Infections

candidiasis

(moniliasis) white, cheesy, curdlike patch due to superficial fungal infection

A female sex trade worker has been diagnosed with secondary syphilis. Which findings would most likely correlate with this diagnosis? 1 sore throat and flu-like symptoms 2 pain-free crusty genital lesions 3 yellow vaginal discharge 4 painful dysuria

1 Present would be a maculopapular rash (hands and feet); a sore throat; lymphadenopathy; and flu-like symptoms. NOT 2 With a secondary infection of syphilis, there would be no evidence of vaginal lesions present. 4 Dysuria is not seen in the secondary infection. 3 A yellow vaginal discharge is for gonorrhea

A woman comes to the clinic reporting vaginal discharge. The nurse suspects trichomoniasis based on which symptoms? Select all that apply. 1 urinary frequency 2 yellow/green discharge 3 joint pain 4 blister-like lesions 5 muscle aches

1.2.Manifestations of trichomoniasis include a yellow/green or gray frothy or bubbly discharge, dysuria, urinary frequency, and irritation or itching of the genital area. NOT 3 Joint pain suggesting arthritis is associated with gonorrhea. 4.5. Blister-like lesions and muscle aches would suggest genital herpes.

Which finding would alert the nurse to suspect that a client has a yeast infection? 1 changes in skin color 2 vulvar burning and itching 3 lymphadenopathy 4 acidic vaginal secretions

2 The primary symptom of a yeast infection is burning and itching on the vulva or in the vagina. NOT 4 Acidic vaginal secretions are not the primary symptoms of a yeast infection. 1.3. Skin changes and lymphadenopathy may occur in the breast and require a follow up for breast exam; however, these are not associated with yeast infections.

The nurse explains to a client diagnosed with trichomoniasis that the disease is caused by the parasitic protozoan Trichomonas vaginalis. What would the nurse say is a factor that triggers growth of trichomoniasis? 1 trauma to the bladder 2 being postmenopausal 3 irritation of vaginal walls 4 spontaneous abortion (miscarriage)

3 Factors that trigger growth of trichomoniasis include irritation of vaginal walls, pregnancy, sexual activity, trauma to the vaginal walls, systemic illness, menstruation, and emotional upsets.

Copious amounts of frothy, greenish vaginal discharge would be a symptom of which infection? 1 candidiasis 2 Gardnerella vaginalis vaginitis 3 gonorrhea 4 trichomoniasis

4 The discharge associated with infection caused by Trichomonas organisms is homogenous, greenish gray, watery, and frothy or purulent. NOT 1 The discharge associated with candidiasis is thick, white, and resembles cottage cheese in appearance. 2 The discharge associated with infection due to G. vaginalis is thin and grayish white, with a marked fishy odor. 3 With gonorrhea, vaginal discharge is purulent when present but, in many women, gonorrhea produces no symptoms

Hepatitis _____ is transmitted primarily by the fecal/oral route.

A

Condyloma lata

A cutaneous condition characterized by wart-like lesions on the genitals. They are generally symptoms of the secondary phase of syphilis

What is the medication of choice for early syphilis (plus backup if allergic to first choice)?

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 who are allergic to penicillin are usually treated with doxycycline or tetracycline.

Gonorrhea

Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. Like chlamydia, gonorrhea can be passed by oral and rectal sex, in addition to vaginal intercourse. Symptoms, when they occur, are similar to those of chlamydia: urethritis in men and cervicitis in women.

Ways to help prevent vaginitis.

Prevention activities include avoiding douching to prevent altering the vaginal pH (causing an alkaline environment where candida infections thrive); using condoms to avoid spreading the organism; urinating with knees spread wide apart; avoiding tights, nylon underpants, and tight clothes; wiping from front to back after using the toilet; washing only with hypoallergenic bar soap, avoiding liquid soaps or body washes; avoiding powders, bubble baths, and perfumed vaginal sprays (these upset the acid balance); wearing clean cotton underpants (promotes vaginal dryness, which will help prevent vaginal infections); washing and drying the vulvar area gently after baths or showers. Infections also thrive when blood glucose levels are high; (diabetics must maintain balanced levels to promote healing and limit infections)

Stages of Syphilis

The first stage involves a painless sore on the genitals, rectum, or mouth. After the initial sore heals, the second stage is characterized by a rash. Then, there are no symptoms until the final stage which may occur years later. This final stage can result in damage to the brain, nerves, eyes, or heart.

