Reproduction Flashcards
Sexual rights
Right to sexual freedom
Right to sexual autonomy, integrity, privacy and equity
Right to sexual and reproductive healthcare services
Right to sexual education
Right to make free and responsible reproductive choices
Epidimiology of sexual health
357 million new infections of curable STI’s occur each year
Incidence is highest in younger adults ages 15-24
Women have higher rates of ghonnorea
Men have higher rates of chlymadia and syphillis
How would you go about interviewing men
Conduc during health screening
Preceded physical examination
MEdical history, chronic conditions
Current problem
Medications
Family history
Lifestyle stressors
Sexual choices, behaviors
How would you go about interviewing women
Same as men except you would ask about menstra; and childbirth history and medications/ use of birth control
STI’s
Sexually transmitted infections
Transmitted by vaginal, oral, and anal intimate contact and intercourse
CAN BE TREATED AND CURED
STD’s
Sexually transmitted disease
MANANGED NOT CURED
HPV, HSV, HIV
Describe STI’s
Caused by bacteria, viruses, fungi, protozoa and parasites
Prevented by using latex condoms
Transmitted during heterosexual and homosexual activities
For treatment to be effective, sexual partners of infected individual must also be treated
What are the risk factors to STI’s
Multiple sexual partners
Sex with someone who has sex with many people
Exchange of sex for money or drugs
Poverty, unemployment and low education
Young men and women under 25 years of age
Drug or alcohol use that lowers inhibitions
Prevention and control is based on what
Education, detection, effective diagnosis, treatment of infected, treatment and counseling of sex partners of people infected
5 P’s in obtaining a sexual history
Parnters
Practice
Protection from STI’s
Past history of STI
Prevention of pregancy
What are some STI’s
Herpes
Chlymadia
Gonorrhea
Syphillis
HPV
Human Papillomavirus
Most common STI in US, 40 types
Genital warts, painless, soft, raised or flat, large or small, flesh colored
Causative agent in many genital cancers
Women are at greater risks ( larger mucosa area )
Majority infected are asymptomatic
Incubation period of 3 weeks-3 months
Diagnosis to HPV
Based on clinical appearance
Pap tests identify
No drug cure to HPV
Warts removed with treatment applied
Gardasil and Cervarix vaccines prevent
Genital Herpes
Caused by herpes simplex viruses HSV-1 and HSV-2
Most caused by HSV-2
Most commonly found in young, sexually active adults and are associated with early onset of sexual activity
2-12 days after exposure painful red papule appear on genital area—-small blisters filled with clear fluids form right after
Genital herpes diagnosis
first outbreak average 2-4 weeks
reaccurent infections are less severe and shorter duration
No cure, only relief of symptoms to prevent spread
Acyclovir helps reduce length and severity
Chlamydia
Caused by chlamydia trachomatis
Most commonly REPORTED bacterial STI in the US
Asymptomatic in most women until uterus, Fallopian tubes have been invaded
90% of men asymptomatic
Chlamydia diagnosis
Dysuria, urinary frequency and discharge= manifestations
Untreated can ascend to upper reproductive tract;PID
Treated with antibiotics, Zithromax and Addax
Both partners must be treated at the same time
Gonorrhea
Caused by neisseria gonorrhoeae, gram - diplococcus
African Americans have higher rates then non-hispanic whites
Causes inflammation
Transmitted through intercourse and delivery of baby passing through infected birth canal
In men=acute painful epididymis, glands
In women=PID, endometritis
Gonorrhea diagnosis
In men=dysuria, serous, milky discharge from penis
In women=dysuria, urinary frequency, abdominal menses, increased vaginal discharge
Can lead to blinds, infection of joints and sterility
Dual treatment of ceftiaxone and a single dose of azithromycin
Syphilis
Incubation period ranges from 12-90 days, averaging 21 days
Four clinical stages
Primary syphilis
Apperacne of chancre, regional enlargement of lymph nodes, little or no pain= 3-4 weeks after infectious contact
secondary syphilis
Systemic
Rash on palm and soles of feet, mucus membrane in oral cavity, sore throat, flu like symptoms
Disappears within 2-6 weeks
Latent syphilis
No sypmtoms
Sexual transmission possible in early stages
May last 1 year to a lifetime
Tertiary syphilis
Two types of late-stage syphilis
Benign late syphilis=rapid onset
Cardiovascular syphilis=can be treated but much damage irreversable
Syphilis diagnosis
complex
Darkfield microscopy
Educate patient about how to prevent reinfection or further transmission
Pharmacologic therapy- Antibiotics
Important maternal-newborn considerations
All pregnant women should be tested for STI’s including HIV as part of medical care routine
Maternal complications generally occur during pregnancy and for the child shortly after
STI’s in children
Diagnosis in children under 10 years old is suggestive of sexual abuse
Examination and specimen collection should be conducted by a clinician with experience in child sexual abuse
Treatment based on test results and accompanied by counseling
STI’s in adolescents
Increased risk especially in females
They may be concerned about confidentiality and may not trust local clinics
Important to discuss sexual behavior, infection risk, and safer sex practices
Vaccinations for HPV and hepatitis A and B
STI’s in older adults
Many won’t think of them as sexually active and wont assess for STI or provide education which then delays diagnosis
Higher risk of infection
May not believe themselves to be at risk, so educate
Nursing diagnosis’s
Acute pain, sexual dysfunction and knowledge deficit
Planning
Describe strategies for reducing risks
Plan to contact anyone who may have been exposed
Abstain from sexual activity until STI is resolved
Pain control
Implementation
Care in the community
Counsel patients about disease
Discuss available antiviral therapies
Arrange follow up visits
