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Treatments for Diseases contagious from vaginal sex

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Book Excerpts: Treatment of Diseases contagious from vaginal sex

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Dysmenorrhea: Treatment
(In a Page: Signs and Symptoms)

  • Primary dysmenorrhea is initially treated with NSAIDs
    –High-dose ibuprofen may be administered beginning the day before the onset of menses
    –Oral contraceptives with or without NSAIDs may be effective when NSAIDs alone are inadequate
    –Low-fat vegetarian diet, a fish oil supplement, and vitamin E may reduce pain severity
  • Patients unresponsive to NSAIDs and oral contraceptives should be evaluated for pelvic pathology (secondary dysmenorrhea)
    –Endometriosis: GnRH analogs, danazol; laparoscopy in severe cases; treat infertility if necessary
    –Adenomyosis: Hysterectomy is treatment of choice
    –Leiomyoma: Removal, embolization, hysterectomy
    –Pelvic inflammatory disease: Antibiotics, oral contraceptives (to prevent ectopic pregnancy), treat infertility if necessary
    –Treat depression and/or anxiety as necessary

» READ BOOK EXCERPT ONLINE »

Source: In a Page: Signs and Symptoms, 2004

Vaginal Discharge: Treatment
(In a Page: Signs and Symptoms)

  • See most recent CDC guidelines for all STDs
  • Trichomonas
    –Metronidazole single dose or for 7 days (avoid alcohol with metronidazole use)
    –Intravaginal clotrimazole if pregnant or unable to use metronidazole
  • Gonorrhea
    –Oral ciprofloxacin or IM ceftriaxone
  • Chlamydia –Azithromycin or doxycycline orally
  • Bacterial vaginosis
    –Metronidazole single dose or for 7 days
  • Candida
    –Clotrimazole cream or intravaginal suppository
    –Fluconazole single dose
  • Atrophic vaginitis
    –Topical or oral hormone replacement if appropriate
  • Advise to avoid douching/perfumed hygiene products
  • >

    » READ BOOK EXCERPT ONLINE »

    Source: In a Page: Signs and Symptoms, 2004

    Vaginal Discharge: Treatment
    (In A Page: Pediatric Signs and Symptoms)

    • Physiologic leukorrhea: Provide reassurance
    • Irritative vaginal discharge: Educate on proper wiping techniques, avoidance of tight clothing and irritants
    • Foreign bodies such as toilet paper can usually be removed with gentle vaginal lavage, sitz baths
    • Treatments for infectious causes of vaginal discharge:
      –Bacterial vaginosis: Metronidazole or topical clindamycin
      Candida can be treated with topical or oral antifungals
      Trichomonas is treated with metronidazole
      –Group A β-hemolytic streptococci: Penicillin
      Chlamydia is treated with doxycycline or azithromycin
      –Gonorrhea: Ceftriaxone, ciprofloxacin, or ofloxacin
      Shigella is treated with trimethoprim-sulfamethoxazole
      • Encourage barrier contraception in sexually active adolescents

    » READ BOOK EXCERPT ONLINE »

    Source: In A Page: Pediatric Signs and Symptoms, 2007

    Dysmenorrhea: Treatment
    (Professional Guide to Diseases (Eighth Edition))

    Initial treatment aims to relieve pain. Pain-relief measures may include:

    ❑ analgesics (such as aspirin) for mild to moderate pain (most effective when taken 24 to 48 hours before onset of menses; are especially effective for treating dysmenorrhea because they also inhibit prostaglandin synthesis; stronger anti-inflammatories may be used.

    ❑ opioids if pain is severe (infrequently used)

    ❑ prostaglandin inhibitors (such as mefenamic acid and ibuprofen) to relieve pain by decreasing the severity of uterine contractions

    ❑ cox-2 inhibitors (such as celecoxib, rofecoxib, and valdecoxib) to promote comfort

    ❑ heat applied locally to the lower abdomen (may relieve discomfort in mature women but isn’t recommended in young adolescents because appendicitis may mimic dysmenorrhea).

    For primary dysmenorrhea, administration of sex steroids is an effective alternative to treatment with antiprostaglandins or analgesics. Such therapy usually consists of hormonal contraceptives to relieve pain by suppressing ovulation. However, patients who are attempting pregnancy should rely on antiprostaglandin therapy instead of hormonal contraceptives to relieve symptoms of primary dysmenorrhea.

    Because persistently severe dysmenorrhea may have a psychogenic cause, psychological evaluation and appropriate counseling may be helpful.

    In secondary dysmenorrhea, treatment is designed to identify and correct the underlying cause. This may include surgical treatment of underlying disorders, such as endometriosis or uterine leiomyomas. However, surgical treatment is recommended only after conservative therapy fails.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Diseases (Eighth Edition), 2005

    Dysmenorrhea: Patient counseling
    (Professional Guide to Signs & Symptoms (Fifth Edition))

    If dysmenorrhea is idiopathic, advise the patient to place a heating pad on her abdomen to relieve the pain. This therapy reduces abdominal muscle tension and increases blood flow.

    Effleurage, a light circular massage with the fingertips, may also provide relief. Other comfort measures include drinking warm beverages, taking a warm shower, performing waist-bending and pelvic-rocking exercises, and walking. Inform the patient that increasing aerobic exercise and dietary intake of vitamin B1 and fish oil capsules have also proved effective in relieving dysmenorrhea.

    Inform the patient that taking a nonsteroidal anti-inflammatory drug (NSAID) 1 to 2 days before the onset of menses is usually helpful. If she isn’t trying to get pregnant, taking monophasic birth control pills is also beneficial. Warn the patient that both of these treatments may reduce menstrual flow and duration. Be sure to rule out the possibility of pregnancy before starting contraceptive or NSAID therapy. Explain the actions and adverse effects of these drugs. (See Relief for dysmenorrhea.)

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

    Vaginal discharge: Patient counseling
    (Signs & Symptoms: A 2-in-1 Reference for Nurses)

    Teach the patient to keep her perineum clean and dry. Also, tell her to avoid wearing tight-fitting clothing and nylon underwear and to instead wear cotton-crotched underwear and pantyhose. If appropriate, suggest that the patient douche with a solution of 5 tbs of white vinegar to 2 qt (2 L) of warm water to help relieve her discomfort.

    If the patient has a vaginal infection, tell her to continue taking the prescribed medication even if her symptoms clear or she menstruates. Also, advise her to avoid intercourse until her symptoms clear and then to have her partner use condoms until she completes her course of medication. If her condition is sexually transmitted, instruct her on safer sex methods.

    » READ BOOK EXCERPT ONLINE »

    Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

    Dysmenorrhea: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

     Assess the patient's level of discomfort and use pharmacologic and nonpharmacologic methods to relieve discomfort.

    Patient teaching

    Encourage the patient to view dysmenorrhea as a medical problem—not as a sign of maladjustment—and explain her treatment options. (See Relief for dysmenorrhea.)

     Explain the cause of the patient's dysmenorrhea once a diagnosis is established.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007

    Vaginal discharge: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

     Obtain cultures of the vaginal discharge.

     Give antibiotics, antivirals, or other drugs, as ordered.

     Observe standard precautions to prevent the spread of infection.

    Patient teaching

     Explain to the patient the cause of vaginal discharge and its treatment.

     Teach the patient proper perineal hygiene and advise her to avoid tight-fitting clothing and nylon underwear.

    Suggest douching with vinegar and warm water to help relieve discomfort, if appropriate.

     Tell the patient to continue taking prescribed drugs even if her symptoms clear.

     Advise the patient to avoid intercourse until symptoms resolve.

     Provide information on safer sex practices.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007



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