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Nursing of Adults with Medical & Surgical Conditions

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1 Nursing of Adults with Medical & Surgical Conditions
Reproductive Disorders

2 Amenorrhea Etiology/Pathophysiology
Absent or suppressed menstrual flow Primary Menarche has not occurred by age 18 years Secondary Menarche has occurred but ceased for at least 3 months

3 Amenorrhea Frequent, vigorous exercise Depression Anorexia or bulimia
Normal Before puberty After menopause During pregnancy Hormonal abnormalities Surgical interventions Hysterectomy

4 Amenorrhea Signs & Symptoms No menstrual flow for at least 3 months

5 Amenorrhea Treatment Based on underlying cause
Hormone replacement may be necessary

6 Dysmenorrhea Etiology/Pathophysiology Uterine pain with menstruation
Primary Not associated with pelvic disorders Usually disappears with pregnancy or by the woman’s late 20’s Secondary Caused by organic disease PID Endometriosis Usually over 20 years of age

7 Dysmenorrhea Signs & Symptoms Breast tenderness Abdominal distention
Nausea and vomiting Headache Vertigo Palpitations Excessive perspiration Colicky and cyclic pain Dull pain in the lower pelvis

8 Dysmenorrhea Treatment Exercise Nutritious foods, high in fiber
Heat to pelvic area Mild analgesics Prostaglandin inhibitors Ibuprofin (Motrin) Naproxen (Anaprox)

9 Abnormal Uterine Bleeding
Menorrhagia Excessive bleeding at the time of the regular menstrual flow Endocrine disorders Inflammatory disdurbances Uterine tumors Metrorrhagia Uterine bleeding between regular menstrual periods or after menopause May indicate cancer or benign tumors of the uterus

10 Premenstrual Syndrome (PMS)
Etiology/Pathophysiology Related to the neuroendocrine events occurring within the anterior pituitary gland Occurs 7-10 days prior to the menstrual period Subsides within the first 3 days after the onset of menstrual flow

11 Premenstrual Syndrome (PMS)
Signs & Symptoms Irritability Lethargy & Fatigue Sleep disturbances Depression Headache Vertigo Backache Breast tenderness Abdominal distention Acne Paresthesia of hands and feet

12 Premenstrual Syndrome (PMS)
Treatment Analgesics Diuretics Progesterone Diet High in complex carbohydrates Moderate in protein Low in refined sugar and sodium Limit caffeine, chocolate, and alcohol Reduce or eliminate smoking Exercise Adequate rest, sleep, and relaxation

13 Female Climacteric (menopause)
Etiology/Pathophysiology The normal decline of ovarian functin resulting from the aging process Begins between the ages of 35 and 60 years (average 51yrs) May be induced by irradiation of the ovaries or surgical removal of both ovaries Not considered complete until 1 year after the last menstrual period

14 Female Climacteric Signs & Symptoms
Decrease in frequency, amount, and duration of the normal menstrual flow Shrinkage of vulval structures Shortening of the vagina Dryness of the vaginal wall Pelvic relaxation Loss of skin turgor and elasticity Increased subcutaneous fat Decreased breast tissue Thinning of hair Osteoporosis

15 Female Climacteric (menopause)
Treatment Estrogen therapy Premarin Provera Calcium supplements

16 Male Climacteric Etiology/Pathophysiology
Gradual decrease of testosterone levels and seminal fluid production Occurs between the ages of 55 and 70

17 Male Climacteric Signs & Symptoms Decreased erections
Enlarged prostate gland Decreased seminal fluid Loss or thinning of hair Decreased muscle tone

18 Male Climacteric Treatment Emotional support Treatment for impotence

19 Impotence Etiology/Pathophysiology
Inability of an adult man to achieve penile erection Functional Psychological Anatomical Physical defect of genital structures Atonic Disturbed neuromuscular function

20 Impotence Treatment Remove cause if possible Treat diseases Viagra
Medications Illicit or abused substances Alcohol, cocaine, nicotine Treat diseases DM, renal, heart and pulmonary diseases Viagra Mechnical devices Penile prostesis

