PELVIC INFLAMMATORY DISEASE

MINIMUM CRITERIA FOR PELVIC EXAMINATION

1. Cervical Motion Tenderness 2. Uterine Tenderness 3. Andexal Tenderness

The nurse is planning care for a client who has a sexually transmitted disease (STD). Which interventions address the client's psychosocial needs?Select all that apply. A. Allowing the client to express fears and anxieties B. Approaching the client with a nonjudgmental attitude C. Ensuring that the client's sexual partner is aware of the diagnosis D. Referring the client to the appropriate support groups E. Reporting the STD to the public health department F. Sharing experiences about working with clients with STDs

A. Allowing the client to express fears and anxieties B. Approaching the client with a nonjudgmental attitude D. Referring the client to the appropriate support groups

The nurse is evaluating a client's response to antibiotic treatment for pelvic inflammatory disease (PID). Which finding indicates that the treatment is effective? A. Decreased pelvic tenderness B. Decreased vaginal discharge C. Increased appetite D. Increased Libido

A. Decreased pelvic tenderness

What is another name for PID?

Acute Salpingitis

Pelvic inflammatory disease (PID) is rare before menarche, during pregnancy, or after menopause. Of the risk factors for PID, which of the following is NOT a risk factor for PID? A. Older age (> 35 years) B. Low socioeconomic status C. Presence of bacterial vaginosis D. Previous PID

Answer: A: Older age is not a risk factor. Women younger than 35 years are at higher risk. Choice B: Low socioeconomic status is a risk factor for PID particularly if the patient has gonorrhea or chlamydia. Choices B, C, and D: These are risk factors for PID.

Treatment for pelvic inflammatory disease (PID) includes antibiotic therapy to cover the usual pathogens. If patients do not improve after undergoing antibiotic therapy, PID due to which of the following pathogens should be considered? A. Chlamydia trachomatis B. Mycoplasma genitalium C. Neisseria gonorrhoeae D. Streptococcus agalactiae

Answer: B: Mycoplasma genitalium. If a patient does not improve with usual antibiotic therapy, C. trachomatis, N. gonorrhoeae or S. agalactiae (choices A, C, and D) are likely not the pathogens and treatment for M. genitalium (choice B) should be considered. The appropriate treatment for M. genitalium is moxifloxacin 400 mg orally once a day for 7 to 14 days.

A 19-year-old woman comes to the emergency department because she has had lower abdominal pain, irregular vaginal bleeding, and pain with sexual intercourse during the past 3 weeks. The patient is currently living in a homeless shelter and has multiple sex partners. Pelvic examination with a speculum cannot be performed due to tenderness. Which of the following is the most appropriate next step in diagnosis? A. Bimanual examination B. Laparoscopy C. Ultrasonography D. White blood cell count

Answer: C: Ultrasonography. When pelvic examination cannot be done due to tenderness, ultrasonography is done as soon as possible. Choice A: Bimanual examination is likely to cause tenderness as well, therefore, this should be avoided, and ultrasonography should be done. Choice B: Laparoscopy is too invasive at this point; if ultrasonography does not confirm a diagnosis, then laparoscopy is done. Choice D: In patients with PID, white blood cell count may be elevated, but it is not helpful in confirming the diagnosis.

A nurse is counseling a client who tests positive for syphilis in an inner-city clinic that offers free sexually transmitted disease testing. What will the nurse tell the client about providing confidential treatment for the client and the client's partners? A. The client would notify sexual partners and encourage them to seek treatment. B. The client would provide accurate information about partners so prophylactic care can be initiated. C. Syphilis is not reportable to the local health agency and follow-up is voluntary. D. The clinic will provide information about this client to other potential partners until treatment is complete

B. The client would provide accurate information about partners so prophylactic care can be initiated.

The nurse is teaching a client who is diagnosed with gonorrhea. What does the nurse tell the client about the disease? A. "Close follow-up is required because treatment failure is common." B. "Do not engage in sexual activity until your blood tests are negative." C. "You are contagious even if you have no outward symptoms." D. "You are only infectious while the lesions are draining."

C. "You are contagious even if you have no outward symptoms."

The nurse is discussing the prevention of sexually transmitted diseases (STDs) with a group of young adults. What information does the nurse include? A.Female condoms are not effective in preventing the transmission of STDs. B. Spermicidal agents, when used with condoms, will prevent the transmission of STDs. C. The risk of STDs increases with the number of sexual partners. D. Using latex condoms always keeps STDs from spreading and infecting others.

C. The risk of STDs increases with the number of sexual partners.

The nurse is teaching a 19-year-old female with genital warts about her condition. Which client statement requires further education from the nurse? A. "There is no known treatment that will cure genital warts." B. "The warts may actually disappear or resolve without any treatment at all." C. "Genital warts may reappear at the same site." D. "Wart remover treatment from the drugstore will help me get rid of them."

D. "Wart remover treatment from the drugstore will help me get rid of them."

What are the most common organisms associated with PID?

Neisseria gonorrhoeae and Chlamydia trachomatis

A clinical syndrome attributed to the ascending spread of microorganisms from the vagina and endocervix to the endometrium, fallopian tubes, one or both ovaries, and possibly pelvic and abdominal peritoneum

PELVIC INFLAMMATORY DISEASE (PID)