MS1 Exam Three > STDs > Flashcards

STDs Flashcards

(59 cards)

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1
Q

Taking care of a person with STDs will include…

A
  • taking a sexual history
  • inspection of the genitalia
  • admin of treatment and education about prevention of transmission
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2
Q

STD Incidence

A
  • at epidemic level

- youth between ages of 15-24 and minorities have the highest incidence

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3
Q

STD impact of women

A
  • STIs more easily transmitted from men to women (receiver of sexual fluid)
  • Women experience fewer early symptoms of STIs
  • At higher risk for PID genital cancers, and reproductive complications
  • Adolescent females have a more vulnerable cervix
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4
Q

Other vulnerable populations

A
  • infants
  • adolescents of both sexes
  • older adults
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5
Q

Risk factors for STDs

A
  • sexual partners and behaviors
  • age
  • substance use
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6
Q

Prevention and control

A
  • starts with screening
  • CDC recommended assessment
  • transmission of most STDs can be prevented by use of latex condoms
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7
Q

CDC recommended assessment

A

5 P’s:

  • Partners
  • Prevention of pregnancy
  • Protection from STIs
  • Practice
  • Past hx of STIs
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8
Q

Once infected, control strategies include…

A
  • avoid intercourse with infected partner
  • use protection, if having intercourse with infected partner
  • partner notification
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9
Q

Genital Herpes

A

(HSV)

-Caused by the herpes simplex viruses HSV-1 and HSV-2

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10
Q

Genital Herpes Pathophysiology

A

Gain entry via mucocutaneous surfaces.

Begins to multiply causing cell destruction and vesicle formation

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11
Q

Genital Herpes Manifestations

A
  • May have no symptoms
  • Painful red vesicles 2-14 days after exposure
  • Small, painful blisters filled with clear fluid
  • First outbreak average duration 10-20 days
  • Recurrent infections 4-5 days
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12
Q

Genital Herpes Diagnosis and treatment

A
  • Presumptive diagnosis

- No cure

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13
Q

Genital Herpes Pharmacologic Therapy

A

-Acyclovir (Zovirax)

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14
Q

Acyclovir (Zovirax)

A
  • antiviral
  • reduce the length and severity of each outbreak
  • treatment of choice for genital herpes
  • also used to suppress the virus, thereby decreasing the number of outbreaks
  • oral form is most effective for the first episode and recurrences and is given for 7-10 days or until lesions heal
  • can be given IV
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15
Q

Acyclovir (Zovirax) and HIV patients

A

evidence shows that some strains of HSV are becoming resistant to Acyclovir, particularly in HIV-positive patients.

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16
Q

Other antivirals used for treatment and suppression with Genital Herpes

A
  • Valacyclovir (Valtrex)

- Famciclovir (Famvir)

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17
Q

HPV

A

Human Papillomavirus

  • Genital warts
  • most common genital infection in US
  • women at greater risk
  • Majority of infected individuals asymptomatic
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18
Q

HPV Pathophysiology

A
  • HPV transmitted by vaginal, anal, oral-genital contact

- incubation period 2-3 months

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19
Q

HPV Manifestations

A
  • some exhibit none

- others exhibit genital warts

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20
Q

HPV Diagnosis and treatment

A
  • clinical appearance on physical examination
  • regular screening, Pap tests
  • identify precancerous lesions
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21
Q

HPV Pharmacologic therapies

A
  • no drug to cure virus itself
  • topical agents
  • Gardasil, Cervarix vaccinations
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22
Q

HPV Topical agents

A
  • Podofilox, imiquimod (client applied)

- Podophyllum, trichloroacetic acid (provider administered)