21 Penile Prosthesis

22 Infertility Etiology/Pathophysiology
Inability to conceive after 1 year of sexual intercourse without birth control Impaired sperm or ovum production Occlusion in the reproductive system that prevents the sperm and ova from meeting Infections of the reproductive tract Primary Never conceived Secondary Conceived but are now unable to do so Females most fertile time is between the ages of 20 and 29

23 Infertility Treatment Depends on the cause Hormone therapy
Repair occlusion Intrauterine insemination Partner or donor sperm In vitro fertilization

24 Simple Vaginitis Etiology/Pathophysiology Common vaginal infection
Causitive organisms E. coli Staphylococcal Streptococcal T. vaginalis C. albicans (yeast) Gardnerella

25 Simple Vaginitis Signs & Symptoms Inflammation of the vagina
Yellow, white, or grayish white, curdlike discharge Pruritus Vaginal burning T. vginalis Profuse foamy exudate C. albicans Thick, cheeselike discharge Bacterial Milk-like discharge; foul odor

26 Simple Vaginitis Treatment Douching
Vaginal suppositories, ointments, and creams Organism specific Sitz baths Abstain from sexual intercourse during treatment Treat partner if necessary

27 Cervicitis Etiology/Pathophysiology Infection of the cervix
One of the most common diseases of the reproductive system May be caused by vaginal infection, STD, childbirth or abortion

28 Cervicitis Signs & Symptoms Backache Whitish exudate
Menstrual irregulatities

29 Cervicitis Treatment Vaginal suppositories, ointments, and creams
Organism specific

30 Pelvic Inflammatory Disease (PID)
Etiology/Pathophysiology Any acute, subacute, recurrent or chronic infection of the cervix, uterus, fallopian tubes and overies that has extended to the connective tissues Most common causative organisms Gonorrhea Streptococcus Staphylococcus Chlamydia Tubercle bacilli

31 Pelvic Inflammatory Disease (PID)
Surgical and examination procedures Sexual intercourse Especially with multiple partners Pregnancy

32 Pelvic Inflammatory Disease (PID)
Signs & Symptoms Fever Chills Severe abdominal pain Malaise Nausea and vomiting Malodorous purulent vaginal exudate

33 Pelvic Inflammatory Disease (PID)
Treatment Antibiotics IV or IM Analgesics Bedrest

34 Toxic Shock Syndrome Etiology/Pathophysiology
Acute bacterial infection caused by Staphylococcus aureus Usually occurs in women who are menstrujating and using tampons

35 Toxic Shock Syndrome Signs & Symptoms
Usually occur between days 2 and 4 of the menstrual period Flulike symptoms Temperture up to 102 degrees Vomiting Diarrhea Myalgia Hypotension Sore throat Headache Red macular palmar or diffuse rash

36 Toxic Shock Syndrome Decreased urinary output BUN elevated
Disorientation Pulmonary edema Inflammation of mucous membranes

37 Toxic Shock Syndrome Treatment Antibiotics IV fluid therapy Oxygen
Bacterial specific IV fluid therapy Oxygen

38 Endometriosis Etiology/Pathophysiology
Endometrial tissue appears outside the uterus The tissue responds to the normal stimulation of the ovaries; bleeds each month Most common in caucasian women 25 to 35 years old

39 Endometriosis Signs & Symptoms Lower abdominal pain Pelvic pain
May radiate to lower back, legs, and groin Most acute during menstruation and subside after menstruation

40 Endometriosis Treatment Antiovulatory medications Pregnancy
Suppress menstruation Pregnancy Laparoscopy Remove endometrial cells and adhesions Total hysterectomy

41 Vaginal Fistula Etiology/Pathophysiology
Abnormal opening between two organs Named for organs involved Urethrovaginal fistula: between the urethra and vagina Vesicovaginal fistula: between the bladder and vagina Rectovaginal fistula: between the rectum ad the vagina Vesicouterine fistula: between the bladder and the uterus Vesicocervical fistula: between the bladder and the cervix Perineovagina fistula: between the perineum and the vagina

