An antenatal client has been diagnosed with a vaginal infection from the organism candida albicans. Which findings should the nurse expect to note on assessment of the client?

1. A

   Costo-vertebral angle pain

2. B

   Pain, itching and vaginal discharge

3. C

   Absence of any signs and symptoms

4. D

   Proteinuria, hematuria, edema and hypertension

Appeared in: DHS Staff Nurse - 2018 (Shift-2nd)

Explanation

• The organism Candida albicans causes vulvovaginal candidiasis, commonly known as a yeast infection.
• This infection leads to inflammation of the vaginal and vulvar tissues.
• The classic triad of symptoms resulting from this inflammation is intense itching (pruritus), pain (soreness, burning), and a characteristic thick, white, 'cottage cheese-like' vaginal discharge.

Why Other Options Were Wrong

• Option A: Costo-vertebral angle (CVA) pain, or flank pain, is a classic sign of a kidney infection (pyelonephritis), not a vaginal infection.
• Option C: While some infections can be asymptomatic, vulvovaginal candidiasis is typically characterized by prominent and uncomfortable symptoms, especially intense itching.
• Option D: This combination of symptoms—protein in the urine, blood in the urine, swelling, and high blood pressure—are the hallmark signs of preeclampsia, a serious hypertensive disorder of pregnancy.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Clinical manifestations of vulvovaginal candidiasis to guide bedside assessment, documentation, and the next nursing action.
• Nurses play a crucial role in educating pregnant clients about the signs of common infections like candidiasis and the importance of seeking treatment to relieve discomfort and prevent complications.
• Patient teaching should include preventive measures such as wearing loose-fitting cotton underwear, avoiding douching, and maintaining proper perineal hygiene (wiping front to back).
• What if? If the client reported a 'fishy' odor with a thin, grayish discharge, the nurse should suspect Bacterial Vaginosis (BV) instead of candidiasis, which requires a different treatment (e.g., metronidazole).

How to Approach the Question

• First, identify the key information in the question: the client is pregnant and has a confirmed diagnosis of Candida albicans infection.
• Recall the classic signs and symptoms associated with vulvovaginal candidiasis (yeast infection). The main symptoms are itching, irritation/pain, and a specific type of discharge.
• Evaluate each option to see which one matches these classic symptoms.
• Eliminate option A, as CVA pain relates to the kidneys.
• Eliminate option D, as proteinuria, edema, and hypertension are signs of preeclampsia.
• Eliminate option C, as candidiasis is typically symptomatic.

Concept Tested & Keywords

• Concept Tested: Clinical manifestations of vulvovaginal candidiasis
• Stem keywords: antenatal client, vaginal infection, Candida albicans, assessment findings
• Lead-in keywords: expect to note
• Clinical cues: The diagnosis of Candida albicans is a key cue, pointing directly to a yeast infection.
• Negative lead-in flag: NOT changes the reasoning strategy; look for the exception or incorrect statement rather than the true statement.

Question ID

QwVeSd4F825DCNRU1t0U6_

Copy ID

Reference Book

E6 Medicine Harrison 22e Part 1 pp. 1144-1146, 1142-1144