Rabu, 29 Juni 2011

NURSING CARE BARTOLINITIS THEORY REVIEW


NURSING CARE BARTOLINITIS
THEORY REVIEW

A. 
DEFINITIONS
Infection of the gland is Bartolinitis bartolin or bartolinitis can also cause swelling of the external female genitalia. 
Usually, the swelling is accompanied by severe pain and even could not walk. It can also be accompanied by fever, swelling of the genitals as a blush.
B. 
Etiology
Bartolinitis infection caused by germs on bartolin glands located inside the vagina slightly out. 
Starting from chlamydia, gonorrhea, and so on. This infection can then clog the mouth of the gland produces a lubricating fluid vaginal
Etiology INFECTION
a. 
Female genital infections are usually caused by the lower part:
Virus: akuminata condylomata and herpes simplex.
Fungi: Candida albikan.
Protozoa: amobiasis and trichomoniasis.
Bacteria: neiseria gonorrhea.
b. 
Infections of the upper female genitalia:
Virus: Chlamydia trachomatis and parotitis epidemika.
Fungi: asinomises.
Bacteria: neiseria gonorrhea, staphylococcal and E. coli
C. 
PATHOPHYSIOLOGY
Eventually the liquid meets the bag so that the gland is called a cyst (fluid-filled pouches). 
"Germs in the vagina may infect one bartolin glands to clog and swell. If no infection, will not cause complaints
D. 
SIGNS and SYMPTOMS
Signs and symptoms
o In the vulva: skin discoloration, swelling, pus deposits in the glands, tenderness.
o bartolin swollen glands, sore once when penderia walking or sitting, may also be accompanied by fever
o; most women with these patients come to a health center with complaints of vaginal discharge and itching, pain during intercourse with her husband, pain when urinating, or lumps around the genitals.
o There were abscesses in the genital area
o On physical examination found mucoid fluid and mixes with the smell of blood.
E. 
TREATMENT
Treatment is quite effective at this time is to: antibiotic classes cefadroxyl 500 mg, taken 3 × 1 after meals, for at least 5-7 days, and mefenamic acid 500 mg (for example: ponstelax, molasic, etc.), taken 3 × 1 for ease 
pain and swelling, until the gland was deflated.
F. 
EXAMINATION SUPPORT
Laboratory
Vullva
In speculo
G. 
MANAGEMENT
FEMALE SEX INFECTION MANAGEMENT TOOLS

