Journals Watch 2002

This section features a regularly updated list of recently published articles relevant to nurse prescribing.

Abstracts of the papers are included and users are encouraged to submit their views about published papers through the feedback section.

Please note: In this section of the website we aim to cover articles on areas where nurses do prescribe. However, not all the treatments or appliances mentioned are prescribable by nurses. For that reason, nurses should check the up-to-date versions of the Nurse Prescribers’ Formulary for District Nurses and Health Visitors (NPF) and the Nurse Prescribers’ Extended Formulary (NPEF) and Drug tariff if they are in any doubt. Alternatively contact your Regional Nurse Prescribing Lead for clarification.

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Genito-Urinary conditions

Click on the article titles below to read the summaries.

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  • Abnormal vaginal discharge

Young F. Vaginal health. Nursing Standard 2002; 16(23):47-52.

This article discusses the most common causes of abnormal vaginal discharge and the methods used to treat them. It also provides advice on the consultation and patient education.

The symptoms and diagnosis of three common vaginal infections are discussed: bacterial vaginosis, candidiasis and trichomoniasis. For bacterial vaginosis, oral metronidazole or topical treatment with intravaginal gel or clindamycin gel are the treatment options. For candidiasis, over-the-counter clotrimazole treatments are the first-line treatments but there are a variety of others. For trichomoniasis, metronidazole is the first-line treatment.

Website: Nursing Standard

 

Pritchard J. Bacterial vaginosis. Practice Nurse 2002; 23(5): 19-20

Bacterial vaginosis should be treated even if the woman is asymptomatic and it is detected during tests for some other reason, according to current recommendations. A correlation between pre-term rupture of the membranes in pregnancy and presence of bacterial vaginosis has been reported and some studies have linked it with pelvic inflammatory disease.

The diagnosis of bacterial vaginosis depends on three of the four following conditions:

  • an increased pH>4.5
  • presence of amines (detectable by smell)
  • the presence of ‘clue cells’
  • a homogeneous vaginal discharge

One study showed a link between risk for bacterial vaginosis and both the number of sexual partners and smoking. The presence of blood or semen in the genital tract increases the pH. Other risk factors and preventive measures are discussed.

Metronidazole 400 mg twice daily for one week is the treatment of choice (oral metronidazole for bacterial vaginosis is now on the list of POMs prescribable by nurses). Topical metronidazole or topical clindamycin creams can be used intravaginally.

 

Hainsworth T. Diagnosis and management of candidiasis vaginitis. Nursing Times 2002; 98(49): 30-32

Although 75% of women may be affected at some time by vaginal thrush, many need information about causes, treatment and prevention. Recurrent infections in particular can be distressing but the condition is, however, usually easily recognized and treated.

This article discusses diagnosis, pointing out that examination is not always necessary if both the practitioner and the woman are both sure it is thrush. Treatment is with antifungal agents, with little evidence of differences in efficacy. Recurrent infections may be the result of underlying conditions such as diabetes and these possible factors should be considered. The author then considers prevention and self-help measures and dispels myths about thrush.

Website: www.nursingtimes.net