Sexually Transmitted Infections and Contraception

Who should use IUDs?

Women with children or with one partner

Can diaphragms and sponges be used with a latex allergy?

Yes, do not contain latex

Can you breastfeed while on the birth control pill?

You can if on the mini pill -cannot breastfeed when taking estrogen

What are the symptoms of chlamydia?

*Commonly asymptomatic* Thin, mucopurulent discharge Burning and frequency Lower abdominal pain

What are the risks a pregnant woman with syphilis would have?

*Intrauterine growth restriction* Preterm birth Stillbirth

What are the risks of having chlamydia for pregnant women?

*Newborn eye infection if exposed (chlamydia is most common cause) PID-blocked fallopian tubes resulting in ectopic pg Infertility

What are the risks of having gonorrhea for pregnant women?

*Newborn eye infection if exposed*

What is the treatment for HSV?

*No cure Acylovir/Valacyclovir PO as suppression in third trimester of pregnancy

What is the risk of having BV while pregnant?

*PROM* Preterm Labor Infection

How many injections is included in the complete Hep B series?

3 IM injections

What is the normal pH of the vagina?

3.8-4.5

How many stages of syphilis are there?

4 stages: Primary Secondary Latent Tertiary

What are the symptoms of gonorrhea?

80% asymptomatic *purulent*, greenish, yellow discharge Swelling/inflammation of vulva/cervix

What is a risk for a pregnant woman having HSV?

Getting the newborn infected during delivery

What is the most common STD (overall)?

HPV -most symptoms are unreported

Which STIs are caused by viruses?

HPV HIV HSV Viral Hep A and Hep B

Which of the STIs have an available vaccine?

HPV and Hep B

What is true about having an STD?

Have higher risk for getting another

Do diaphragms and sponges prevent against STDs?

No

Can you breastfeed when using the Nuva ring?

No because it contains estrogen

What are things the nurse can educate the gonorrhea patient on?

No intercourse for 7 days Treat partners Verify cure

What is the treatment like for HPV?

No single treatment

Do condoms protect against all STIs?

No they don't

Is "pulling out" an effective birth control method?

No, it is only 80% effective

Can condoms be used with a latex allergy?

No, they contain latex

What are symptoms of latent syphilis?

None

What is the treatment for trichmoniasis?

Nonpg: Flagyl* Pg: Flagyl* Treat partners

Why is it important to receive the HPV vaccine?

The human papilloma virus is associated with cervical dysplasia and cancer.

What is the treatment for early syphilis?

Penicillin G x1

What is the long duration treatment for syphilis?

Penicillin IM once a week for 3 weeks

What is the HPV treatment for non pregnant women?

Podofilex solution Cryotherapy Gardisil vaccine 3 doses

What are the symptoms of trichmoniasis?

Possibly asymptomatic Yellow, green *frothy*, malodorous discharge Pain during intercourse Strawberry red marks on cervix

How does Plan B work?

Prevents ovulation, fertilization and implantation -must take within 5 days after unprotected sex (within 72 hours is better) -will not work if already pregnant

What is the Mirena IUD?

Progesterone only -lasts 3-5 years

What is the Depo shot?

Progesterone only Lasts 3 months *Breastfeeding is allowed

What are the benefits of condoms over other methods?

Protect against all STDs Good for those with multiple partners

How are male condoms used?

Pull back foreskin for non-circumcised penis Keep space at the tip

What is Herpes Simplex Virus (HSV)?

Recurrent lifelong disease

What are the risks of having gonorrhea for non pregnant women?

Risk of Pelvic Inflammatory Disease (PID)

If you had a woman who was high risk for HIV infection "opt-out" of testing - what might you educate her on?

Risk of transmitting HIV to her baby

Mucocutaneous lesions and rash are most commonly seen during which stage of syphilis?

Secondary

What are the symptoms of Human Papilloma Virus (HPV)?

Soft grayish cauliflower-like lesions (genital warts) May cause itching Friable(bleed), painful

What are the risks for using a diaphragm?

TSS / UTIs

What are the symptoms of tertiary syphilis?

Tumors

How are female condoms used?

Twist before removing

What are the symptoms of BV?

Watery gray discharge *Possible fishy odor*

What is the treatment for gonorrhea?

Ceftriaxone/Rocephin 250mg IM Azithromycin 1 gm PO

What is a risk of having HPV?

Cervical cancer for women

What are the symptoms of primary syphilis?

Chancre x 4wks Weight loss Fever

What is the leading cause of infertility?

