Chapter 56: Caring for Clients with Sexually Transmitted Infections
A 23-year-old sexually active woman is having a yearly check-up. The nurse advises the client that she should be screened for chlamydia: annually. every 5 years. every 6 months. if symptoms develop.
annually. Explanation: The CDC recommends annual screening for chlamydia in all sexually active women younger than 26 years of age and in women with new or multiple sexual partners to reduce the incidence of PID.
The nurse is providing education to a client who has a positive nontreponemal test (NTT). The client states, "If I've already had a positive test and I know I have syphilis, why do I need to have another test?" How should the nurse respond? "An additional test needs to be done to determine which antibiotics you will need." "This test will help determine of the infection has moved to the third stage." "Another test can identify additional sexually transmitted infections you may have acquired." "A second test can help confirm the diagnosis, because the NTT can give a false-positive result."
"A second test can help confirm the diagnosis, because the NTT can give a false-positive result." Explanation: Treponemal tests, such as the fluorescent treponemal antibody absorption test (FTA-ABS) and the microhemagglutination assay test (MHA-TP), are used to verify that the screening test did not represent a false-positive result. The NTT and treponemal tests are only used for diagnostic purposes. They do not provide details to decide which antibiotic is best for the client's treatment. This decision is made based on any medication allergies or sensitivities the client may have. The tests do not offer information about the stage of the infection, only that it is present. Positive results usually are positive for life and, therefore, are not appropriate to determine therapeutic effectiveness. The nontreponemal and treponemal tests are used to diagnose syphilis only.
The nurse is providing education to a client who has been diagnosed with chlamydia. The client will begin treatment with azithromycin today. Which teaching point should the nurse reinforce with this client? "Abstain from any sexual activity for 1 week after the antibiotic is complete." "It is very important to maintain good handwashing, even while you are being treated." "Coinfection with the herpes simplex virus is common with chlamydia." "If you become reinfected, symptoms will immediately be present."
"Abstain from any sexual activity for 1 week after the antibiotic is complete." Explanation: Client counseling includes abstinence for 1 week after treatment, in addition to the completion of the partner's treatment. Although handwashing is an important aspect of preventing the spread of infection, the nurse must emphasize prevention of chlamydia through the normal route of transmission of this infection, which is sexually. Coinfection with chlamydia often occurs in clients infected with gonorrhea. Chlamydia and gonorrhea are caused by bacteria that are transmitted during sexual relations. Both chlamydia and gonorrhea infections frequently do not cause symptoms in women and thus are often referred to as "silent" related to clinical presentation. It is important to retest women 3 months' posttreatment, due to the possibility of reinfection.
The nurse is providing education to a client who has been diagnosed with chlamydia. The client will begin treatment with azithromycin today. Which teaching point should the nurse reinforce with this client? "It is very important to maintain good handwashing, even while you are being treated." "If you become reinfected, symptoms will immediately be present." "Abstain from any sexual activity for 1 week after the antibiotic is complete." "Coinfection with the herpes simplex virus is common with chlamydia."
"Abstain from any sexual activity for 1 week after the antibiotic is complete." Explanation: Client counseling includes abstinence for 1 week after treatment, in addition to the completion of the partner's treatment. Although handwashing is an important aspect of preventing the spread of infection, the nurse must emphasize prevention of chlamydia through the normal route of transmission of this infection, which is sexually. Coinfection with chlamydia often occurs in clients infected with gonorrhea. Chlamydia and gonorrhea are caused by bacteria that are transmitted during sexual relations. Both chlamydia and gonorrhea infections frequently do not cause symptoms in women and thus are often referred to as "silent" related to clinical presentation. It is important to retest women 3 months' posttreatment, due to the possibility of reinfection.
A 28-year-old sexually active client presented to a clinic because they were concerned about a round, painless sore on the shaft of their penis that had appeared 2 days prior to the visit. The nurse practitioner recognized the lesion as a "chancre," an indicator of primary syphilis. What information should the nurse communicate to the patient? "Without treatment, the lesion will increase in size and become painful." "An antibiotic injection is the best treatment since the lesion has just occurred." "No treatment is necessary unless you notice a rash on your chest." "Abstain from sexual activity for 2 weeks, after which the lesion will resolve."
"An antibiotic injection is the best treatment since the lesion has just occurred." Explanation: An untreated chancre will usually resolve within 2 months, but a generalized infection will occur as the microorganisms spread from the original site. A rash will occur in 2 to 8 weeks after the chancre. A single dose of penicillin G benzathine is the medication of choice for early syphilis.
Which statement made by a client with a chlamydial infection indicates understanding of the potential complications? "If I had known a diaphragm would put me at risk for this, I would have taken birth control pills." "I hope this medicine works before this disease gets into my urine and destroys my kidneys." "I'm glad I'm not pregnant; I'd hate to have a malformed baby from this disease." "I need to treat this infection so it doesn't spread into my pelvis because I want to have children some day."
"I need to treat this infection so it doesn't spread into my pelvis because I want to have children some day." Explanation: Chlamydia is a common cause of pelvic inflammatory disease and infertility. It doesn't affect the kidneys or cause birth defects. It can cause conjunctivitis and respiratory infection in neonates exposed to infected cervicovaginal secretions during delivery. Use of a diaphragm isn't a risk factor.
The nurse is seeing a client who came into the sexual health clinic after discovering condylomata along their labia. The client states, "This makes no sense, I don't even know who I got this from and I have been so careful!" What is the nurse's best response? "You are high risk simply because you are sexually active with more than one partner. Do you know how many partners all your partners have had?" "If a condom was used during all sexual contacts, it is unlikely the warts that you have were caused by the human papillomavirus (HPV)." "It sounds like you are feeling angry. Let's talk more about human papillomavirus (HPV) and strategies to stay healthy while you are being treated." "If you make a list of your sexual partners over the past month you should be able to narrow down the person who is the source of your infection."
"It sounds like you are feeling angry. Let's talk more about human papillomavirus (HPV) and strategies to stay healthy while you are being treated." Explanation: In many cases, clients are angry about having warts from HPV and do not know who infected them because the incubation period can be long and partners may have no symptoms. Acknowledging emotional distress that occurs when a sexually transmitted infection is diagnosed and providing support and facts are important nursing actions. The client in this case is clearly feeling angry and overwhelmed. The nurse should first provide empathy and help the client focus on information regarding treatment in a solution focused way. Discussing the number of sexual partners and risk factors is important in prevention; however, given the client's emotional state the alternative responses would not be helpful and supportive. In addition, to inform the client that if a condom was used the virus cannot be transmitted is incorrect. Transmission can also occur through skin-on-skin contact in areas not covered by condoms.
