family planning and STI's
herpes
caused by herpes simplex virus both type 1 and 2 - transmission occurs with direct contact of infected skin/mucous membranes or through asymptomatic shedding - the virus usually persists within the individual for life - complications: spread of virus to self - diagnostics: serologic tests to determine HSV1 and HSV 2 & CDC doesn't recommend routine screening
Trichomoniasis
caused by protozoan called Trichomonas vaginalis - common and curable - not common to have infection on other body parts, like the hands, mouth, or anus - most prevalent nonviral sexually transmitted infection
trichomoniasis
caused by protozoan parasite symptoms- men- itching, irritation, burning with urination, discharge women- itching, burning, redness, soreness, dysuria, discharge with unusual smell, strawberry cervix diagnostics- - wet prep - OSOM trich rapid test treatment- - Metronidazole - Tinidazole --- avoid alcohol
bacterial STI's
chlamydia, syphilis, gonorrhea
viral STI's
herpes, HPV, zika, HIV, hep B and C
human papilloma virus (HPV)
highly contagious STI - more than 100 types- many sexually transmitted - 90% of genital warts are caused by HPV 6 and 11 - some types cause cancer- 6, and 18 - incubation period of the virus is genera;;y 3-4 months - minor trauma during intercourse can cause HPV to enter body
chlamydia complications
men- abscess, infertility, skin lesions women- Fallopian tube damage causing ectopic pregnancy, infertility, PID
uterine phases
menstrual, proliferation, secretory, ischemic, menstrual
chlamydia
most common STI reported in US - incubation period of 1-4 weeks - known as silent disease because symptoms may be absent or minor in most infected women and men men- urethritis (dysuria, urethral discharge), Proctitis (rectal discharge and pain with defecation), Epididymitis (unilateral scrotal pain, swelling, tenderness, fever) women- Cervicitis (mucopurulent discharge, friable), urethritis, bartholinitis, painful intercourse, menstrual abnormalities
trichomoniasis diagnostics
most common is wet prep OSOM trichomonas rapid test
genital herpes- primary clinical manifestations
occur between 17 and 20 days after exposure - multiple small vesicular sometimes painless lesions - burning, itching, or tingling at the site of inoculation - the vesicles contain large amounts of viral particles - the lesions rupture and form shallow moist ulcerations - crusting and epilthelialization of the lesions
genital herpes- recurrent clinical manifestations
occurs in 50-80% during the 1st year common triggers- stress, fatigue, sunburn, menses, illness - may note tingling/burning prior to development of lesions - outbreak is usually less severe and lesions heal in 1-2 weeks
zika
recently found to be spread by sexual contact common symptoms- rash, fever, muscle/joint pain, headache - can have impact of fetus - use condoms or abstinence
gonorrhea
second most reported STI in US, it elicits an inflammatory response which if left untreated can lead to reproductive problems - gram neg diplococcus - spread by direct physical contact of infected host (vaginal, oral, anal) - incubation 3-8 days
syphilis
spirochete enters skin through minor abrasions - affects many organs and tissues - about 1/3 of all exposed become infected - infected have a high risk for HIV - sometimes difficulty to recognize due to stages
genital herpes- drug therapy
start prior to test results - reduces transmission - reduces healing time of ulcers local - pain may require an anesthetic like lidocaine antiviral treatment - Acyclovir - Valacyclovir (Valtrex) - Famciclovir (Famvir) - they inhibit viral replication - used for primary and recurrent infections
luteal phase
tends to be more constant usually 14 days
bacterial vaginosis
transmission is unclear symptoms- watery discharge, fishy odor, irriation diagnostics- - saline wet prep - pH > 4.5 - whiff test treatment- - Metronidazole - Clindamycin
other STI's
trichomonas
follicular phase
variable from individual to individual but usually 10-17 days
HPV- clinical manifestations
- many dont know they are infected - genital warts can be discrete single or multiple papillary growths - white to gray and pink flesh colored - grow to form large cauliflower-like masses - usually no other signs, may have itching or bleeding
