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Mother-Infant > Chapter 5: STIs > Flashcards

Chapter 5: STIs Flashcards

1
Q

What are 4 curable STIs?

A

Chlamydia
Gonorrhea
Syphilis
Trichomoniasis

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2
Q

What are 4 incurable STIs?

A

Hepatitis B
Herpes Simplex Virus (HSV)
Human immunodeficiency virus (HIV)
Human Papillomavirus (HPV)

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3
Q

What infections are characterized by vaginal discharge?

A

Vaginal Candidiasis
Trichomoniasis
Bacterial Vaginosis

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4
Q

What infections are characterized by cervicitis?

A

Chlamydia
Gonorrhea

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5
Q

What infections are characterized by genital ulcers?

A

Herpes simplex virus
Syphilis

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6
Q

What are the vaccine preventable STIs?

A

Hepatitis A, hepatitis B and HPV

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7
Q

What is the nurse’s primary role in managing vaginitis?

A

The nurse should aim to educate and do primary prevention to limit the recurrences and infections

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8
Q

What is the first step in primary prevention for women at risk for an STI?

A

Changing the sexual behaviors that may place a woman at risk

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9
Q

Candidiasis is one of the most common causes for what?

A

Vaginal discharge

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10
Q

Is candidiasis an STI? Why?

A

It is not. It is one of the most common causes for vaginal discharge but it is not an STI

It is not an STI because candida, is a normal part of the vaginal flora. It only becomes pathologic when the vaginal environment becomes altered

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11
Q

What is the typical pharmacological tx for vaginal candidiasis?

A

Topical azole preps (miconazole, clotrimazole, terconazole)

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12
Q

What are some pre-disposing factors that can lead to vaginal candiasis?

A

-Abx tx
-Pregnancy
-Obesity
-DM
-Use of steroids or immunosuppressive drugs
-Wearing tight restrictive clothes

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13
Q

What are some clinical manifestations of (VC)

A

-Vaginal discharge (thick, white, curd-like)
-Vaginal soreness
-Pruritus
-Vulvar burning
-External dysuria

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14
Q

What examination can confirm the presence of (VC) ?

A

Speculum exam will reveal white plaques on the vaginal walls and a wet smear can reveal filamentous hyphae and spores of a fungus

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15
Q

What are some nursing management strategies for women with (VC)

A

-Limit simple sugars and soda
-Wear white, 100% cotton underwear
-Avoid bubble baths
-Avoid vaginal sprays/deodorants
-Avoid douching

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16
Q

What is trichomoniasis?

A
  • Most common NONVIRAL STI in the US
  • Causes vaginal discharge
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17
Q

How else can trichomoniasis be transmitted if not sexually?

A

Organism can live on damp/wet surfaces that are poorly cleaned and mantained. Like hottubs or drains

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18
Q

What are some symptoms for trichomoniasis?

A
  • Vulvar itching
  • Foamy, bubbly, frothy, malodorous vaginal discharge
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19
Q

What effects can this have on the baby if the mother is pregnant and infcted w/ trichomoniasis?

A

Preterm birth and postpartmu endometritis

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20
Q

What is the pharmacological tx for trichomoniasis?

A

Single dose of oral metronidazole or tinidazole

This is an abx

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21
Q

Clinical manifestations of trichomonisis?

A
  • Foamy, bubbly, frothy green/gray vaginal discharge
  • Vulvar itching and soreness
  • Cervix may bleed on contact
  • Dysuria
  • Petechiae on the cervix
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22
Q

How can we dx trichomoniasis?

A

We can dx w/ cultures and view them under the microscope. A vaginal pH level of 4.5 is also typical

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23
Q

What is Bacterial Vaginosis?

A

Most prevalent cause of vaginal discharge or malodor

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24
Q

Why is BV not considered bacterial vaginitis?

A

BV does not usually present w/ inflammation, redness, swelling of the vagina

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25
Q

How does bacterial vaginosis happen?

A

It is a sexually associated infx that is characterized by alterations in the vaginal flora where lactobacilli is replaced by high concentrations of anaerobic bacteria

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26
Q

What are some factors that may alter the lactobacilli concentration in the vagina that may lead to BV?

A

Not fully understood but generally beleived that it is d/t
* Multiple sex partners
* douching
* lack of vaginal lactobacilli

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27
Q

What effect to BV have on the pregnant woman?

A
  • Preterm labor
  • Premature rupture of membranes (PROM)
  • Chorioamnionitis
  • Postpartum endometiris
  • PID
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28
Q

What is the pharmacological tx for BV

A

Metronidazole (oral or gel)
Clindamycin cream

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29
Q

What is cervicitis usually caused by?

A

Chlamydia and Gonorrhea

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30
Q

What is most commonly reported bacterial STI in the US?

A

Chlamydia

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31
Q

Highest predictor for chlamydia infection is what?

A

Age group!

It is noted that the highest rates of infection w/ chlamydia is in the age group of 15-19 years

32
Q

Describe common risk factors associated w/ chlamydia

A
  1. Being age less than 25
  2. Recent change in sex partners
  3. Multiple sex partners
  4. Lack of use of barrier contraceptives
  5. Nonwhite race
  6. Single status
33
Q

Chlamydia can present with symptoms, but most often than not it is _______

A

Asymptomatic

34
Q

In women, chlamydia is linked with what abnormal conditions?

A
  • Cervicitis
  • Salpingitis
  • Ectopic pregnancy
  • PID
  • Infertility
35
Q

This type of bacterial inx causes half of the 1 million recognized cases of PID

A

Chlamydia

36
Q

If a mother is infx w/ chlamydia during pregnancy, what effects can this have on the newborn?

A

The baby will be born with conjuctivitis or opthalmia neonatum

37
Q

Chlamydia is one of the 4 STI’s that can be treated. How is it treated?