The nurse is talking to a client who has come to the doctor's office to ensure that the client's sexually transmitted infection (STI) has been successfully treated. Which statement by the client requires further instruction? "I'm glad that the health care practitioner checked me for STIs when I came for my regular checkup because I didn't have any symptoms." "I will plan to use a dental dam from now on whenever I engage in oral sex." "I realize that using a condom with a spermicide will eliminate most chances of getting any type of a sexually transmitted infection." "It's great that I don't have to worry about having this infection again because I'm now immune to it."
"It's great that I don't have to worry about having this infection again because I'm now immune to it." Explanation: Having a sexually transmitted infection does not confer permanent immunity, so it is important that a client who is treated for an STI understands that the contact with an individual who has the same infection will result in the individual being infected again. All sexually active women under the age of 24 are to be checked yearly for STIs. The use of a dental dam during oral sex and condoms with spermicide help to prevent becoming infected with any type of STI.
The nurse is caring for a client who has just been diagnosed with chlamydia and is very upset. The client says, "I don't understand this. The person I had sex with did not have any symptoms at all. How could I have known?" What is the best response by the nurse to this client? "It is very hard to see signs of infection in the heat of passion." "It is really important that you know the sexual history of every potential lover. It may be uncomfortable but it will prevent the situation you are dealing with right now." "Many people with chlamydia won't have symptoms for up to 3 weeks after being infected." "I think you realize that if you had used some form of a barrier protection such as a condom, it would have helped prevent this situation."
"Many people with chlamydia won't have symptoms for up to 3 weeks after being infected." Explanation: As many as 75% of infected women and 25% of infected men are symptom free. It may take 1-3 weeks for symptoms to appear. Whether in passion or not, if symptoms are present, an individual would be able to see them. It is true that a condom would help decrease the incidence of an STI but the nurse should not try to condemn or judge the client with the STI. Knowing a client's sexual history is important but it does not answer the question that the client posed?
The nurse is caring for a client who has just been diagnosed with chlamydia and is very upset. The client says, "I don't understand this. The person I had sex with did not have any symptoms at all. How could I have known?" What is the best response by the nurse to this client? "It is very hard to see signs of infection in the heat of passion." "Many people with chlamydia won't have symptoms for up to 3 weeks after being infected." "It is really important that you know the sexual history of every potential lover. It may be uncomfortable but it will prevent the situation you are dealing with right now." "I think you realize that if you had used some form of a barrier protection such as a condom, it would have helped prevent this situation."
"Many people with chlamydia won't have symptoms for up to 3 weeks after being infected." Explanation: As many as 75% of infected women and 25% of infected men are symptom free. It may take 1-3 weeks for symptoms to appear. Whether in passion or not, if symptoms are present, an individual would be able to see them. It is true that a condom would help decrease the incidence of an STI but the nurse should not try to condemn or judge the client with the STI. Knowing a client's sexual history is important but it does not answer the question that the client posed?
A client is diagnosed with herpes simplex 2 viral infection (HSV-2). After educating the client regarding this infection, which statement indicates the education is effective? Select all that apply. "Stress can trigger a recurrence of symptoms." "The virus causes 'cold sores' of the lips." "The goal is to relieve the symptoms of the virus." "When the virus is active it can't be contracted during intercourse." "If I take the antibiotics as prescribed, the lesions will go away."
"The goal is to relieve the symptoms of the virus." "Stress can trigger a recurrence of symptoms." Explanation: HSV-2 causes genital herpes and is known to ascend the peripheral sensory nerves and remain inactive after infection, becoming active in times of stress. The virus is not curable, but treatment is aimed at controlling symptoms. Often, recurrences are associated with stress, sunburn, dental work, or inadequate rest or nutrition—all situations that may tax the immune system. The virus can be contracted during intercourse at any time. HSV-1 causes "cold sores," and varicella zoster causes shingles.
A client with genital herpes simplex infection asks the nurse, "Will I ever be cured of this infection?" Which response by the nurse would be most appropriate? "All you need is a dose of penicillin and the infection will be gone." "There is a new vaccine available that prevents the infection from returning." "Once you have the infection, you develop an immunity to it." "There is no cure, but drug therapy helps to reduce symptoms and recurrences."
"There is no cure, but drug therapy helps to reduce symptoms and recurrences." Explanation: Genital herpes is a life-long viral infection. No cure exists, but antiviral drug therapy helps to reduce or suppress symptoms, shedding, and recurrent episodes. A vaccine is available for HPV infection but not genital herpes. Penicillin is used to treat syphilis. No immunity develops after a genital herpes infection.
The nurse is seeing a client for a follow up appointment in the sexual health clinic. The nurse recognizes the client continues to have a knowledge deficit regarding safe sexual practices when the client makes which statement? "My partner and I use a new condom when transitioning from vaginal to anal sexual intercourse." "Using oil to lubricate the condom has helped to increase comfort for me during sexual intercourse." "My partner squeezes air out of the tip of the condom prior to unrolling it down over the erect penis." "Using a condom does not completely eliminate the risk of acquiring a sexually transmitted infection."
"Using oil to lubricate the condom has helped to increase comfort for me during sexual intercourse." Explanation: The client should be reminded to never use skin lotions, oils, petroleum jelly, or cold cream with condoms. The oil in these products will cause the condom to break. The client statement in the correct option indicates the client continues to have this knowledge deficit. It is an effective sexual health practice to squeeze the air out of the tip of the condom before unrolling it over the penis, because this action can prevent the donned condom from tearing. To more effectively prevent the transmission of infection, it is important to apply a new condom when transitioning from vaginal to anal intercourse. The client is correct in stating that using a condom does not completely eliminate the risk of acquiring a sexually transmitted infection, though this practice does significantly reduce this risk.
The nurse is providing education about treatment for syphilis to a client who has a confirmed infection. The client states, "Penicillin causes me to have raised, red bumps all over my body. Will I have to take it again?" How should the nurse respond? "You can be treated with an alternative antibiotic called doxycycline." "Ceftriaxone is an antibiotic that is also effective in the treatment of this infection." "Topical application of an immune response modifier can be used instead." "There are many alternatives to taking antibiotics to treat syphilis."