42 Fistulas

43 Vaginal Fistula Result from Cancer Radiation
Weakening of tissue by pregnancies Surgical interventions

44 Vaginal Fistula Signs & Symptoms
Urine and/or feces being expelled from vagina

45 Vaginal Fistula Treatment Oral or parenteral antibiotics Diet Surgery
High protein Increase Vitamin C Surgery Repair fistula Urinary or fecal diversion

46 Displaced Uterus Etiology/Pathophysiology Congenital Childbirth
Backward Displacement Retroversion Retroflexion Forward Displacement Anteversion Anteflexion


48 Displaced Uterus Signs & Symptoms Backache Muscle strain
Leukorrheal discharge Heaviness in the pelvic area

49 Displaced Uterus Treatment Pessary Uterine Suspension
Rubber or plastic doughnut-shaped ring Uterine Suspension

50 Uterine Prolapse Etiology/Pathophysiology Obstetrical trauma
Overstretching of the support system Coughing, straining, and lifting heavy objects

51 A. Normal B. First Degree C. Second Degree D. Third Degree
Cervix comes down into the vagina (approx half way) C. Second Degree Cervix comes down to the vaginal opening D. Third Degree The cervix and uterus protrude through the vaginal opening

52 Uterine Prolapse Signs & Symptoms Fullness in vaginal area Backache
Bowel or bladder problems Protrusion of cervix and vaginal walls in perineal area

53 Uterine Prolapse Treatment Pessary Surgery Vaginal hysterectomy
Anteroposterior colporrhaphy Anterior and posterior repair of the vagina Shortening of the supporting muscles

54 Cystocele and Rectocele
Etiology/Pathophysiology Cystocele Displacement of the bladder into the vagina Rectocele Rectum moves toward the posterior vaginal wall Supporting tissues, muscles and ligaments have been stretched and weakened Childbirth Multiple births Cervical tears

55 Cystocele Rectocele Bladder Rectum

56 Cystocele and Rectocele
Signs & Symptoms Cystocele Urinary urgency, frequency, and incontinence Fatigue Pelvic pressure Rectocele Constipation Rectal pressure Hemorrhoids

57 Cystocele and Rectocele
Treatment Surgical repair Anteroposterior colporrhaphy (A&P Repair) Shortening of the muscles that support the bladder

58 Benign Tumors of the Uterus Fibroid Tumors (Myomas)
Etiology/Pathophysiology Arise from the musle tissue of the uterus Stimulated by ovarian hormones

59 Benign Tumors of the Uterus Fibroid Tumors (Myomas)
Signs & Symptoms Pelvic pressure Pain Dysmenorrhea Abnormal uterine bleeding Menorrhagia Backache Constipation Urinary symptoms

60 Benign Tumors of the Uterus Fibroid Tumors (Myomas)
Treatment Surgery Myomectomy Removal of uterine myomas Hysterectomy

61 Ovarian Cysts Etiology/Pathophysiology
Benign tumors that arise from dermoid cells of the ovary or from a corpus luteum or graafian follicle

62 Ovarian Cysts Signs & Symptoms May be no symptoms
Palpable on examination Disturbance of menstruation Pelvic heaviness Slight vaginal bleeding Pain, with enlargement

63 Ovarian Cysts Treatment Ovarian cystectomy

64 Cancer of the Cervix Etiology/Pathophysiology Squamous cell carcinoma
Carcinoma in situ Preinvasive, asymptomatic carcinoma 100% curable Untreated, invades the vagina, pelvic wall, bladder, rectum, and regional lymph nodes High Risk Sexually active during teens Multiple sexual partners Multiple births

65 Carcinoma of the Cervix

66 Cancer of the Cervix Signs & Symptoms Few symptoms in early stages
Leukorrhea Irregular vaginal bleeding Spotting between periods Often occurs after coitus Advanced Pain in the back, upper thighs and legs

