Ch 69: concepts of care for patients with STIs

____/100 sexually active adults in the US have genital warts at any given time

1

chlamydia infection the incubation period ranges from ___ to ____ weeks

1 to 3

gonorrhea the first s/s occur within ____ _______ after exposure

1 week

Primary stage of syphilis appearance of ulcer _____ to ____ days after exposure. VERY infectious

10 to 90

pelvic inflammatory disease (PID) Treatment oral antibiotics are continues at home until the course of treatment has lasted _____ days

14

genital herpes incubation period is _____ to _____ days

2 to 20

pelvic inflammatory disease (PID) RISK FACTORS (for sexually active women) being younger than _______ years old

26

genital warts inform patients that recurrence is likely, especially in the first ____ months

3

chlamydia infection retesting after ____ _______ is advised in order to detect repeat infection

3 months

keep all patients at the health care agency for at least ______ ______ after they have received the antibiotic so s/s of an allergic reaction can be detected and treated

30 minutes

secondary stage of syphilis the rash subsides without treatment in _____ to _____ weeks, the patient enters early latent stage

4 to 10

tertiary stage of syphilis _____ to _____ years later

4 to 20 years

syphilis follow up evaluations and blood tests should be done at ___, _____ and _____ months

6, 12, and 24

chlamydia infection SYMPTOMS ______% of women are asymptomatic with chlamydia

70

gay, bisexual, and other men who have sex with men are at greatest risk for contracting primary and secondary syphilis and made up of _______% of cases of these diseases

79

_____% of victims of human trafficking have had to seek medical care at some point

88

The nurse hears a patient tell her partner that condoms with spermicide are important to protect themselves from sexually transmitted infections (STIs). What is the appropriate nursing response? A. Teach that spermicide has not been shown to be effective in STI prevention. B. Do nothing because the nurse should not be listening to the client's conversation. C. Educate that spermicide must be used with water-based lubricant to be effective. D. Affirm that spermicide helps to block the transfer of sexually transmitted organisms.

A

Which teaching will the nurse provide to a client who has been prescribed antibiotics for pelvic inflammatory disease (PID)? Select all that apply. A. "Finish all of the prescribed drug even if you begin to feel better." B. "If you feel nauseated from the antibiotics, take a dose of Tums or Maalox." C. "Take antibiotics with food to decrease the chance of stomach irritation." D. "You may resume intercourse once you have been on the antibiotic for 48 hours." E. "You will need to return to see the health care provider after finishing drug therapy."

A, E

The nurse is caring for a 33-year-old female client who has been intimate with women and men. What teaching will the nurse provide regarding the Gardisil 9 vaccine? A. "Patients older than 26 cannot receive an HPV vaccine." B. "You will need three doses of the vaccine instead of two." C. "I will give you a single dose and you will be protected from future HPV." D. "HPV vaccines must be administered to people who have never had intercourse."

B

a single injection of long acting _______ ________ ___ will cure a person who has primary, secondary or early latent syphilis

Benzathine penicillin G

The nurse is caring for a client who has just been diagnosed with primary syphilis. Which client statement reflects that teaching has been effective? Select all that apply. A. "I can resume having intercourse right after this injection." B. "At least this infection is not as serious as gonorrhea or chlamydia." C. "I'm afraid, but I'm going to tell my partners about my diagnosis." D. "After my treatment, I still need several follow-up appointments." E. "I can take acetaminophen if I get a fever and chills after this shot." F. "I am going to wait here in the clinic 30 minutes after treatment."