"You can be treated with an alternative antibiotic called doxycycline." Explanation: A single dose of penicillin G benzathine intramuscular injection is the medication of choice for early syphilis or early latent syphilis of less than 1 year's duration. Clients with late latent or latent syphilis of unknown duration should receive three injections at 1-week intervals. Usually clients who are allergic to penicillin are treated with doxycycline or tetracycline. There are no alternative treatments for syphilis that are effective other than antibiotics. Ceftriaxone is used to treat gonorrhea. Immune response modifiers such as imiquimod, are topical agents used in the treatment of external lesions associated with the human papillomavirus (HPV).
The nurse is seeing a client who was recently diagnosed with primary syphilis after reporting a painless penis lesion to his health care provider. The client states, "I don't want anyone to find out that I have this disease." How should the nurse respond? "Your health is personal and confidential. No one outside this room needs to know about your infection." "It is part of my role to contact anyone you have had sexual contact with. Please provide the contact information to me." "It is important that you inform your sexual partners you have this infection. I can sit with you while you make the necessary phone calls." "You're test results are reported to a public health department. You will need to share the information about your sexual contacts, and they will notify and screen those people."
"You're test results are reported to a public health department. You will need to share the information about your sexual contacts, and they will notify and screen those people." Explanation: Syphilis is a reportable communicable disease. The public health department is responsible for identification of sexual contacts, contact notification and contact screening. Although the nurse can reassure the client that all personal health information is confidential, it is imperative that the people who the infection may have been transmitted to are notified so they may seek screening and, if needed, treatment. The client is not obligated to make the phone calls to the contacts directly. Best practice is to provide the information to the public health department and have the health care providers contact the individuals affected. Although the nurse seeing the client should ask for detailed information about the contacts, it is for the purpose of passing it forward to the public health department to initiate contact and screening.
The nurse is caring for a client with syphilis. Which nursing interventions would the nurse expect to do? Select all that apply. -inquire about the client's allergy history -refer the client to mental health services -inform the client of communications that will be made by the department of public health -prepare client for diagnostic laboratory tests -collect health information and sexual history
-collect health information and sexual history -inquire about the client's allergy history -prepare client for diagnostic laboratory tests -inform the client of communications that will be made by the department of public health Explanation: The nurse caring for a client with syphilis gathers health information and sexual history, asks about the client's allergy history in anticipation of antibiotic treatment, prepares the client for diagnostic laboratory tests, and informs the client that notification of the sexual partner by the department of public health is important for their evaluation and treatment. The nurse would not necessarily refer the client to mental health services unless the situation warranted it; rather, the nurse would generally support the client emotionally when the diagnosis is confirmed.
The nurse is caring for a client with syphilis. Which nursing interventions would the nurse expect to do? Select all that apply. -refer the client to mental health services -inquire about the client's allergy history -inform the client of communications that will be made by -the department of public health -prepare client for diagnostic laboratory tests -collect health information and sexual history
-collect health information and sexual history -inquire about the client's allergy history -prepare client for diagnostic laboratory tests -inform the client of communications that will be made by the department of public health The nurse caring for a client with syphilis gathers health information and sexual history, asks about the client's allergy history in anticipation of antibiotic treatment, prepares the client for diagnostic laboratory tests, and informs the client that notification of the sexual partner by the department of public health is important for their evaluation and treatment. The nurse would not necessarily refer the client to mental health services unless the situation warranted it; rather, the nurse would generally support the client emotionally when the diagnosis is confirmed.
The nurse is teaching a class at the community center about sexually transmitted infections (STIs) and is reviewing information about the increasing incidence of STIs. Which are contributing factors to the incidence of STIs? Select all that apply. -lack of awareness about transmission methods for STIs -asymptomatic sexual partners -STI organism mutation and antimicrobial resistance -lack of adequate treatment options -sexual contact between infection and symptom manifestation
-lack of awareness about transmission methods for STIs -STI organism mutation and antimicrobial resistance -sexual contact between infection and symptom manifestation -asymptomatic sexual partners Explanation: Social, sexual, and biologic factors contribute to the high incidence of STIs, including ignorance of how STIs are transmitted or prevented, asymptomatic presentation, sexual contact during the period between infection and the manifestation of symptoms, and mutation and resistance of microorganisms to antimicrobial drug therapy. There are many treatment options for STIs and some reported STIs, such as chlamydia, gonorrhea, and syphilis, are easily cured with early and adequate treatment. The issue is that individuals often do not seek early treatment, are nonadherent to treatment, or fail to refrain from sexual contact until treatment is complete.
A nurse is developing a plan of care for a client experiencing their first outbreak of genital herpes. Which issue would the nurse most likely identify as the priority? Deficient knowledge related to the disease and its transmission Ineffective coping related to the increased stress associated with the infection Hyperthermia related to body's response to an infectious process Acute pain related to the development of the genital lesions
Acute pain related to the development of the genital lesions Explanation: Although deficient knowledge, ineffective coping, and hyperthermia are possible issues, the priority would be acute pain because the initial infection is usually very painful and lasts about 1 week.
A nurse is developing a plan of care for a client experiencing their first outbreak of genital herpes. Which issue would the nurse most likely identify as the priority? Ineffective coping related to the increased stress associated with the infection Hyperthermia related to body's response to an infectious process Acute pain related to the development of the genital lesions Deficient knowledge related to the disease and its transmission
Acute pain related to the development of the genital lesions Explanation: Although deficient knowledge, ineffective coping, and hyperthermia are possible issues, the priority would be acute pain because the initial infection is usually very painful and lasts about 1 week.
A client diagnosed with genital herpes is experiencing an acute exacerbation. Which medication as prescribed will the nurse administer to suppress the symptoms and shorten the course of the infection? Select all that apply. Podophyllin Clotrimazole Metronidazole Acyclovir Famciclovir
Acyclovir Famciclovir Explanation: Acyclovir and famciclovir are antiviral agents that can suppress the symptoms of genital herpes and shorten the course of the infection. It is effective at reducing the duration of lesions and preventing recurrences. Clotrimazole is used in the treatment of yeast infections. Metronidazole is the most effective treatment for trichomoniasis. Podophyllin is used to treat external genital warts.
A client diagnosed with genital herpes is experiencing an acute exacerbation. Which medication as prescribed will the nurse administer to suppress the symptoms and shorten the course of the infection? Select all that apply. Famciclovir Clotrimazole Acyclovir Podophyllin Metronidazole
Acyclovir Famciclovir Acyclovir and famciclovir are antiviral agents that can suppress the symptoms of genital herpes and shorten the course of the infection. It is effective at reducing the duration of lesions and preventing recurrences. Clotrimazole is used in the treatment of yeast infections. Metronidazole is the most effective treatment for trichomoniasis. Podophyllin is used to treat external genital warts.
