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