C, D, E, F

we DO or DONT know if removing warts decreases the risk of transmitting HPV

DONT

condylomata acuminata (genital warts) are caused by certain types of ______

HPV

pelvic inflammatory disease (PID) RISK FACTORS (for sexually active women) having had an ______ placed within the previous 3 weeks (small risk)

IUD

chronic STIs are called

STDs

great risks for acquiring an STI include those who..... have a history of having a ________

STI

gonorrhea SYMPTOMS in women ________ and _______ pain

abdominal and pelvic

remind patients to ________ from sexual activity while GH lesions are present

abstain

3 common drugs for HSV

acyclovir (Zovirax) valacyclovir (valtrex) famciclovir (famvir)

syphilis prevalence of syphilis was highest abong ______ _______ and ______ _______

african americans and native hawaiians

secondary stage of syphilis patchy _________ on the scalp or facial hair is another symptom

alopecia

pelvic inflammatory disease (PID) Treatment other measures to treat pain include taking mild ______ and applying heat to the lower abdomen or back

analgesics

diagnosis of genital herpes consists of .... (3)

appearance of lesions pap smear or culture of lesions

chlamydia infection: treatment DRUG THERAPY this drug is usually given in a single dose at the time of the initial visit with the health care provider.

azithromycin

chlamydia infection: treatment DRUG THERAPY treatment of choice for chlamydia infections is _________ or __________

azithromycin or doxcycline

tertiary stage of syphilis _______ _______ of skin, mucous membranes, and bones

benign lesions

gonorrhea SYMPTOMS in women vaginal ________ between periods

bleeding

gonorrhea oral cavity manifestations _________ in the throat

blisters

gonorrhea anal manifestations spots of ______ _____ blood on toilet tissue

bright red

____________ should be performed on pregnant women that are positive for HSV

c-section

you CAN or CAN NOT get herpes from infected sex partner who doesn't have visible or sore

can

due to the emerging strains of drug-resistant N. gonorrhoeae, the CDC recommends that uncomplicated gonorrhea be treated with only __________ in combination of either azithromycin or doxycyclline

ceftriaxone (Rocephin)

gonorrhea treatment DRUG THERAPY three common drugs used to treat gonorrhea

ceftriaxone (rocephin) azithromycin (zithromax) doxycycline (monodox)

genital warts increase risk for _______ cancers, cancer of the ________ and the _______

cervical, penis, oropharynx

chlamydia can cause ______, ________, and _______

cervicitis, urethritis, and proctitis

The ulcer that is the first sign of syphilis. It develops at the site of entry (inoculation) of the organism, usually 3 weeks after exposure. The lesion may be found on any area of the skin or mucous membranes but occurs most often on the genitalia, lips, nipples, and hands and in the oral cavity, anus, and rectum.

chancre

pelvic inflammatory disease (PID) RISK FACTORS (for sexually active women) having a concurrent _______ or ________ infection, or having bacterial vaginosis

chlamydia or gonorrhea

genital warts Teach to keep the area _______ and ______, and to be alert for any signs or symptoms of further infection or side effects of the treatment.

clean and dry

pelvic inflammatory disease (PID) RISK FACTORS (for sexually active women) having a sexual partner who has other __________ sexual partners

concurrent

great risks for acquiring an STI include those who..... engage in anal, vaginal, or oral sex without a ________

condom

urge ________ ______ during all sexual encounters because of the increased risk of HSV transmission from viral shedding, which can occur even when lesions are not present.

condom use

genital warts patients may be prescribed _____________ therapies such as podophyllotoxin, podophyllum resin, or trichloroacetic acid (TCA) as personally applied topical applications for treatment of warts

cryodestruction

HSV outbreaks tend to INCREASE or DECREASE in length and severity over the years

decrease

gonorrhea SYMPTOMS in women increased vaginal _______

discharge

pelvic inflammatory disease (PID) SYMPTOMS increase or change in vaginal ________

discharge

chlamydia infection SYMPTOMS mucopurulent vaginal or urethral ________, _________, pelvic pain, and irregular ________

discharge, dysuria, bleeding

pelvic inflammatory disease (PID) some patients have only mild ________ or _________ ________, and others expierence no symptoms at all

discomfort or menstrual irregularity

genital herpes many people HAVE or DO NOT HAVE symptoms during the primary outbreak

do not have

pelvic inflammatory disease (PID) RISK FACTORS (for sexually active women) practicing vaginal ________

douching

______ ______ is a significant risk factor for STI because effects on decision making and risk taking behavior

drug use

great risks for acquiring an STI include those who..... have sex while using _______ or _______

drugs or alcohol

painful sexual intercourse

dyspareunia

painful urination

dysuria

chlamydia infection diagnosis is made by swab or tissue culture of cells from _________ or male _________; can also do urine testing

endocervix or urethra

endometrial infection

endometritis

The practice of treating sexual partners of patients diagnosed with chlamydia infection or gonorrhea by providing prescriptions or medication to the patient, which they can take to their partner(s), without the primary health care provider examining the partner(s). Also called patient-delivered partner therapy.

