STI

Question 1

Nursing Assessment

Answer 1

Risk factors
Discharge
Painful lesions
Contact with infected persons
Multiple partners
Pregnancy

Question 2

Nursing Assessment

Answer 2

Contraceptive use
Needle sharing
Lesions
Itching, chills, N/V, alopecia
Dysuria, urinary frequency, retention

Question 3

Nursing Assessment

Answer 3

Fever
Lymphadenopathy
Symmetric rash
Erythema
Inflamed Bartholin's glands
Positive cultures/ smears/ DNA amplification

Question 4

Planning

Answer 4

Client with STI will:
Demonstrate understanding of mode of transmission and risk imposed
Complete treatment and follow-up

Question 5

Planning

Answer 5

Notify sexual contacts of need for testing
Abstain until infection is resolved
Demonstrate knowledge of safer sex practices

Question 6

Gonorrhea Collaborative Care

Answer 6

Reportable STI
Drug therapy:
- Penicillin
- Rocefin
- Penicillin resistant cephalosporins
- Suprax (most common), Cipro, Floxin, Ceftriaxone or Levaquin
- Treat for chlamydia

Question 7

Syphillis Collaborative Care

Answer 7

Reportable STI
Drug therapy:
- Penicillin G
- Doxycline
- Recurring or persistant symptoms after drug therapy are re-treated
Monitor neurosyphillis with periodic serological testing

Question 8

Chlamydial Infections: Collaborative Care

Answer 8

Not reportable
Drug therapy:
- Vibramycin
- Zithromax
- Doxycycline
- Alternatives of floxin or erythromycin if pregnant

Question 9

Chlamydial Infections: Collaborative Care

Answer 9

Follow-up care for persistent symptoms
Treatment of partners
Encourage use of condoms

Question 10

Genital Herpes: Collaborative Care

Answer 10

Not reportable
Drug therapy
- Antivirals: Acyclovir (most common), Valtrex, Famvir
- Inhibit viral replication and suppress frequent recurrences

Question 11

Genital Herpes: Collaborative Care

Answer 11

Symptomatic care

• Genital hygiene
• Loose-fitting cotton underwear
• Lesions clean and dry
• Sitz baths
• Drying agents
• Condoms

Question 12

Genital Warts: Collaborative Care

Answer 12

Not reportable
PAP screening
Removal of symptomatic warts
- TCA or BCA
- Podophyllin resin for small extragenital warts

Question 13

Genital Warts: Collaborative Care

Answer 13

Podofilox liquid/ gel
Imiquimod cream
Cryotherapy
Electrocautery
Laser therapy
Surgical excision
Vaccination as prevention

Question 14

Nursing Diagnoses

Answer 14

Risk for infection: r/t lack of knowledge, inadequate genital hygiene, failure to practice precautionary measures
Ineffective health maintenance: r/t lack of knowledge, appropriate follow-up, possibility of re-infection
Anxiety: r/t effect of condition on relationships
Acute pain: r/t presence of lesions
Impaired skin integrity: r/t presence of lesions
Situational low self esteem: r/t disease manifestations, social stigma
Sexual Dysfunction: r/t presence of STI

Question 15

Nursing Implementation

Answer 15

Discuss practices with all clients
Screen for cervical cancer
Teach to inspect partner's genitals
Proper use of condoms
Avoid sexual contact with HIV infected persons
Establish risk of contracting STI

Question 16

Nursing Implementation

Answer 16

Compassion and respect
Screening programs
Locating and examining all contacts of person with STI for testing/ treatment
Education programs
Counselling to verbalize feelings
Explain side effects, need for treatment adherence, and follow-ups

Question 17

Nursing Implementation

Answer 17

Emphasize hygien (hand washing, bathing)
Avoid douching
Avoid synthetic materials in undergarments
Abstinence during treatment period, condoms afterwards
Avoid oral-genital contact

Question 18

Evaluation

Answer 18

Client with STI will:
Demonstrate modes of transmission
Use appropriate hygienic measures
Experience no reinfection
Demonstrate compliance with follow-up protocol