A client reports experiencing vulvar pruritus. Which assessment factor may indicate that the client has an infection caused by Candida albicans?
A. Cottage cheese-like discharge
B. Yellow-green discharge
C. Gray-white discharge
D. Discharge with a fishy odor
Correct Answer: A. Cottage cheese-like discharge
The symptoms of C. albicans include itching and a scant white discharge that has the consistency of cottage cheese. The patient with vulvovaginitis may present with intense itching and irritation in the vagina and vulva, a burning sensation with urination which can be mistaken for urinary tract infection, vaginal soreness, or pain, a dry erythematous rash, and a thick white cottage cheese-like discharge.
Option B: Yellow-green discharge is a sign of Trichomonas vaginalis. A vaginal discharge is common in women; the discharge is thin, froth, and has an abnormal odor. The genitals are often red and edematous. A strawberry cervix is seen in about 40% of patients. Palpation of the pelvis may reveal mild tenderness.
Option C: Gray-white discharge is a sign of Gardnerella vaginalis. Gray vaginal discharge is not healthy, and it can be a symptom of a common bacterial infection called bacterial vaginosis (BV). Anyone with gray discharge should promptly see a doctor. Following diagnosis, the doctor will usually prescribe antibiotics to treat the BV.
Option D: Most women with BV present with a complaint of malodorous vaginal discharge, which often becomes more pronounced after sexual intercourse. The whiff test is performed by adding a small amount of potassium hydroxide (KOH) to the microscopic slide containing the vaginal discharge and is considered to be positive if a characteristic fishy-scent is revealed.
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