Sexually transmitted infections (STIs)
After teaching a group of college-aged students about condom use, the nurse determines that additional teaching is needed when the students make which statement?
"It's okay to use petroleum jelly with a latex condom." If external lubricants are used, use only water-based lubricants with latex condoms. Oil-based or petroleum-based lubricants, such as body lotion, massage oil, or cooking oil, can weaken latex condoms. Latex condoms are the best protection from STIs. Condoms are applied before any genital contact because sperm is present in preejactulate fluid. Condoms also should be stored in a cool, dry place away from direct sunlight to prevent deterioration
A woman seen in the emergency walk-in clinic is diagnosed with chlamydia trachomatis. She asks the nurse how this disease is different from other sexually transmitted infectious diseases. What is the nurse's best response?
"This STI is characterized by an infection of your cervix." STIs like chlamydia result in a cervicitis that implies the presence of inflammation or infection of the cervix. It produces quantities of purulent discharge. Cervicitis is usually caused by gonorrhea or chlamydia. Chlamydia will not produce ulcers or warts and is not a STI that has itching associated with it.
At a sexual health workshop for older teenagers, the nurse discusses the human papillomavirus (HPV). Which statements made by the participants lead the nurse to believe teaching was successful? Select all that apply.
"Women between the ages of 13 and 26 can receive the vaccination series." Correctoption"The HPV vaccine can be given to girls and boys as young as 9 years old." Correctoption"By getting the HPV vaccine, this infection can be prevented." Correctoption"The HPV vaccines will help prevent cervical cancer."
Preventing Vaginitis
*Avoid douching to prevent altering the vaginal environment *Use condoms to avoid spreading the organism *Avoid tight, nylon underpants, and tight clothes *Wipe from front to back after using the toilet *Avoid powders, bubble baths, and perfumed vaginal sprays *Wear clean cotton underpants *Change out of wet bathing suits as soon as possible *Become familiar with the signs and symptoms of vaginitis *Choose to lead a healthy lifestyle
If fluconazole is prescribed, a
150-mg oral tablet is taken as a single dose.
Secondary syphilis appears
2 to 6 months after the initial exposure and is manifested by flu-like symptoms and a maculopapular rash of the trunk, palms, and soles.Alopecia and adenopathy are both common during this stage
Assess the client for clinical manifestations of trichomoniasis, which include:
A heavy yellow/green or gray frothy or bubbly discharge Vaginal pruritus and vulvar soreness Dyspareunia(r painful intercourse) Cervix may bleed on contact Dysuria Vaginal odor, described as foul Vaginal or vulvar erythema Petechiae on the cervix
What is the common treatment for trichomoniasis?
A single 2-g dose of oral metronidazole or tinidazole for both partners is a common treatment for this infection. Sex partners of women with trichomoniasis should be treated to avoid recurrence of infection.
support a diagnosis of PID are
Abnormal cervical or vaginal mucopurulent discharge Oral temperature above 101° F Cervical motion tenderness Elevated erythrocyte sedimentation rate (inflammatory process) Elevated C-reactive protein level (inflammatory process) N. gonorrhoeae or C. trachomatis infection documented (causative bacterial organism) White blood cells on saline vaginal smear Prolonged or increased menstrual bleeding Dysmenorrhea Dysuria Painful sexual intercourse Nausea Vomiting
risk factors for PID, which may include:
Adolescence or young adulthood Non-White female Having multiple sex partners Early onset of sexual activity History of PID or STI Sexual intercourse at an early age Alcohol or drug use Having intercourse with a partner who has untreated urethritis Recent insertion of an intrauterine contraceptive (IUC) Nulliparity Cigarette smoking Recent termination of pregnancy Lack of consistent condom use Lack of contraceptive use Douching Prostitution
Syphilis STAGE 2
After the initial sores heal, a rash presents, then the infection hides with no signs/symptoms
Chlamydia Risk Factors
Age less than 25 years Recent change in sexual partner or multiple sexual partners Poor socioeconomic conditions Exchange of sex for money Nonwhite race Single status Lack of use of barrier contraception.
