A patient you are assessing reports an increase in vaginal discharge that has a foul odor, but she does not report other symptoms. The patient has been in a monogamous relationship for 3 years. Which of the following would be the most useful for this patient? Select all that apply. (NCLEX/HESI/TEAS)
a. Evaluate her urine for increased white blood cells.
b. Perform a Gram stain on the vaginal discharge.
c. Run a pregnancy test.
d. Test for an STI.
e. Perform a whiff test.

Verified step by step guidance

1. Evaluate the symptoms presented by the patient, focusing on the increase in vaginal discharge with a foul odor.
2. Consider the common causes of vaginal discharge with a foul odor, such as bacterial vaginosis or trichomoniasis.
3. Determine which diagnostic tests are most relevant for identifying the cause of the symptoms.
4. Recognize that a Gram stain on the vaginal discharge (option b) can help identify bacterial infections by revealing the presence of specific bacteria.
5. Consider performing a whiff test (option e), which is a simple test used to detect bacterial vaginosis by identifying a fishy odor when potassium hydroxide is added to the discharge.

Key Concepts

Vaginal Discharge and Its Characteristics

Vaginal discharge can vary in color, consistency, and odor, and changes may indicate underlying health issues. A foul-smelling discharge often suggests bacterial vaginosis or an infection, which can be differentiated by its characteristics. Understanding these variations is crucial for diagnosing potential infections and guiding appropriate treatment.

Diagnostic Tests for Vaginal Infections

Various diagnostic tests can help identify the cause of abnormal vaginal discharge. A Gram stain can reveal the presence of specific bacteria, while a whiff test can indicate bacterial vaginosis by producing a fishy odor when potassium hydroxide is added. These tests are essential for accurate diagnosis and treatment planning.

Sexually Transmitted Infections (STIs)

STIs can present with symptoms such as abnormal discharge and may require testing to confirm their presence. Given the patient's monogamous relationship, the risk of STIs may be lower, but testing remains important to rule out infections that could cause the reported symptoms. Understanding STIs is vital for comprehensive patient care.