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