A

Abx tx like doxycycline

38
Q

It is recommended to test and to tx chlamydia along w/ what other curable STI?

A

Gonorrhea

Common coinfection w/ chlamydia and gonorrhea is frequently seen

39
Q

Clinical manifestations of chlamydia?

A
  • Vaginal discharge
  • Urethritis
  • Bartholonitis
  • Endometritis
40
Q

How is chlamydia dx’d?

A

Through urine testing or swabs of the endocervix or vagina

41
Q

Second most commonly bacterial infx reported in the US?

A

Gonorrhea

42
Q

What does gonorrhea increase the risk of?

A
  • Pid
  • Infertility
  • Ectopic pregnancy
  • HIV acquisition
43
Q

Gonorrhea can affect the baby in what ways?

A

Baby can be born with Opthalmia neonatorum

44
Q

What complications can arise from neonatorum opthalmia?

A
  • Blindness
  • Joint infection
  • Blood infection
45
Q

How is gonorrhea treated?

A

W/ dual therapy that can help w/ preventing drug resistance and also have it be effective against chlamydia

46
Q

How can gonococcal opthalmia neonatorum be prevented?

A

Instilling prophylactic agent in the eyes of all newborns. This is required by law in most states

47
Q

How can gonorrhea cause PID?

A

Untreated gonorrhea can ascend through the endocervical canal to the endometrium of the uterus, where it then travels to the fallopian tubes and into the peritoneal cavity. If the ovaries become involved then it becomes PID

48
Q

How does dessiminated gonoccoal gonorrheal infx happen?

A

If it is left untreated, it can enter the bloodstream and infect joints, heart, brain, and liver

49
Q

When should pregnant women be tested for gonorrhea?

A

Screened at first prenatal visits and at 36 weeks gestation

50
Q

What are two types of Genital Herpes Simplex Virus?

A
  1. HSV-1: oral, fever blisters
  2. HSV-2: genital HSV
51
Q

How is HSV transmitted?

A

Contact w/ mucous membranes or breaks in the skin of visible or nonvisible lesions

52
Q

What causes recurrent genital herpes outbreaks? What triggers them?

A
  • Stressful situations
  • Menses
  • Sexual intercourse
  • Most often….nothing
53
Q

How can HSV affect newborns

A

Causes neonatal herpes which can lead to mortality and morbidity

54
Q

How is HSV treated?

A

There is no cure but antiviral drugs can be used to manage herpes

55
Q

Syphilis is what?

A

A chronic, multistage bacterial infection that is curable

Sexually transmitted and/or congenitally from an infected mother to her fetus

56
Q

Why is syphilis of such concern?

A

Because of its biologic realtionship w/ HIV acquisition and transmission and the impact on infant health

57
Q

How is syphilis treated?

A

Benzathine penicillin G, IM injection

NO injection to prevent syphillis, but there is a cure for it

58
Q

What are the effects of syphilis on a baby?

A
  • Spontaneous birth
  • low birth rate
  • fetal growth restriction
  • stillbirth
  • multisystem heart failure
  • structural bone damage and nervous system involvement of mental retardation
59
Q

What are the mosti nfectious stages of syphilis?

A
  • Primary
  • Secondary
  • Early latent
60
Q

What is characteristic of a primary stage of syphilis?

A
  • Chancres (painless ulcers)
  • Painless bilateral adenopathy

They usually disappear 1-6 weeks w/o intervention

61
Q

What is characteristic of a secondary stage of syphilis?

A
  • Flu like symptoms
  • Maculopapular rash

Lasts about 2 years

62
Q

What is characteristic of a latency stage of syphilis?

A

Nothing. Asysmptomatic

Serological tests still positiive for syphilis. Can las 20 years

63
Q

What is characteristic of a tertiary (late) stage of syphilis?

A

Life threatening heart disease and neurologic disease

64
Q

What is the most effective way of controlling PID?

A

STI tx and prevention because it is d/t polybacterials ascending the upepr female reproductive tract

Usually caused by gonorrha and chlamydia

65
Q

How would you treat PID?

A

W/ the proper antibiotic treatment to eradicate all bacterial infections.

66
Q

What are some vaccine preventable STIs?

A
  • HAV
  • HBV
  • HPV
67
Q

Most common viral infection in the US

A

HPV

68
Q

What are the main s/s of HPV

A
  • Genital warts or condylomata
69
Q

HPV is important in terms of its implications in the health of people infected w/ it because….

A

HPV is the cause of essentially all cases of cervical, vuvlar, vaginal, penile, anal and oropharyngeal cancers

70
Q

What clinical exam can help detect the cellular changes assocaited HPV

A

Pap smears

71
Q

There is no tx for HPV, so what is the main focus for HCP?

A

Main focus is the promotion of the vaccine and to prevent infection through education

72
Q

The vaccine for HPV is primary intervention. What if she does not want or does not receive the vaccine?

A

The nurse would move to secondary prevention where the promotion of regular pap smears and education would take forefront

73
Q

How is hepatitis A transmitted?

A

Fecal-orally w/ an infected person but also through infected shellfish from contaminated waters, or from food handled by a hepatitis carrier w/ poor hygiene

74
Q

What are the s/s for HAV?

A

Flu like symptoms, malaise, skin rashes, fatigue, anorexia, nausea, fever, and RUQ pain

75
Q

Best way to prevent HAV?

A

Vaccination

76
Q

Best nursing education for HPV?

A
  • Gardasil 9 vaccine
  • Regular pap-smears
  • Teach women link between HPV and cervical cancer
  • Safe sex practices
77
Q

Bacterial vaginosis may cause women to be susceptible to what?

A

Other STIs

Mother-Infant (15 decks)

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