Trichomoniasis

Trichomoniasis (caused by a microscopic flagellated protozoan, Trichomonas vaginalis) S/Sx similar to those of BV(bacterial vaginosis): thin vaginal discharge, fishy odor, and vulvar irritation. Also, pelvic pain, dysuria, urinary frequency, and off-schedule vaginal bleeding. Up to half of women with trichomoniasis are asymptomatic With trichomoniasis, the cervical mucosa may reveal punctate hemorrhages with accompanying vesicles or papules, also known as strawberry cervix

The most commonly diagnosed bacterial sexually transmitted infection is ________________.

chlamydia

Common symptoms of ________________ include urinary frequency and urgency, a sensation of incomplete emptying, and pain with urination.

cystitis

maculopapular rash

rash characterized by flat red rashes that are covered in small bumps

Gardnerella vaginalis vaginitis

vaginitis that is marked by a grayish vaginal discharge usually of foul odor and that is associated with the presence of a bacterium especially of the genus Gardnerella

Bacterial ________________ is a common cause of abnormal vaginal discharge accounting for approximately half of complaints

vaginosis

A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis? 1 a painless genital ulcer that appeared about 3 weeks after unprotected sex 2 copper-colored macules on the palms and soles that appeared after a brief fever 3 patchy hair loss and red, broken skin involving the scalp, eyebrows, and beard areas 4 one or more flat, wartlike papules in the genital area that are sensitive to touch

1 A painless genital ulcer is a symptom of primary syphilis. NOT 2.3. Macules on the palms and soles after fever are indicative of secondary syphilis, as is patchy hair loss. 4 Wartlike papules are indicative of genital warts.

1 acyclovir 2 benzathine penicillin 3 chloroquine 4 mefloquine

1 Acyclovir or valacyclovir can both be safely administered to women with HSV who develop lesions during pregnancy as well as to their newborns at birth. 2 Benzathine penicillin is given for syphilis. 3.4. Chloroquine can be given in the first trimester and mefloquine can be given in the second and third trimester for treatment of malaria.

Which instruction should the nurse give to a client with genital herpes to help control the infection? 1 Avoid sexual contact until sores heal. 2 Apply antibacterial medication. 3 Avoid people with upper respiratory infections. 4 Apply imiquimod cream.

1 The nurse should instruct the client to avoid sexual contact until sores heal completely and new skin forms. NOT 2 Application of antibacterial medication is suggested for wounds in case of lymphedema. 3 Clients with HIV are advised to avoid people with upper respiratory infections. 4 Application of imiquimod cream is suggested for clients infected with human papillomavirus.

A nurse is teaching personal hygiene care techniques to a client with genital herpes. Which statement by the client indicates the teaching has been effective? 1 "I will wear loose cotton underwear." 2 "I will apply a water-based lubricant to my lesions." 3 "I should rub rather than scratch in response to itching." 4 "I can pour hydrogen peroxide and water over my lesions."

1 Wearing loose cotton underwear promotes drying and helps avoid irritation of the lesions. NOT 2 The use of lubricants is contraindicated because they can prolong healing time and increase the risk of secondary infection. 3 Lesions should not be rubbed or scratched because of the risk of tissue damage and additional infection. Cool, wet compresses can be used to soothe the itch. 4 The use of hydrogen peroxide and water on lesions is not recommended.

A nurse is preparing for a class discussion on STIs to be given at a local high school. Which would the nurse include as a discussion priority? 1 Adults aged 21 to 30 years are at greater risk of contracting an STI. 2 Adolescents and young adults are the largest age group diagnosed with an STI. 3 College students are more likely to engage in risky sexual behaviors leading to an STI. 4 More single mothers are diagnosed with an STI causing sterility.

2. NOT 1 Individuals aged 15 to 24 years represent almost half of all cases of new STIs. 4 Four in ten sexually active teen girls, not single mothers, have an STI that can cause infertility. 3 In the United States, teens who are sexually active, not college-aged students, experience high rates of STIs.