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23
Q

Chlamydia

A
  • most commonly reported bacterial STI

- asymptomatic in most women

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24
Q

Chlamydia risk factors

Study These Flashcards
A
  • any sexually active individuals, especially females 14-19
  • personal or partner hx
  • cervical ectopy
  • adolescent sexual activity
  • oral contraceptives
  • drug or alcohol use that increases risky sexual behavior
25
Chlamydia is the leading cause of...
preventable blindness -newborns
26
Chlamydia pathophysiology
- Chlamydia trachomatis - intracellular bacterium that resembles viruses in that it can reproduce only within a host cell - enters body as an elementary body, a form which it is capable of entering uninfected cells - infection begins when the organism enters a cell, becomes a parasite, and reproduces until the cell ruptures and about 1,000 new elemental bodies are disseminated to adjoining cells
27
Chlamydia Manidestations
- incubation period 1-3 weeks - may be present for months, years - still potentially infectious
28
Chlamydia complications
untreated: - PID - infertility - ectopic pregnancy
29
Chlamydia Diagnostic Tests
- gram stain of discharge - add nucleic acid hybridization test - NAATs diagnostic method of choice
30
Chlamydia Pharmacologic Therapy
- Azithromycin, doxycycline | - both partners treated
31
Gonorrhea
- caused by Neisseria gonorrhoeae - most common STI in the US - "GC" or "the clap"
32
Gonorrhea Pathophysiology
pyogenic bacteria that causes: * men: acute pain and inflammation of epididymis and periurethral glands * women: PID, endometritis, salpngitis, pelvic peritonitis
33
Gonorrhea Manisfestations
Men: dysuria, serous, milky, purulent penile discharge Women: dysuria, urinary frequency, abnormal menses. Increased vaginal discharge, dyspareunia - Anorectal gonorrhea: pruritus, mucopurulent discharge, bleeding, pain - Gonococcal pharyngitis
34
Gonorrhea Complications
- PID in women - newborn: blindness, infection of joints, potentially lethal - epididymitis, prostatitis in men resulting in infertility - spread of infection to blood, joints - increased susceptibility to, transmission of HIV
35
epididymitis
inflammation of the coiled tube (epididymis) at the back of the testicle that stores and carries sperm
36
Collaboration for Gonorrhea
- eradication of organism | - prevention of reinfection or transmission
37
Diagnostic Tests for Gonorrhea
- Cultures - Urinalysis - Gram stain - Tests for other STIs
38
Syphilis
- Complex systemic STI | - Treponema pallidum
39
Syphilis Pathophysiology
- break in skin, mucous membrane - spread through blood, lymphatic system - congenital syphilis
40
congenital syphilis
transferred to fetus through placental circulation
41
Syphilis Manifestations: Primary
- chancre, regional lymph node enlargement - 3 to 4 weeks after infectious contact - little or no pain - highly infectious
42
Syphilis Manifestations: Secondary
- 6 weeks after initial chancre - skin rash, mucous patches in oral cavity, sore throat - generalized lympadenopathy, condyloma lata
43
condyloma lata
flat, broad-based papules, unlike the pedunculated structure of genital warts
44
Syphilis Manifestations: Latent and tertiary
- 2 or more years after initial infection - sexual transmission is possible in latent syphilis - two types: benign late syphilis and diffuse inflammatory response
45
Syphilis Diagnosis and treatment
- Venereal Disease Research Laboratory (CDRL) | - FTA-ABS confirmatory
46
Venereal Disease Research Laboratory (VDRL) & RPR
blood tests that measure antibody production -rapid plasma reagin
47
FTA-ABS confirmatory
fluorescent treponema antibody absorption - specific for T. pallidum and can be used to confirm VDRL and RPR findings - used when clinical presenting syphilis, but negative VDRL
48
Pharmacologic Therapies for Syphilis
- PCN G | - IM in single dose: treatment may result in Jarisch-Herzheimer rxn
49
PID
- caused by untreated STD - serious condition - infection of a woman's reproductive organs - often complication of chlamydia and gonorrhea - no tests for PID, usually diagnosed based on medical hx, physical exam. - may not have symptoms - if you do, pain in lower abdomen, fever, unusual discharge with a bad odor from vagina, pain/bleeding during sex, burning when pee, bleeding between periods
50
Can PID be cured?
yes, if diagnosed early, it can be treated. won't undo any damage that has already happened to your reproductive system
51
What happens if PID is not treated?
- formation of scar tissue both outside and inside the fallopian tubes that can lead to tubal blockage - ectopic pregnancy - infertility - long term pelvic/abdominal pain
52
Nursing Process with STD
- Short and long term implications - Symptom relief - Treatment - Prevention of further transmission - Additional screening if condition is chronic
53
Nursing Assessment with STD
Focused interview: - Data collection: sexual practices, health hx, info about genital areas, reproduction, sexual activity - Physical assessment: reports of pain, discharge, inflammation
54
Nursing Diagnoses associated with STD
- acute pain - sexual dysfunction - deficient knowledge
55
Planning with STD
Patient: - describes strategies for reducing risk, - develops plan to communicate with sexual contacts, - abstains from sexual activity until STI resolved, -takes appropriate actions to avoid infecting others *Pain is controlled to a tolerable level
56
Implementation: Relieve Acute Pain
Relieve acute pain - oral analgesics - teach client to keep HSV blisters clean, dry - dysuria, suggest pouring water over genital while urinating - suggest use of sitz baths 15-30 minutes
57
Implementation: Sexual Dysfunction
- Provide supportive, nonjudgmental environment - discussion of feelings, asking questions - offer information, referrals
58
Implementation: Discuss Disease Management
- recognize prodromal symptoms of recurrence - need for abstinence (from prodromal symptoms until lesions healed) - use of topical acyclovir - use of latex condoms due to viral shedding at any time - need for handwashing - culture and sensitivity performed on infected lesions - need to discuss infection with partner
59
Evaluation
- client has resolution of STI - Client explains strategies to prevent infection of others - Client abstains from sexual activity until STI treated - Client describes barrier methods to reduce risk of contracting STI
MS1 Exam Three
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