Which of the following medications are used to suppress viral load of the HSV-2 infection? Clindamycin (Cleocin) Penicillin Metronidazole (Flagyl) Acyclovir (Zovirax)
Acyclovir (Zovirax) Explanation: With Herpes simplex virus 2 (HSV-2), the antiviral agents acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir) are recommended to suppress the viral load and decrease recurrence and shedding. Flagyl and Cleocin are not used for this purpose.
A client with a trichomoniasis infection is prescribed metronidazole. Which teaching will the nurse provide to the client about this medication? This medication prevents future trichomoniasis infections. Report to the health care provider any metallic taste. Avoid all alcohol for 24 hours after taking the medication. Abstain from sexual activity for a month after taking the medication.
Avoid all alcohol for 24 hours after taking the medication. Explanation: The most effective treatment for trichomoniasis is metronidazole. Clients are strongly advised to abstain from alcohol during treatment and for 24 hours after taking metronidazole because nausea and vomiting, as well as a hot, flushed feeling, can occur when this medication is taken with an alcoholic beverage. A metallic taste can occur when taking this medication and does not need to be reported to the health care provider. Metronidazole does not prevent future trichomoniasis infections. It is used to treat the current infection. Sexual activity should be abstained from for 7 to 10 days after completing the course of medication therapy.
A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea? -Burning on urination -Dry, hacking cough -Painless chancre -Diffuse skin rash
Burning on urination Explanation: Burning on urination may be a symptom of gonorrhea or urinary tract infection. A dry, hacking cough is a sign of a respiratory infection, not gonorrhea. A diffuse rash may indicate secondary stage syphilis. A painless chancre is the hallmark of primary syphilis. It appears wherever the organisms enter the body, such as on the genitalia, anus, or lips.
A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea? -Diffuse skin rash -Dry, hacking cough -Painless chancre -Burning on urination
Burning on urination Explanation: Burning on urination may be a symptom of gonorrhea or urinary tract infection. A dry, hacking cough is a sign of a respiratory infection, not gonorrhea. A diffuse rash may indicate secondary stage syphilis. A painless chancre is the hallmark of primary syphilis. It appears wherever the organisms enter the body, such as on the genitalia, anus, or lips.
The nurse educator is teaching a group of nursing students about the physiologic manifestations of tertiary syphilis. The students respond correctly by stating which major organ systems are identified as the most affected by tertiary syphilis? -Cardiovascular and neurological -Respiratory and endocrine -Musculoskeletal and gastrointestinal -Integumentary and genitourinary
Cardiovascular and neurological Explanation: The most common complications of untreated syphilis manifest as aortitis (inflammation of the aorta) and neurosyphilis and are evidenced by dementia, psychosis, paresis, stroke, or meningitis.
The nurse educator is teaching a group of young adult clients about sexually transmitted infections. The nurse explains that which infection is most likely to be "silent" with no overt symptoms? Herpes genitalis (HSV-2) Syphilis Chlamydia Pelvic inflammatory disease
Chlamydia Explanation: Both Chlamydia and gonorrhea infections frequently do not cause symptoms in women and thus are often referred to as "silent" related to clinical presentation. When infected with syphilis, both men and women will find a painless lesion at the site of infection is called a chancre. This finding often leads people to being assessed and the diagnosis of primary syphilis. With an HSV-2 infection, individuals may have a range of symptoms leading to awareness of the infection including but not limited to Itching and pain accompany the process as the infected area becomes red and edematous. Primary infection may begin with macules (small flat spots on skin) and papules (small circumscribed elevations) and progress to vesicles (small, serous-filled elevated spots) and ulcers. Pelvic inflammatory disease manifests with clinical symptoms that usually begin with vaginal discharge, dyspareunia (painful sexual intercourse), lower abdominal pelvic pain, and tenderness that occurs after menses. Pain may increase with voiding or with defecation.
A nurse is teaching a community health class of women and explains that a sexually transmitted infection (STI) is associated with an increased risk of infertility in women. Which of the following STIs would the nurse identify? Syphilis Herpes simplex Chlamydia Gonorrhea
Chlamydia Explanation: Women with chlamydial infection may be asymptomatic and may unknowingly experience damage to the reproductive system. Herpes simplex virus (HSV), syphilis, and gonorrhea consistently produce symptoms in infected women.
In which group is it most important for the client to understand the importance of an annual Papanicolaou test? Clients with a pregnancy before age 20 Clients with a history of recurrent candidiasis Clients infected with the human papillomavirus (HPV) Clients with a long history of hormonal contraceptive use
Clients infected with the human papillomavirus (HPV) Explanation: HPV causes genital warts, which are associated with an increased incidence of cervical cancer. Recurrent candidiasis, pregnancy before age 20, and use of hormonal contraceptives don't increase the risk of cervical cancer.
In which group is it most important for the client to understand the importance of an annual Papanicolaou test? -Clients with a history of recurrent candidiasis -Clients with a long history of hormonal contraceptive use -Clients with a pregnancy before age 20 -Clients infected with the human papillomavirus (HPV)
Clients infected with the human papillomavirus (HPV) Explanation: HPV causes genital warts, which are associated with an increased incidence of cervical cancer. Recurrent candidiasis, pregnancy before age 20, and use of hormonal contraceptives don't increase the risk of cervical cancer.
A student nurse is doing clinical hours at an OB/GYN clinic. The student is helping to develop a plan of care for a patient with gonorrhea has presented at the clinic. The student knows that the care plan for this patient should be include what in the treatment of gonorrhea? Avoidance of the use of tampons Concurrent treatment for chlamydia Vaginal smears every 6 months Radiation therapy to destroy cancerous cells
Concurrent treatment for chlamydia Explanation: Because of the high incidence of coinfection with chlamydia and gonorrhea, treatment for gonorrhea should also include treatment for chlamydia. One cause of cervicitis is chlamydia. A management strategy used in the treatment of chlamydia is a cytologic examination of cervical smear. Avoiding the use of tampons is part of the self-care management of a patient with possible toxic shock syndrome (TSS). Gonorrhea is considered a sexually transmitted infection (STI), not a carcinoma.
A student nurse is doing clinical hours at an OB/GYN clinic. The student is helping to develop a plan of care for a patient with gonorrhea has presented at the clinic. The student knows that the care plan for this patient should be include what in the treatment of gonorrhea? Concurrent treatment for chlamydia Radiation therapy to destroy cancerous cells Avoidance of the use of tampons Vaginal smears every 6 months
Concurrent treatment for chlamydia Explanation: Because of the high incidence of coinfection with chlamydia and gonorrhea, treatment for gonorrhea should also include treatment for chlamydia. One cause of cervicitis is chlamydia. A management strategy used in the treatment of chlamydia is a cytologic examination of cervical smear. Avoiding the use of tampons is part of the self-care management of a patient with possible toxic shock syndrome (TSS). Gonorrhea is considered a sexually transmitted infection (STI), not a carcinoma.