Working at the local health clinic, the nurse recognizes that STIs can often result in pelvic inflammatory disease. When a client with a history of repeat STIs presents to the clinic reporting severe abdominal cramping and bleeding, the immediate concern is to ensure the client does not have: 1 ectopic pregnancy. 2 genital herpes simplex. 3 endometriosis. 4 secondary UTI.

1 Every day, more than one million people are newly infected with STIs that can lead to morbidity, mortality, and an increased risk of human immunodeficiency virus (HIV) acquisition. STIs may contribute to cervical cancer, infertility, ectopic pregnancy[pregnancy occurring outside the uterus, commonly in the uterine (fallopian) tubes], chronic pelvic pain, and death

A woman is diagnosed with a vaginal infection. After teaching the client about measures to reduce her risk, the nurse determines that the client needs additional teaching when she states which factor as increasing her risk? 1 antibiotic therapy 2 menstruation 3 douching 4 use of feminine hygiene sprays

2 The vagina has an acidic environment, which protects it against ascending infections. Antibiotic therapy, douching, perineal hygiene sprays, and deodorants upset the acid balance within the vaginal environment and can predispose women to infections. Menstruation is not considered a risk factor.

A primary care provider tells a client to return 2 to 3 months after treatment to have a repeat culture done to verify the cure. This prescription would be appropriate for a woman with which condition? 1 genital warts 2 genital herpes 3 gonorrhea 4 syphilis

3 Gonococcal (bacteria that causes gonorrhea) infections can be completely eliminated by drug therapy. NOT 1 Genital warts are not curable and are identified by appearance, not culture. 2 Genital herpes is not curable and is identified by the appearance of the lesions or cytologic studies. 4 The diagnosis of syphilis is done using dark-field microscopy or serologic tests.

A woman trying to conceive has been prescribed metronidazole for bacterial vaginosis. What should the nurse caution this client while taking this medication? 1 The medication will be continued to treat the infection. She will be monitored closely if she discovers she is pregnant. 2 This medication is safe for use in pregnancy. 3 This drug is the only treatment for bacterial vaginosis and must be taken as prescribed even if pregnancy is suspected. 4 This drug can be teratogenic early in pregnancy and she should inform the health care provider if pregnancy is suspected.

4 The nurse cautions a client who is prescribed metronidazole for bacterial vaginosis to inform the health care provider if she thinks she may be pregnant. Treatment with metronidazole in pregnancy is controversial because of inconsistent evidence about risks and benefits.

he nursing instructor is teaching about Bartholin cysts and informs the students that Bartholin cysts are the most common cystic growth in the vulva. She describes this type of cyst as being: 1 a benign proliferation composed of smooth muscle and fibrous connective tissue in the uterus. 2 a swollen, fluid-filled, sac-like structure. 3 a small growth that is benign. 4 an abnormal opening between a genital tract organ and another organ.

2 A Bartholin cyst is a swollen, fluid-filled, sac-like structure that results when one of the ducts of the Bartholin's gland becomes blocked. NOT 1 A uterine fibroid (uterine myoma) is a benign proliferation composed of smooth muscle and fibrous connective tissue in the uterus. 4 A fistula is an abnormal opening between a genital tract organ and another organ. 3 A polyp is a small benign growth.

What is the most important consideration for the nurse when communicating with an adolescent about sexually transmitted infections (STI)? 1 adjust information to the client's developmental level 2 use communication techniques that are direct and nonjudgmental 3 utilize audio and visual aids to reinforce teaching 4 design teaching for the best effect in the shortest time

2 All of the answers are correct, but the most important consideration for a nurse communicating with an adolescent about STIs is to be direct and nonjudgmental. NOT 1 The style, content, and the message has to be aimed at the adolescent's developmental level. 3 Any aids to help the adolescent learn should be used. 4 The content should be designed to be delivered in the shortest amount of time because many clinics and health care provider offices are busy and do not lend themselves to long class times.

