Med-Surg Ch. 53 EAQ: Sexually Transmitted Infections
A women's clinic nurse is seeing a patient who is receiving treatment for condylomata. The patient asks the nurse, "Why is it important to get this treatment?" Identify the best nursing response.
"Because this sexually transmitted infection increases the risk of developing cervical cancer." Explanation: HPV is associated with cervical dysplasia and cancer. A vaccine has been developed and is recommended for young women. HPV does not cause gonorrhea, recurrent UTIs, or herpes.
When collecting health history from a patient with chlamydial infection, what symptoms is the patient likely to report? Select all that apply.
-Frequent and painful urination -Pain during intercourse -Menstrual abnormalities
A young woman is cured of an existing sexually transmitted infection (STI). What instructions should the nurse provide to this patient to prevent reinfection or complications? Select all that apply.
-Use Condoms -Avoid having multiple sexual partners -Make sure to get periodic Pap Smears
How is Herpes treated?
With acyclovir (Zovirax), famciclovir (Famvir), or valacyclovir (Valtrex).
Because of high infectivity of this sexually transmitted infection (STI), treatment is started before culture results are obtained. Standard treatment is an intramuscular (IM) dose of ceftriaxone (Rocephin) or cefixime (Suprax) orally. Which infection does this apply to?
Gonorrhea
How is HIV treated?
Human immunodeficiency virus is managed rather than treated and uses several categories of drugs.
How is Candidiasis treated?
Is a yeast infection that may be treated with amphotericin B or fluconazole for systemic infections, or topical azole for vaginal infections.
The physical assessment and history of a 29-year-old female patient are indicative of human papillomavirus (HPV) infection. What teaching should the nurse provide to the patient?
Wart Removal Options
A nurse is screening a person for syphilis. What are the behavior patterns that contribute to an increased risk for developing syphilis? Select all that apply.
-Sexual intercourse with an infected person -Sharing of intravenous needles for drugs -Contact with lesions of a person with syphilis
What instructions should the nurse give a patient with lesions of herpes? Select all that apply.
-Maintain good hygiene -Keep the lesions clean and dry -Take frequent sitz baths -Wear loose-fitting cotton undergarments
When performing a physical examination of a man with suspected gonorrhea, what symptoms is the nurse likely to find? Select all that apply.
-Pain during urination -Purulent discharge from the urethra -Swollen testicles
Erythromycin ophthalmic ointment or silver nitrate aqueous solution is given prophylactically to all newborns to prevent blindness as a result of exposure to
Gonorrhea
A patient has tested positive for syphilis. Which other condition should the patient be tested for, based on the positive syphilis test result?
HIV
What should teaching for patients with a sexually transmitted infection (STI) include? Select all that apply.
-Treatment of Sexual Partners -Cotton Undergarments are preferred over synthetic materials. -Sexual abstinence is indicated during the communicable phase of the disease. -Condoms should be used during, as well as after, treatment during sexual activity.
The herpes simplex virus (HSV) causes genital herpes. The development of genital herpes involves several pathophysiologic processes. Arrange the processes in the order of occurrence.
1.) HSV enters through the mucous membranes or breaks in the skin during contact with an infected person. 2.) The virus reproduces inside the cell and spreads to the surrounding cells. 3.) The virus enters the peripheral or autonomic nerve endings and ascends to the sensory or autonomic nerve ganglion, where it often becomes dormant. 4.) Viral reactivation may occur when the virus descends to the initial site of infection (either the mucous membranes or the skin).
Upon examination of a 30-year-old man, the nurse notes profuse, purulent urethral discharge. The man also complains of dysuria and "painful testicles." Based on these findings, which medication does the nurse anticipate the primary health care provider will prescribe?
Ceftriaxone (Rocephin) This patient's clinical manifestations are indicative of a gonorrheal infection. The treatment of gonorrhea in the early stage is curative with a cephalosporin antibiotic. Treatment for gonorrhea is an intramuscular (IM) dose of ceftriaxone or cefixime (Suprax) orally. Acyclovir is an antiviral medication used for the treatment of herpes. Penicillin G is an antibiotic, but effective in treating syphilis, not gonorrhea. Podofilox is used to treat human papillomavirus (HPV).
A young male patient is seeking treatment for his sexually transmitted infection (STI) because he knows a recurrence is imminent due to the tingling, burning, and itching he is experiencing. Based on his symptoms, the nurse should know that this patient's STI will be treated with which type of medication?
Antivirals Explanation: This patient is experiencing a reoccurrence of genital herpes (HSV2). Although not a cure, he will be treated with antiviral medications to decrease the duration of viral shedding and the healing time of genital lesions and to reduce outbreaks.
A patient reports dysuria and profuse purulent urethral discharge. During the assessment, the nurse finds that the patient's testicles are swollen and performs a nucleic acid amplification test. Which disease does nurse anticipate on the basis of the assessment data?
Gonorrhea Explanation: Gonorrhea is a contagious sexually transmitted infection caused by Neisseria gonorrhoeae. The symptoms of gonorrhea infection in male patients include dysuria; profuse, purulent urethral discharge; and swollen testicles. The diagnostic test for gonorrhea is a nucleic acid amplification test. Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum. The symptoms of syphilis include the presence of painless indurated lesions on the penis, vulva, lips, mouth, vagina, and/or rectum. Genital warts are small fleshy growths, bumps, or skin changes that appear near the genital or anal areas. Chlamydia infections are caused by Chlamydia trachomatis; the symptoms include urethritis and rectal discharge and pain during defecation.
A patient who does not exhibit signs or symptoms of syphilis receives a positive treponemal antibody test result. On the basis of these data, which stage of syphilis does the nurse suspect?
Latent Explanation: Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum. The patient does not exhibit signs or symptoms of the disease, which indicates that the patient is noninfectious and in the latent stage of the disease process. In the late stage of the disease, chronic destructive lesions are seen in any part of the body. In the primary stage of the disease, the symptoms include painless indurated lesions on the penis, vulva, lips, mouth, vagina, and/or rectum. Flu-like symptoms are seen in the secondary stage of the disease.
The nurse is assessing a patient suspected of having syphilis. The nurse should expect the health care provider to prescribe:
Penicillin G benzathine (Bicillin) Explanation: Penicillin G benzathine or aqueous procaine penicillin G is the treatment of choice for all stages of syphilis. Podophyllin resin is a topical treatment for external genital warts. Acyclovir is a treatment for herpes simplex virus. Azithromycin is not the first choice of treatment for syphilis.
The nurse knows that the patient with which stage of syphilis is most infectious and may have chancres.
Primary Explanation: A chancre is a lesion of the penis, vulva, lips, mouth, vagina, or rectum that is painless, occurring up to 90 days after inoculation. This is the most infectious stage. Secondary syphilis occurs a few weeks after the appearance of a chancre, in which a rash appears. During the latent phase, there is absence of symptoms. Tertiary syphilis is characterized by gummas, which are lesions that destroy organs.
