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Sexual Exposure Chart the scary truth

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Number of sexual partners 5 Number of people exposed to STD 31 Number of sexual partners 10 Number of people exposed to STD 1023 Number of sexual partners 12 Number of people exposed to STD 4095 So if that does not shake you what will ? Imagine having sex with only one person and he had sex with 50 you were just exposed to who knows how many STD' s

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Pelvic Inflammatory Disease (PID)

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inflammation of organs in the pelvic cavity; usually includes the fallopian tubes, ovaries, and endometrium; most often caused by bacteria from STD Main symptom is constant lower abdominal pain Can lead to ectopic pregnancy and infertility Treated with antibiotics

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Pelvic Inflammatory Disease (PID)

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Pelvic inflammatory disease (PID) refers to infection of the uterus (womb), fallopian tubes (tubes that carry eggs from the ovaries to the uterus) and other reproductive organs that causes symptoms such as lower abdominal pain. It is a serious complication of some sexually transmitted diseases (STDs), especially chlamydia and gonorrhea. PID can damage the fallopian tubes and tissues in and near the uterus and ovaries. PID can lead to serious consequences including infertility, ectopic pregnancy (a pregnancy in the fallopian tube or elsewhere outside of the womb), abscess formation, and chronic pelvic pain.

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Sexually Transmitted Diseases

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Infectious diseases most commonly transmitted through sexual contact Can also be transmitted by Blood Blood products Autoinoculation Can be bacterial or viral Usually start as lesions on genitals or mucous membranes and can spread to other areas

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Sexually Transmitted Diseases

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Can be bacterial or viral

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Sexually Transmitted Diseases

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Latent or subclinical phase present with all STDs Leads to a long-term persistent infection people do not even know they are infected Contributes to the transmission of disease from asymptomatic (but infected) person to another person

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All cases of gonorrhea and syphilis (and in most states chlamydia)

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must be reported to state or local public health authorities Still underreported

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Best protection against STD

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Condom- Barrier - but is still not used frequently in general population

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Oral contraceptive effects

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acidity of vaginal/cervical secretions promote growth of certain organisms causing STDs

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Health Promotion

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The process of enabling people to increase control over, and to improve their health.

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Primary health promotion for STD - Prevention

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Prevention 1) Abstinence 2) Safe Sex Limit partners Use condoms both male and female Condoms both male and female will < risk of gonorrhea, chlamydia, and some other STD's. Will not prevent HPV 1) Abstinence 2) Safe Sex Limit partners Use condoms both male and female Condoms both male and female will < risk of gonorrhea, chlamydia, and some other STD's. Will not prevent HPV

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secondary health promotion For STD- Early detection

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Health screening Annual physical with pelvic exam Vulvar self exam (VSE) Perform once per month Use mirror and good lighting Spread labia and check for lesions, growths, warts, changes in skin color

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tertiary Prevention of complications from untreated STD's

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Infertility Cancer Death

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Women who get STD's sometimes have a hard time with

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Infertility

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Condoms

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Will not prevent HPV

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Infertility

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Untreated STD's or a delay in treatment can lead to infertility.

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Sexual decision making

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Nurse empower the public with accurate information If you do not know the answer to a sexual question make sure you tell the patient then look up the answer always give coreect accurate information.

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Confidentiality with STD's

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Some STD's are reportable. All information is held in the strictest confidence only shared when need to. Encourage patients to discuss illness with partners

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Candida (Yeast) fungus among us wow

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Itching and burning on urination, inflammation of vulva and vagina. Cottage Cheese appearance to discharge.

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How do you treat Candida (Yeast)

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Tx: miconazole (Monistat), Clotrimazole (Gyne-Lotrimen) Nystatin (Mycostatin) Fluconazole (Diflucan) Available over the counter

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How do you Diagnosis Candida (Yeast)

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Diagnosis- S&S or identification of spores of the fungus

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Bacterial vaginosis (Gardnerella)

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Thin, grayish white discharge that has a fishy odor

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How do you diagnosis Bacterial vaginosis (Gardnerella)

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Diagnosis- microscopic evidence of clue cells (epithelials with bacteria)

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How do you TX Bacterial vaginosis (Gardnerella)

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TX: Bacteria is normal to vagina, this condition occurs when overgrowth occurs, try first to restore normal balance. Can use Metronidazole (Flagyl). Avoid alcohol during and for 24 hours after flagyl tx. Cannot be used during 1st trimester

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Trichomoniasis

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Thin, foul smelling, greenish yellow vaginal discharge, vulvar itching, edema, redness

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Trichomoniasis diagnosis

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- specimen under a microscope or DNA and PCR testing for more rapid therapy

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Trichomoniasis TX

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Tx: Metronidazole (Flagyl), Clotrimazole (Gyne-Lotrimen) for symptom relief. Flagyl contraindicated during 1st trimester. Organism thrives in alkaline environment.

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What is trichomoniasis?

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is a very common sexually transmitted disease (STD) that is caused by infection with ais a very common sexually transmitted disease (STD) that is caused by infection with a protozoan parasite called Trichomonas vaginalis. Although symptoms of the disease vary, most women and men who have the parasite cannot tell they are infected. called Trichomonas vaginalis. Although symptoms of the disease vary, most women and men who have the parasite cannot tell they are infected.

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Chlamydia -( bacterium, Chlamydia trachomatis)

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Most commonly reported STD in US Incubation period is 1-3 weeks Silent disease, symptoms may be absent or minor, often not diagnosed until complications occur Also associated with gonococcal infections, usually tx'd concurrently even if no proof of disease.