The nurse is preparing a presentation for a local community group about sexually transmitted infections (STIs). Which most common bacterial STI in the United States would the nurse expect to include? 1 gonorrhea 2 chlamydia 3 syphilis 4 genital herpes

2 Chlamydia is the most common and fastest-spreading bacterial STI in the United States, with 2.8 million new cases occurring each year. NOT 1 Gonorrhea is the second most frequently reported communicable disease in the U.S. 3 The incidence of syphilis had been increasing for the past 6 years. 4 Genital herpes is a viral STI. One in five people older than age 12, however, is infected with the virus that causes genital herpes.

Which factor in a client's history indicates she is at risk for candidiasis? 1 nulliparity 2 menopause 3 use of corticosteroids 4 use of spermicidal jelly

3 Small numbers of the fungus Candida albicans are commonly in the vagina. Because corticosteroids decrease host defense, they increase the risk of candidiasis. NOT 1 Pregnancy, not nulliparity (a woman who hasn't given birth to a child), increases the risk of candidiasis. 2 Candidiasis is rare before menarche and after menopause. 4 The use of hormonal contraceptives, not spermicidal jelly, increases the risk of candidiasis.

A female client with genital herpes is prescribed acyclovir as treatment. After teaching the client about this treatment, which statement by the client indicates effective teaching? 1 "If I use this drug, I will be cured of the infection." 2 "This drug will help reduce my risk for a recurrence after discontinuing it." 3 "The severity of future attacks will be much less after using this drug." 4 "This drug will help to suppress any symptoms of the infection."

4 No cure exists, but antiviral drug therapy helps to reduce or suppress symptoms, shedding, and recurrent episodes. Advances in treatment with acyclovir, famciclovir, or valacyclovir have resulted in an improved quality of life for those infected with HSV. NOT 1.2.3. However, according to the CDC, these drugs neither eradicate latent virus nor affect the risk, frequency, or severity of recurrences after the drug is discontinued.

Which instruction should be given to a woman newly diagnosed with genital herpes? 1 Obtain a Papanicolaou test every 3 years. 2 Have your partner use a condom when lesions are present. 3 Use a water-soluble lubricant for relief of pruritus. 4 Limit stress and emotional upset as much as possible.

4 Stress, anxiety, and emotional upset seem to predispose a client to recurrent outbreaks of genital herpes. NOT 2 Sexual intercourse should be avoided during outbreaks, and a condom should be used between outbreaks; it is not known whether the virus can be transmitted at this time. 3 During an outbreak, creams and lubricants should be avoided because they may prolong healing. 1 Because a relationship has been found between genital herpes and cervical cancer, a Papanicolaou test is recommended every year.

Which stage or period of syphilis occurs when the infected person has no signs or symptoms of syphilis? 1 latency 2 secondary 3 primary 4 tertiary

1 A period of latency occurs when the infected person has no signs or symptoms of syphilis. NOT 2 Secondary syphilis occurs when the hematogenous spread of organisms from the original chancre (painless ulcer) leads to generalized infection. 3 Primary syphilis occurs 2 to 3 weeks after initial inoculation with the organism. 4 Tertiary syphilis presents as a slowly progressive inflammatory disease with the potential to affect multiple organs.

A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea? 1 burning on urination 2 dry, hacking cough 3 diffuse skin rash 4 painless chancre

1 Burning on urination may be a symptom of gonorrhea or UTI. NOT 2 A dry, hacking cough is a sign of a respiratory infection, not gonorrhea. 3 A diffuse rash may indicate secondary stage syphilis. 4 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.

Pelvic infection is most commonly caused by: 1 sexual transmission. 2 induced abortion (medical abortion). 3 hysteroscopy. 4 insertion of intrauterine device.

1 Pelvic infection is most commonly caused by sexual transmission but can also occur with invasive procedures such as endometrial biopsy, induced abortion (medical abortion), hysteroscopy, or insertion of an intrauterine device.

