A nurse in a gynecology office is caring for a client.
Nurses' Notes
1000:
Client reports vaginal itching and discharge in the last week. Describes the discharge as thick and "smelly." Reports pain with urination and sexual intercourse. Verbalizes that the discharge became worse after their menstrual period this month. Reports has been treated for STIs in the past and is currently sexually active in a new relationship. Provider notified.
1035:
Vaginal swab for culture and nucleic acid amplification testing (NAAT) performed. Physical Examination
1015:
Labia majora and minora inflamed. Large amount of frothy, yellow-green, malodorous discharge observed.
Based on the information found in the client's medical record, which of the following prescriptions should the nurse anticipate receiving from the provider?
(Select all that apply.)
Have the client douche every morning and night.
Instruct the client to avoid alcohol for 72 hr after treatment.
Administer metronidazole 2 g PO x 1 dose.
Recommend the client's partner receive treatment.
Perform an oatmeal sitz bath.
Correct Answer : B,C,D
A. Having the client douche every morning and night is not recommended as it can disrupt the natural balance of vaginal flora and exacerbate the condition. It may worsen symptoms and increase the risk of complications.
B. Instructing the client to avoid alcohol for 72 hours after treatment is not necessary in this scenario. Metronidazole is an antibiotic used to treat bacterial vaginosis and does not typically interact with alcohol.
C. Metronidazole is the treatment of choice for bacterial vaginosis, which is suggested by the client's symptoms (frothy, yellow-green, malodorous discharge) and the provider's likely diagnosis based on the clinical presentation.
D. Recommending the client's partner receive treatment is important to prevent reinfection or transmission of the infection. Bacterial vaginosis can be sexually transmitted, and treating both partners helps reduce the risk of recurrence.
E. Performing an oatmeal sitz bath may provide symptomatic relief for certain conditions, but it is not typically indicated for the treatment of bacterial vaginosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"B"}
Explanation
The nurse should anticipate a provider prescription for an antiviral medication, as evidenced by the client's presentation of small pinpoint open vesicles and pustules on the labia majora, which are indicative of a herpes simplex virus infection, a common cause of genital ulcers. The clear drainage and absence of pain are consistent with this diagnosis. Additionally, the thick, mucopurulent discharge could suggest a secondary bacterial infection, for which the provider may prescribe antibiotics.
Antiviral medication is likely prescribed for perineal lesions because these can be indicative of a viral infection, such as herpes. The nurse should recognize the need for antivirals to manage and treat the underlying cause.
Correct Answer is C
Explanation
Rationale:
A. Panting may be indicated if pushing is premature, but the sudden urge to push suggests the need to assess for crowning.
B. While assisting the client into a comfortable position may be appropriate, it's essential to first assess for signs of imminent delivery.
C. This action is crucial to determine if the client is fully dilated and ready for delivery.
D. Helping the client to void may relieve pressure on the bladder but does not address the sudden urge to push, which may indicate imminent delivery.
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