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DISORDERS OF THE VULVA (Bartholinitis (Assessment findings (Bartholinitis…
DISORDERS OF THE VULVA
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Vulvitis
Defination
Is an infection and inflammation of the vulva that is secondary to many condition such as diabetes mellitus.
Pathophysiology
The external female genitalia include labia majora, labia minora, clitoris and introitus become inflammated. It may occur as vulvovaginitis with vaginitis and may have infectious and non-infectious causes.
Assessment findings
Vulval irritation, pruritus and discomfort.
Risk factors
Contact with bacteria, vaginal infection and STDs, lack of estrogen, skin condition, allergens and irritants.
Symptoms
Itching, redness, burning,swelling, soreness and thickened or white patches, vaginal discharge, small cracks.
Causes
Vaginal sprays or douches, shampoos and hair conditioner, laundry detergents, topical creams and medication,colored or perfumed toilet paper.
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Nursing management
Measures to relieve irritation should be done, such as sitz bath with 1:30 dilution of savlon to water at least twice a day. External application of low dosage steroid ointment may be used as prescribed.
Health education
Nurse should teach the patient about good personal hygiene, nurse also should emphasize the importance of wiping from front to back so that the faeces is kept away from the vulva.
Bartholinitis
Assessment findings
Bartholinitis is usually present with a painful swelling that may form an abscess. Patient will find it difficult to walk or sit.
Symptoms
Pain and soreness in the region of one of the labia minora, swelling in the same area, possibly a slight discharge.
Pathophysiology
Bartholin gland are form cysts and abscesses in the women. Bartholin cyst form when the ostium of the duct become obstructed, leading to distention of the gland or duct with fluids.
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Risk factors
Infection around the vaginal area, injury around the vagina.
Nursing management
Assist patient to meet personal hygiene, monitor the state of the wound, assess the level of pain,a sitz bath to ease the patient pain and discomfort.
Defination
Is a bacterial infection of the bartholin's gland by gonococci, streptococci, escherichia and staphylococci.
Health education
Emphasize the importance of wiping from front to back, and teach the patient about good personal hygiene.
Bartholin's cyst
Causes
Doctors are not sure why the glands sometimes become blocked, in rare cases, it may be due to sexually transmitted infection like gonorrhea.
Pathophysiology
Bartholin's cyst form when the ostium of the duct becomes obstructed, leading to distention of the gland or duct with fluid. Obstruction is usually secondary to nonspecific inflammation or traum. Typically this lesion present as a gradually enlarging gland in an asymptomatic and menopausal women.
Assessment findings
Pain, pyrexia and dyspareunia.
Symptoms
Patient may not have any, unless the cyst is large or become infected. extreme pain at the site of cyst, sex and even walking may hurt.
Risk factors
Personal history of bartholin's cyst, sexually active and history of vulval surgery.
Defination
Is when the opening of the bartholin's gland becomes obstructed due to infection or injury and fluid may be accumulated.
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Nursing management
Administration of prescribed medication such as antibiotics and analgesics. Application of heat in the form of sitz baths. Daily wound care following incision and drainage.
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Medical management
Topical and local anesthetics, antibiotics for empiric treatment of STDs.
VULVAL DYSTROPHY
Symptoms
Burning, painful intercourse, itching, sores on the vaginal area scaling, cracking and bleeding of the vulva
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Assessment findings
Grey or white patches, vulvar skin become too thick or too thin
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Health education
Applying petroleum jelly in cases of dryness, and advise the patient not to scratch the vulva when it itchy.
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CANCER OF THE VULVA
Assessment findings
Patient may report pain on the vulva with chronic pruritus, dyspareunia and lump that continue to grow. Hard ulcerated on the vulva, dicharge become bloody and foul smelling.
Symptoms
Red, pink or white bumps that has a raw or wart-like surface. Persistent itching, pain burning while urinating, a white area that feels rough, bleeding and discharge not associated with menstruation.
Pathophysiology
Vulvar neoplasms may arise from varying cell origins. Because much of the vulva is made of skin, any type of skin cancer can develop there. The majority of vulvar cancers arise from squamous epithelial cells.
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Causes
Not known but may be related to chronic vulval irritation with general dermatitis and HPV in sexually transmitted diseases.
Risk factors
Hypertension, diabetes mellitus, presence of malignancies resulting in general debility.
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Health education
Inform the patient about the pathophysiology of the condition, Assist the patient with finding coping mechanism, Assist the patient cleaning herself and changing dressings.
Surgical management
Surgery may involve a wide local excision, radical partial vulvectomy or radical complete vulvectomy with the removal of vulvar tissues, inguinal and femoral lyphy node.
Nursing management
Administering medication as prescribed, Use sterile dressings if applying dressing, A sitz bath and vulval swabbing to promote comfort and keep the lesion clean.
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