adverse events with IUDs
- menstrual irregularities and spotting - Mirena--- ammenorrhea - increased cramping - pain with insertion or removal - infection
estrogen/progesterone MOA
- negative feedback loop to the pituitary to inhibit the secretion of LH and FSH - without FSH/LH the ovarian follicle cannot mature and ovulation is prevented - no FSH surge, no egg, no baby
disdvantages of Depo-provera
- no immediate discontinuation - visits every 3 months - HDL fall in women - bone density decline, significant with prolonged use > 2 years, black box warning - increased appetite, weight gain, fatigue, acne, hirsutism
menstrual phase
- normal blood lost is 20-80 ml - average duration 4-6 days
secondary syphilis stage
- occurs a few weeks after chancre appears - systemic symptoms- fever, sore, throat, fatigue, arthralgia - systemic rash on trunk, palms, and soles - weight loss, alopecia - duration for 1-2 years
androgenic effects
- oral contraceptives raise SHBG sex hormone binding globulin thus reducing free testosterone - benefit of reduced acne, oily skin, hirsutism - may reduce libido
IUD
- primary MOA is to prevent fertilization - may act by preventing implantation
contraceptive benefits
- reduces cesarean birth - reduces spontaneous abortion - reduces ectopic pregnancy - reduces ovarian cysts - decreased bleeding/anemia
CDC recommendations for chlamydia
- routine screening for all sexually active women 25 years or younger - annual screening for women 25 + years with one or more risk factors --- new/multiple sexual partners --- history of STIs --- coexisitng STIs --- inconsistent or incorrect condom use
Progesterone only "mini pill" Micronor
- slightly less effective than combined OC - must be taken same time everyday - avoid estrogen effects - irregular bleeding - may be used with breastfeeding
estrogenic effects
- the endometrial secretions and cellular structures are altered - altered local levels of prostaglandins contribute to the degeneration of the corpus luteum
fertility awareness
- utilizes basal body temperature and cervical mucus condition to determine ovulatory status - aids in planning or preventing conception
other modes of delivery of birth control
- vaginal ring- NuvaRing - Ortho patch- black box warning
A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis? a. A painless genital ulcer that appeared about 3 weeks after unprotected sex b. Copper-colored macules on the palms and soles that appeared after a brief fever Patchy hair loss and red, broken skin involving the scalp, eyebrows, and beard areas One or more flat, wartlike papules in the genital area that are sensitive to touch
*a. A painless genital ulcer that appeared about 3 weeks after unprotected sex* A painless genital ulcer is a symptom of primary syphilis. Macules on the palms and soles after fever are indicative of secondary syphilis, as is patchy hair loss. Wartlike papules are indicative of genital warts.
syphilis
bacterial- spirochete enters skin through abrasions symptoms- primary- chancre (highly infectious) secondary- fever, sore throat, fatigue, rash on hands, trunk, and soles latent- asymptomatic late- gummas diagnostics- - VDRL and RPR treatment- - Penicllin G
Which of the following medications are used to suppress viral load of the HSV-2 infection? a. Acyclovir (Zovirax) b. Penicillin c. Metronidazole (Flagyl) d. Clindamycin (Cleocin)
*a. Acyclovir (Zovirax)* The antiviral agents acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir) are recommended to suppress the viral load and decreases recurrence and shedding.
gonorrhea diagnostic study
CDC recommends, annual screening for N. gonorrhoeae infection for all sexually active women aged <25 years and for older women at increased risk for infection Culture PCR (Polymerase chain reaction) testing- as sensitive as cultures Specimen can be taken from endocervical, urethra, anus, throat, and urine
vulvovaginal candidiasis
Candida albicans (fungus) Symptoms- pruritis, thick white curdlike discharge Diagnostics- - KOH examnation reveals pseudohyphae - pH 4.0-4.7 Treatment- - Antifungal creams OTC --- Micoazole --- Clotrimazole - Fluconazole
HPV- treatments
Chemical - TCA or BCA - Podophyllin resin - Podofiloz Electrocautery Cyrotherapy
What STD is a common cause of Pelvic Inflammatory Disease and infertility?