expedited partner therapy (EPT)

genital herpes the vesicles (blisters) rupture spontaneously in a day or two and leave ulcerations that can become __________ and _______

extensive and painful

true or false herpes medicine will prevent viral shedding

false

pelvic inflammatory disease (PID) SYMPTOMS dysuria, dyspareunia, malaise, ________ and ______

fever and chills

An acute, recurring incurable viral disease of the genitalia caused by the herpes simplex virus and transmitted through contact with an infected person.

genital herpes

genital warts sexual contact needs to be avoided until are the lesions are _________

healed

while GH lesions are present, sexual activity can cause pain, and likelihood of viral transmission is LOWER or HIGHER

higher

severe HSV may require __________ and ___ ______

hospitalization and IV acyclovir

be alert for victims of ______ ______

human trafficking

pelvic inflammatory disease (PID) asses for and document..... ________-______ gait

hunched-over

pelvic inflammatory disease (PID) RISK FACTORS (for sexually active women) practicing ________ use of condoms

inconsistent

pelvic inflammatory disease (PID) is the major cause of _______ and _______ pregnancies

infertility and ectopic

great risks for acquiring an STI include those who..... use or have a partner who uses (used) _________ drug

intravenous (IV)

pelvic inflammatory disease (PID) SYMPTOMS ____________ vaginal _________

irregular bleeding

gonorrhea anal manifestations anal _______

itching

this reaction may also follow antibiotic therapy for syphilis. this reaction is caused by rapid release of products from the disruption of the cells of the organism

jarisch herxheimer reaction

gonorrhea _____ or ________ pain might be felt and may be a sign of ascending PID or epididymitis

joint or tendon

pelvic inflammatory disease (PID) Treatment encourage ______ ______ to promote gravity drainage of the infection that may help relieve pain

limited ambulation

in pregnancy, genital herpes can lead to _______, ________ ______, and ________ ______

miscarriage, premature delivery, and neonatal herpes

long term complications include risk for _______ ______ and an increased risk for acquiring _______ ________

neonatal transmission and HIV infection

_________ can occur at any time in any stage; patients with this form of the disease may experience meningitis, vision or hearing loss, and brain and spinal cord dysfunction

neurosyphilis

most __________ _______ such as cold sores are caused by HSV-1, transmitted oral to oral contact

non-genital lesions

pelvic inflammatory disease (PID) Treatment encourage the patient to increase the intake of fluids and eat ________ foods that promote healing

nutritious

great risks for acquiring an STI include those who..... have more than ______ sexual partner

one

gonorrhea that affects your eyes may cause eye _______, _________, and pus like discharge from one or both eyes

pain and photophobia

gonorrhea SYMPTOMS in men _______ or _______ in one testicle

pain or swelling

genital warts Teach patients that, after treatment with podophyllotoxin, podophyllum resin, or trichloroacetic acid (TCA), they may experience ______, _______ , or ________ from the site or sloughing of parts of warts.

pain, bleeding, or discharge

gonorrhea SYMPTOMS in women ________ and ________ urination

painful and frequent

secondary stage of syphilis has moved systematically, the patient experiences flu-like symptoms. presence of _________ and _______ ______.

palmar and plantar rash

pelvic inflammatory disease (PID) SYMPTOMS _____ pain

pelvic

20% to 40% of individuals with chlamydia will develop ______ ________ ______

pelvic inflammatory disease (PID)

An acute syndrome resulting in tenderness in the Fallopian tubes and ovaries (adnexa) and, typically, dull pelvic pain.

