nursing care for patients with STIs

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1

bacterial STIs

  • chlamydia
  • gonorrhea
  • syphilis
2

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
3

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
4

chlamydia characteristics

  • genital, oral, or anal transmission/infection
  • "silent disease" underreported, asymptomatic and spread more
5

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
6

clinical manifestation of chlamydia in women

  • cervicitis, mucopurulent discharge
  • urethritis, dysuria, frequent urination, pyuria
  • PID -> infertility
7

diagnostic test of chlamydia

  • nucleic acid amplification testing (NAAT)
  • testing for other STIs
8

nucleic acid amplification testing

culturing where the discharge is in the urethral area

9

drug therapy for chlamydia

azithromycin and doxycycline

  • taken PO, one time administration
10

nursing care of chlamydia

  • abstinence from sexual intercourse for 7 days after completing treatment
  • treatment of all sexual partners!!
  • encourage use of condoms
11

transmission of gonorrhea

  • general, oral, or anal transmission/infection
  • eye infections in newborns
12

prevention of gonorrhea in newborns

  • prophylactic ophthalmic antibiotic ointment
  • untreated causes permanent blindness
13

S/S of gonorrhea in men

  • profuse, purulent urethral discharge
  • dysuria
  • unusual to be asymptomatic
14

how long does it take gonorrhea to manifest in men? what are some signs?

  • 2 to 5 days after infection
  • painful, swollen testicles
15

color of discharge from women who have gonorrhea

greenish, yellow purulent cervical and/or urethral exudate often develop

16

gonorrhea in women may spread to where

to uterus, Fallopian tubes and ovaries -> PID -> infertility

17

S/S of gonorrhea in women

  • mostly asymptomatic or minor symptoms
  • dysuria, frequency of urination
18

diagnostic test of gonorrhea

  • nucleic acid amplification testing (NAAT)
  • culture and gram stain of urethral
  • testing for other STIs
19

drug therapy for gonorrhea

  • single IM dose of ceftriaxone with oral azithromycin
  • treat all sexual contacts of patients
20

patient teach for gonorrhea

  • abstain from sexual intercourse during and one week after treatment
  • encourage use of condoms
21

genital herpes can recur during

  • stress or immunosuppression
  • fatigue, sunburn
  • menses
22

how long does genital herpes last

  • it is dormant in nerve ganglions
  • persists for life!!!
23

HSV 1 infection is usually where..... HSV 2 frequently infect where

  • above the waist
  • genital tract and perineum
24

which strain of genital herpes can cause disease on mouth or genitals

either strain can

25

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
26

what usually happen to genital herpes lesions

  • rupture and form moist ulcerations
  • eventually dry out and heal (up to 6 weeks)
27

patient teaching for genital herpes

  • use condoms
  • no sexual activity when lesions are present
  • avoid auto inoculation to extra genital sites
28

diagnostic test of genital herpes

  • tissue/fluid culture
  • blood test for HSV 1 and 2 antibodies
29

drug therapy for genital herpes

  • acyclovir
  • famciclovir
  • valacyclovir
  • reduce recurrence frequency and duration, DOES NOT CURE
30

diagnostic test of HPV

  • biopsy of questionable growth
  • cervical HPV test with Pap smear
31

complications of HPV

HPV 16 and 18 can lead to cancer of the genitals, rectum, throat, pharynx

32

HPV vaccines for prevention

  • gardasil
  • cervarix
  • Gardasil 9
33

removal of symptomatic warts

  • chemical removal
  • laser, electrocautery
  • cryotherapy (freeze)
  • warts may recur
34

characteristics of syphillis

  • infects many organs and tissues
  • not all exposure cause disease
35

mode of transmission of syphillis

  • vaginal, anal or oral
36

other ways syphilis is spread

  • contact with infectious lesions
  • sharing needles among IV drug users
  • congenital syphilis (in utero)
37

syphilic lesions on genitals enhance the transmission of what?

HIV

38

primary stage of syphilis

  • chancre lesions (genitalia, lips, mouth, and rectum)
  • regional lymphadenopathy
39

primary stage of syphilis lasts____. secondary stage lasts_____

  • 3 to 6 weeks
  • 1-2yrs
40

secondary stage of syphilis

  • flu-like symptoms
  • bilateral symmetric rash
  • mucous patches in mouth, tongue, cervix, genitals, and anal area
  • weight loss, alopecia
41

latent stage of syphilis

  • asymptomatic (will have a positive test and can still transmit)
  • diagnosis with positive syphilis test
42

the late stage of syphilis is after how long?

  • 3-20yrs after initial infection
  • rare due to treatment with antibiotics
43

organ damage and other complications that can occur if syphilis is not treated

  • aneurysm, heart failure, neurosyphilis
  • blindness, pain
44

diagnostic test of syphilis

  • screening: VDRL, RPR
  • test for HIV and other STIs
45

confirmed diagnosis of syphilis

treponema tests - (FTA-Abs, TP-PA) - blood test

46

drug therapy for syphilis

  • penicillin G: given IM
  • tetracycline and doxycycline if penicillin allergy
  • repeat testing at 6 and 12 months
47

patient teaching about treatment of syphilis

treatment cannot repair damage already present in late stage

48

patient teaching about STIs

  • good hygiene
  • abstinence during treatment and condoms after
  • routine screen
49

patient teaching of female clients on how to prevent STIs

  • urination and washing after intercourse
  • avoid douching
  • cotton undergarments