Here are some of the female genital infections are common in the health center and management tailored to the means of diagnosis and drugs that are available.
1. 
Gonorrhea (GO)
Anamnese:
a. 
GO 99 cases in women and attacked the cervix uteri in women 50-75% of cases there are no symptoms or complaints.
b. 
If there are complaints usually dysuria and lekore, which is often ignored by sufferers.
c. 
Anamnese often only obtained a history of contact with patients.
Examination:
Examination with the speculum: uterine ostium eksternum can appear normal, reddish or erosive. 
Seem vaginal discharge with properties turbid mucoid, or purulent mukopurulen. Maybe get complications such as: bartolinitis, salpingitis, pelvic abscess and even peritonitis ovary tubo. The third complication JAR called Pelvis inflammatory disease (PID).
Laboratory:
Intake of cervical or vaginal discharge: Diplokokus gram-negative intracellular leucocytes.
Minimal Criteria:
1) History of contact (+).
2) intake of cervical or vaginal discharge: Diplokokus intracellular gram-negative leucocytes.
Therapy:
1) Procaine Penicillin: 4.8 million IU IM (skin test first), 2 consecutive days, or
2) kanamycin: 2 g IM single dose, or
3) Amoxicillin or Ampicillin: 3.5 grams orally single dose (more potent when added Probenecid 1 gram), or
4). Tetracyclines cap: 4 X 500 mg for 5 days, or
initial dose of 1,500 mg, followed by 4 X 500 mg for 4 days, or
5) co-trimoxazole tablets 480: 1 X 4 tablets for 5 days
6) When there are complications: Amoxicillin or Ampicillin: 3.5 grams orally single dose forwarded 4 X 500 mg for 10 days.
7) Observation and repeated administration performed on days 3, 7 and 14, then every month for 3 months.
Note:
Therapy should be given also to the sex partners of people with (husband) simultaneously. 
During the period of therapy should be discontinued sex activities.
2. 
NON gonorrhea urethritis
Anamnese:
Usually there are no complaints. 
If any, complaints usually are dysuria with or without discharge. Often also complained of bleeding at the end of urination (terminal dysuria). Often are recurrent-kumatan (which distinguishes the GO) contact history is often (+)
Examination:
There may be a urethral discharge. 
When accompanied by cystitis, there may be suprapubic tenderness.
Laboratory:
Urethral discharge: diplokokus (-), leucocytes> 10/lapangan view.
Urine: cloudy or acquired short threads (threads)
Minimal Criteria:
1) History of contact (+).
2) Laboratory:
Urethral discharge: diplokokus (-)
Urine: cloudy or threads (+).
Management:
1) Tetracycline: 4 X 500 mg for 5-7 days or
2) Erytromisin: 4 X 500 mg for 5-7 days.
3) In case of persistent duration of treatment 21 days.
3. 
Trichomoniasis
Anamnese:
The main complaint is that there is usually whitish with large amounts, yellow or greenish white. 
Pain during sex (dyspareunia) is also often complain about. History of gonorrhea husbands need to be asked, because> 50% of patients with GO women with trichomoniasis.
Examination:
Examination in speculo: pain, fluor albus and large quantities of liquid with yellow or greenish-white, typical: get red spots (red spots punctatae or strawberry cervix) in the vaginal wall.
Laboratory:
Fluor albus: mikroskup light with Trichomonas vaginalis (+).
Minimal Criteria:
1) Fluor albus: a liquid, a lot, yellow or greenish white.
2) Punctatae red spots (+)
3) Laboratory: Puskesmas?
Management:
1) Metronidasol: 1 X 2000 mg, as a single dose.
4. 
Candidiasis
Anamnese:
The main complaint is usually a vaginal discharge and itching in the vagina.
It may also complained of pain when doing sexual activity.Predisposing factors: diabetes mellitus, use of birth control pills, and uncontrolled use of antibiotics as well as obesity.
Examination: Vulva: red, edema, presence of white plaques, may be obtained also fissure or erosion (vulvovaginitis).
In speculo: It feels sore, thick discharge, little, white cheese and usually closes lower portion.
Laboratory:
Yeast cells (yeast cells) or buds (budding body) and pseudohypha
or spores.
Minimal Criteria:
1) Vuvovaginitis.
2) Discharge thick, a little, white cheese and usually closes lower portion.
Management:
1) Topical: nystatin vaginal tablets: 1 X 1, for 7 days, and
2) nystatin tablets: 4 X 1 tablet, for 14 days.
H. 
PREVENTION
To block inflammation, various ways can be done. 
One is a clean and healthy lifestyle:
1. 
Consumption of healthy and nutritious foods. Try not to let you avoid obesity which causes the thigh rub. This condition can cause injury, so the state of the skin around the groin gets hot and humid.Germs can live abundantly in the area.
2. 
Avoid wearing tight pants, because it can lead to moisture.Choose the underwear of a material that absorbs sweat so that vital area is always dry.
3. 
Consult a doctor if you experience vaginal discharge long enough. Nothing to be ashamed to consult with a gynecologist though not yet married. Because vaginal discharge can be experienced by all women.
4. 
Be careful when using public toilets. Who knows, there are people with arthritis who used it before you.
5. 
Get used to clean themselves after defecating, with a movement from front to back wash.
6. 
Get used to clean the genitals after sexual intercourse.
7. 
If not needed, do not use pantyliner. Women are often misguided.They feel uncomfortable if her underwear is clean. Though the use pantyliner can increase the humidity of the skin around the vagina.
8. 
Reproduction has a self cleaning system to fight germs that harm health. Vaginal cleaning products and fragrances that many actually traded is not required. Conversely, if used excessively can be dangerous.
9. 
Avoid sexual intercourse multiple partners. Remember, bacteria can also be derived from your spouse. If you have multiple sexual partners, not easily detect the source of transmission of bacteria.Inflammation is closely linked with sexually transmitted diseases and sexual patterns are free.
CARE KEPERWATAN
A. 
ASSESSMENT
- Changes in skin color
- Udem
- Fluid in the gland
- Pain
- Lump on vaginal lips
- The smell of the fluid
- Cleanliness of the body
- The number and color of urine
B. 
DIAGNOSIS
- Self-care deficit b.d limited motion
- Damage the integrity of skin on skin edema b.d
- The deficit of knowledge bd lack of understanding of the sources of state information resources bd pain injury worry
- Sexual Dysfunction b.d disease process
C. 
INTERVENTION
- Assisting patients to meet the personal hygiene
- Monitor the state of the wound
- Provide health education regarding self-care (hygiene tool genetal)
- Assess the level of pain
- Use an interactive way that focuses on the need to make adjustments in sexual peraktik or to enhance coping with problems / sexual disorders

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