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MS1 Exam Three > STDs > Flashcards

STDs Flashcards

1
Q

Taking care of a person with STDs will include…

A
  • taking a sexual history
  • inspection of the genitalia
  • admin of treatment and education about prevention of transmission
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2
Q

STD Incidence

A
  • at epidemic level

- youth between ages of 15-24 and minorities have the highest incidence

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3
Q

STD impact of women

A
  • STIs more easily transmitted from men to women (receiver of sexual fluid)
  • Women experience fewer early symptoms of STIs
  • At higher risk for PID genital cancers, and reproductive complications
  • Adolescent females have a more vulnerable cervix
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4
Q

Other vulnerable populations

A
  • infants
  • adolescents of both sexes
  • older adults
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5
Q

Risk factors for STDs

A
  • sexual partners and behaviors
  • age
  • substance use
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6
Q

Prevention and control

A
  • starts with screening
  • CDC recommended assessment
  • transmission of most STDs can be prevented by use of latex condoms
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7
Q

CDC recommended assessment

A

5 P’s:

  • Partners
  • Prevention of pregnancy
  • Protection from STIs
  • Practice
  • Past hx of STIs
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8
Q

Once infected, control strategies include…

A
  • avoid intercourse with infected partner
  • use protection, if having intercourse with infected partner
  • partner notification
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9
Q

Genital Herpes

A

(HSV)

-Caused by the herpes simplex viruses HSV-1 and HSV-2

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10
Q

Genital Herpes Pathophysiology

A

Gain entry via mucocutaneous surfaces.

Begins to multiply causing cell destruction and vesicle formation

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11
Q

Genital Herpes Manifestations

A
  • May have no symptoms
  • Painful red vesicles 2-14 days after exposure
  • Small, painful blisters filled with clear fluid
  • First outbreak average duration 10-20 days
  • Recurrent infections 4-5 days
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12
Q

Genital Herpes Diagnosis and treatment

A
  • Presumptive diagnosis

- No cure

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13
Q

Genital Herpes Pharmacologic Therapy

A

-Acyclovir (Zovirax)

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14
Q

Acyclovir (Zovirax)

A
  • antiviral
  • reduce the length and severity of each outbreak
  • treatment of choice for genital herpes
  • also used to suppress the virus, thereby decreasing the number of outbreaks
  • oral form is most effective for the first episode and recurrences and is given for 7-10 days or until lesions heal
  • can be given IV
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15
Q

Acyclovir (Zovirax) and HIV patients

A

evidence shows that some strains of HSV are becoming resistant to Acyclovir, particularly in HIV-positive patients.

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16
Q

Other antivirals used for treatment and suppression with Genital Herpes

A
  • Valacyclovir (Valtrex)

- Famciclovir (Famvir)

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17
Q

HPV

A

Human Papillomavirus

  • Genital warts
  • most common genital infection in US
  • women at greater risk
  • Majority of infected individuals asymptomatic
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18
Q

HPV Pathophysiology

A
  • HPV transmitted by vaginal, anal, oral-genital contact

- incubation period 2-3 months

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19
Q

HPV Manifestations

A
  • some exhibit none

- others exhibit genital warts

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20
Q

HPV Diagnosis and treatment

A
  • clinical appearance on physical examination
  • regular screening, Pap tests
  • identify precancerous lesions
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21
Q

HPV Pharmacologic therapies

A
  • no drug to cure virus itself
  • topical agents
  • Gardasil, Cervarix vaccinations
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22
Q

HPV Topical agents

A
  • Podofilox, imiquimod (client applied)

- Podophyllum, trichloroacetic acid (provider administered)

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23
Q

Chlamydia

A
  • most commonly reported bacterial STI

- asymptomatic in most women

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24
Q

Chlamydia risk factors

A
  • any sexually active individuals, especially females 14-19
  • personal or partner hx
  • cervical ectopy
  • adolescent sexual activity
  • oral contraceptives
  • drug or alcohol use that increases risky sexual behavior
25
Q

Chlamydia is the leading cause of…

A

preventable blindness

-newborns

26
Q

Chlamydia pathophysiology

A
  • Chlamydia trachomatis
  • intracellular bacterium that resembles viruses in that it can reproduce only within a host cell
  • enters body as an elementary body, a form which it is capable of entering uninfected cells
  • infection begins when the organism enters a cell, becomes a parasite, and reproduces until the cell ruptures and about 1,000 new elemental bodies are disseminated to adjoining cells
27
Q

Chlamydia Manidestations

A
  • incubation period 1-3 weeks
  • may be present for months, years
  • still potentially infectious
28
Q

Chlamydia complications

A

untreated:

  • PID
  • infertility
  • ectopic pregnancy
29
Q

Chlamydia Diagnostic Tests

A
  • gram stain of discharge
  • add nucleic acid hybridization test
  • NAATs diagnostic method of choice
30
Q

Chlamydia Pharmacologic Therapy

A
  • Azithromycin, doxycycline

- both partners treated

31
Q

Gonorrhea

A
  • caused by Neisseria gonorrhoeae
  • most common STI in the US
  • “GC” or “the clap”
32
Q

Gonorrhea Pathophysiology

A

pyogenic bacteria that causes:

  • men: acute pain and inflammation of epididymis and periurethral glands
  • women: PID, endometritis, salpngitis, pelvic peritonitis
33
Q

