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STD's
factors, etiology/patho, Nursing Interventions, Pt Education, trust
| Question | Answer |
|---|---|
| STD | are usually transmitted during intimate sexual contact, infected mother to newborn, may occur w/ or w/o symptoms with long periods of asymptomatic infectivity |
| incidence of STD | continues to increase worldwide, 2000 CDC reported 774,467 cumulative cases of AIDS in the US, HIV 800,000 to 900,000, Gonorrhea 3 million people worldwide, |
| Gonorrhea | most reported in US, 2 mil unreported cases occur each year, 20-24 yrs age, followed by 15-19 age, |
| what are risk factors for Gonorrhea | sexually active individuals, women who use birth control pills, and women who are otherwise susceptible to infections, theree times as many men are infected as women |
| Syphilis | 50,223 cases in US, 50 million cases worldwide, thrid most frequent reported communicable disease, problem with African Americans, |
| what is the age group with highest incidence of Syphilis | 20 to 40 yrs age |
| occurs primarily in who | young, heterosecual, minority populations of a low education and socioeconomic level, Incidence may be related to cocaine use and exchange of sex for drugs, especially crack cocaine |
| True of False, STD's such as tricomoniasis, heres simplex virus, veneral warts are probably even more prevalent | True |
| Chlamydial infections may be the most commonly ocurring STD in the US, why? | not a reportable disease, actual number of cases in unknow, estimated 3-4 mil Americans suffer it, primarily i young, promiscuous, indigent, unmarried women wholive in the inner city and in those who have a prior history of STDs |
| Factors that contribute to the spreas of STDs | Any sexually active person may bea at risk, unprotected sex, sexual behavior patterns and permissiveness, treatment delay, antibiotic resistance, , |
| what are patterns and permissiveness? | frequent sexual contact with multiple partners, multiple partners occur i young, single, urban, poor, male, and homosexuals, |
| Genital herpes patho | infectious viral disease caused by HSV, acute, painful, red perineal blisters, recurrent with no cure |
| Type 1 | infrequent recurrences of lesions around the lips |
| Type 2 | usually acquired sexually in the genital or anal regions |
| Assessment of clinical manifestations | Fluid vessicles on cervix, labia, rectum, vulva, vagina or skin of females, penis, foreskin shaft of men, lesions on mouth and anus, rupture/develop into painful ulcers, 3-10 dys of initial lesion, recurrent 7-10 days, lymph nodes may be involved, |
| a person with a primary Genital herpes infection may also complain of what? | fever, malaise, myalgia, dysuria, leukorrhea |
| DX of Genital herpes | physical exam, pt hx, tissue cultures |
| med mgm | lesions heal spontaneously unless secondary infection occurs, nursing interventions for symptomatic treatment, local anesthetic or systemic analgesics may be rx for pain, meds inhibit herpetic viral reprlication for primary, recurrent, and suppression |
| Acyclovir (Zovirax) | not a cure for HSV, shortens duration of viral shedding, suppresses 75%of recurrences with daily use. |
| S/E of Acyclovir | Safety of systemic acyclovir use during pregnanc6y has not been established, ointment appears to be of no clinical benefit in the treatment of recurrent leasions, therefor, it is not commonly recommended and IV is reserved for life threatening infections |
| Valacyclovir, Famciclovir | |
| sypphilis | caused by the coiled spirochete Treponema pallidum, spirochete penetrates skin and membranes of the geintal organs, rectom, mouth, spread via the primary, secondary and latentcy, lesions, shared needles, prenatal from mother, congenitally 1 in 10k |
| Secondary Stage | skin rash, moist, raised, gray to pink lesions perineal area, enlarged lymph nodes, Fever, fatigue, infections of the yes, bones, .liver or meninges, |
| latent stage | Dementia, pain, lossof sensation in legs, destruction of aorta, destructive inflammatory masses can appear in any organ |
| tertiary stage | heart and blodd vessels, central nervous system, Tabes dorsalis, Paresis, various psychoses may result |
| DX of syphilis | Venereal Disease Research Laboratory slide test, Rapid Plasma Eagin, all pts should be checkd for gonorrhea |
| med mgm | eradication of all syphilitic organsims, : Parenteral penicillin remains the tr3eatment of choice for all stages of syph, |
| Maternal syphilis | before the 18th week of pregnancy prevents infection of the fetus, after 18 weeks antibiotic crosses placenta barrier, may pose a risk of premature labor, |
| neurosyphilis | pts must be carefully monitored, with periodic serologic testing, clinical eval at 6 month intervals, and repeated CSF exams for at least 3 years. Specific therapeutic mgm is based on the specific symptoms. |
| Gonorrhea | cause by N. gonorrhoeae, gram neg, diplococcoid bacterium, almost exclusively follows sex contact, genital/rectal/mucosal, mouth, throat via oral sex, eyes, incubation perios is 3-5 days |
| clinical manifestations | men asymptomatic after theincubation period but in a short time develp s/s, urethritis, dysuria, infection with a purulent discharge, eduma of affected area |
| clinical womenifestations | most remain asymptomatic, greenish-yellow dc of cervix, freq urinate, purulent urethral dc, pruritus, burn vulva, vaginal engorgemnt, abd pain, diste ntion, muscular rigidty, tenderness; w/infection :n/v, fever,tachy, pharyn/tonsilitis |
| dx, | cultures isolate/establish an ID, after 24-48 hrs definitive dx, coexisting chlamydial infection in up to 45%, test for syphilis also |
| med mgm | gonorrhea in early stage is curable, recurrence common, ABX-ceftriaxone, (Rocephin) Suprax, Add Doxycycline (Vibramycin or Tetracycline for coexisting chlamydia, treat before culture w/hx of known sexual contact w/gonorrhea, Pt should abstain from sex, |
| How long should a pt being treated for gonorrhea must be treated to prevent reinfection | until advised by a hcp |
| avoid alcohol or how long and why? | 2-4 weeks, due to the irritant effect on the healing of urethral walls, |
| Trichomoniasis |
Created by:
redhawk101
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