pelvic inflammatory disease (PID)

gonorrhea can ascend and cause _________ _________ __________

pelvic inflammatory disease (PID)

gonorrhea SYMPTOMS in men pus-like discharge from the ______

penis

HSV medications can ________ or ______ outbreaks

prevent or shorten

what stage of syphilis? localized chancre

primary

list the three stages of syphilis

primary, secondary, and tertiary

genital herpes ask the patient if he or she felt itching or a tingling sensation in the skin 1 to 2 days before the outbreak, known as the ________

prodrome

many patients with syphilis never notice the chancre and are unaware of their infection until they present with _______ consistent with secondary syphilis

rashes

gonorrhea anal manifestations pus-like discharge from the _______

rectum

______ are not caused by reinfection, they are related viral shedding, and the patient IS infectious at this time

recurrences

gonorrhea oral cavity manifestations ________ throat

reddened

jarisch herxheimer reaction symptoms include fever, generalized aches, _________, ________, diaphoresis, hypotension and worsening of any _______ that was present

rigors, vasodilation and rash

Interventions that reduce the risk of nonintact skin or mucous membranes coming in contact with infected body fluids and blood, such as using a condom.

safer sex practices

fallopian tube infection

salpingitis

what stage of syphilis? systemic illness

secondary

pelvic inflammatory disease (PID) Treatment teach the patient to rest in ______________ position

semi-fowler

________ and _______ can occur if pelvic inflammatory disease (PID) is not treated adequately

sepsis and death

untreated or undertreated severe HSV can lead to ______, ______, _________

sepsis, DIC, encephalitis

great risks for acquiring an STI include those who..... engage in _______ ______ with someone who has an STI

sexual activity

syphilis is transmitted by ______ _____ or ______ _____ but can be contracted through close ______ ______

sexual contact, blood exposure, or body contact

instruct women who are being treated for PID on an ambulatory care basis to avoid _______ _______ for the full course of antibiotic treatment and until their symptoms have resolved

sexual intercourse

chlamydia infection RISK FACTORS new or multiple _______ _______

sexual partners

pelvic inflammatory disease (PID) RISK FACTORS (for sexually active women) new or multiple ______ ______

sexual partners

older adults may not realize their risk for STIs or feel comfortable discussing ________ with health care providers

sexuality

Term used by the Centers for Disease Control and Prevention for sexually transmitted infection.

sexually transmitted disease (STD)

Infectious organisms that have been passed from one person to another through intimate contact.

sexually transmitted infection (STI)

teach the patient that OTC wart treatments SHOULD or SHOULD NOT be used on genital tissue

should not

gonorrhea anal manifestations having to _______ during bowel movements

strain

HSV recurrences may be triggered by physical or emotional _______

stress

gonorrhea throat manifestations may include a sore throat and ________ lymph nodes

swollen

genital herpes SYMPTOMS first time someone has outbreak they may also have flu-like symptoms such as headache, fever, body aches, or ________ _______ _______

swollen inguinal glands

gonorrhea patients may be _________ and spreading infection unaware

symptomless

A complex sexually transmitted disease that can become systemic and cause serious complications and even death.

syphilis

teach women who are being treated for PID to check their ________ twice daily

temperature

gonorrhea oral cavity manifestations _________ gums

tender

pelvic inflammatory disease (PID) asses for and document..... abdominal ________, ________ or rebound tenderness

tenderness or rigidity

what stage of syphilis? symptomatic infection

tertiary

________ doses of long acting Benzathine penicillin G at weekly intervals is recommended for individuals with late (tertiary) syphilis

three

true or false HSV stays in your body for life

true

true or false genital warts are very common

true

gonorrhea oral cavity manifestations ________ lips

ulcerated

gonorrhea SYMPTOMS in men painful ______

urination

genital herpes itching or tingling sensations are usually followed by the appearance of _______ in a typical cluster on the vulva, vagina, cervix, scrotum, penis, or perianal region at the site of inoculation

vesicles (blisters)

gonorrhea if one or more joints become infected by bacteria, the affected joints may be ______, ______, ______, and extremely painful

warm, red, swollen

MEN or WOMEN are more easily infected with STIs

women