Chlamydia

What is the most common reportable STD in the United States?

Chlamydia

Which STIs are caused by bacteria?

Chlamydia Gonorrhea Syphilis BV

What is the test to determine BV?

Clue cells seen on wet mount

What are the kinds of birth control pills?

Combination- estrogen and progesterone Mini pill- progesterone only

What are the symptoms of secondary syphilis?

Contagious condyloma

What is important to know about treatments for STIs?

-Tell partner to get screened -Education

Which contraception is 100% pregnancy and STD-free?

Abstinence

Who is tested for syphilis?

All pregnant women

What population is always screened for gonorrhea?

All pregnant women screened

What is the mucus method?

Assess mucus daily -If clear, elastic, and slippery =no sex until 4 days after it goes back to normal

What is the treatment for pregnant women with chlamydia?

Azithromycin 1 gram No intercourse for 7 days

What is the treatment for non pregnant women with chlamydia?

Azithromycin 1 gram x1 OR Doxycycline 1 gram x7 days

Are there any specific concerns we need to warn women about while taking Flagyl regarding consuming alcohol?

Cannot drink alcohol while on Flagyl because this will cause nausea and vomiting

Is there a pH difference between Candidiasis, Bacterial Vaginosis and Trichomoniasis? If so what is it for all three?

BV and trichomoniasis have higher pH Candidiasis does not have pH change

What causes bacterial vaginosis (BV)?

Bacteria

What causes chlamydia?

Bacteria

What causes gonorrhea?

Bacteria

What causes syphilis?

Bacteria

Who receives the HPV vaccine?

Both women and men

When are women with a 32 day cycle fertile?

Days 8-19

What form of birth control should be avoided if a woman has had TSS?

Diaphragm

Why is there a risk for UTI with a diaphragm?

Diaphragm increases risk of UTI because it sits on ureters

How can a woman get a diaphragm?

Dr. needs to prescribe and fit -refit if weight fluctuates 10-15lbs up or down

What is an appropriate nursing action after fetal demise?

Dress the baby in a tee shirt and swaddle the baby in a receiving blanket

What is a risk from the IUD?

Ectopic pregnancy if become pregnant while using IUD

What is the newborn treatment for gonorrhea?

Erythromycin ointment

What is BV treatment for non pregnant women?

Flagyl* PO x 7days/PV x5 days

What is BV treatment for pregnant women?

Flagyl* or Clindamycin PO x 7days No sexual intercourse

What is the risk associated with the pill and smoking?

Increased risk of DVT

How is the Nuva ring used?

Insert one per week Wear for three weeks, remove for period week

How is the copper IUD different from the Mirena?

It is non hormonal and lasts up to 10 years

Is HIV testing required for all pregnant women? What if women does not want to be tested?

It is offered to all. Women have to opt out -nurse required to educate on what can happen if mom has HIV and births baby

What is the most common S&S of STDs?

Lack of signs or symptoms

What is the correct way to use a diaphragm?

Look frequently and inspect for holes No powders *No more than 4 hours before sex *Remove 6 hours after sex Use with spermicide

What best describes the clinical signs/symptoms of chlamydial infection in woman?

Most women are asymptomatic

Which of the following statements about HIV screening in pregnancy is most accurate?

Must be given option to opt out of routine HIV testing

How can a woman correctly use the sponge?

Must moisten with water before use *Can keep in for 24 hours Covers multiple sexual encounters Disposable

What is the calendar contraception method?

Must record 6-8 months of cycles -subtract 18 days from shortest cycle and 11 days from longest cycle Not good for women with irregular cycles

What is the temperature method?

Must take temperature every morning upon awakening -if there is an increase in temperature a 10th of degree= no sex for 3 days.

What are the adverse effects of Plan B?

Nausea, cramping, bleeding

What are the risks of having trichmoniasis for pregnant women?

PROM Preterm Labor

What are the symptoms of HSV?

Painful blisters/vesicles Flu like symptoms Unpredictable recurrence

Why does primary syphilis become secondary?

Painless chancre--> easy to ignore

What causes trichmoniasis?

Parasite

Which STIs are caused by parasites?

Pediculosis (may not be sexually transmitted) Scabies (may not be sexually transmitted) Trichomoniasis

Who is the pill not recommended for?

Those with multiple partners

What are the nursing considerations for chlamydia?

Treat partners Repeat test-of-cure after 3 wks(pg) Screen urine in women <25, at risk, or pregnant