Med Surge

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Author:
yagurl_dana
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24947
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Med Surge
Updated:
2010-06-27 19:50:50
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Sexually Transmitted Infections
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Chpter 56
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  1. What is Chlamydia?
    Most common and fastest-spreading bacterial STI in US

    Causes = microorganism is a bacterium, Chlamydia trachomatis. spread by sexual intercourse or genital contact w/out penetration. Usually causes PID in chicks and epididymis in dudes. Peeps w/ chlamydia r @ greater risk for AIDS. Untreated clap causes sterility in chicks, pregos can infect their babies, clap can spread 2 the eyes by autoinoculation by not washing your hands.

    Signs&Symptoms = 75% chicks & 25% dudes r asymptomatic. Symptoms usually occur 1 to 3wks after gettin that, includ sparse, clear urethral discharge, redness, and irritation of infected tissue, burning on urination, lower ABD pain in chicks, and testicular pain in men. test kit takes 15min, CDC says annual screening in sexually active women younger than 26 in chicks or w/ multiple sex partners 2 reduce the incidence in PID.

    Nursing does = sensitively gets sex hx, assists in collecting specimen 4 microscop analysis, explains course of tx, & methods of preventing spreading and reinfection
  2. What is Gonorrhea?
    second most frequently std in the US. usually in 15-24yr olds.

    Causes = bacterium Neisseria gonorrhoeae, spread by heterosexually, homosexually. Invades the urethra, vagina, rectum or pharynx. In untreated men it may spread 2 prostate, seminal vesicles, epididymitis, chicks usually get PID, gonorrhea increases peeps getting HIV, pregos can spread it 2 their baby's eyes @ birth.

    Signs & Symptoms = men usually 2 to 6 days after infection, get urethritis with purulent discharge and pain on urination. Small portion of men r asymptomatic and half of infected women experience no symptoms. But if chicks do they get white or yellow discharge, intermenstrual bleeding 2 cervitis, painful pissin. Anal infection (YUCK) is painful 2 drop @ duece and pus coming out the azz; throat is sore when pharynx is infected. If the microorganism scatters thru/out body some Gonorrheans (LMAO i just made that up....haa haa Gonorrheans..ok bck 2 bidness LMAO okkk k if it scatters may get rash, fever, & painful joints.

    DX & Medical tx = Specimens of drainage from infected tissue r looked @ under a microscope ASAP. TX usually with broad spectrums 4 7to 10 days cuz gonorrhea is gettin resistance 2 PCN, tetracyclines, & fluoroquinolones. Chicks w/ PID r usually hospitalized & tx w/ multiple IV drug therapy

    Nurses do = teaching is same as w/ clap but when a culture is collected from a chick the vaginal speculum is moistened w/ water instead of lube cuz it destroys the gonococci & causes inaccurate test results.
  3. What is Syphilis?
    a curable STI tht transmitted from blood of an infected person like from a lesion or placenta 2 unborn infant. Increase in US especially in chicks, newborns, African americans, dudes having sex w/ dudes.

    Causes = spirochete called (Treponema Pallidum) If untreated Has 3 stages primary, secondary, and tertiary. ONly infectious in primary and secondary stages. Teriary stage peeps usually r demented and die from complications of other organ systems.

    Signs&Symptoms = Usually occur about 21days, early stage a chanre (painless ulcer) appears on genitals, anus, cervix or other body parts, the chancre heals in several wks if untreated goes 2 second stage which include fever, malaise, rash, headache, sore throat, and lymph node enlargement. Late stage is noninfectious cuz its already in CNS as well as other organs of body but symptoms r tabes dorsalis (loss of peripheral reflexes) ataxia, neuropathic joint disease aka charcot's joints, cardiovascular complications liek aortic aneurysm and aortic valve insufficiency.

    DX & medical tx = scrapings of chancre r looked @ under a microscope by a VDRL test or rapid plasma reagin (RPA). Sometimes false + in peeps w/ systemic lupis erythematosus, connective tissue disease, rheumatoid arthritis. A single dose of PCN G 4 primary and secondary. Follow up/ exams and lab tests r recommended 3, 6, 12 months after initial tx. With tertiary may have 2 use 3 doses of PCN @ 1wk intervals 2 prevent complications. Response poor in peeps w/ cardiovascular syphilis.