Chlamydia highest rates of infection are
Among those aged 15 to 19 years It is estimated that one in 20 sexually active young women aged 14 to 24 years has chlamydia
CDC guidelines for chlamydia management
Annual screening for sexually active women, screening of all high-risk individuals, and treatment with antibiotics effective against both gonorrhea and chlamydia for anyone diagnosed with a gonococcal infection. Test-of-cure is not recommended for women treated with the recommended or alternative regimens, except in pregnant women or when therapeutic compliance is in question, symptoms persist, or reinfection is suspected. Testing for sexually transmitted infections (STIs) is important during pregnancy to prevent serious complications for both the mother and baby. In the case of chlamydia and gonorrhea, the Centers for Disease Control and Prevention (CDC) recommends that pregnant women be tested at their first prenatal visit, and if positive, treated with antibiotics. The CDC also recommends retesting 3-4 weeks after completing treatment to confirm that the infection has been successfully treated. However, the CDC guidelines state that test-of-cure (retesting after treatment) is not routinely recommended for women who are not pregnant and have been treated for chlamydia or gonorrhea, as long as they completed the recommended or alternative treatment and do not have any symptoms or signs of reinfection. The reason for this is that the tests used to detect chlamydia and gonorrhea can remain positive for several weeks after treatment, even if the infection has been successfully treated. Retesting too soon after treatment may yield a false positive result, which can cause unnecessary worry and additional testing. For pregnant women, test-of-cure is recommended because untreated or inadequately treated STIs can have serious consequences for both the mother and the baby, including preterm labor, low birth weight, and potentially life-threatening infections in the baby.
What is the therapeutic management of Chlamydia trachomatis?
Antibiotics are the only treatment currently available, with doxycycline 100 mg orally twice a day for 7 days or azithromycin 1 g orally in a single dose being the CDC recommended treatment options. Combination regimen of ceftriaxone with doxycycline or azithromycin is also prescribed frequently because of the common coinfection of chlamydia and gonorrhea. instruct patient to abstain from sexual intercourse for 7 days after treatment and until all sexual partners have completed a full course of treatment advise patient to return if symptoms persist or recur
Syphilis
Bacterial infection commonly spread by sexual contact & during pregnancy can cross the placenta which can harm or kill the baby.
PID treatment
Broad-spectrum antibiotic therapy is generally required A parenteral cephalosporin in a single injection with doxycycline 100 mg twice a day for 14 days is the current CDC recommendation PID in pregnancy is uncommon, but a combination of cefotaxime, azithromycin, and metronidazole for 14 days may be used
A community health nurse is conducting a class on sexually transmitted infections (STIs). She states that "STIs are discriminatory." What would the nurse most likely use to support this statement?
Certain infections can be transmitted to the newborn." After only a single exposure, women are twice as likely as men to acquire STIs." "Women are diagnosed with two thirds of the new cases of STIs annually." STIs are biologically sexist, presenting greater risk and causing more complications among women than among men. Women are diagnosed with two thirds of the new cases of STIs annually in the United States. After only a single exposure, women are twice as likely as men to acquire infections from pathogens. Certain infections can be transmitted in utero to the fetus or during childbirth to the newborn.
Diagnostic methods for Chlamydia Why is it important to screen for asymptomatic women?
Chlamydia can be diagnosed through urine testing or swab specimens from the vagina or cervix. Tests such as culture, direct immunofluorescence, enzyme immunoassay, and nucleic acid amplification are highly sensitive and specific. The chain reaction tests are the most sensitive and cost-effective. The CDC recommends screening of asymptomatic women at high risk to detect infection that would otherwise go undetected.
What is the bacterium that causes chlamydia and what are its characteristics
Chlamydia trachomatis is the bacterium that causes chlamydia. It is an intracellular parasite that depends on the host for survival and cannot produce its own energy. It is difficult to detect and untreated infections can pose long-term consequences for women and provide more opportunity for the infection to be transmitted to sexual partners. Newborns delivered to infected mothers may develop conjunctivitis*(Ophthalmia neonatorum is an acute mucopurulent conjunctivitis), which occurs in 25% to 50% of all newborn
At a health education class for teenagers, the nurse discusses the sexually transmitted infection chlamydia trachomatis. Which information would the nurse most likely include?