The following outcome appears on the plan of care for a client with genital herpes: "Client demonstrates knowledge about measures to reduce the risk of transmission and recurrences." Which of the following, if reported by the client, would support achievement of this outcome? Consistently uses condoms with sexual activity Applies occlusive dressings to lesions Avoids sexual activity when lesions are present Cleans lesions with strong anti-bacterial soap
Consistently uses condoms with sexual activity Explanation: Consistent use of condoms for sexual activity indicates that the client has knowledge of the disorder and its transmission, thereby taking steps to reduce the risk of transmission. This action supports achievement of the outcome. Sexual activity even when lesions are not present can still lead to transmission of the infection. Lesions should be cleaned with mild soap and water and patted dry; occlusive ointments, powders, or dressings should be avoided because they do not allow the lesions to dry.
A nurse is caring for a client diagnosed with a chlamydia infection. The nurse teaches the client about disease transmission and advises the client to inform sexual partners of the infection. The client refuses, stating, "This is my business and I'm not telling anyone. Beside, chlamydia doesn't cause any harm like the other STIs." How should the nurse proceed? Select all that apply. Educate the client about why it's important to inform sexual contacts so they can receive treatment. Do nothing because the client's sexual habits place him at risk for contracting other sexually transmitted infections. Inform the client's sexual contacts of their possible exposure to chlamydia. Continue to pressure the client for the sexual partner's contact information. Inform the health department that this client contracted a chlamydia infection.
Educate the client about why it's important to inform sexual contacts so they can receive treatment. Inform the health department that this client contracted a chlamydia infection. Gonorrhea and chlamydia are reportable communicable diseases. The nurse should educate the client about the disease and how it impacts a person's health. Further education allows the client to make an informed decision about notifying sexual contacts. The department of health should contact the sexual contacts, not the nurse. Doing nothing for the client is judgmental; everyone is entitled to healthcare regardless of health habits.
A male client reports urethral pain and a creamy yellow, bloody discharge from the penis. The nurse associates these characteristics with which of the following sexually transmitted infections? -Chancroid -Gonorrhea -Trichomoniasis -Candidiasis
Gonorrhea Explanation: In men, the initial symptoms of gonorrhea include urethral pain and a creamy, yellow, sometimes bloody discharge. Candidiasis, trichomoniasis, and bacterial vaginosis are vaginal infections that can be sexually transmitted, and the male partner usually is asymptomatic. Chancroid causes genital ulcers; the lesions begin as macules, progress to pustules, and then rupture.
A woman gives birth to a healthy newborn. As part of the newborn's care, the nurse instills erythromycin ophthalmic ointment as a preventive measure related to which STI? -Genital herpes -Hepatitis B -Syphilis -Gonorrhea
Gonorrhea Explanation: To prevent gonococcal ophthalmia neonatorum, erythromycin or tetracycline ophthalmic ointment is instilled into the eyes of all newborns. This action is required by law in most states. The ointment is not used to prevent conditions related to genital herpes, hepatitis B, or syphilis.
The nurse is assessing a client in the emergency department who grimaces and reports swelling of the testicles, burning on urination and a green discharge from the penis. The nurse suspects the client will be diagnosed with which infection? Primary syphilis Gonorrhea Herpes genitalis Trichomoniasis
Gonorrhea Explanation: When symptoms of gonorrhea are present in male clients, the symptoms may include burning during urination and penile discharge. Clients with Neisseria gonorrhoeae infection also may report painful swollen testicles. The latter symptoms distinguishes this infection from the infections in the alternate options. Primary syphilis occurs 2 to 3 weeks after initial inoculation with the organism. A painless lesion at the site of infection is called a chancre. Untreated, these lesions usually resolve spontaneously within about 2 months. With herpes genitalis primary infection may begin with macules (small flat spots on skin) and papules (small circumscribed elevations) and progress to vesicles (small, serous-filled elevated spots) and ulcers. The vesicular state often appears as a blister, which later coalesces, ulcerates, and encrusts. Influenza-like symptoms may occur 3 or 4 days after the lesions appear, often with inguinal lymphadenopathy (enlarged lymph nodes in the groin). Men with trichomoniasis may notice itching or irritation inside the penis, burning after urination or ejaculation, discharge from the penis.
A nurse is taking a class on public health and studying information about sexually transmitted infections (STIs). Which of the following would the nurse correctly recognize as true about STIs? Select all that apply. From 2005 to 2006, HIV/AIDS was the fastest-growing STI in the United States. Cases of genital herpes are reportable by law. Health care providers are responsible for reporting STIs. STIs represent a diverse groups of infections. Reported STIs are highest among Caucasian men.
Health care providers are responsible for reporting STIs. STIs represent a diverse groups of infections. Explanation: Sexually transmitted infections (STIs) are a diverse group of infections spread through sexual activity with an infected person. Reporting of new STI cases is the responsibility of either the health care provider or the testing laboratory. STIs such as genital herpes, hepatitis B, venereal warts (condylomata acuminata), granuloma inguinale, and lymphoma venereum are not reportable by law. The reported incidence of STIs is disproportionately higher in racial and ethnic minorities. STIs occur more often in women than in men. Since the 1990s, yearly increases in new cases of HIV/AIDS have remained relatively stable.
Which of the following sexually transmitted infections (STIs) could be transmitted perinatally? Trichomoniasis Gonorrhea Chlamydia Herpes simplex
Herpes simplex Explanation: Herpes simplex and syphilis can be transmitted perinatally and sexually. Chlamydia, gonorrhea, and trichomoniasis are transmitted sexually.
Which of the following sexually transmitted infections (STIs) could be transmitted perinatally? Trichomoniasis Herpes simplex Chlamydia Gonorrhea
Herpes simplex Explanation: Herpes simplex and syphilis can be transmitted perinatally and sexually. Chlamydia, gonorrhea, and trichomoniasis are transmitted sexually.
A nurse practitioner who works for Planned Parenthood is responsible for health education seminars. During these presentations, the nurse always discusses the symptoms of the most common STI among young, sexually active people. This is: Endocervicitis. Candidiasis. Human papillomavirus. Salpingitis.