    Nurse does= hx of sexual activity, allergies, prepares peeps 4 diagnostic lab tests, support peeps emotionally @ time dx is confirmed and informs peep about telling peeps they slept w/ cuz its part of deptment of public health safety 4 treatment.
  4. Herpes Infection
    is highly contangious STI tht is contrallable but not curable. inreases the risk of cervical CA & infection w/ HIV.

    Causes = HSV-2 aka genital herpes and HSV-1 cold sores Caused by direct contact w/ oral or genital secretions from active stage of HSV. Mother 2 infant during vaginal and carries neonatal mortality rate of 50%. Can infect the eyes, mouth, genital area or a skin site. HSV recurs cuz after inital infection virus remains dormant in ganglia of nerves

    Signs&Symptoms = sypmtoms more severe w/ inital outbreak then shorter & less intense w/ next outbreaks, stress, emotional situations, exposure 2 sunlight, menstruation, fever reactivate HSV. single or multiple vesicles on penis, prepuce, butt, thighs, introitus, or cervix. Lesions burn, itch and bcome fluid-filled blisters, may rupture in 1-3 days followed by painful reddened ulcers tht scab over and go away, swelling, ingunal lymph nodes & headache first outbreak 3-4wks then other 10days.

    Medications = Dx of HSV1 & HSV2 is by inspecting lesions, smears & scrapings from lesions are examined under microscope. Take oral antiviral meds

    Nurse does = Tell all sex partners u got it, use condom, avoid sex if HSV is active cuz condoms dont protect skin and mucous membrane left exposed, keep lesions dry w/ alcohol, peroxide, witch hazel, and warm air from hair dryer, chck w/ dr about taking warm baths w/ epsom salts or baking soda, wear loose clothing, perform good handwashing, Use separate towel 2 pat lesions dry & another when drying body parts, Have yrly papanicolaou test 2 detect cervical CA, avoid stress.
  5. Genital Warts?
    genital warts aka condylomata, are an STI tht tends 2 recur even after tx. peeps w/ aids &immunodeficiency r particularly susceptible. Untreated gentital warts may go away on their own, remain unchanged, or increase in size or number.

    Causes = HPV strains 6, 11, 16, 18, 31, 33, 35 cause genital warts. transmitted by genital 2 genital, genital 2 anal, or genital 2 oral contact w/ an infected person. virus contagious as long as warts r present.

    Signs&Symptoms = warts can grow in mouth and throat of infants infected @ birth. Warts r painless and appear as a single lesion or cluster of soft, fleshy growths on genitalia or cervix in the vagina, or perineum, anus, throat, or mouth. Look like cauliflower. Warts turn white when vinegar is applied 2 lesion.

    Medical tx = prescribe podofilox solution or gel for self application 3days followed by nontx for 4 days. Surgical excision w/scalpel or scissors, laser therapy, electrocautery(heat), cryotherapy (freezing) w/ liquid nitrogen, local applications of chemicals. If you get them removed doesn't mean your cured, just means your temporarily noncontagious once warts r destroyed.

    Nurse does= give info on spreading STIs to sexually active peeps and prepare them 4 medical examination, dx, and tx. Peeps w/ warts avoid intimate contact until warts are removed, tell all sex partner 2 get treated, get tx when warts return, Use condom even when warts are gone, avoid stress, and genital trauma, get yrly exams 2 prevent reproductive cancers
  6. What is Ganuloma Inguinale?
    aka donovanosis caused by calymatobacterium granulomatis

    Signs&Symptoms = lesions in gential, inguinal and anal areas

    Medical tx= antimicrobials, usually tetracycline or sulfisoxazole
  7. What is a chancroid/
    caused by haemophilus dureyi bacillus.

    Signs&symptoms= macule followed by vesicle-pustule formation and finally painful genital ulcer and enlarged tender lymph nodes in inguinal area

    Medical tx = azithromycin
  8. What is Lymphogranuloma venereum?
    caused by a strain of C trachomatis

    Signs&Symptoms = small erosion or papule and enlargement of lymph nodes. Affected lymph nodes can become necrotic usually in genital area

    TX = w/ doxycycline or erythromycin

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