Correct optionThis infection is the most common infectious cause of infertility. The young have the most to lose from acquiring STIs, since they may not reach their full reproductive potential. In women, chlamydia is linked with cervicitis, salpingitis, ectopic pregnancy, pelvic inflammatory disease, and infertility. It is likely the most common infectious cause of infertility in women. Recombinant human papillomavirus vaccine is for the HPV STI. Antibiotics will cure this STI only.
A pregnant woman recently diagnosed with the genital herpes virus asks the nurse for more information on the virus. Which responses by the nurse would be appropriate? Select all that apply
Correctoption"Transmission is through contact of infected mucous membranes." Correctoption"Infections may be transmitted by individuals unaware that they have it." Correctoption"The virus remains quiet until a stressful event occurs to reactivate it."
Which medications are appropriate to treat vaginal candidiasis? Select all that apply.
Correctoptionmiconazole Correctoptionfluconazole Therapeutic management for vaginal candidiasis includes miconazole, clotrimazole, terconazole, and fluconazole. The other choices are antibiotics and are not effective treatment for a fungal infection such as vaginal candidiasis.
Syphilis STAGE 3
DEADLY damage to the brain, nerves, eyes, or heart
: Syphilis diagnosis for early stages
Dark-field microscopic examinations and direct fluorescent antibody tests of lesion exudate or tissue are the definitive methods for diagnosing early syphilis.
Why is dual therapy recommended for gonorrhea treatment?
Dual therapy is recommended for gonorrhea treatment to prevent drug resistance and to ensure effectiveness against chlamydia, which is commonly present with gonorrhea.
Syphilis How is it transmitted?
During sexual activity through minute breaks in the skin or mucous membranes
What is the recommended prophylactic agent to prevent gonococcal ophthalmia neonatorum?
Erythromycin or tetracycline ophthalmic ointment in a single application is recommended as a prophylactic agent to prevent gonococcal ophthalmia neonatorum.
What makes female adolescents more susceptible to STIs?
Female adolescents are more susceptible to STIs due to their anatomy. During adolescence and young adulthood, women's columnar epithelial cells are especially sensitive to invasion by sexually transmitted organisms, such as chlamydia and gonococci, because they extend out over the vaginal surface of the cervix, where they are unprotected by cervical mucus; these cells recede to a more protected location as women age.
Gardnerella vaginalis
Gardnerella vaginalis is the specific type of bacteria strain that causes a vaginal infection on the female genital tract, called bacterial vaginosis or simply, BV.
A newborn is diagnosed with ophthalmia neonatorum. The nurse understands that this newborn was exposed to which infection?
Gonorrhea can be transmitted to the newborn in the form of ophthalmia neonatorum during birth by direct contact with gonococcal organisms in the cervix. The newborn would develop congenital syphilis if exposed in utero. Exposure to Candida would cause thrush in the newborn. Exposure to HIV during gestation could lead to the birth of an HIV-positive newborn
What can happen if a gonorrhea infection is left untreated?
If left untreated, a local gonorrhea infection can spread upward through the endocervical canal to the endometrium of the uterus, further on to the fallopian tubes, and out into the peritoneal cavity, leading to a condition known as PID. The scarring to the fallopian tubes is permanent and can cause infertility and be a contributing factor in ectopic pregnancy.
Assess the client for clinical manifestations of chlamydia. The majority of women (70% to 80%) are asymptomatic (CDC, 2019d). If the client is symptomatic, clinical manifestations include:
Mucopurulent vaginal discharge Urethritis Bartholinitis Endometritis Salpingitis Dysfunctional uterine bleeding
Is follow-up testing to document eradication of gonorrhea recommended?
No, with use of recommended treatment, follow-up testing to document eradication of gonorrhea is no longer recommended. Instead, rescreening in 2 to 3 months to identify reinfection is suggested
A pregnant client has been prescribed a quinolone medication to treat gonorrhea. What is most important for the nurse to do before administering the medication?
Notify the health care provider Although quinolone drugs are very effective in the treatment of gonorrhea, their effect on the fetus has not been totally proven. It has been believed quinolones cause fetal malformations, especially if taken in the first trimester. Therefore, it is advised quinolones not be taken in pregnancy. When the nurse receives this prescription the health care provider must be notified. There may be a reason for the medication unknown to the nurse or there could simply be a mistake in realizing the client is pregnant. The health care worker should prescribe knowing all the facts and weigh risks versus benefits. Allergies, teaching and retesting instructions should all be done, but alerting the health care provider would be the first action.