A 24-year-old female presents with vulvar pruritus accompanied by irritation, pain on urination, erythema, and an odorless, thick, acid vaginal discharge. She denies sexual activity during the last six months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of antimicrobial medication is most likely to clear her symptoms? 1 an azole antifungal agent 2 a penicillin antibiotic 3 a quinolone antibiotic 4 an antiviral agent

1 The character of the discharge and the lack of recent sexual activity suggest infection with Candida, which can exist asymptomatically and flare up only if conditions, such as an imbalance in normal vaginal flora resulting from antibiotic treatment, diabetes, or oral contraceptive use, enable the fungus to proliferate. Candidiasis responds well to treatment with azole antifungal agents

A group of students is reviewing class material on sexually transmitted infections in preparation for a test. The students demonstrate understanding of the material when they identify which cause of condylomata? 1 herpes virus 2 human papillomavirus 3 Treponema pallidum 4 Haemophilus ducreyi bacillus

2 Genital warts or condylomata are caused by the human papilloma virus (HPV). NOT 1 Herpes virus causes genital herpes. 3 Treponema pallidum is the cause of syphilis. 4 Haemophilus ducreyi bacillus is the cause of chancroid.

A client is experiencing situational low self-esteem about acquiring a sexually transmitted infection. Which nursing intervention may help foster the client's self-esteem? 1 Explain the cause of the sexually transmitted infection (STI). 2 Provide the client with a telephone number for obtaining accurate information. 3 Affirm the client's good judgment in seeking treatment. 4 Schedule an appointment for follow-up care.

3 The nurse should affirm the client's good judgment in seeking treatment. Acknowledging positive action helps increase the client's self-esteem. NOT 1 Explaining the cause of the STI and how to avoid potential consequences or complications dispels inaccurate beliefs and misconceptions and helps the client to acquire realistic information. It does not help the client's self-esteem to be positive. 2 Providing the client with a telephone number for obtaining objective and authoritative information helps the client to ask more questions about an STI and its treatment. 4 Medical follow-up promotes compliance with therapeutic regimen and does not help the client's self-esteem to be positive.

The nurse is developing a plan of care for a client who is receiving antiretroviral therapy (ART) for treatment of HIV. What would the nurse identify as the goal of this therapy? 1 promote the progression of disease 2 intervene in late-stage AIDS 3 improve morbidity and mortality rates 4 conduct additional drug research

3 The use of ART aims to improve the prognosis of HIV/AIDS with the goal of reducing morbidity and mortality rates. Dramatic advances with antiretroviral medication have turned a disease that used to be a death sentence into a chronic, manageable one for individuals who live in countries where antiretroviral therapy is available. NOT 1 Drug therapy does not promote the progression of the disease. 2 It is started at the time of the first infection, not in late-stage AIDS. 4 Treatment advances have been based on research, but drug therapy is not prescribed to conduct additional research.

Which statement made by a client with a chlamydial infection indicates understanding of the potential complications? 1 "I'm glad I'm not pregnant; I'd hate to have a malformed baby from this disease." 2 "I hope this medicine works before this disease gets into my urine and destroys my kidneys." 3 "If I had known a diaphragm would put me at risk for this, I would have taken birth control pills." 4 "I need to treat this infection so it doesn't spread into my pelvis because I want to have children some day."

4 Chlamydia is a common cause of pelvic inflammatory disease and infertility. NOT 2 It doesn't affect the kidneys 1 or cause birth defects. It can cause conjunctivitis and respiratory infection in neonates exposed to infected cervicovaginal secretions during delivery. 3 Use of a diaphragm isn't a risk factor.

A client with syphilis did not receive treatment and has now progressed into the tertiary stage of the disorder. Which symptoms would the nurse expect the client to exhibit? 1 ulcerated chancre, aortic valve insufficiency, lymphadenopathy 2 fever, malaise, sore throat 3 papular lesion, rash, headache 4 heart disease and inflammation of the aorta, eyes, brain, central nervous system, and skin

4 The client with late or tertiary syphilis is noninfectious because the microorganism has invaded the central nervous system (CNS) as well as other organs of the body. Symptoms of tertiary syphilis include heart disease and neurologic disease that slowly destroys the heart, with inflammation of the aorta, eyes, brain, central nervous system, and skin. NOT 3 Symptoms of secondary syphilis include fever, malaise, rash, headache, sore throat, and lymph node enlargement. 1 Ulcerated chancre occurs in the primary stage.

________________ is a UTI that has ascended to the kidneys

Pyelonephritis