Chlamydia Chlamydia is a common cause of pelvic inflammatory disease and infertility. It doesn't affect the kidneys or cause birth defects. It can cause conjunctivitis and respiratory infection in neonates exposed to infected cervicovaginal secretions during delivery. Use of a diaphragm isn't a risk factor.
A client who is suspected of having trichomoniasis is scheduled for laboratory testing. Which test would the nurse prepare the client to undergo to confirm the diagnosis? a. Gram stain b. NAAT c. Wet mount specimen d. VDRL
*b. NAAT* Diagnosis is made most accurately with NAAT. A Gram stain is used to diagnose gonorrhea. A wet mount may be used to diagnose trichomoniasis but it is not as reliable as NAAT. VDRL is used to diagnose syphilis.
disadvantages of OC
- lack of protection from STD - lack of protection fro the heart and soul - daily administration of pills - cost - occasional decreased libido - risk of cardiovascular disease
post ovulatory infertile phase
- low volume - thick - cloudy - no ferning - low elasticity
The nurse educator is teaching a class about the chain of infection. The nurse educator correctly states that sexually transmitted infections are passed on through which route of transmission? a.Direct transmission b. Airborne transmission c. Vehicle transmission d. Vector transmission
*a. Direct Transmission* A route of transmission is necessary and specific to each pathogen. Organisms may be transmitted through sexual contact, skin-to-skin contact, percutaneous injection, or through infectious particles carried in the air. *Sexually transmitted infections require direct contact with a susceptible host*. These infections are not spread through airborne transmission, when infectious agents are carried by dust or droplet nuclei suspended in air; through vehicle transmission, vehicles that indirectly transmit an infectious agent include food, water, biologic products (blood), and fomites (inanimate objects such as handkerchiefs, bedding, or surgical scalpels); or through vectors, such as mosquitoes, fleas, and ticks that may carry an infectious agent through purely mechanical means or may support growth or changes in the agent.
A nurse provided health teaching to a patient with a STI. The nurse advised her patient that transmission of the organism was by three routes: sexual, percutaneous, and perinatal. Choose the STI that was diagnosed. a. Herpes simplex b. Chlamydia c. Gonorrhea d. Trichomoniasis
*a. Herpes simplex* All STIs are transmitted sexually. Only one, herpes simplex, has three routes of transmission: sexual, percutaneous, and perinatal.
Which of the following is the most effective treatment for trichomoniasis? a. Metronidazole (Flagyl) b. Penicillin G benzathine c. Doxycycline (Adoxa) d. Azithromycin (Zithromax)
*a. Metronidazole (Flagyl)* The most effective treatment for trichomoniasis is metronidazole and tinidazole. Penicillin G benzathine is used for syphilis. Doxycycline and azithromycin are used in the treatment of Chlamydia.
Which of the following is the medication of choice for early syphilis? a.Penicillin G benzathine b. Doxycycline c. Tetracycline d. Rocephin
*a. Penicillin G benzathine* 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. Patients who are allergic to penicillin are usually treated with doxycycline or tetracycline. Rocephin is not the medication of choice for syphilis.
A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea? a. Burning on urination b. Dry, hacking cough c. Diffuse skin rash d. Painless chancre
*a. burning on urination* Burning on urination may be a symptom of gonorrhea or urinary tract infection. A dry, hacking cough is a sign of a respiratory infection, not gonorrhea. A diffuse rash may indicate secondary stage syphilis. 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.
