisms that produce hydrogen peroxide (Hainer & Gibson, 2011). Due to the lack of hydrogen peroxide, there is a change in the vaginal PH. This results in the survival of organisms that are usually suppressed. Examples of such microorganisms are mobiluncus and G. vaginalis. The organisms typically yield some metabolic byproducts, for instance, amines, that increase the PH of the vagina and result in exfoliation of the epithelial cells (Hainer & Gibson, 2011). The amines also cause the characteristic stinking discharge in the infectious vaginosis.

Likewise, variations in the virginal environment, for instance, the upsurge in the production of glycogen during pregnancy or alteration of the levels of progesterone and estrogen due to the use of contraceptives increase the devotion of c. Albicans to the cells of the vagina and that leads to yeast germination in the vagina (Hainer & Gibson, 2011). The above changes may lead to the transformation of asymptomatic colonization to symptomatic infections. Alteration in the progesterone and estrogen levels, together with the PH levels in people suffering from trichomoniasis may boost the occurrence of vaginalis.

Pharmacology

Metronidazole 500 mg tablet

Metronidazole tablet is in a group of medicines that are referred to as anti-infective agents (Rediguieri, Porta, Nunes, Junginger, Kopp & Barends, 2011). The tablets may be used to treat the following conditions:

Infections that may be caused by bacteria in the brain, stomach, blood, or pelvic areas that may be caused by childbirth or wounds that are left after an operation

Genital infections that may be as a result of trichomonas or parasites

Genital infections that may arise in women as a result of bacteria

Amoebiasis, which is usually a parasitic disease

Giardiasis

Infections of the teeth and gum

Before Taking. Before taking metronidazole tablets, there are some aspects that one should first consider. One should not take metronidazole tablets if he/she is allergic to them, or any ingredient used in its manufacture. If the patient knows that they are allergic, they should tell the doctor so as for the doctor to make another prescription of a drug that can play the same role.

Patients should check the following with their doctor before taking metronidazole tablets.

• Whether they have kidney complications
• Whether they have ever suffered from liver disease
• Whether they are in the fourth to the ninth month of pregnancy
• Whether they are suffering from porphyria
• Whether they have any blood disorder
• Whether they have any disturbance of the nervous system
• Whether they are suffering from any sexually transmitted disease

Possible Side Effects. Similar to any other medicine, metronidazole tablets can lead to side effects. The side effects are mostly experienced at the beginning of taking the medication. However, not everyone experiences the side effects (Rediguieri et al.2011). A patient who is taking metronidazole tablets should inform his/her doctor once he/she experience the following side effects:

• The appearance of bruises, sore throats, and nose bleeding. The doctor should take a blood test because the medicine may alter with the blood cells.
• Mental problems such as hallucination, dizziness, encephalopathy, or drowsiness. The patient may also feel pain in the legs and arms or numbness
• The person may also experience cerebellar syndrome, whereby he/she has poor muscle control and coordination
• Short-sightedness and double vision are other side effects of this medicine
• Skin rashes and darkening of urine are other side effects of metronidazole

Clindamycin Vaginal Cream

This medication helps in the treatment of bacterial vaginosis (Bradshaw, Pirotta, Guingand, Hocking, Morton, Garland, & Fairley, 2012). The medicine is an antibiotic that helps by preventing bacteria growth in the vagina. By stopping the growth of bacteria, the medication is efficient in the treatment of vaginosis. Thus, it can be used as an alternative for metronidazole.

A study was conducted whereby, clindamycin vaginal cream was compared to metronidazole. One hundred eighty-five women suffering from bacterial vaginosis were used to help in the study experiment (Bradshaw et al. 2012). Capsules were used for the group that was to experiment using clindamycin. Placebo cream was administered for the group that was to test metronidazole. The results showed that clindamycin cream has similar proficiency compared to oral metronidazole.

Additionally, there were no observed relapses in the group that used clindamycin cream. In the metronidazole group, seven percent relapse was observed. Also, the clindamycin group had a 3% failure compared to 15% in metronidazole.

