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Nursing 2 > OB Ch. 5: STIs > Flashcards

OB Ch. 5: STIs Flashcards

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1
Q

8 infections total

A

-4 incurable
-4 curable

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2
Q

Curable STIs

A

-syphilis
-gonnorrhea
-chlamydia
-trichomoniasis

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3
Q

Uncurable STIs

A

-hepatitis B
-herpes simplex virus (HSV)
-HIV & HIV/AIDS
-human papillomavirus (HPV)

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4
Q

Vaginitis STI or not STI?

A

NOT STI. inflammation and infection of vagina, not always caused by sex

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5
Q

Vaginitis types

A

-candida: fungus
-trichomoniasis: protozoa
-gardnerella: bacteria

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6
Q

primary role for RNs in relation to STIs…

A

EDUCATE

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7
Q

P-LI-SS-IT model

A

P: permission
LI: limited information
SS: specific suggestions
IT: intensive therapy

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8
Q

Permission of P-LI-SS-IT

A

allow woman to talk about experience

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9
Q

Limited Information of P-LI-SS-IT

A

information given to woman about STIs are factual (dispel myths), and have specific measurements to prevent transmission

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10
Q

Specific Suggestions of P-LI-SS-IT

A

an attempt to help the woman change their behavior to prevent recurrence and further transmission of STI

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11
Q

IT of P-LI-SS-IT

A

involves referring woman or couple for appropriate treatment based on circumstance

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12
Q

Vaginal Candidiasis

A

-fungal infection –> NOT STI
-vaginal discharge
-yeast
-monlia

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13
Q

Vaginal Candidiasis TX:

A

-miconazole cream or suppository
-clotrimazole cream or tablet
-terconazole cream or intravaginal suppository
-fluconazol oral tablet (single dose 150 mg)
-either as cream, ointment, or suppository
for 3-7 days

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14
Q

what happens if vaginal candidiasis is not treated before birth?

A

TRUSH: fungal yeast infection in mouth, vagina, and other parts of the body
-can be given to baby during delivery if not treated

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15
Q

Vaginal Candidiasis nursing management

A

-100% white cotton panties
-avoid tight pants
-shower, avoid baths
-use unscented soap and dry gentle
-avoid vaginal sprays/deodorants
-avoid douching
-wipe front to back

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16
Q

Trichomoniasis

A

-NOT CONSIDERED STI
-caused by protozoan Trichomonas vaginalis (found in contaminated still water)
-common cause of vaginal infection

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17
Q

Trichomoniasis screening and diagnosis

A

-discharge is yellowish green or gray/frothy
-pruritis
-soreness
-cervix may bleed

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18
Q

Trichomoniasis TX

A

metronidazole or tinidasole 2 g PO one time

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19
Q

Bacterial Vaginosis S/S

A

-STALE FISHY ODOR!!!!!!!!
-thin, white discharge

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20
Q

Bacterial Vaginosis TX

A

metronidazole (flagyl) PO or gel
-clindamycin cream up the vagina

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21
Q

Chlamydia pathophysiology

A

-most common bacterial STI
-caused by chlamydia trachomitis bacteria
-can be asymptomatic

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22
Q

Chlamydia clinical manifestations

A

-mucopurulent discharge
-urethritis
-bartholinitis
-endometritis
-salpingitis
-dysfunctional uterine bleeding

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23
Q

Chlamydia diagnostic

A

-urine testing
-swab specimen collected from endocervix or vagina

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24
Q

Chlamydia TX:

A

-doxycycline 100 mg PO BID for 7 days
-azithromycin 1 g PO single dose

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25
Q

How can chlamydia affect baby

A

-newborns delivered by chlamydia positive mothers may develop conjunctivitis
-opthalmia neonatorum is HIGHLY CONTAGIOUS and if untreated, leads to blindness, joint infection, or life threatening blood infection in newborn

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26
Q

Chlamydia Risk factors

A

-adolescence
-multiple sex partners
-new sex partner
-engaging in sex without using barrier contraceptive
-oral contraceptives
-being pregnant
-history of another STI