A nurse is assessing a client with HSV-2 infection and notes the appearance of genital warts. The nurse documents this finding using which term? a. condylomata b. chancre c. dyspareunia d. orchitis
*a. condylomata* Genital warts are termed condylomata. Chancre is a painless lesion of syphilis. Dyspareunia refers to painful intercourse. Orchitis is an inflammation of the testes.
After teaching a group of students about sexually transmitted infections (STIs), the instructor determines that additional teaching is necessary when the students identify which STI as curable with treatment? a.Genital herpes b. Syphillis c. Gonorrhea d. Chlamydia
*a. genital herpes* Besides AIDS, the five most common STIs are chlamydia, gonorrhea, syphilis, genital herpes, and genital warts. Of these, chlamydia, gonorrhea, and syphilis are easily cured with early and adequate treatment. Genital herpes recurs.
The nurse is presenting a community lecture about STIs, and emphasizes that some STIs are easily cured with early and adequate treatment. Which is not among these easily treated diseases? a. genital herpes b. chlamydia c. gonorrhea d. syphilis
*a. genital herpes* Chlamydia, gonorrhea, and syphilis are easily cured with early and adequate treatment. Genital herpes is not.
The nurse is providing education to a client who has been diagnosed with chlamydia. The client will begin treatment with azithromycin today. Which teaching point should the nurse reinforce with this client? a. "It is very important to maintain good handwashing, even while you are being treated." b. "Abstain from any sexual activity for 1 week after the antibiotic is complete." c. "Coinfection with the herpes simplex virus is common with chlamydia." d. "If you become reinfected, symptoms will immediately be present."
*b. "Abstain from any sexual activity for 1 week after the antibiotic is complete." * Client counseling includes abstinence for 1 week after treatment, in addition to the completion of the partner's treatment. Although handwashing is an important aspect of preventing the spread of infection, the nurse must emphasize prevention of chlamydia through the normal route of transmission of this infection, which is sexually. Coinfection with chlamydia often occurs in clients infected with gonorrhea. Chlamydia and gonorrhea are caused by bacteria that are transmitted during sexual relations. Both chlamydia and gonorrhea infections frequently do not cause symptoms in women and thus are often referred to as "silent" related to clinical presentation. It is important to retest women 3 months' posttreatment, due to the possibility of reinfection.
The nurse is caring for a client who has just been diagnosed with chlamydia and is very upset. The client says, "I don't understand this. The person I had sex with did not have any symptoms at all. How could I have known?" What is the best response by the nurse to this client? a. "It is very hard to see signs of infection in the heat of passion." b."Many people with chlamydia won't have symptoms for up to 3 weeks after being infected." c."I think you realize that if you had used some form of a barrier protection such as a condom, it would have helped prevent this situation." d."It is really important that you know the sexual history of every potential lover. It may be uncomfortable but it will prevent the situation you are dealing with right now."
*b. "Many people with chlamydia won't have symptoms for up to 3 weeks after being infected."* As many as 75% of infected women and 25% of infected men are symptom free. It may take 1-3 weeks for symptoms to appear. Whether in passion or not, if symptoms are present, an individual would be able to see them. It is true that a condom would help decrease the incidence of an STI but the nurse should not try to condemn or judge the client with the STI. Knowing a client's sexual history is important but it does not answer the question that the client posed?
pre-ovulatory mucus
- low volume - thick - cloudy - no ferning - maximal cellularity - low elasticity
Which of the following describes microorganisms present without host interference or interaction? a. reservoir b. colonization c. infection d. infectious disease
*b. colonization* The term colonization is used to describe microorganisms present without host interference or interaction. Infection indicates a host interaction with an organism. Infectious disease is the state in which the infected host displays a decline in wellness due to the infection. Reservoir is the term used for any person, plant, animal, substance, or location that provides nourishment for microorganisms and enables further dispersal of the organisms.