P-LI-SS-IT Model
P - Permission—gives the woman permission to talk about her experience LI - Limited Information—information given to the woman about STIs Factual information to dispel myths about STIs Specific measures to prevent transmission Ways to reveal information to her partners Physical consequences if the infections are untreated SS - Specific Suggestions—an attempt to help women change their behavior to prevent recurrence and prevent further transmission of the STI IT - Intensive Therapy—involves referring the woman or couple for appropriate treatment elsewhere based on their life circumstances
Gonorrhea increases the risk for
PID, infertility, ectopic pregnancy, and HIV acquisition and transmission it is now capable of developing resistance to multiple antibiotic classes.
Syphilis STAGE 1
Painless sores on the genitals, rectum, or mouth
PID cause
Pelvic Inflammatory Disease Gonorrhea & Chlamydia if go untreated it can cause infertility causative organism reach the pelvic organs through the cervix in an ascending manner
Teach preventive measures to women with frequent VVC infections, including:
Reduce dietary intake of simple sugars and soda. Wear white, 100% cotton underpants. Avoid wearing tight pants or exercise clothes with spandex. Shower rather than taking tub baths. Wash with a mild, unscented soap and dry the genitals gently. Avoid the use of bubble baths or scented bath products. Wash underwear in unscented laundry detergent and hot water. Dry underwear in a hot dryer to kill the yeast that clings to the fabric. Remove wet bathing suits promptly. Practice good body hygiene. Avoid vaginal sprays/deodorants. Avoid wearing pantyhose (or cut out the crotch to allow air circulation). Use white, unscented toilet paper and wipe from front to back. Avoid douching (which washes away protective vaginal mucus). Avoid the use of super-absorbent tampons (use pads instead).
Are STIs more common among women or men?
STIs are biologically sexist, presenting greater risk and causing more complications among women than among men. Women are diagnosed with two thirds of the estimated 20 million new cases of STIs annually in the United States.
What are the potential health complications associated with STIs?
STIs may contribute to cervical cancer, infertility, ectopic pregnancy, chronic pelvic pain, and death. Certain infections can be transmitted in utero to the fetus or during childbirth to the newborn
What are some safer-sex practices that can reduce the risk of STIs?
Safer-sex practices that include limiting the number of sexual partners and using latex condoms during sexual activity must be recommended to all sexually active individuals.
What are the common medications used for the treatment of vaginal candidiasis?
The common medications used for the treatment of vaginal candidiasis include Miconazole cream or suppository, Clotrimazole tablet or cream, Terconazole cream or intravaginal suppository, and Fluconazole oral tablet. Most of these medications are used intravaginally in the form of a cream, tablet, or suppositories for 3 to 7 days
What are the typical findings for the diagnosis of trichomoniasis?
The diagnosis is confirmed when a motile flagellated trichomonad is visualized under the microscope. In addition, a vaginal pH of greater than 4.5 is a typical finding. FDA-cleared tests for trichomoniasis in women include OSOM Trichomonas Rapid Test (Genzyme Diagnostics, Cambridge, Massachusetts), an immunochromatographic capillary flow dipstick technology, and the Affirm VP III (Becton Dickenson, San Jose, California), a nucleic acid probe test that evaluates for T. vaginalis, Gardnerella vaginalis, and Candida albicans. Each of these tests, which are performed on vaginal secretions, have a sensitivity of 83% and a specificity of 97%. Both tests are considered point-of-care diagnostics
What is the new drug that shows promise in the treatment of gonorrhea?
The new drug that shows promise in the treatment of gonorrhea is zoliflodacin, which is currently under development.
What is the preferred drug for all stages of syphilis and what is the recommended dosage for pregnant or nonpregnant women with syphilis of less than 1 year's duration?
The preferred drug for all stages of syphilis is benzathine penicillin G, and the recommended dosage for pregnant or nonpregnant women with syphilis of less than 1 year's duration is 2.4 million units of benzathine penicillin G intramuscularly in a single dose once a week for 3 weeks.Other medications, such as doxycycline, are available if the client is allergic to penicillin.( no pegrentperson)
What are the primary symptoms of bacterial vaginosis?
