Gynecologic Nursing Care | Common Gynecologic Conditions and Disorders | Pelvic Inflammatory Disease (PID) |

 

Pelvic Inflammatory Disease (PID) :

1. Definition

Pelvic Inflammatory Disease (PID) is an infection of the female reproductive organs, including the uterus, fallopian tubes, and ovaries, often caused by sexually transmitted infections (STIs). It leads to inflammation, scarring, and potential complications such as infertility, ectopic pregnancy, and chronic pelvic pain if left untreated.

2. Causes and Risk Factors

A. Causes

PID is most commonly caused by bacteria that spread from the vagina and cervix to the upper reproductive organs. The most frequent causative agents include:

  • Sexually Transmitted Infections (STIs):
    • Neisseria gonorrhoeae (gonorrhea)
    • Chlamydia trachomatis (chlamydia)
  • Other Bacteria:
    • Mycoplasma genitalium
    • Anaerobic bacteria (e.g., Bacteroides fragilis)
    • Post-abortion or postpartum infections

B. Risk Factors

  • Unprotected sexual intercourse with multiple partners
  • History of STIs or previous PID
  • Use of intrauterine devices (IUDs) without proper screening
  • Frequent douching (which disrupts the normal vaginal flora)
  • Recent gynecologic procedures (e.g., abortion, endometrial biopsy)

3. Signs and Symptoms

PID symptoms range from mild to severe and may include:

A. Common Symptoms:

✅ Lower abdominal or pelvic pain (dull or sharp)
✅ Abnormal vaginal discharge (yellow/green, foul-smelling)
✅ Irregular menstrual bleeding
✅ Pain during intercourse (dyspareunia)
✅ Painful urination (dysuria)
✅ Fever and chills

B. Severe Symptoms (Indicating Emergency Care Needed):

🚨 High fever (>101°F or 38.5°C)
🚨 Nausea and vomiting
🚨 Severe lower abdominal pain
🚨 Signs of sepsis or shock in untreated cases

4. Diagnosis

Clinical Diagnosis: Based on pelvic exam findings (uterine tenderness, cervical motion tenderness).

Laboratory Tests:

  • STI screening (chlamydia, gonorrhea)
  • Blood tests (WBC count, ESR, CRP – to assess inflammation)
  • Pregnancy test (to rule out ectopic pregnancy)

Imaging Studies:

  • Pelvic ultrasound (to detect abscesses or fluid buildup)
  • Laparoscopy (for severe or complicated cases)

5. Gynecologic Nursing Care Plan for PID

A. Nursing Assessment

🔍 Monitor vital signs (temperature, heart rate)
🔍 Assess pain severity and location
🔍 Evaluate vaginal discharge (color, odor, amount)
🔍 Check menstrual irregularities and sexual history
🔍 Assess for emotional distress (as PID is often linked to STIs)

B. Nursing Diagnoses

  1. Acute Pain related to inflammation of reproductive organs.
  2. Risk for Infection Spread due to untreated bacterial infection.
  3. Deficient Knowledge regarding PID and its complications.
  4. Anxiety and Emotional Distress related to reproductive health concerns.

C. Nursing Interventions and Care Plan

Nursing InterventionRationale
Administer antibiotics as prescribed (IV/oral)To eliminate bacterial infection and prevent complications.
Monitor temperature and vital signs regularlyTo detect worsening infection or sepsis early.
Encourage rest and proper hydrationHelps the body fight infection and recover faster.
Provide analgesics (NSAIDs or acetaminophen)To relieve pelvic pain and discomfort.
Educate patient on safe sex practices (condom use, STI screening)Prevents reinfection and spread of STIs.
Emotional support and counselingReduces anxiety and stigma related to PID.
Monitor for signs of complications (abscess, infertility, chronic pain)Early intervention can prevent long-term damage.

D. Patient Education and Discharge Planning

✅ Complete full course of antibiotics even if symptoms improve.
✅ Avoid sexual activity until the infection is fully treated.
✅ Encourage partner testing and treatment to prevent reinfection.
✅ Educate on long-term complications like infertility and ectopic pregnancy.
✅ Schedule follow-up visits for assessment of treatment response.

6. Complications of PID

⚠ Infertility (due to scarring of fallopian tubes)
⚠ Ectopic pregnancy (increased risk due to damaged tubes)
⚠ Chronic pelvic pain (lasting months or years)
⚠ Tubo-ovarian abscess (life-threatening if ruptured)
⚠ Sepsis (if untreated, can lead to multi-organ failure)

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