In which group is it most important for the client to understand the importance of an annual Papanicolaou test? a. Clients with a history of recurrent candidiasis b. Clients with a pregnancy before age 20 c. Clients infected with the human papillomavirus (HPV) d. Clients with a long history of hormonal contraceptive use
*c. Clients infected with the human papillomavirus (HPV)* HPV causes genital warts, which are associated with an increased incidence of cervical cancer. Recurrent candidiasis, pregnancy before age 20, and use of hormonal contraceptives don't increase the risk of cervical cancer.
A male patient comes to the clinic and is diagnosed with *gonorrhea*. Which symptom most likely prompted him to seek medical attention? a. rashes on palms of hands and soles of feet b. cauliflower-like warts on penis c. painful red papules on the shaft of the penis d. foul-smelling discharge from the penis.
*d. foul-smelling discharge from the penis.* Signs and symptoms of gonorrhea in men include purulent, foul-smelling drainage from the penis and painful urination. Rashes on the palms of the hands and soles of the feet are a sign of the secondary stage of syphilis. Cauliflower-like warts on the penis are a sign of human papillomavirus. Painful red papules on the shaft of the penis may be a sign of the first stage of genital herpes.
absolute contradictions against oral contraceptive use
- DVT, pulmonary embolism - CVA, CAD - structural heart problems - diabetes with vascular disease - breast cancer - lactation - liver problems - major surgeries with prolonged immobilization - over 35 heavy smoker - hypertension
progesterone only
- Depo Provera injection- one injection every 3 months --- side effects: weight gain, decreased libido, acne - $200-$250 annually - no estrogen side effects - amonorrhea- hygiene - culturally acceptable - no drug interactions - better choice for smokers > 35 years old
A young woman was diagnosed with gonorrhea several months ago and prescribed antibiotics but failed to adhere to the prescribed treatment regimen. Consequently, she recently sought care with complaints of abdominal pain and was diagnosed with pelvic inflammatory disease (PID). The exacerbation of her symptoms has prompted an admission to the hospital for intensive therapy. The nurse who is planning this patient's care should identify which of the following aspects of care?
- IV antibiotics - bed rest Intensive therapy for PID includes bed rest, IV fluids, and IV antibiotic therapy.
gonorrhea in men
- Initial site of infection- Uretha - Purulent urethral discharge developing 2-5 days after infection - May also have painful/swollen testicles - Unusual for men to be asymptomatic
syphilis treatment
- Penicillin G benzathine (Bicillin) --- If PCN is contraindicated, doxycycline and tetracycline may be used. - No reversal of damage - Treat all of sexual contacts in last 90 days
temperature
- The temperature shifts by around 0.2 deg. C following ovulation - A biphasic chart indicates that ovulation has taken place - A monophasic chart (all temperatures on one level) indicates the absence of ovulation - The temperature chart can also help to confirm pregnancy
syphilis diagnostics
- Venereal Disease Research Lab (VDRL) and Rapid plasma reagin (RPR) - Suitable for screening purposes - Usually positive 10-14 days after appearance of chancre
adverse effects of combined oral contraceptives
- abnormal menstrual bleeding - amenorrhea or hypermenorrhea - hypertension- estrogen - thromboembolic disorders: estrogen - no birth defects - nausea, edema, breast tenderness - depression
latent syphilis stage
- absence of signs and symptoms - diagnosis based on positive antibody test - noninfectious after 4 years - 25% of persons with later syphilis will develop late syphilis
meds that may impact OC
- antibiotics: amoxicillin, ampicillin, doxycycline, griseofulvi, monocycline, penicillin, tetracycline - seizure meds: phenytoin, carbamazepine - barbiturate
late syphilis stage
- appearance 3-20 years after initial infections - noninfectious - gummas- destructive lesions affecting any organ, minimally skin - duration is chronic and possibly fatal
progestational effects
- cervical mucus is thickened - ovulation is inhibited - the activity of the cilia in tubes is reduced - the endometrium becomes atrophic and impairs implantation
primary syphilis stage
- chancre- painless indurated lesion occurs 10-90 days after inoculation - exudate from chancre highly infections - most infectious stage - duration 3-8 weeks