The primary symptoms of bacterial vaginosis are a thin, white homogeneous vaginal discharge and a characteristic "stale fish" odor.
To diagnose bacterial vaginosis, three of the four criteria must be met:
Thin, white homogeneous vaginal discharge Vaginal pH 4.5 Positive "whiff test" (secretion is mixed with a drop of 10% potassium hydroxide on a slide, producing a characteristic stale fishy odor) The presence of clue cells on wet-mount examination (
What is Trichomoniasis and how is it transmitted?
Trichomoniasis is a common vaginal infection caused by a protozoan parasite, Trichomonas vaginalis, that can increase the risk of HIV transmission. It can be observed under the microscope making a jerky swaying motion. The parasite is transferred from an infected person to an uninfected person during sexual contact.
What is trichomoniasis?
Trichomoniasis is a common vaginal infection caused by the protozoan parasite Trichomonas vaginalis. It is the most prevalent nonviral STI in the United States and affects both men and women. Women may experience vulvar itching and a malodorous, foamy vaginal discharge. Men are typically asymptomatic carriers. Trichomoniasis is not always sexually transmitted and can be contracted from damp/wet surfaces, poorly cleaned/maintained hot tubs and drains.
Topical azole preparations are effective in the treatment of
VC(Vaginal Candidiasis), relieving symptoms and producing negative cultures in 80% to 90% of women who complete therapy
What is vaginal candidiasis and how common is it in women?
Vaginal candidiasis, also known as yeast or fungal infection, is one of the most common causes of vaginal discharge. It is not considered an STI as Candida is a normal constituent in the vagina and becomes pathologic only when the vaginal environment becomes altered. An estimated 75% of women will have at least one episode of candidiasis, and 40% to 50% will have two or more episodes in their lifetime.
Who is more susceptible to the complications caused by STIs, men or women?
Women are more susceptible to the complications caused by STIs. They are diagnosed with two thirds of the estimated 20 million new cases of STIs annually in the United States. After only a single exposure, women are twice as likely as men to acquire infections from pathogens causing gonorrhea, chlamydia infection, hepatitis B, HPV, and syphilis
What is the recommended follow-up for women after treatment for primary or secondary syphilis?
Women should be re-evaluated at 6 and 12 months after treatment with additional serologic testing.
latency period of syphilis
absence of any clinical manifestations of disease, although the serology is positive. stage can last as long as 20 years If not treated, tertiary or late syphilis occurs, with life-threatening heart disease and neurologic disease that slowly destroys the heart, eyes, brain, central nervous system, and skin.
For teens who have already had sexual intercourse, the clinician can encourage
abstinence at this point.
A nurse is engaged in primary prevention activities for human papillomavirus (HPV). The nurse would be most likely involved with which activity
administering HPV vaccine
Doxycycline(Vibramycin) alerts
avoid unnecessary exposure to sunlight do not take with antacids, iron or dairy products pregnant women should not take doxycycline(acg test before taking)
The nurse is preparing to administer medication therapy to a woman diagnosed with syphilis. The nurse would expect to administer:
azithromycin Single-dose therapy is preferred for ease of use of azithromycin (Zithromax, Z-Pak) 1 g orally once; ceftriaxone (Rocephin) 250 mg IM once; ciprofloxacin (Cipro) 500 mg orally twice a day for 3 days; or erythromycin base 500 mg orally three times a day for 7 days. Penicillin G benzathine 2.4 million units IM weekly for 3 weeks can also be used for treatment, but client adherence can be challenging. Miconazole is used to treat candidiasis. Metronidazole is used to treat trichomoniasis. Doxycycline is used to treat chlamydia.
