36468 - 1 - Page within 4Hrs

36468 Topic: HA19 w9 R1 Number of Pages: 1 (Double Spaced) Number of sources: 2 Writing Style: APA Type of document: Essay Academic Level:Master Category: Nursing Language Style: English (U.S.) Order Instructions: ATTACHED Manage Discussion Entry The patient’s complaint of a vaginal discharge that has a fishy-odor is characteristic of bacterial vaginosis, this type of infection often comes with a large amount of grey or white discharge as well (Brickley, 2017). I would complete an external, bimanual, and internal examination of the genitalia and I would order a potassium hydroxide and wet mount/preparation to confirm my suspicion of bacterial vaginosis (Dains, Baumann, & Scheibel, 2016). A potassium hydroxide and wet mount/preparation is needed because specificity and selectivity is low based on characteristics of vaginal discharge (Brickley, 2017). Majority of women about, 50-75% with bacterial vaginosis have no symptoms (Sobel, 2019). Often women with bacterial vaginosis have more than one infection at the same time (Dains, Baumann, & Scheibel, 2016). When a patient has symptoms of dysuria, dyspareunia, itching, burning, and vaginal inflammation they often have more than one infection (two pathogens or more) at the same time (Sobel, 2019). It is important to assess the external genitalia for the presence of swollen inguinal lymph nodes, and to assess for reddened, excoriated, or indurated vulva and labia that often occur with bacterial vaginosis (Dains, Baumann, & Scheibel, 2016). The internal vaginal exam is necessary for obtaining a wet mount, while doing the internal exam a Pap smear should not be collected due to existing abnormality and increased risk for atypical results (Dains, Baumann, & Scheibel, 2016). The bimanual exam is important because it assesses for cervical motion tenderness and pain and confirms the spread of infection to the upper genital tract and pelvic inflammatory disease (Dains, Baumann, & Scheibel, 2016). It is unclear if pelvic inflammatory disease is a casual or independent factor for bacterial vaginosis, however bacterial vaginosis is more common in women with pelvic inflammatory disease (Sobel, 2019). References Brickley, L.S. (2017). Bates’ Guide to Physical Examination and History Taking. [VitalSource]. Retrieved from https://online.vitalsource.com/#/books/9781496354709/ Dains, J., Baumann, L., & Scheibel, P. (2016). Advanced Health Assessment & Clinical Diagnosis in Primary Care. [VitalSource]. Retrieved from https://online.vitalsource.com/#/books/9780323266253/ ** Provide response writing with references. All references must be in APA format and published within the last 5 years.