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Chlamydia ( bacterium, Chlamydia trachomatis)

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Most commonly reported STD in US

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How do people get chlamydia?

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Chlamydia can be transmitted during vaginal, anal, or oral sex. Chlamydia can also be passed from an infected mother to her baby during vaginal childbirth.

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Chlamydia (GM - bacteria)

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Yellowish discharge and painful urination. Women may be asymptomatic which delays treatment. Men c/o dysuria or have urethral discharge.

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Chlamydia how to diagnosis

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Culture, rapid detection tests. DNA probe using urine specimen is noninvasive NAAT.

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Chlamydia Tx:

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Tx:Azithromycin, doxycline, erythromycin in pregnancy. All newborns have prophylactic eye care. Transmitted via birth canal and can cause conjuntivitis and pneumonia in newborns.

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Gonorrhea

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2nd most frequently reported STD in US Highest incidence in adolescents, people living in Southern US, and minorities.

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Gonorrhea Symptoms

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Men: initial site of infection is urethra, 2-5 days after infection they develop dysuria, profuse purulent urethral discharge. Unusual for males to be asymptomatic. Females: mostly asymptomatic or have minor problems like dysuria, frequent urination, or vaginal discharge After incubation redness or swelling occur at site of contact, greenish yellow exudate may develop.

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Gonorrhea (GM - Bacteria)

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Purulent discharge, painful urination, dyspareunia

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Gonorrhea diagnosis

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- culture of organism NAAT

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NAAT

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non-culture-based laboratory technology, such as a diagnostic test called the Nucleic Acid Amplification Test (NAAT). Currently, there is no reliable technology that allows for antibiotic susceptibility testing from non-culture specimens.

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Gonorrhea (GM - Bacteria) Tx

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: antibiotics. IM Ceftriaxone (Rocephin) most common tx

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Gonorrhea (GM - Bacteria)

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Can be transferred to newborns eyes during birth causing blindness.

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Gonorrhea (GM - Bacteria)

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Can cause pelvic inflammatory disease (PID) with tubal scarring.

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Gonorrhea (GM - Bacteria) Education

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Abstain from sex until tx complete. If single dose tx wait 7 days. Treat partners.

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Genital Herpes

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Virus enters through mucous membrane or breaks in the skin during contact with infected person Virus sheds even in the absence of lesions

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Genital Herpes lesions

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are painful. Nursing diagnosis may include pain management, skin care, or coping

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Genital Herpes Symptoms

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include itching or burning before the appearance of lesions (sores). Condition is highly contagious at all times, including when visible lesions are not present. Antiviral drugs ease symptoms and can suppress future outbreaks; howeve, currently there is no cure.

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Genital herpes (herpes simplex virus) HSV

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Clusters of painful blisters (vescicles) on the vulva, perineum, and anal areas. Vesicles rupture in 1-7 days and heal in 12 days.

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Genital herpes (herpes simplex virus) HSV

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Can cause spontaneous abortion or stillbirth. Active genital infection requires c-section for delivery. Causes neonatal CNS problems.

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Genital herpes (herpes simplex virus) HSV DX & TX

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Dx> S&S, confirmed by viral culture, antibody or DNA-based rapid test. TX> no cure, can treat symptoms with acyclovir (zovirax), valacyclovir (valtex).

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Genital herpes (herpes simplex virus) HSV

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HSV-1 causes infection above the waist HSV-2 frequently infects genital tract and perineum Either strain can cause disease on mouth or genitals

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Genital warts

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100 types of Pappiloma virus, 40 affect the genital tract. Types 6 and 11 most common. Incubation period is 3-4 months Most do not know they are infected. No symptoms may be present. Estimated 20 million Americans currently infected. Frequently seen in young, sexually active adults. Growth is more rapid during pregnancy, transmitted to newborn. In men warts appear on penis, scrotum, around anus, or in urethra. In women may be located on vulva, vagina, cervix, or perineal area

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Genital warts (Human Papiloma Virus) HPV

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Dry wartlike growths on vagina, labia, cervix, and perineum. Highly contagious.

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Genital warts (Human Papiloma Virus) HPV DX & TX

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Dx> by typical appearance and location Tx>removal with cryotherapy, electrocautery, laser, or chemicals Trichloroacetic acid (TCA), Bichloroacetic acid (BCA), Podophyllin resin (for small external genital warts) Primary goal is removal. Recurrence and re-infection possible, careful long term follow up advised

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Genital warts (Human Papiloma Virus) HPV DX & TX

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Increased incidence of cancers

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Vaccine for HPV virus

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Recommended prior to start of sexual activity (age 9-26) but those who are active, as well as those who are infected, would still get protection form viruses not acquired.

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Vaccine for HPV virus is

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Given in 3 IM doses over a 6 - month period

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HPV types 6, 11,16,18

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Gardasil vaccine must be given before you are exposed

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Cervarix vaccine

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HPV types 16, 18 - Cervical Cancer Vaccine

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Gardasil on males.

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Ongoing clinical trials are assessing the effectiveness of Gardasil on males.

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Syphilis

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serious bacterial STD that progresses through sever distinct stages but is only curable in its early stages

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Syphilis

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Caused by Treponema pallidum Spirochete bacterium Enters the body through breaks in skin or mucous membranes Facilitated by abrasions that occur during sexual intercourse , sexually transmitted infection caused by a spirochete, which may involve any organ or tissue over time; usually manifests first on the skin with the appearance of small, painless red papules that erode and form bloddless urcers called chancres

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Syphilis & pregnancy

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Spread in utero after 10th week of pregnancy Infected mother has a greater risk of a stillbirth or having a baby who dies shortly after birth

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