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27
Q

Gonorrhea Pathophysiology

A

-aerobic gram negative diplococcus; Nisserria gonorrhoeae infects mucosal surfaces
-STI
-severe STI; highly contagious

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28
Q

Gonorrhea clinical manifestations

A

-abnormal vaginal discharge
-dysuria
-cervicitis
-enlarged local lymph glands
-abnormal vaginal bleeding
-bartholin abscess
-PID (pelvic inflammatory disease)
-mild sore throat (for pharyngeal gonorrhea)
-rectal infection
-perihepatitis

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29
Q

Untreated gonorrhea

A

-enter bloodstream and produce a disseminated gonococcal infection. Severe form can invade joints and cause arthritis, endocarditis of the heart, meningitis of the brain , hepatitis of the liver

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30
Q

Gonorrhea Diagnosis

A

-urinalysis
-swab mucosal lining

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31
Q

Gonorrhea TX

A

-azithromycin 1 g PO single dose
-ceftriaxone 250 mg IM single dose

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32
Q

Genital Herpes Simplex Pathopysiology

A

-recurrent, lifelong, viral infection that has the potential for transmission throughout lifespan; will stay dormant until stimuli
-HSV 1/HSV 2

33
Q

HSV1

A

mostly causes fever blisters or col sores on lips, eyes, and face

34
Q

HSV2

A

typically invades the mucous membranes on the genital tract and is known as genital herpes

35
Q

HSV transmission

A

-direct contact w/ infected individual who is shedding the virus
-kissing, oral sex, sexual contact, vaginal birth are means of transmission

36
Q

HSV stimuli

A

-fever
-ultraviolet radiation
-stress
-immunosuppressants

37
Q

HSV clinical manifestations (viral shredding)

A

-multiple painful vesicular lesions
-mucopurulent discharge
-superinfection w/ candida
-fever
-chills
-malaise
-dysuria
headache
-genital irritation
-inguinal tenderness
-lymphadenopathy

38
Q

HSV TX

A

-uncurable
-antiviral therapy can help suppress clinical manifestations and outbreaks
-acyclovir 400 mg TID PO 7-10 days
-famciclovir 250 mg TID PO 7-10 days
-valacyclovir 1 g BID PO 7-10 days
-ABSTAIN FROM SEXUAL ACTIVITY UNTIL HSW LESIONS FULLY RESOLVE
-hand hygiene

39
Q

Syphilis pathophysiology

A

chronic, multistage, CURABLE infection caused by Treponema pallidum that is transmitted via sexual activity or from mother to fetus

40
Q

syphilis risk factors

A

-spontaneous abortion
-low birth weight, fetal growth restriction
prematurity
-stillbirth
-multisystem failure of heart, lungs, pancreas, liver, spleen
-structural bone damage w/ nervous system involvement
-mental retardation

41
Q

syphilis stages

A
  1. primary
  2. secondary
  3. early latent
  4. late latent
  5. tertiary
42
Q

primary syphilis

A

-chancre (PAINLESS ulcer) at site of bacterial entry that will disappear within 1-6 weeks without intervention
-motile spirochetes present on dark field exam of ulcer exudate
-painless B/L adenopathy

43
Q

secondary syphilis

A

appears 2-6 months after initial exposure
-flu like symptoms
-maculopapular rash of trunk, palms, soles
-alopecia
-adenopathy
-fever
-pharyngitis
-weight loss
-fatigue
-latency: THIS STAGE CAN LAST UP TO 20 YEARS. If not treated, heart disease and neurological disease slowly destroys heart, eyes, brain, CNS, skin

44
Q

syphilis TX

A

-benzathine pcn G - IM or IV, 2.4 million units IM in one dose
-if syphilis duration longer than 1 year or unknown duration, 2.4 million units of benzathine pcn G given IM once a week for 3 weeks
-if allergic to PCN, doxycycline can be given

