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PELVIC INFLAMMATORY DISEASE (assessment and common findings (pyrexia and…
PELVIC INFLAMMATORY DISEASE
Definition
it is a clinical syndrome that describes simultaneous infection of several infection of several organs in the female reproductive system by several infective organs
risk factors
abortion or childbirth
pueperium
sexual intercourse
causes
causal organisms include; Gonococci, Chlamydia, Gardnerella vaginalae, Klepsiella, Streptococci, Staphilococci, Eschericia coli, Trichomonas
viruses
parasites
assessment and common findings
pyrexia and tachycardia
nausea and vomiting
mucopurulent and malodorous vaginal discharge
dyspareunia
urinary frequency and urgency
if an abscess forms,there is abdominal distention and rigidity
lower abdominal pain
there may be lower abdominal tenderness with guarding denoting peritonitis
medical and surgical management
antibiotics of choice depending on the infective organism as identified in the culture and sensitivity test
a single dose of ciprofloxacin 500mg may be prescribed to treat gonorrhoea
doxycycline 100mg twice a day for ten days will treat Chlamydia
metronidazole 400mg three times a day will be prescribed for anaerobic organisms
nursing management and health education
monitor and accurately monitor vital signs
using gloves observe vaginal discharge by recording a pad check every time
provide plenty of water to drink
maintain the patients personal hygiene by giving a daily bat, vulva swabbing, and changing undercloths daily
wash hands after attending the patient
health education
stress the importance of good personal hygiene
washing hands after each pad change
daily exercise and proper nutrition
counseling is necessary
pathophysiology
the infective organ colonise the vagina and cervix causing a low grade vaginitis and cervicitis
the infection ascends to the uterus and fallopian tube causing endometritis, salpingitis and oophoritis. the endometrim may be necrotic in appearance.
salpingitis and oophoritis causes the tubes to become congested, oedematous and occluded with limited mobility.
the ovaries become inflammed and oedematous and may adhere to the fimbria of the tubes
the inflammation of the tubes and the ovaries may suppurate and develop to an abscess that will later burst into the pelvic peritoneal cavity
occasionally the infection may be through the blood stream, the increased blood supply to the fetus may provide a viable pathway for the infection
with broad-spectrum antibiotic treatment the infection may resolve. adhesions may result in ectopic pregnancies or infertility afterwards