A nurse educator is teaching a client about sexually transmitted infections. The client would learn that which medications are appropriate to treat chlamydia? Select all that apply.
azithromycin ceftriaxone doxycycline Antibiotics are usually used in treating this STI. The CDC treatment options for chlamydia include doxycycline or azithromycin. Because of the common co-infection of chlamydia and gonorrhea, a combination regimen of ceftriaxone with doxycycline or azithromycin is prescribed frequently
the first-line drug for all stages of syphilis
benzathine penicillin given intramuscularly
Hepatitis B Fetal Effects
can become chronic carrier of hepatitis B which may lead to liver cancer or cirrhosis May cause preterm birth; can be transmitted to fetus if active in last trimester
Chlamydia symptoms
cervicitis mucopurulent discharge with mucus with pus, bleeding, dysuria and pain with intercourse acute urethral syndrome, salpingitis, ectopic pregnancy, PID, and infertility
Primary syphilis is characterized by a
chancre (painless ulcer) at the site of bacterial entry that will disappear within 1 to 6 weeks without intervention
A woman seen in the emergency department is diagnosed with primary syphilis. What finding is most likely?
chancres at the vaginal site Syphilis is divided into four stages: primary, secondary, latency, and tertiary. Primary syphilis is characterized by a chancre at the site of bacterial entry. Foul-smelling discharge would not be noted. Vesicles on the labia are not associated with syphilis. Bleeding from the vagina could be normal menses and does not correlate with syphilis.
In pregnant women, gonorrhea is associated with
chorioamnionitis, premature labor, PROM, and postpartum endometritis It can also be transmitted to the newborn in the form of ophthalmia neonatorum during birth by direct contact with gonococcal organisms in the cervix. Ophthalmia neonatorum is highly contagious and if untreated leads to blindness, joint infection, or a life-threatening blood infection in the newborn.
If adolescents are sexually active, they should be directed to teen clinics where
contraceptive options can be explained. In areas where specialized teen clinics are not available, nurses should feel comfortable discussing sexuality, safety, and contraception with teens.
Which medications are appropriate to treat chlamydia trachomatis? Select all that apply.
doxycycline azithromycin ofloxacin
What is the most common early symptom of a sexually transmitted infection?
dysuria
When developing a program for STI prevention, which action would need to be done first?
educating on how to promote sexual health
STIs are responsible for genital tract infections that may lead to later complications in women such as
elvic inflammatory disease (PID) or infertility also cause chronic liver diseases and cancer due to hepatitis B virus (HBV) and hepatitis C virus (HCV) infections: genital cancer associated with HPV, and AIDS caused by HIV
PID s/s
fever pelvic pain painful intercourse
secondary syphilis may present with symptoms of
fever, pharyngitis, weight loss, and fatigue The secondary stage of syphilis lasts about 2 year
A young woman comes to the walk-in clinic seeking treatment for chronic chlamydia trachomatis. Which finding is most likely because it often correlates with this diagnosis?
gonorrhea There is a common co-infection of chlamydia and gonorrhea when chlamydia is not treated with the necessary antibiotic medication combination. Anemia does not correlate with chlamydia, and there is no evidence that it precipitates liver disease. CNS disorders would be from syphilis
HPV
human papillomavirus most common with Worts and cervical cancer s/s asymptotic
PID complications
infertility, ectopic pregnancy, chronic pelvic pain
If gonorrhea remains untreated, it can enter the bloodstream and produce a disseminated gonococcal infection. This severe form of infection can invade the
joints (arthritis), the heart (endocarditis), the brain (meningitis), and the liver (toxic hepatitis)
A male client appears in the walk-in clinic and requests treatment for trichomoniasis as his girlfriend was recently diagnosed with it. What medication would the health care provider most likely prescribe?
metronidazole Trichomoniasis is a common vaginal infection with the therapeutic management of metronidazole or tinidazole for both partners. Trichomoniasis is a common, curable sexually transmitted infection (STI) caused by a parasitic protozoa called Trichomonas.
Bacterial Vaginosis risk factors
new or multiple sex partners vaginal irrigation (douche) antimicrobial use vRisk factors oMultiple sex partners oDouching oLack of vaginal lactobacilli-Encourage pt to take probiotics
PID risk factors
non-white, non asian multiple partners douching prior PID smoking sexual intercourse with multiple partners unprotected sex(no condom history of sti (chlamydia and gonorrhea ) recent pelvic surgery/ abortion placement of Iud within 3 weeks
vNursing management PID
oHydration oAnalgesics oEducation to prevent recurrence (see Teaching Guidelines 5.4) oRisk assessment oSexual counseling emi-Fowler positioning facilitates pelvic drainage.
Encourage adolescents to postpone initiation of sexual intercourse for as long as possible, but if they choose to have sexual intercourse, explain the necessity
of using barrier methods, such as male and female condoms
If VVC is not treated effectively during pregnancy, the newborn can develop an
oral infection known as thrush during the birth process; that infection must be treated with a local azole preparation after birth.
