Definition
Inserting vaginal medication such as creams, foams, tablets, or suppositories is a common nursing and self-care procedure used to treat infections, inflammation, dryness, or deliver hormonal therapy.
Purposes
- To treat/prevent infections.
- To reduce inflammation.
- To relieve vaginal discomfort.
Articles
- Triangular drape.
- Prescribed medication.
- Applicator with plunger in case of vaginal cream.
- Clean gloves.
- Lubricant (in case of suppository).
- Towel for wiping perineum.
- Mackintosh and towel for placing under buttocks.
Procedure
| Nursing action | Rationale | |
| 1. | Before procedure Check medication order and identify the patient. Check the physician’s order for specific medication ordered its dosage and time of administration. | Reduces medication errors. Ensures that the right procedure is done on right patient. |
| 2. | Assess the patient for: Allergy to medication. Inflammation of external meatus/vagina. Color, character, and odor of vaginal discharge. Complaints of vaginal discomfort. | |
| 3. | Explain procedure to the patient. Explain that insertion of medication is painless and will bring relief from pain, itching, and discomfort. | Reduces anxiety and ensures cooperation. |
| 4. | Encourage patient to perform procedure herself if she prefers. | |
| 5. | Instruct patient to empty bowel and bladder. | Provides comfort to patients and reduces injury to vaginal lining. |
| 6. | Provide privacy. | Reduces embarrassment. |
| 7. | During procedure Position the patient in dorsal recumbent/Sim’s position and drape using triangular drape, so that only perineal area is exposed. | |
| 8. | Prepare articles, unwrap suppository and keep it ready on the opened wrapper. Fill applicator with prescribed cream, jelly or foam, as per manufacturer’s instruction. | |
| 9. | Put on clean gloves. | Protect nurse’s hands from vaginal and perineal microorganisms. |
| 10. | Inspect perineum/vagina for any odor, discharge etc. | |
| 11. | Provide perineal care to remove microorganisms. Encourage the patient to perform her own perineal care in the toilet, if able. | Reduces chance of microorganisms moving into vagina. |
| 12. | Administer vaginal suppository, using one of the following methods: a. Apply cream/foam and lubricate the rounded smooth end of suppository: Lubricate your gloved index finger. Expose the vaginal orifice by separating the labia with your non dominant hand. Insert suppository about 8 to 10 cm along posterior wall of vagina, or as far as it will go. Ask patient to remain lying in supine position for 5 to 10 minutes following insertion. The hip may also be elevated on a pillow. | |
| b. If using an applicator for inserting tablet or cream: Gently insert the loaded applicator about 5cm and slowly push the plunger until applicator is empty. Discard applicator if disposable or clean it according to manufacturer’s instruction. Ask patient to be in a supine position for 5 to 10 minutes following insertion. Ensure patient comfort. | ||
| 13. | Dry perineum using towel. | Ensures patient comfort. |
| 14. | Apply a clean perineal pad if there is excessive drainage. | |
| 15. | After procedure Remove gloves and wash hands. | Reduces risk of transmission of microorganisms. |
| 16. | Dispose of all used articles and replace all reusable articles. | |
| 17. | Document all relevant information. | Promotes communication between staff members. |
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwer’s, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884.
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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