Human papillomavirus. Explanation: At least 50% of sexually active men and women acquire genital HPV infection at some point in their lives.
The nurse is caring for a client with genital herpes experiencing a reoccurrence. Which nursing diagnosis would be the priority? -Impaired Skin Integrity -Anxiety -Powerlessness -Knowledge Deficit
Impaired Skin Integrity Explanation: The priority nursing diagnosis focuses on the Impaired Skin Integrity. Interventions would include nursing instruction on the care of the skin to prevent further infection to self and others. The nurse would also focus on the management of the disease. Because this is a reoccurrence, Knowledge Deficit is not a priority. Psychosocial nursing diagnoses are not a priority at this time unless other data suggests.
The nurse understands that a single dose of azithromycin as treatment for a chlamydia infection is prescribed by the health care provider for what reason? It is the most effective medication against the infection. The client can have unprotected sexual intercourse within 24 hours of administration of the medication. The client experiences fewer side effects. It can be administered to the client at the health care provider's office.
It can be administered to the client at the health care provider's office. Explanation: A single dose of azithromycin has a 100% adherence rate because the nurse in the health care practitioner's office can administer it and ensure that the client receives it. A single dose actually has increased side effects especially gastric distress. It is an effective medication but it is not the most effective medication. Other medications are just as effective. Administering the medication as a single dose does not ensure that the infection is cleared in 24 hours which would allow for unprotected sexual intercourse.
A nurse is assisting with a physical examination of a male client. Which of the following signs and symptoms is most clearly suggestive of primary genital herpes? Itching, pain, and the emergence of pustules on the penis Presence of purulent, whitish discharge from the penis Emergence of hard, painless nodules on the shaft of the penis Production of cloudy, foul-smelling urine
Itching, pain, and the emergence of pustules on the penis Explanation: The initial symptoms of primary genital herpes infection include tingling, itching, and pain in the genital area, followed by eruption of small pustules and vesicles. Firm, subcutaneous nodules are not associated with herpes simplex virus (HSV), and the production of penile discharge and cloudy urine are not suggestive of the disease.
A nurse is assisting with a physical examination of a male client. Which of the following signs and symptoms is most clearly suggestive of primary genital herpes? Presence of purulent, whitish discharge from the penis Emergence of hard, painless nodules on the shaft of the penis Production of cloudy, foul-smelling urine Itching, pain, and the emergence of pustules on the penis
Itching, pain, and the emergence of pustules on the penis Explanation: The initial symptoms of primary genital herpes infection include tingling, itching, and pain in the genital area, followed by eruption of small pustules and vesicles. Firm, subcutaneous nodules are not associated with herpes simplex virus (HSV), and the production of penile discharge and cloudy urine are not suggestive of the disease.
The nurse recognizes the client is in which stage of syphilis when the client has no signs or symptoms of syphilis? Secondary Primary Tertiary Latency
Latency Explanation: Primary syphilis occurs 2 to 3 weeks after initial inoculation with the organism. Secondary syphilis occurs when the hematogenous spread of organisms from the original chancre leads to generalized infection. A period of latency occurs when the infected person has no signs or symptoms of syphilis. Tertiary syphilis presents as a slowly progressive inflammatory disease with the potential to affect multiple organs.
Which instruction should be given to a woman newly diagnosed with genital herpes? Have your partner use a condom when lesions are present. Limit stress and emotional upset as much as possible. Obtain a Papanicolaou (Pap) test every 3 years. Use a water-soluble lubricant for relief of pruritus.
Limit stress and emotional upset as much as possible. Explanation: Stress, anxiety, and emotional upset seem to predispose a client to recurrent outbreaks of genital herpes. Sexual intercourse should be avoided during outbreaks, and a condom should be used between outbreaks; it isn't known whether the virus can be transmitted at this time. During an outbreak, creams and lubricants should be avoided because they may prolong healing. Because a relationship has been found between genital herpes and cervical cancer, a Pap test is recommended every year.
Which of the following types of condoms is appropriate only if the client is in a long-standing relationship? Lubricated condom Latex condom Natural membrane condom Ribbed condom
Natural membrane condom Explanation: Using a natural membrane condom is only appropriate when the client is in a long-standing relationship. The natural membrane condom acts as a barrier preventing sperm from encountering the female reproductive tract, but it allows viruses to pass through the membrane. A latex condom is appropriate unless an individual is allergic to latex. A lubricated or ribbed condom is related to sexual pleasure.
Culture and sensitivity testing of a swab taken from a chancre on the penis of a 27-year-old man has confirmed the presence of Treponema pallidum. The nurse providing care for the patient should anticipate administering which of the following drugs? Azithromycin Ciprofloxacin Vancomycin Penicillin
Penicillin Explanation: T. pallidum is the microorganism that is responsible for syphilis, a disease that is treated in the early stages by a single dose of penicillin G benzathine.
Culture and sensitivity testing of a swab taken from a chancre on the penis of a 27-year-old man has confirmed the presence of Treponema pallidum. The nurse providing care for the patient should anticipate administering which of the following drugs? Ciprofloxacin Vancomycin Penicillin Azithromycin
Penicillin Explanation: T. pallidum is the microorganism that is responsible for syphilis, a disease that is treated in the early stages by a single dose of penicillin G benzathine.
Culture and sensitivity testing of a swab taken from a chancre on the penis of a 27-year-old man has confirmed the presence of Treponema pallidum. The nurse providing care for the patient should anticipate administering which of the following drugs? Penicillin Azithromycin Ciprofloxacin Vancomycin
Penicillin Explanation: T. pallidum is the microorganism that is responsible for syphilis, a disease that is treated in the early stages by a single dose of penicillin G benzathine.
The nurse has received several laboratory studies back at the clinic. Which of these results should be reported to the local health department? Positive mononucleosis Wound infection with MRSA Positive gonorrhea Positive influenza
Positive gonorrhea Explanation: Gonorrhea and chlamydia are reportable communicable diseases. In any healthcare facility, a mechanism should be in place to ensure that all diagnosed patients are reported to the local public health department to ensure follow-up of the patient. The public health department also is responsible for interviewing the patient to identify sexual contacts so that contact notification and screening can be initiated.
The nurse has received several laboratory studies back at the clinic. Which of these results should be reported to the local health department? Wound infection with MRSA Positive influenza Positive gonorrhea Positive mononucleosis
Positive gonorrhea Explanation: Gonorrhea and chlamydia are reportable communicable diseases. In any healthcare facility, a mechanism should be in place to ensure that all diagnosed patients are reported to the local public health department to ensure follow-up of the patient. The public health department also is responsible for interviewing the patient to identify sexual contacts so that contact notification and screening can be initiated.