Ectoparasitic Infections
pubic lice and scabies permethrin cream or lindane shampoo; decontamination of bedding and clothing; treatment of family members and sexual partners vThree-tiered approach: eradicate infestation, remove nits, prevent spread or recurrence
What is the recommended treatment for pregnant women with a positive test for gonorrhea
regnant women with a positive test for gonorrhea should be treated with the same recommended dual therapy of ceftriaxone with either azithromycin or amoxicillin and should never take should not be treated with quinolones or tetracyclines
curable stis are
syphilis, gonorrhea, chlamydia, and trichomoniasis
The CDC recommends screening for all women at risk for gonorrhea. Pregnant women should be screened at the
the first prenatal visit and again at 36 weeks' gestation Nucleic acid hybridization tests (GenProbe) are used for diagnosis. Any woman suspected of having gonorrhea should be tested for chlamydia also because coinfection (45%) is extremely common
The primary, secondary, and early latent stages are considered
the most infectious: the estimated risk of per person transmission is 60%
What is the recommended treatment for uncomplicated gonorrheal infections according to CDC?
the recommended treatment for uncomplicated gonorrheal infections according to CDC is dual therapy, which involves using two drugs: azithromycin 1 g orally in a single dose and ceftriaxone 250 mg intramuscular (IM) in a single dose.
The nurse is assessing a 15-year-old female who reports extreme itching in the genital area, dysuria, and foul-smelling, yellow, foamy, vaginal discharge. What would most likely be responsible for these symptoms?
trichomoniasis
Hepatitis A and B
vHepatitis A spreads via GI tract vHepatitis B via saliva, blood, semen, menstrual blood, and vaginal secretions vTherapeutic management: prevention through immunization vNursing assessment: hepatitis A manifestations; hepatitis B manifestations vNursing management: screening, vaccination
STIs
vMore than 30 different bacteria, viruses, and parasites are known to be transmitted through sexual contact. Eight of these pathogens are linked to the greatest incidence of sexually transmitted disease.
HPV education
vaccination age 9-26 annual pap test skin to skin contact reduce condoms do not protect 100 transmits even when asymptomatic
Incurable STI's are
viral infections which are incurable: hepatitis B, herpes simplex virus (HSV or herpes), HIV, and human papillomavirus (HPV).
A woman comes to the clinic reporting intense pruritus and a thick curd-like vaginal discharge. On examination, white plaques on observed on the vaginal wall. The nurse suspects which condition?
vulvovaginal candidiasis
When teaching a woman diagnosed with genital herpes lesions, the nurse would include which measure?
washing hands with soap and water after touching lesions
What is the recommended follow-up for women with latent syphilis?
women with latent syphilis should be followed clinically and serologically at 6, 12, and 24 months and also tested for HIV.
Preventing Pelvic Inflammatory Disease
• Advise sexually active girls and women to insist their partners use condoms. • Discourage routine vaginal douching, as this may lead to bacterial overgrowth. • Encourage regular STI screening. • Emphasize the importance of having each sexual partner receive antibiotic treatment.
Syphilis Screening During Pregnancy
• First prenatal visit • 3rd trimester • Delivery (if high risk) • Penicillin (only prenatal treatment) if client allergic to Assess: which type of allergic reaction Intervention: penicillin desensitization if doesnt want to take About the potential death or harm to the fetus if Penicillin is NOT taken
Selected Nursing Strategies to Prevent the Spread of STIs
• Provide basic information about STI transmission. • Outline safer-sexual behaviors for people at risk for STIs. • Refer clients to appropriate community resources to reduce risk. • Screen asymptomatic persons with STIs. • Identify barriers to STI testing and remove them. • Offer pre-exposure immunizations for vaccine-preventable STIs. • Respond honestly about testing results and options available. • Counsel and treat sexual partners of persons with STIs. • Educate school administrators, parents, and teens about STIs. • Support youth development activities to reduce sexual risk-taking. • Promote the use of barrier methods (condoms, diaphragms) to prevent the spread of STIs. • Assist clients to gain skills in negotiating safer sex. • Discuss reducing the number of sexual partners to reduce risk.