45
Q

syphilis DX

A

-nontreponemal test (Veneral Disease Researc Laboratory (VDRL))
-Rapid Plasma Reagin (RPR)
-Treponemal tests (fluorescent treponemal antibody absorbed (FTA-ABS))
-T. pallidum particle agglutination (TP-PA)

46
Q

Syphilis TX and Management

A

-abstain from intercourse during prodromal period and when lesions are present
hand hygiene
-comfort measures such as wearing non constricting clothes, wearing cotton underwear
-lukewarm sitz baths
-air drying lesions or using hair dryer on low heat
-avoid extreme temperatures (ice or hot packs)
-use condoms with all new or noninfected partners

47
Q

Pelvic Inflammatory Disease

A

-when ovaries and peritoneum are involved; scarring to fallopian tubes
-can cause infertility and may cause ectopic pregnancy
-frequently caused by intreated chlamydia or gonorrhea

48
Q

PID risk factors

A

-adolescence or young adulthood
-non white female
-multiple sex partners
-early onset of sexual activity
-history of PID or STI
-alcohol/drug use
-having intercourse with partner who has untreated urethritis
-recurrent insertion of intrauterine contraceptive (IUC)
-nulliparity
-cigarette smoking
-recent termination of pregnancy
-lack of condom or contraceptive use
-douching
-prostitution

49
Q

PID S/S

A

-abnormal cervical or vaginal mucupurulent discharge
-oral temp above 101F
-cervical motion tenderness
-elevated erythrocyte sedimentation rate (ESR)
-elevated C-reactive protein level (CRP)
-N. gonorrhea or C. trachomatis infection documented
-white blood cells on saline vaginal smear
-prolonged or increased menstrual bleeding
-dysmennorrhea
-dysuria
-painful sex
-N/V

50
Q

PID TX/Management

A

-broad spectrum ABX
-parenteral cephalosporin in single injection w/ doxycycline 100 mg BID for 14 days
-follow up appt
-IF HOSPITALIZED, maintain hydration w/ IV fluids, administer analgesics PRN, and put in semi-fowler position to promote pelvic drainage

51
Q

PID DX

A

-endometrial biopsy
-transvaginal ultrasound
-laparoscopic examination

52
Q

Human Papillomavirus (HPV) clinical manifestations

A

-visible warts diagnosed by inspection
-warts are fleshy papules with granular surface
-lesions can grow large during pregnancy, affecting urination, defecation, motility, mobility, descent of fetus
large lesions may resemble CAULIFLOWERS, existing in clusters, easy to bleed

**NO VAGINAL DELIVERY IF ACTIVE HPV

53
Q

HPV Risk Factors

A

-multiple sex partners
-ages 15-25 years
-sex with make who has had multiple sex partners
-first intercourse at age 16 or younger

54
Q

HPV TX/management

A

-no current medical treatment
-HPV vaccine
ages 11-14 are 2 injections, after age 15 is three injections
-side effects of vaccine include: pain, fainting, redness, swelling at injection site, fatigue, H/A, muscle and joint aches, GI distress
-serial pap smears performed for low risk women –> can detect cellular changes made by HPV

55
Q

Treatment options for precancerous cervical lesions or genital warts d/t HPV

A

-topical tricholoroacetic acid 80-90%
-liquid nitrogen cryotherapy
-topical imiquimod 5% cream
-topical podophyllin 10-25%
-sincatechins 15% ointment
-laser carbon dioxide vaporization
-client applied podofilox 0.5% solution or gel
-simple surgical excision
-loop electrosurgical excision procedure (LEEP)
-intralesional interferon therapy

56
Q

Hep. A

A

-acute, systematic viral infection that can be transmitted through sexual activity, or fecal-oral route
-drinking polluted water, uncooked shellfish from sewage contaminated waters or food handled by hep. carrier w/ poor hygiene
-oral sexual contact
-sexual activity between 2 men

