Women Health Module 4 Discussion Case 1
A 28-year-old female patient wanted to be evaluated for thin white vaginal discharge, which usually increases after sexual intercourse. The vaginal discharge has a pH of 5.2, positive KOH test, and clue cells which are equivalent to more than 40% of epithelial cells on microscopic examination. The primary diagnosis is bacterial vaginosis with an ICD10 code is N76.0 (Blumenfeld et al., 2021, p.4).
Some of the most common causes of abnormal uterine bleeding are Pregnancy, Spontaneous abortion, Uterine fibroids, Uterine polyps, Endometriosis, Adenomyosis, Ovarian cysts, and Ovarian tumors. Uterine fibroids (ICD10: D25.2) are a very common cause of abnormal uterine bleeding (AUD). These masses in the uterus usually manifest by menstrual symptoms as cyclic pain, dysmenorrhea, menorrhagia. Fibroids are usually diagnosed by vaginal ultrasound. Fibroids can be treated by resection if they are affecting pregnancy. Ectopic pregnancy is another cause of abnormal uterine bleeding and may manifest by vaginal bleeding, missed menses, or pelvic pain. Ectopic pregnancy (ICD10: o00.80) is usually diagnosed by pregnancy testing and vaginal ultrasound. The third cause of abnormal uterine bleeding is endometriosis. Endometriosis is the implantation of the endometrial tissue outside of the uterus endometrium. Endometriosis (ICD10: N80.9) can present by dyspareunia (pain and discomfort during sexual intercourse), cyclical menstrual pain, and pelvic tenderness. Endometriosis is usually diagnosed by vaginal ultrasound (Schuiling & Likis, 2022, p.273, 565).
The patient education in a case of infective disease as bacterial vaginosis should target many aspects. It is very important to finish the course of the antibiotic to avoid any resistance or worsening of the disease course. It is also advised to avoid alcohol during and even 24 hours after treatment with metronidazole, and 72 hours after treatment with tinidazole treatment to avoid the disulfiram reaction, which is manifested by metallic taste, nausea, vomiting, abdominal cramps. The patient should also be advised to avoid intercourse or consistently use condoms as a non-pharmacological intervention during treatment. The treatment that the patient should follow with the current condition is oral metronidazole. Patients with recurrent episodes of bacterial vaginosis should also add metronidazole gel vaginally twice weekly for 4-6 months or oral metronidazole with fluconazole every month (Schuiling & Likis, 2022, p.410).
An effective health assessment incorporates parameters other than physiological parameters. Health assessment should also include mental, emotional, and social health parameters (Schuiling & Likis, 2022, p.225).
Family is going through different stages starting from a single individual ending as elderly or being grandparents. the first stage is establishing a home and learn how to solve different home issues. Childbearing comes next and this step includes learning about pregnancy, giving birth, and lactation, and taking care of a newborn baby. The third step is child-rearing. An example of this step is taking care of a child and manage the financial situation of the home to afford a good living environment for the family and children. Child launching comes after that. this is a very important step, and an example of this step includes promoting a healthy emotional lifestyle of children to be able to succeed in their education, work, marriage, etc. The final stage is an empty nest. This is the final step after parents or individuals have accomplished their mission in developing a family and it needs the parents to adjust to their new situation of living alone, retirement, and practicing their hobbies.
Family structure is also very important for the emotional and economic support of any individual should any situation happen like IPV, abuse, or a financial crisis.
References
Blumenfeld, Y., Maric, I., Stevenson, D., Gibbs, R., & Shaw, G. (2021). Treatment of persistent bacterial vaginosis and risk for spontaneous preterm birth. https://doi.org/10.22541/au.161784971.11994862/v1 (Links to an external site.)
Schuiling, K. D., Likis, F. E. (2022). Gynecologic Health Care with an Introduction to Prenatal and Postpartum Care (4th Ed). Jones & Bartlett Learning, Burlington, MA. ISBN: 9781284182347
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