Module III-STD

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Module III-STD
2011-10-31 14:02:03
STD candida vaginitis syphillis gonorrhea chlamydia genital herpes hpv

nursing care for std's
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  1. General infor for STD's
    • There is no immunity
    • Self treatment is dangerous and usually ineffective
    • Be responsible for insuring that all sexual partners receive exam
    • Social stigma-client may feel guilty/marital problems
    • Abstinence is the only proven method of preventing the spread of STD's
  2. Candida Vaginitis
    • Yeast infection
    • Common after taking antibiotics
  3. S/S of candida vaginitis
    • Vaginal itching
    • Burning
    • Rash
  4. Contributing factors of candida vaginitis
    • Vaginal douches
    • Bubble baths
    • Perfumes
    • Increased perspiration
  5. Syphilis, organism & transmission mode
    • Third most reportable STD in US
    • Bacterial, can be cured
    • Dies quickly out of body

    • Organism-Spirochete (Treponema pallidum)
    • Transmission-enters the bloodstream and infects the whole body
  6. Days of incubation for syphilis
    10-90 days
  7. Complications that can cause a false positive reaction of Syphilis
    • Lupus Erythematosus (LE)
    • Rheumatoid Arthritis (RA)
    • Infectious mono
  8. Name of test for syphilis
    RPR (Rapid Plasma Reagin)
  9. Stages of syphilis
    • Primary
    • Secondary
    • Latent
    • Tertiary
  10. Preferred method of treatment for syphilis
  11. MHA-TP (Microhemmagglutination Assay-Treponema pallidum
    • Most specific and sensitive test for latent stage of syphilis
    • Remains positive after appropriate treatment
    • Performed on spinal fluid and confirms onset of neurosyphilis
    • Rash develops on palms and soles of feet, which are also contagious
  12. Symptoms of the primary stage of syphilis
    • Chancre sore at the site of initial contact
    • Disappears in about 2-8 weeks but spreads throughout the body if not treated
    • Painless papule
    • Shallow, non-tender endurated module
  13. Symptoms of secondary stage of syphilis
    • Develops from 6 wks to 6 months after primary
    • Experience malaise, low-grade fever, headache, muscular aches, "flu" like symptoms
  14. Latent stage of syphilis
    • Can last years
    • Skin lesions disappear
    • No clinical manifestations
    • Still contagious
  15. How long can a latent stage of syphilis last?
    Up to 20 years
  16. Tertiary stage of syphilis
    • May proceed immediately or after delay of 10-30 years
    • Usually not infectious during this stage
  17. Late complications of tertiary stage of syphilis
    • Insanity
    • Blindness
    • Deafness
    • Heart Disease
    • Ulcerous Tumors (gummas)
    • Destructive leasions of bones
    • Seizures
    • Coma
    • Death
  18. Nursing actions for patients with syphilis
    • Universal precautions (gloves, hand washing)
    • Skin lesions of primary and secondary may be highly infective
    • Test for additional STI's
    • Recommend notification/tx of all partners
    • Large condylomas may need to be removed
  19. Gonorrhea
    • Also called the clap
    • 2nd most reportable STD in the US
    • Bacterial infection
    • Usually found with Chlamydia
    • Primarily an infection of the genital or rectal mucosa commonly resulting in cervicitis and urethritis
  20. Transmission of Gonorrhea
    • Sexual intercourse or infected birth canal
    • Unable to contract through inanimate objects
  21. Organism of Gonorrhea
    Neisseria gonorrhea
  22. S/S of Gonorrhea
    • Men: Dysuria, penile discharge
    • Women: Change in vaginal discharge, urinary frequency, dysuria and later PID (Pelvic Inflammatory Disease)
  23. When do symptoms develops for Gonorrhea & Clamydia
    3-5 days after intercourse with infected person
  24. Diagnostic tests for Gonorrhea & Chlamydia
    • Males: Smears taken with a sterile smooth loop then usually a Gram stain is performed
    • Females: Tissue cultures are collected from either the vaginal or cervical exudate
  25. Treatments for Gonorrhea
    • Ceftriaxone
    • Doxycyclin
  26. Treatments for Chlamydia
    • Doxycycline
    • Tetracycline
    • Azithromycin
  27. Systemic infections that can occur from Gonorrhea
    • Tonsillitis
    • Pharyngitis
    • Conjunctivitis
    • Rectal inflammation with bloody mucous discharge
  28. Chlamydia
    Most preventable STD in the US
  29. Organism of Chlamydia
    Chlamydia trachomatis
  30. Chlamydia is transmitted through
    sexual intercourse & bodily fluids including tears
  31. Incubation time of Chlamydia
    1-3 weeks
  32. Newborn complications of Chlamydia
    • Ophthalamia neonatorum
    • Pneumonia
    • Otitis media
    • URI
  33. Female complications of Chlamydia
    • PID
    • Tubal scarring
    • Ectopic pregnancy
    • Infertility
  34. Genital Herpes
    • Viral infection - can't be cured
    • Can become latent
    • Produces persistent infections
    • Multiple PAINFUL lesions
  35. Organism for Herpes
    Herpes Simplex 1 and 2
  36. Incubation time for herpes
    2-20 days
  37. HSV-1 virus
    • Oral cavity
    • Cold sores
    • Fever blisters
    • Skin lesions above the waist
  38. HSV-2 virus
    • Genital area
    • Herpes labialis
    • Neonatal
    • Skin lesions below the waist
  39. Symptoms of active herpes virus
    Tingling sensation 1-2 days before the vesicle develops
  40. Course of herpes virus
    • Lesions resolve within 2-6 weeks
    • Virus remains dormant in the nerve ganglia
  41. Treatments for herpes
    • Keep lesions dry and clean
    • Acyclovir (Zovirax): antiviral drug to accelerate healing
    • More effective when taken orally
    • Safe to take during pregnancy
  42. Complications of herpes
    • Risk for deveolping cervical cancer
    • Neonatal transmission
    • Increased risk of HIV
  43. Care of patient with herpes virus
    Contact isolation if lesions are present
  44. HPV
    How many types, how many w/genital warts
    How many oncogenic
    How many can be carried at once
    • Human Papilloma Virus - primary cause of cervical cancer
    • Over 30 types
    • 5 types
    • 8 types
    • Can carry several types at once
  45. How is HPV detected
    PAP smear
  46. Symptoms of HPV
    • Small warty growths (Condylomas) on the vulva, labia, vaginal wall or rectum
    • Itching, bleed easily, or pain dependent on location
  47. Treatments for HPV
    • Cryotherapy with liquid nitrogen
    • Topical podophyllin
    • Trichloracetic acid (TCA)
    • Bichloroacetic acid (BCA)
    • Laser surgery
    • Currettage
    • Shave excission
  48. Which HPV treatement can't be used during pregnancy and why?
    • Topical podophyllin
    • Causes teratogenic effects
  49. Prevention of HPV
    • Abstinance
    • Monogamous relationships
    • Vaccine
  50. Vaccine for HPV
    Gardisil - 3 dose vaccine - Males & females can be vaccinated
  51. Procedures to follow if + for HPV
    • Females: PAP smears every 6 months
    • Males: Growths removed to prevent re-infecting partners