Differential Diagnoses

The differential diagnosis of acute vaginitis is based on physical examinations, symptoms of patients, and also the results obtained from the test of the PH litmus (Hainer & Gibson, 2011). The history of the symptoms should be recorded, including the problem's duration, the smell and the color of the discharge. Fever and abdominal pains in women are another sign that they may be suffering from acute vaginitis, and thus such women should visit the doctor. Additionally, the discharge of thrush in women is also a possible symptom that needs examination.

Priority Diagnoses

• To diagnose vaginitis, the doctor is likely to carry out the following steps:
• The doctor may review the person's medical history, which includes one's history of sexually transmitted diseases
• The doctor may also perform a pelvic exam. In the pelvic exam, the medic uses a speculum to look inside one's vagina to see if there is abnormal discharge
• The doctor may also collect a sample of the vaginal or cervical discharge to perform tests in the lab to confirm the available type of vaginitis
• The doctor may also need to check the PH of the vagina by the application of a PH paper or PH stick on the walls of the person's vagina
• The rationale for crucial elements of the plan of care

They include the following:

• The assessment of the client, diagnostic reports, and the medical reports of the client. To create a care plan, this is usually the first step.
• The long term or short-term patient outcomes that are expected should be outlined
• Nursing interventions should also be documented in the plan
• Validation for responses to base the care on evidence
• Evaluation is the last strep
• Review the Provisions of the ANA Code of Ethics

The Nature of Health

During my encounter with the patient, I made sure that I respected the patient regardless of the reasons that directed to her health status. For instance, I realized that her illness was as a result of unprotected sex, but I still respected the patient according to the provisions of the code. Additionally, I provided care to the patient and gave her the support that she needed to get well.

Actual or Potential Cultural Implications for This Encounter

Due to cultural diversity, it is of essence that nurses should know the cultural implications of the services they offer to patients (Kagawa & Kassim, 2003). The cultural differences between patients and nurses may play a role in affecting their relationship. Some of the potential cultural barriers include differences in genetics and communication barrier.

The Actual and Potential Barriers for Patients

Shortage of health providers is one barrier that faces patients. One reason for the lack of health providers is the uneven distribution of healthcare providers, with most of them working in urban areas (Lippe, 2019). Some clinics in the rural areas are staffed by voluntary community health providers or visiting doctors who leave after a short duration of time.

Financial barriers are also a problem in the provision of healthcare to patients. The lack of money for health insurance and the high cost of treatment are barriers to health care (Lippe, 2019). Additionally, some patients lack funds for life-sustaining treatments that they require.

Nonfinancial barriers are barriers that are not as a result of financial problems. There are four common nonfinancial barriers to healthcare (Lippe, 2019). The obstacles include accommodation, whereby individuals are busy with other commitments or work. Availability is the second nonfinancial barrier, whereby patients couldn't get an appointment in time. Another nonfinancial wall is accessibility, whereby patients took a long time to get to the doctor. The fourth nonfinancial barrier is acceptability, whereby a given hospital or physician could not accept insurance.

Three Priority Social Determinants of Health for Patient

The three priority social determinants of the health of my patient were affordable housing, availability of healthy foods, and education (Social Determinants of Health | CDC, 2019). Poverty levels limit the quality of food that patients consume, together with the housing that they live in. Proper education results in good health since individuals can live well.

Relevant Health Care Policy

Nurses should advocate for the healthcare policies that assist in eliminating poverty so as for their patients to afford them (Virginia Henderson Repository, 2019). In my case, the relevant policy is on the eradication of poverty and the provision of free health services by the government. I support the incorporation of SDOH into the policies of the public for it will help in the improvement of healthcare services.

Evidence-Based Practice

I used diagnosis questions to direct my search in the library database. The reason for this is because I needed to get a diagnosis to separate different diseases with similar symptoms. The research is of good quality because there is the presence of e...