A patient comes to the clinic with complaints of a painless sore on their lip 2 weeks after they had oral sex with their partner. The nurse observes a chancre on the lips and the physician orders testing for syphilis. If results are positive, what is the likely stage the patient is in? Secondary Latency Tertiary Primary
Primary Explanation: Primary syphilis occurs 2 to 3 weeks after initial inoculation with the organism. A painless lesion at the site of infection is called a chancre. These lesions usually resolve spontaneously within 3 to 12 weeks, with or without treatment.
A patient comes to the clinic with complaints of a painless sore on their lip 2 weeks after they had oral sex with their partner. The nurse observes a chancre on the lips and the physician orders testing for syphilis. If results are positive, what is the likely stage the patient is in? Secondary Tertiary Latency Primary
Primary Explanation: Primary syphilis occurs 2 to 3 weeks after initial inoculation with the organism. A painless lesion at the site of infection is called a chancre. These lesions usually resolve spontaneously within 3 to 12 weeks, with or without treatment.
A client in the clinic is being treated with podofilox resin for genital warts. What should the nurse teach the client about this medication regimen? Blood levels will need to be taken after one week. Several repeated treatments will likely be needed. The drug must be taken on an empty stomach. The treatment may or may not be cured by the medication.
Several repeated treatments will likely be needed. Explanation: Podofilox is given topically, not orally, and blood levels are unnecessary. The goal is eradication of warts, but cure is not possible.
To confirm a diagnosis of syphilis, the nurse would identify the gram-negative bacteria, Treponema palladium, on the laboratory report. The nurse knows that this bacteria is classified among: Spirochetes Cyanobacteria Proteobacteria Green-sulphur bacteria
Spirochetes Explanation: Direct identification of the spirochete bacteria obtained from the chancre lesion of primary syphilis is used for a positive diagnosis.
The nurse is assessing a client who reports stiff joints and alopecia. While taking the client's health history, the client reports having multiple sexual partners in the past 6 months and finding a lesion on her labia about 1 month before today's appointment. What should the nurse anticipate based on the signs and symptoms presented? Treatment planning for a chlamydial infection is needed. The client will require a colposcopy to confirm any diagnosis. The client will require treatment for the secondary stage of syphilis. Pelvic inflammatory disease is the likely cause of the hair loss.
The client will require treatment for the secondary stage of syphilis. Explanation: In the secondary stage of syphilis, generalized signs of infection may include lymphadenopathy (abnormal enlargement of lymph nodes), arthritis, meningitis (inflammation of the pia mater, arachnoid, and the subarachnoid space), hair loss, fever, malaise, and weight loss. Hair loss and arthritis are not common symptoms associated with a chlamydial infection or pelvic inflammatory disease. The information collected in the health history confirms that the client has moved past the primary stage of the infection. A colposcopy is a diagnostic procedure carried out to determine if there have been any changes in cervical cells (dysplasia). Given the client's reported health history, secondary syphilis should be further investigated first.
The nurse is educating a client about their recent diagnosis of genital warts. The nurse would include which information about untreated genital warts? Untreated genital warts will not resolve on their own and will increase in size with abscess formations. Untreated genital warts do not lead to any other illness. Untreated genital warts may lead to AIDS. Untreated genital wartsmay resolve on their own, remain unchanged, or increase in size or number.
Untreated genital wartsmay resolve on their own, remain unchanged, or increase in size or number. Explanation: Untreated genital warts may resolve on their own, remain unchanged, or increase in size or number. They may lead to cervical or other pelvic reproductive types of cancer. Untreated genital warts do not lead to AIDS.
The nurse is assessing a client who reports stiff joints and alopecia. While taking the client's health history, the client reports having multiple sexual partners in the past 6 months and finding a lesion on her labia about 1 month before today's appointment. What should the nurse anticipate based on the signs and symptoms presented? Treatment planning for a chlamydial infection is needed. The client will require treatment for the secondary stage of syphilis. The client will require a colposcopy to confirm any diagnosis. Pelvic inflammatory disease is the likely cause of the hair loss.
The client will require treatment for the secondary stage of syphilis. Explanation: In the secondary stage of syphilis, generalized signs of infection may include lymphadenopathy (abnormal enlargement of lymph nodes), arthritis, meningitis (inflammation of the pia mater, arachnoid, and the subarachnoid space), hair loss, fever, malaise, and weight loss. Hair loss and arthritis are not common symptoms associated with a chlamydial infection or pelvic inflammatory disease. The information collected in the health history confirms that the client has moved past the primary stage of the infection. A colposcopy is a diagnostic procedure carried out to determine if there have been any changes in cervical cells (dysplasia). Given the client's reported health history, secondary syphilis should be further investigated first.
The school health nurse is conducting a teaching session for parents to provide information about the human papillomavirus (HPV) vaccination. What prevention information should the nurse include in the session? The HPV vaccination prevents the future need for cervical cancer screening in women. The vaccination is available only to girls but, in the long term, protects both genders from sexually transmitted infections. A Pap smear test is required prior to administration of the HPV vaccination. The effect of the vaccination is optimized if it is administered before the child becomes sexually active.
The effect of the vaccination is optimized if it is administered before the child becomes sexually active. Explanation: The nurse should advise the parents that the vaccination should ideally be administered before the onset of sexual activity, to prevent genital warts. The vaccination is available and effective when administered to both men and women. The HPV vaccination does not preclude women from having regular cervical cancer screening in the future. A Pap smear prior to the administration of the vaccination is not required, particularly for those woman who are not yet sexually active.
The school health nurse is conducting a teaching session for parents to provide information about the human papillomavirus (HPV) vaccination. What prevention information should the nurse include in the session? The effect of the vaccination is optimized if it is administered before the child becomes sexually active. The vaccination is available only to girls but, in the long term, protects both genders from sexually transmitted infections. The HPV vaccination prevents the future need for cervical cancer screening in women. A Pap smear test is required prior to administration of the HPV vaccination.
The effect of the vaccination is optimized if it is administered before the child becomes sexually active. Explanation: The nurse should advise the parents that the vaccination should ideally be administered before the onset of sexual activity, to prevent genital warts. The vaccination is available and effective when administered to both men and women. The HPV vaccination does not preclude women from having regular cervical cancer screening in the future. A Pap smear prior to the administration of the vaccination is not required, particularly for those woman who are not yet sexually active.