barrier contraception
- condoms - diaphragm with spermicidal - cervical cap - sponge - spermicidal foam - spermicidal film - spermicidal suppository
non contraceptive benefits of oral contraceptives
- dysmenorrhea (painful) - hypermenorrhea (prolonged) - metorrhagia (irregular but frequent) - decreased PMS - decreased acne - decreased ovarian/endometrial cancer - menstrual regulation - desirable effects on lipids
genital herpes- collaborative care
- good genital hygiene: clean and dry - loose cotton undergarments - sitz bath to reduce inflammation - drying agents such as collodial oatmeal and aluminum salts - sexual transmission can occur during asymptomatic periods --- encourage condoms - avoid sexual activity when lesions are present --- barrier methods not satisfactory in stopping transmission
fertile cervical mucus
- high volume - thin - clear - ferning - minimal cellularity - high elasticity
nexplanon
- is a flexible plastic rod the size of a matchstick that is put under the skin of your arm - one rod is used up to three years - most cost effective of the long acting reversible contraception
hormones
1. CNS 2. Hypothalamus--- GnRH 3. Anterior pituitary--- FSH and LH - Developing ovarian follicle- estrogen - Corpus Luteum- progesterone
bacterial vaginosis
Gardner Ella Vaginosis Mode of transition unclear Symptoms include- watery discharge. fishy odor, irritation Diagnostics - Saline wet prep - Clue cells, Poly - pH > 4.5 - Whiff test -KOH Treatment - Metronidazole (Oral or vaginal) - Clindamycin - May need to treat partner - Lactobacillus acidophilus
HPV- diagnostics
2/3rds of early lesions caused by HPV are undetectable by visual examination - serologic and cytologic testing should be done to rule out these conditions - pap test used tp detect HPV DNA - vaccinations- gardisil/cervarix
Early pill danger signs
A: abdominal pain C: chest pain, cough H: head ache, dizziness, weakness, numbness E: eye problems, speech problems S: severe leg pain
STI nursing management
Accurate risk assessment, education, and counseling of persons at risk on ways to avoid STDs through education Pre-exposure vaccination of persons at risk for vaccine-preventable STDs Identification of asymptomatically infected persons and persons with symptoms associated with STDs Effective diagnosis, treatment, counseling, and follow up of infected persons Evaluation, treatment, and counseling of sex partners of persons who are infected with an STD
general symptoms of gonorrhea
Anorectal gonorrhea with anal intercourse Mucopurulent anal discharge, bleeding, and feeling need to pass stool
disseminated gonococcal infection
Disseminated gonococcal infection-septic arthritis, asymmetric polyarthralgia, muscle pain, pustular skin lesions Hospitalization with infectious-disease consult is recommended for initial therapy, especially for persons who might not comply with treatment, have an uncertain diagnosis, or have purulent synovial effusions
What major symptom and complication do men experience with Chlamydia & Gonorrhea?
Epididymitis
gonnorhea in women
Minor symptoms or asymptomatic - May have vaginal discharge, dysuria, urinary frequency - Infection can spread to female reproductive organs
combined oral contraceptives pills
One of the most observed medications in the world - combination of estrogen and progesterone
trichomoniasis clinical manifestations
Only 30% will develop symptoms Men- - Itching or irritation inside the penis - Burning after urination or ejaculation - Some discharge from the penis. Women- - Itching, burning, redness or soreness of the genitals - Discomfort with urination - Thin discharge with an unusual smell that can be clear, white, yellowish, or greenish. - "Strawberry" cervix noted during pelvic exam
chlamydia diagnostic studies
PCR testing Cell culture - collected from urine - collected from endocervix, vagina, or urethra
trichomoniasis treatment
Recommended Regimen - Metronidazole 2 g orally in a single dose OR - Tinidazole 2 g orally in a single dose Alternative Regimen - Metronidazole 500 mg orally twice a day for 7 days Alcohol should be avoid with these medications - Disulfiram-like reaction - Abstinence from alcohol use should continue for 24 hours after completion of metronidazole or 72 hours after completion of tinidazole
The school health nurse is conducting a teaching session for parents to provide information about the human papillomavirus (HPV) vaccination. What prevention information should the nurse include in the session?
