Nursing care of patients with Sexually-Transmitted Disease – Flashcards
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sexually transmitted infection are transmitted or passed from person to another primarily through?
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sexual contact
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STDs
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sexually transmitted disease
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STIs
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sexually transmitted infections
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RTIs
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reproductive tract infections
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RTI (Endogenous)
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already present in the body vaginal infection candidiasis or bacterial vaginosis
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RTI (Iatrogenic)
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response to a treatment medical or surgical
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RTI (infection)
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associated with IUD insertion or abortion
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Incidence of STI's
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have been increasing worldwide, 19million Americans are diagnosed annually, with the development of antibiotics in the 1940s a dramatic decrease in STIs was seen however as antibiotics become less affective there has been a steady rise in the number of STIs
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Almost 1/2 of newly diagnosed STIs are among what age group?
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15-24 years old
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The role of the nurse is to?
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education is the key, public education is the most important, safe sex practices taught whether sexually active or not
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The nurse can identified risk and contributing factors for STIs
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asymptomatic carriers of the disease, use of no barrier methods of birth control, lack of knowledge of preventative methods and measures, use of alcohol and illegal drugs, sharing needles among IV drug users, trading of sex for favors, inadequate reporting of SITS
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risk free options
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having a mutually faithful relationship with an uninfected partner, completely abstaining from sexual activity, the only 100% effective way, avoiding contact with body fluids and skin to skin contact
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Chlamydia in women
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spotting, post coital bleeding, cervical discharge or dysuria, low abdominal pain often so subtle that pathological progression can occur without detection
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Chlamydia in men
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dysuria, watery white cloudy discharge from the urethra testicular pain and swelling
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Chlamydia risk factors
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multiple sex partners, nonuse of barrier methods, low socioeconomic status, long term effects may include chronic pain, increase risk for ectopic pregnancy, infertility, postpartum endometritis
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nursing implications
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state law in Utah requires prenatal testing for chlamydia and gonorrhea transmission from a pregnant women to her infant can occur during vaginal delivery and the infant can develop conjunctivitis and pneumonia
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nurses should instruct patients for treatment Chlamydia
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notify sexual partners in the past 2 months of their need to get treatment, no sexually activity or use condoms until both clients and partners are symptom free, use of medications prescribed
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treatment for Chlamydia
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Doxycycline 100mg PO Q12 hours for 7days Azithromycin 1gm PO single dose if gonorrhea suspected must give Rocephine IM
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Gonorrhea characteristics
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multiplies quickly in warm, moist areas of the body, including the oral cavity, reproductive tract and rectum spread during sexual intercourse vaginal, oral, anal, symptoms may occur within 2-10 days after exposure
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Gonorrhea in women
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often asymptomatic, purulent endocervical discharge, yellow or bloody vaginal discharge, irregular menses, chronic pelvic pain
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Gonorrhea in men
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urethral discharge white, yellow, or green and thick, swelling of the testicles and prostate, dysuria, anal irritation and discharge
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Gonorrhea risk factors
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multiple sex partners, nonuse of barrier methods, low socioeconomic status
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nursing instruction for patients with Gonorrhea
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to notify sexual partners in the past 2 months of their need to get treatment, return if symptoms persist, avoid sexual activity until symptoms subside in both patents and partner provide instructions regarding medication prescribed
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treatment for Gonorrhea
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Cipro 250mg followed by a 7-day course of doxycycline 100mg PO single dose of azithromycin 2 GM PO Rocephin 250 Mg IM plus 1 gm azithromycin PO
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Syphilis
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a complex sexually transmitted disease that can become systemic and cause serious complication and even death
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Syphilis is higher in what population?
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areas of the southern United states and men who have sex with men have the highest rates of new syphilis case
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primary stage of syphilis
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chancre clean painless ulcer first sign, within 3-7days if untreated chancre will heal within a few weeks, still infectious continue to spread systemically
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secondary stage of syphilis
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generalized rash (penny sized brown sores) most commonly seen on the palms of hands or sole of feel and flu-like symptoms
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latent period of syphilis
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no symptoms are present and the disease is no longer contagious
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tertiary stage of syphilis
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after 4-20 years bacteria can damage heart, eyes, brain, nervous system, bone, joints, noninfectious expect to fetus
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Risk factors for syphilis
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adolescents, women of color and living in a southern eastern state
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treatment for syphilis
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penicillin 2.4 million units IMX1 if has had infection for more than 1 year repeat dose for a total of 3 x doxycycline used if allergic to penicillin
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Genital Herpes
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is an acute recurring incurable viral disease many people are asymptomatic during the primary infection when symptoms do occur they may be sever during the first infection cause is Herpes simplex virus
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type one herpes
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causes sores of the lips fever blisters, cold sores
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type two herpes
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causes genital sores
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Genital Herpes risk factors
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multiple sex partners, acquired usually through sexual contact with an infected person an infected person may or may not be aware of having genital herpes
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Genital Herpes characteristics
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1st episode, symptoms appear in 2-10 days lasting an average of 2-3 weeks itching or tingling sensation may be felt in the skin 1-2 days before an outbreak in the genital area, legs, buttocks, vagina
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nursing teaching for Genital Herpes
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refer sexual partner for treatment, teach about virus' can be transmitted even when the person experiences no symptoms instruct use of condom
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treatment of genital herpes
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treatment is geared toward alleviating the symptoms
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Human Papillomavirus/ Genital warts
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most common viral STI in the USA, warts occur in the urogenital, perineal or anal areas, incurable,
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characteristics of Genital warts
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the incubation period is approximately 1-2 months but can be as long as 6 month painless soft fleshy growths appearing most commonly on the genital area
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Risk factor for Genital warts
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greatest risk for women is the potential for it to develop into cervical cancer less common in men, multiple sex partners, teenage girls and women in their 20s
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nursing testing about genital warts
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inform and treat sexual partners, provide instructions regarding meds prescribed
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treatment of genital warts
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none to eradicate, some topical or surgical treatments to manage outward lesions Gardasil HPV vaccine
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Trichomoniasis
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one cell protozoan very common STI
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Trichomoniasis in women
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25% have not symptoms, vulvar and vaginal pruritis pain with intercourse and urination grayish malodorous discharge, STRAWBERRY appearance of cervix, frothy yellow-green vaginal mucus discharge
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Trichomoniasis in men
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almost never have symptoms, watery whitish discharge, difficult and pain urination, urethritis and inflammation dormant state usually harbored in the prostate or urethra
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treatment of Trichomoniasis
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Flagyl 250 mg PO Q 8 hours X 7 day
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Hepatitis B
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transmitted primarily through direct contact with blood, vaginal secretions and semen, inflammation of the liver, anorexia
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treatment of Hepatitis B
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based on relieving symptoms no specific tx partners should receive medical prophylaxis within 14 days after exposure and recommend 3 dose immunization series when this episode has abated