A patient has herpes simplex 2 viral infection (HSV-2). The nurse recognizes that which of the following should be included in teaching the patient? -The virus when active may not be contracted during intercourse. -The virus may be cured with antibiotics. -Treatment is focused on relieving symptoms. -The virus causes "cold sores" of the lips.
Treatment is focused on relieving symptoms. Explanation: HSV-2 causes genital herpes and is known to ascend the peripheral sensory nerves and remain inactive after infection, becoming active in times of stress. The virus is not curable, but treatment is aimed at controlling symptoms. HSV-1 causes "cold sores," and varicella zoster causes shingles.
The nurse is educating a client about their recent diagnosis of genital warts. The nurse would include which information about untreated genital warts? Untreated genital wartsmay resolve on their own, remain unchanged, or increase in size or number. Untreated genital warts will not resolve on their own and will increase in size with abscess formations. Untreated genital warts may lead to AIDS. Untreated genital warts do not lead to any other illness.
Untreated genital wartsmay resolve on their own, remain unchanged, or increase in size or number. Explanation: Untreated genital warts may resolve on their own, remain unchanged, or increase in size or number. They may lead to cervical or other pelvic reproductive types of cancer. Untreated genital warts do not lead to AIDS.
The nurse is caring for a patient with secondary syphilis. What nursing interventions would you know to institute when caring for this patient? Have personal protective equipment available. Wear gloves when there is a possibility of coming into contact with lesions. Place in private room. Keep room door closed.
Wear gloves when there is a possibility of coming into contact with lesions. Explanation: Lesions of primary and secondary syphilis may be highly infective. Gloves are worn when direct contact with lesions is likely, and hand hygiene is performed after gloves are removed. Isolation in a private room is not required. It is also not necessary to keep the room door closed. PPE is always available.
The nurse is caring for a patient with secondary syphilis. What nursing interventions would you know to institute when caring for this patient? -Wear gloves when there is a possibility of coming into contact with lesions. -Place in private room. -Have personal protective equipment available. -Keep room door closed.
Wear gloves when there is a possibility of coming into contact with lesions. Explanation: Lesions of primary and secondary syphilis may be highly infective. Gloves are worn when direct contact with lesions is likely, and hand hygiene is performed after gloves are removed. Isolation in a private room is not required. It is also not necessary to keep the room door closed. PPE is always available.
The nurse is preparing a teaching tool about sexually transmitted infections (STIs). Which infection will the nurse designate as the most common and fastest-spreading STI? human papilloma virus (HPV) herpes simplex virus gonorrhea Zika virus
human papilloma virus (HPV) Explanation: HPV infection is the most commonly transmitted sexual disease in the United States, currently affecting 79 million people. The Zika virus is acquired through the bite of a female mosquito. Besides being infected through vector transmission, the Zika virus can also be transmitted from men and women who are infected to their sexual partners whether either is asymptomatic or symptomatic. This virus is not as common as HPV because transmission typically happens in locations where the Zika virus is known to occur and in environments where mosquitos breed. Gonorrhea is the second most frequently reported sexually communicable infection in the United States, but is not as highly reported as HPV. Its highest incidence occurs in the 15- to 24-year-old age group. Herpes simplex virus (HSV) infection is a highly contagious STI that is controllable but not curable. Even though 16% to 21% of people in the United States have herpes, it is not considered the most commonly transmitted sexual infection mainly because the statistics do not differentiate between orofacial herpes simplex and genital herpes.
The nurse is teaching a class at the community center about sexually transmitted infections (STIs) and is reviewing information about the increasing incidence of STIs. Which are contributing factors to the incidence of STIs? Select all that apply. asymptomatic sexual partners sexual contact between infection and symptom manifestation lack of awareness about transmission methods for STIs STI organism mutation and antimicrobial resistance lack of adequate treatment options
lack of awareness about transmission methods for STIs STI organism mutation and antimicrobial resistance sexual contact between infection and symptom manifestation asymptomatic sexual partners Explanation: Social, sexual, and biologic factors contribute to the high incidence of STIs, including ignorance of how STIs are transmitted or prevented, asymptomatic presentation, sexual contact during the period between infection and the manifestation of symptoms, and mutation and resistance of microorganisms to antimicrobial drug therapy. There are many treatment options for STIs and some reported STIs, such as chlamydia, gonorrhea, and syphilis, are easily cured with early and adequate treatment. The issue is that individuals often do not seek early treatment, are nonadherent to treatment, or fail to refrain from sexual contact until treatment is complete.
The nurse is teaching a class at the community center about sexually transmitted infections (STIs) and is reviewing information about the increasing incidence of STIs. Which are contributing factors to the incidence of STIs? Select all that apply. STI organism mutation and antimicrobial resistance sexual contact between infection and symptom manifestation asymptomatic sexual partners lack of awareness about transmission methods for STIs lack of adequate treatment options
lack of awareness about transmission methods for STIs STI organism mutation and antimicrobial resistance sexual contact between infection and symptom manifestation asymptomatic sexual partners Social, sexual, and biologic factors contribute to the high incidence of STIs, including ignorance of how STIs are transmitted or prevented, asymptomatic presentation, sexual contact during the period between infection and the manifestation of symptoms, and mutation and resistance of microorganisms to antimicrobial drug therapy. There are many treatment options for STIs and some reported STIs, such as chlamydia, gonorrhea, and syphilis, are easily cured with early and adequate treatment. The issue is that individuals often do not seek early treatment, are nonadherent to treatment, or fail to refrain from sexual contact until treatment is complete.
A nurse practitioner is treating a client with early latent syphilis of less than 1 year's duration. The nurse told the client about the need to receive penicillin G benzathine injections according to the following protocol: Seven injections, at one per day. three injections at 7-day intervals. eight injections, at 7-day intervals. one injection.
one injection. Explanation: The recommended protocol for primary, secondary, and latent syphilis is 1 injection of 2,400,000 units; for late (tertiary and neurosyphilis), 3 injections of 2,400,000 units are given at 7-day intervals. Clients allergic to penicillin are usually treated with doxycycline or tetracycline.
A nurse is teaching a client with genital herpes. Education for this client should include an explanation of: the option of disregarding safer-sex practices now that he's already infected. the need for the use of petroleum products. why the disease is transmittable only when visible lesions are present. the importance of informing his partners of the disease.
the importance of informing his partners of the disease. Explanation: Clients with genital herpes should inform their partners of the disease to help prevent transmission. Petroleum products should be avoided because they can cause the virus to spread. The notion that genital herpes is only transmittable when visible lesions are present is false. Anyone not in a long-term, monogamous relationship, regardless of current health status, should follow safer-sex practices.
