music It's a typical day. A patient has noticedsome itching, or maybe an unpleasant vaginal odor. During her exam, the ian willcheck vaginal pH, examine any discharge that's present, and collect a sample. Then, it'son to the microscope. music This is where you'll gather more specificinformationabout what's causing those vaginal symptoms. We'll show you how to prepare andexamine vaginal wet preps and how to do a whiff test. The results, combined with the patient's vaginal pH test, will aidthe diagnosis.
Under the microscope, you'll be looking for trichomonads, yeast, and the clue cells associated with bacterial vaginosis. We'll show you how to recognize them. music First, the microscope itself: This is a compoundlight microscope. It has several objective lenses on a rotating mount. For our purpose,one of these has to be a 10x low power objective, and one has to be a 40x for greater magnifiion.This flat part, under the objectives, is the stage. Under the stage is the condenser. Belowthat, at the base of the microscope, is the light source. There are two knobs that controlfocus; one for coarse adjustment and one for
fine adjustment. And these are the oculars,or eyepieces. We'll come back to the microscopea minute, but first, let's look at how to prepare wet mount slides. The complete vaginal wet mount involves botha saline prep and a potassium hyoxide, or KOH, prep. When the vaginal sample was collected,the swab was placeda test tube with approximately half a milliliter of saline. So, for the salineprep, you only have to take a op of the suspension and place it on a slide. Add acoverslip, being careful to avoid trapping air bubbles. Your saline slide is ready.Place a second op of the vaginal sample on another slide and add one op of 10 percentKOH. Sniff the preparation immediately, using
your hand to waft any odor toward your nose.This is the whiff test. Note if there's a fishy or amine odor. Then add a coverslip,avoiding air bubbles. Keepmind that you must work quickly to prepare and examine thewet mounts. That's because trichomonads may lose their characteristic motility within15 to 20 minutes. Before we move on now, though, let's lookat the cast of characters you may discover. These are normal squamous epithelial cellsfoundthe vagina. They're large, flat cells with a small nucleus and a large area of cytoplasm.Note that there is some granularitythe cytoplasm.
Polymorphonuclear leukocytes are known asPolys, or PMNs. They may also be called white blood cells, or WBCs. These are small roundcells. Several lobes of the nucleus are visible within the surrounding cell cytoplasm. Findingmany PMNs may indie infection. Trichomonads are pearshaped protozoa whichmove by means of flagella. Trichomonads are similarsize to PMNs and are identifiedby their characteristic jerking movement. The actual flagella may be too thin and toorapidlymoving to be seen. A clue cell is a squamous epithelial cellcoated with enough small bacteria that at least 75 percent of the cell's border is obliterated.It may look as if someone has spread glue
over the cell and pressed itsand. Cluecells are associated with bacterial vaginosis, a conditionwhich the normal microbialflora of the vagina is disrupted. Yeast may be foundtwo forms. Pseudohyphaeare the long, tubular, branching forms. Budding yeast are paired yeast cells that resemblea shoe print. The larger part is the sole and the smaller bud is the heel of the shoe. The saline prep will allow you to see epithelialcells, PMNs, trichomonads, and clue cells. You can also see yeastsaline, but sometimesit's hidden by epithelial cells or by PMNs. Red blood cells, sperm, and bacteria can alsobe seen.
Signs of Labor at 38 Weeks Pregnant
What are the signs of labor at 38 weeks pregnanté I'm assuming you aren't dealing with theobvious like waking upa pool of bodily fluids and realizing you didn't pee on yourself. I know that when the amniotic sack breaks,it doesn't smell like pee, though if you're standing there, other people think it lookslike it. One of the signs of labor at 38 weeks or anyother week is when the water breaks. Another is when you have that mucus plug fallout. There's so much vaginal discharge I mightnot notice it.
If you see bloodthe vaginal discharge,you may beearly labor or there's something else wrong that needs medical attention. I know that the hormones that increase extrablood supply down there can cause some blood if you've had sex or have some sort of irritationdown there. Only you know if you've had a tampon inthere to capture all the vaginal discharge and ended up irritating something down there. And I'm hoping this isn't a sign of anSTD flare up. I don't have an STD, though I understandsores down there can weep blood if it is bad.
If you feel pelvic pressure, that's a potentialsign of labor. As long as you don't have a bladder infection. I'm assuming you know what the burning sensationwhen you pee and problems peeing mean that it doesn't get to that point. But if it becomes a bladder infection, youcould feel pain as the bladder pulses and bloodthe urine. But that blood would only show up when I pee,and not get mistaken for early labor bleeding. There's the old fashioned back pains asa sign of labor.
Being that I'm nine months pregnant, itcould be a sign everything is normal. If you take a hot shower and it doesn'thelp or you take a walk and it gets worse, you'relabor. If the muscle pains arethe upper backor ease when you take steps literally to relieve them, you aren'tlabor. I know that a particular muscle group strainingisn't a sign of labor. If you have muscle contractions that are theBraxton Hicks contractions, they will ripple across the stomach and then stop.
If the muscles contract again ten or fifteenminutes, it may be early labor. Because I'm that far along, the practicecontractions may be several times a day. Note when one happens, and if the next happenswithin twenty minutes, write it down. Go take a nap, and if it is hard enough towake you up, it isn't practice. Then I want to sleep through the next couplebecause I'm not going to be able to sleep for the next ten hours. If the contractions are every ten minutesand the intervals are getting shorter, you arelabor.
That's the classic definition of being inlabor. Many people have nausea or even vomiting anddiarrhea when you have the contractions first start. That sounds more like food borne illness. If you have stomach pains and vomit or poopa lot, and then the stomach pains are getting worse while the vomiting and pooping stop,you're probablylabor. Are you sure that isn't appendicitisé Appendicitis can happen if you are pregnant,but you'll have sharp painone place,
What Does Brown Discharge Mean While Pregnant
I have had brown discharge for about a weeknow, is that common when pregnanté Whoa, could you give me a little warning beforeyou ask something like thaté Sorry. I'm just kind of worried so it justcame out. That's okay, I understand how that goes. WhenI had my baby, so many different things were happening with my body. So is this brown stuff normal, or should Ibe worriedé Well, brown is usually just old blood. Evenwhen you are not pregnant it can be normal towards the end of your period.
So why would I have it during pregnancyé I'mnot supposed to be bleeding I thought. Well, spotting is normal, and that's probablywhat it was but it wasn't enough to actually discharge. That means it got old and whenyour body decided to excrete something it came along for the ride. Gross. I don't understand why this all hasto be so personal. Ha ha, because it started personally. Unlessyou know, you are into other people present. Whaté I'm just kidding! But I want you to know Iwould love you either way.
You are ridiculous. So are you! Bringing up brown discharge beforewe eat lunch. How am I supposed to look at my applesauce nowé Ha ha! I didn't realize that was what youwere going to have. Maybe you should think of a different snack. Nah, I was kidding. As a nurse, I have hadto eat right after getting pooped on by a patient. What!é Why would you eaté
It was time for my break! We only get oneand you cherish that 30 minutes that you are not on your feet. I'm sorry I brought this whole conversationup. Ha ha. Well, want some applesauceé Ew, gross.