nursing care for patients with STIs
bacterial STIs
- chlamydia
- gonorrhea
- syphilis
viral STIs
- genital herpes(HSV - have it for life)
- genital warts (HPV - treatment for it, goes away but can come back)
- hepatitis B&C
- HIV/AIDS
best protection against STIs. what does not protect against STIs
latex condoms.
- oral contraceptives and other birth control methods such as IUD do not protect from STIs
chlamydia characteristics
- genital, oral, or anal transmission/infection
- "silent disease" underreported, asymptomatic and spread more
clinical manifestation of chlamydia in men
- fever, urethritis, dysuria, urethral discharge
- proctitis, rectal discharge, pain during defecation (if anally transmitted)
- unilateral scrotal pain and swelling
- possible infertility
clinical manifestation of chlamydia in women
- cervicitis, mucopurulent discharge
- urethritis, dysuria, frequent urination, pyuria
- PID -> infertility
diagnostic test of chlamydia
- nucleic acid amplification testing (NAAT)
- testing for other STIs
nucleic acid amplification testing
culturing where the discharge is in the urethral area
drug therapy for chlamydia
azithromycin and doxycycline
- taken PO, one time administration
nursing care of chlamydia
- abstinence from sexual intercourse for 7 days after completing treatment
- treatment of all sexual partners!!
- encourage use of condoms
transmission of gonorrhea
- general, oral, or anal transmission/infection
- eye infections in newborns
prevention of gonorrhea in newborns
- prophylactic ophthalmic antibiotic ointment
- untreated causes permanent blindness
S/S of gonorrhea in men
- profuse, purulent urethral discharge
- dysuria
- unusual to be asymptomatic
how long does it take gonorrhea to manifest in men? what are some signs?
- 2 to 5 days after infection
- painful, swollen testicles
color of discharge from women who have gonorrhea
greenish, yellow purulent cervical and/or urethral exudate often develop
gonorrhea in women may spread to where
to uterus, Fallopian tubes and ovaries -> PID -> infertility
S/S of gonorrhea in women
- mostly asymptomatic or minor symptoms
- dysuria, frequency of urination
diagnostic test of gonorrhea
- nucleic acid amplification testing (NAAT)
- culture and gram stain of urethral
- testing for other STIs
drug therapy for gonorrhea
- single IM dose of ceftriaxone with oral azithromycin
- treat all sexual contacts of patients
patient teach for gonorrhea
- abstain from sexual intercourse during and one week after treatment
- encourage use of condoms
genital herpes can recur during
- stress or immunosuppression
- fatigue, sunburn
- menses
how long does genital herpes last
- it is dormant in nerve ganglions
- persists for life!!!
HSV 1 infection is usually where..... HSV 2 frequently infect where
- above the waist
- genital tract and perineum
which strain of genital herpes can cause disease on mouth or genitals
either strain can
primary episode of genital herpes
- burning or tingling at site of lesions
- small vesicular (fluid-filled) lesions
- pain on urination due to urine touching lesions
what usually happen to genital herpes lesions
- rupture and form moist ulcerations
- eventually dry out and heal (up to 6 weeks)
patient teaching for genital herpes
- use condoms
- no sexual activity when lesions are present
- avoid auto inoculation to extra genital sites
diagnostic test of genital herpes
- tissue/fluid culture
- blood test for HSV 1 and 2 antibodies
drug therapy for genital herpes
- acyclovir
- famciclovir
- valacyclovir
- reduce recurrence frequency and duration, DOES NOT CURE
diagnostic test of HPV
- biopsy of questionable growth
- cervical HPV test with Pap smear
complications of HPV
HPV 16 and 18 can lead to cancer of the genitals, rectum, throat, pharynx
HPV vaccines for prevention
- gardasil
- cervarix
- Gardasil 9
removal of symptomatic warts
- chemical removal
- laser, electrocautery
- cryotherapy (freeze)
- warts may recur
characteristics of syphillis
- infects many organs and tissues
- not all exposure cause disease
mode of transmission of syphillis
- vaginal, anal or oral
other ways syphilis is spread
- contact with infectious lesions
- sharing needles among IV drug users
- congenital syphilis (in utero)
syphilic lesions on genitals enhance the transmission of what?
HIV
primary stage of syphilis
- chancre lesions (genitalia, lips, mouth, and rectum)
- regional lymphadenopathy
primary stage of syphilis lasts____. secondary stage lasts_____
- 3 to 6 weeks
- 1-2yrs
secondary stage of syphilis
- flu-like symptoms
- bilateral symmetric rash
- mucous patches in mouth, tongue, cervix, genitals, and anal area
- weight loss, alopecia
latent stage of syphilis
- asymptomatic (will have a positive test and can still transmit)
- diagnosis with positive syphilis test
the late stage of syphilis is after how long?
- 3-20yrs after initial infection
- rare due to treatment with antibiotics
organ damage and other complications that can occur if syphilis is not treated
- aneurysm, heart failure, neurosyphilis
- blindness, pain
diagnostic test of syphilis
- screening: VDRL, RPR
- test for HIV and other STIs
confirmed diagnosis of syphilis
treponema tests - (FTA-Abs, TP-PA) - blood test
drug therapy for syphilis
- penicillin G: given IM
- tetracycline and doxycycline if penicillin allergy
- repeat testing at 6 and 12 months
patient teaching about treatment of syphilis
treatment cannot repair damage already present in late stage
patient teaching about STIs
- good hygiene
- abstinence during treatment and condoms after
- routine screen
patient teaching of female clients on how to prevent STIs
- urination and washing after intercourse
- avoid douching
- cotton undergarments