Bacterial Vaginosis

Bacterial vaginosis (BV) typically causes less vulvar inflammation compared to candidiasis; therefore, the presence of intense erythema, marked swelling, or severe itching should prompt the nurse to consider diagnoses other than BV alone. A focused assessment of BV may reveal a thin, uniform vaginal discharge coating the walls, often accompanied by a fishy odor and minimal visible inflammation. However, if symptoms such as mucopurulent cervical discharge, postcoital or intermenstrual bleeding, pelvic pain, cervical motion tenderness, fever, or adnexal tenderness are present, these findings raise concern for cervicitis or pelvic inflammatory disease (PID), as well as other genital tract infections or pregnancy-related complications. BV is associated with an increased risk of PID and the acquisition of infections such as HIV, chlamydia, or HPV. The emergence of new pelvic pain, fever, abnormal uterine bleeding, haemodynamic instability, or examination findings suggestive of PID necessitates urgent medical assessment. In such cases, the registered practical nurse (RPN) should obtain vital signs, monitor for clinical deterioration, notify the responsible prescriber or registered nurse according to local escalation protocols, and prepare the patient for urgent evaluation to...