Gonorrhea Manisfestations

A

Men: dysuria, serous, milky, purulent penile discharge

Women: dysuria, urinary frequency, abnormal menses. Increased vaginal discharge, dyspareunia

  • Anorectal gonorrhea: pruritus, mucopurulent discharge, bleeding, pain
  • Gonococcal pharyngitis
34
Q

Gonorrhea Complications

A
  • PID in women
  • newborn: blindness, infection of joints, potentially lethal
  • epididymitis, prostatitis in men resulting in infertility
  • spread of infection to blood, joints
  • increased susceptibility to, transmission of HIV
35
Q

epididymitis

A

inflammation of the coiled tube (epididymis) at the back of the testicle that stores and carries sperm

36
Q

Collaboration for Gonorrhea

A
  • eradication of organism

- prevention of reinfection or transmission

37
Q

Diagnostic Tests for Gonorrhea

A
  • Cultures
  • Urinalysis
  • Gram stain
  • Tests for other STIs
38
Q

Syphilis

A
  • Complex systemic STI

- Treponema pallidum

39
Q

Syphilis Pathophysiology

A
  • break in skin, mucous membrane
  • spread through blood, lymphatic system
  • congenital syphilis
40
Q

congenital syphilis

A

transferred to fetus through placental circulation

41
Q

Syphilis Manifestations: Primary

A
  • chancre, regional lymph node enlargement
  • 3 to 4 weeks after infectious contact
  • little or no pain
  • highly infectious
42
Q

Syphilis Manifestations: Secondary

A
  • 6 weeks after initial chancre
  • skin rash, mucous patches in oral cavity, sore throat
  • generalized lympadenopathy, condyloma lata
43
Q

condyloma lata

A

flat, broad-based papules, unlike the pedunculated structure of genital warts

44
Q

Syphilis Manifestations: Latent and tertiary

A
  • 2 or more years after initial infection
  • sexual transmission is possible in latent syphilis
  • two types: benign late syphilis and diffuse inflammatory response
45
Q

Syphilis Diagnosis and treatment

A
  • Venereal Disease Research Laboratory (CDRL)

- FTA-ABS confirmatory

46
Q

Venereal Disease Research Laboratory (VDRL) & RPR

A

blood tests that measure antibody production

-rapid plasma reagin

47
Q

FTA-ABS confirmatory

A

fluorescent treponema antibody absorption

  • specific for T. pallidum and can be used to confirm VDRL and RPR findings
  • used when clinical presenting syphilis, but negative VDRL
48
Q

Pharmacologic Therapies for Syphilis

A
  • PCN G

- IM in single dose: treatment may result in Jarisch-Herzheimer rxn

49
Q

PID

A
  • caused by untreated STD
  • serious condition
  • infection of a woman’s reproductive organs
  • often complication of chlamydia and gonorrhea
  • no tests for PID, usually diagnosed based on medical hx, physical exam.
  • may not have symptoms
  • if you do, pain in lower abdomen, fever, unusual discharge with a bad odor from vagina, pain/bleeding during sex, burning when pee, bleeding between periods
50
Q

Can PID be cured?

A

yes, if diagnosed early, it can be treated.

won’t undo any damage that has already happened to your reproductive system

51
Q

What happens if PID is not treated?

A
  • formation of scar tissue both outside and inside the fallopian tubes that can lead to tubal blockage
  • ectopic pregnancy
  • infertility
  • long term pelvic/abdominal pain
52
Q

Nursing Process with STD

A
  • Short and long term implications
  • Symptom relief
  • Treatment
  • Prevention of further transmission
  • Additional screening if condition is chronic
53
Q

Nursing Assessment with STD

A

Focused interview:

  • Data collection: sexual practices, health hx, info about genital areas, reproduction, sexual activity
  • Physical assessment: reports of pain, discharge, inflammation
54
Q

Nursing Diagnoses associated with STD

A
  • acute pain
  • sexual dysfunction
  • deficient knowledge
55
Q

Planning with STD

A

Patient:

  • describes strategies for reducing risk,
  • develops plan to communicate with sexual contacts,
  • abstains from sexual activity until STI resolved, -takes appropriate actions to avoid infecting others

*Pain is controlled to a tolerable level

56
Q

Implementation: Relieve Acute Pain

A

Relieve acute pain

  • oral analgesics
  • teach client to keep HSV blisters clean, dry
  • dysuria, suggest pouring water over genital while urinating
  • suggest use of sitz baths 15-30 minutes
57
Q

Implementation: Sexual Dysfunction

A
  • Provide supportive, nonjudgmental environment
  • discussion of feelings, asking questions
  • offer information, referrals
58
Q

Implementation: Discuss Disease Management

A
  • recognize prodromal symptoms of recurrence
  • need for abstinence (from prodromal symptoms until lesions healed)
  • use of topical acyclovir
  • use of latex condoms due to viral shedding at any time
  • need for handwashing
  • culture and sensitivity performed on infected lesions
  • need to discuss infection with partner
59
Q

Evaluation

A
  • client has resolution of STI
  • Client explains strategies to prevent infection of others
  • Client abstains from sexual activity until STI treated
  • Client describes barrier methods to reduce risk of contracting STI

MS1 Exam Three (9 decks)

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