57
Q

Hep. B

A

-transmitted through saliva, blood serum, semen, menstrual blood, vaginal secretions
-incubation period from time of exposure to onset of symptoms is 6 weeks to 6 months
-virus can survive outside body for at least 7 days

58
Q

Hep. B risk factors

A

-multiple sex partners
-engaging in unprotected receptive anal intercourse
-h/o other STIs

59
Q

Hep. B TX

A

-pre exposure immunization

60
Q

S/S of Hep B

A

-flu like symptoms with malaise
-skin rashes
-fatigue
-anorexia
-nausea
-vomiting
-pruritis
-fever
-RUQ pain

**Hep. A s/s are similar, with less fever and skin involvement
**Hep. B tested for in 1st and 3rd trimester

61
Q

Hepatitis DX

A

-IgM antibody is diagnostic sign of acute Hep. A infection
-Hep. B detected by blood test that look sof antibodies and proteins produced by virus/positively DXed by presence of Hep. B surface antibody

62
Q

Hepatitis C

A

-NOT STI
-women at risk if they use injection drugs
-targets liver cells

63
Q

Hep. C high risk

A

-history of injection drug use
-nonsterile tattooing
-HIV positive
-h/o STIs
-multiple sexual partners
h/o blood transfusion or organ transplant before 1992

64
Q

Ectoparasitic Infection

A

-caused by bed bugs, mites, scabies, pubic lice

65
Q

ectoparasitic infection management

A

-symptomatic relief of itching and elimination of infestations

66
Q

Scabies clinical manifestaions

A

intensely pruritic dermatitis with lesions

67
Q

scabies S/S

A

history and appearance of burrows in webs of fingers and genitalia

68
Q

scabies TX

A

-permethrin cream
-oral ivermectin
-benzyl benzoate

69
Q

pubic lice clinical manifestations

A

-pruritis w/ lice or nits
-rash brough on by skin irritation
-usually asymptomatic until after 1 week

70
Q

pubic lice TX

A

-permethrin 1% cream rinse
-pyrethrin w/ piperonyl butoxide
-lindane shampoo
-decontamination of bedding and clothing
-treatment of family members and sexual partners

71
Q

HIV pathophysiology

A

-virus that causes destruction of T cells
-considerd HIV when T cell count is low, but above 200
-precursor to AIDS

72
Q

AIDS

A

-most advanced stage of HIV infection
-considered AIDS when T cell count is 200 or less
-infected person can develop opportunistic infections or malignancies that can be fatal
-depletion of T cells leads to gradual loss of immune function

73
Q

HIV/AIDS DX

A

-nucleic acid test (NAT)
-antigen/antibody test
-if positive antigen/antibody test –> multispot test done
if positive multispot test –> HIV confirmed

HIV or HIV/AIDS dependent on T cell count

74
Q

HIV/AIDS clinical manifestations

A

-fever
-pharyngitis
-rash
-myalgia
-after acute phase, infected person becomes asymptomatic, HIV virus begins to replicate, immunity decreases

75
Q

HIV/AIDS TX

A

-drug therapy to:
-decrease HIV viral load below level of detection
-restore body’s ability to fight off pathogens
improve quality of life
-reduce HIV M&M
-antiviral retro therapy (ART)

76
Q

antiviral retro therapy

A

-used for any person w/ AIDS defining illness or ASAP after DX
-long acting injectable medication and PO meds are available to suppress viral load
-used to prevent transmission to newborn (mother takes ART during pregnancy)
-during active labor, ART agent is given until delivery, administered 6-12 hours after birth and continued for 6 weeks

77
Q

Post Exposure Prophylaxis (PEP)

A

-PEP is post exposure prophylaxis and prevents or controls spread of HIV within 72 hours after possible exposure
-will be taken for 28 days after exposure
-EX: accidental needle stick from positive HIV patient

78
Q

Pre Exposure Prophylaxis (PrEP)

A

-medication taken daily to help reduce chances of contracting HIV for those at high risk of getting it
-partner who is having sexual activity with HIV positive partner

79
Q
A

Nursing 2 (6 decks)

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