The effect of the vaccination is optimized if it is administered before the child becomes sexually active.
A female patient tells the nurse that she thinks she has a vaginal infection because she has noted inflammation of her vulva and a yellow-green discharge. The nurse recognizes that the clinical manifestations described are typical of what vaginal infections?
Trichomonas vaginalis The clinical manifestations indicate T. vaginalis, which is treated with metronidazole in the form of oral tablets.
gonorrhea treatment
Uncomplicated - Ceftriaxone 250 mg IM in a single dose OR Cefixime 400mg PO in shingle dose - PLUS Azithromycin 1g orally in a single dose - Can use Doxycycline instead of azithromycin Cephalosporin resistance - Dual treatment with single doses of oral gemifloxacin 320 mg plus oral azithromycin 2 g or dual treatment with single doses of intramuscular gentamicin 240 mg plus oral azithromycin 2 g can be considered CDC, 2016
The clinical manifestations of primary syphilis can be diagnostic. *Select all* the symptoms consistent with this diagnosis. a. it occurs 2 to 3 weeks after initial inoculation with the organism b. a painless lesion forms at the site of infection c. a rash spreads to the extremities by week 4 d. the lesion resolves in 2 months.
a. it occurs 2 to 3 weeks after initial inoculation with the organism b. a painless lesion forms at the site of infection d. the lesion resolves in 2 months. The presence of a rash occurs with secondary syphilis. Primary syphilis has no rash.
chlamydia
bacterial symptoms- men- urethritis (dysuria, discharge), proctitis (pain with BM), epididmyitis (scrotal pain, swelling) women- cervicitis (discharge), urethritis, painful intercourse, menstrual abnorms diagnostics- - PCR testing - cell culture treatment- - Doxycycline in 1 dose - Azithromycin for 7 days --- avoid intercourse for 7 days after treatment
Patients who have had pelvic inflammatory disease (PID) are prone to which of the following complications? a. inguinal lymphadenopathy b. ectopic pregnancy c. bacteremia d. thrombophlebitis
b. ectopic pregnancy All patients who have had PID need to be informed of the signs and symptoms of ectopic pregnancy because they are prone to this complication. Other complications include bacteriemia with septic shock and thrombophlebitis with possible embolization. Patients who have PID are not prone to inguinal lymphadenopathy
gonorrhea
bacterial- spread by anal, vaginal, oral symptoms- men- purulent urethral discharge, painful, swollen testicles women- minor or no symptoms, vaginal discharge, dysuria, urinary frequency diagnostics- - culture from endocervical, anus, urethra, throat, or urine - PCR testing treatment - Ceftriaxone plus Azithromycin in single dose
After a routine physical exam, a female client is devastated to receive a diagnosis of the sexually transmitted infection, gonorrhea. What would contribute to the client's ignorance of this condition?
being asymptomatic Many women who have gonorrhea are asymptomatic, a factor that contributes to the spread of the disease.
chlamydia drug therapy
doxycycline 100 mg every 12 hours x 7 days azithromycin 1g x 1 dose avoid intercourse during and for 7 days after treatment and until all sexual partners have been treated
ovarian phases
follicular, luteal
vaginal candidasis
fungal symptoms- pruritis, thick curdlike discharge diagnostics- - KOH exam reveals pseudohyphase - pH 4.0-4.7 treatment- - antifungal creams --- Miconazole --- Clotrimazole - Fluconazole