67 Cancer of the Cervix Treatment Carcinoma in situ Early Carcinoma
Removal of the affected area Electrocautery Cryosurgery (freezing) Laser Conization Removal of cone-shaped section of cervix Early Carcinoma Hysterectomy Intracavitary radiation Advanced carcinoma Radical hysterectomy with pelvic lymph node dissection

68 Cancer of the Endometrium
Etiology/Pathophysiology Adenocarcinoma of the uterus Slow growing tumor Usually affects postmenopausal women More likely to be localized can spread to cervix, bladder, rectum and lymph nodes High risk History of irregular menstruation Difficulty during menopause Obesity Hypertension Diabetes mellitus No children Family history of cancer of the uterus

69 Cancer of the Endometrium
Signs & Symptoms Postmenopausal bleeding 50% will have cancer Abdominal pressure Pelvic fullness

70 Cancer of the Endometrium
Treatment Surgery TAH-BSO Radiation Intracavitary radiation Chemotherapy

71 Cancer of the Ovary Etiology/Pathophysiology
4th most common cause of cancer death in women High Risk Infertile Anovulatory Nulliparous Habitual aborters High fat diet Exposure to industrial chemicals Asbestos and talc Common sites of metastisis Peritoneum, Omentum, Bowel surfaces

72 Cancer of the Ovary Signs & Symptoms Early Advanced
Vague abdominal discomfort Flatulence Mild gastric disturbance Advanced Enlarged abdominal girth Flatulence with distention Urinary frequency Nausea Vomiting Constipation Weight loss

73 Cancer of the Ovary Treatment Surgery Radiation Chemotherapy
TAH-BSO and omentectomy Radiation Chemotherapy Combination of the above

74 Hysterectomy Total hysterectomy
Removal of the uterus including the cervix Total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO) Removal of the uterus, fallopian tubes, and ovaries Radical hysterectomy TAH-BSO with removal of the pelvic lymph nodes Vaginal Hysterectomy The uterus is removed through the vagina Abdominal Hysterectomy Abdominal incision is made to perform procedure

75 Hysterectomy Preoperative Interventions
Reinforce explanation of procedure Answer questions Instruct on TCDB Empty colon Low-residue diet Enemas Indwelling catheter Vaginal douche Antiseptic Surgical skin prep of the abdomen, pelvis, and perineum Consent form NPO after midnight

76 Hysterectomy Postoperative Interventions Vital signs
Monitor urinary output Assess bowel sounds and function No oral intake until bowel sounds have returned Early ambulation Promotes peristalsis Prevents thrombophlebitis Antiembolic stockings Analgesics Demerol Monitor for vaginal bleeding May have slight vaginal drainage for 1-2 days Assess abdominal dressing for bleeding Change dressing using aseptic technique as ordered Pelvic rest (4-6 weeks) No heavy lifting (nothing over 10 pounds)

77 Fibrocystic Breast Condition
Etiology/Pathophysiology Benign tumors of the breast Hyperplasia and cystic formation in mammary ducts Usually occurs in women years of age Rarely become malignant, but increases risk of breast cancer

78 Fibrocystic Breast Condition
Signs & Symptoms Cysts are soft, well-differentiated, tender, and freely moveable Often bilateral and multiple More apparent before menses

79 Fibrocystic Breast Condition
Treatment Eliminate methylxanthines Found in caffeine – coffee, tea, colas Danazol (Danocrine) Inhibits FSH and LH production; decreases estrogen production Vitamin E

80 Acute Mastitis Etiology/Pathophysiology Acute bacterial infection
Usually caused by S. aureus or streptococci Most often occurs during lactation and late pregnancy

81 Acute Mastitis Signs & Symptoms
Breasts are tender, inflamed and engorged

82 Acute Mastitis Treatment Keep breasts clean Application of warm packs
Support Well fitting bra Systemic antibiotics

83 Chronic Mastitis Etiology/Pathophysiology
Common in women years of age Increased risk in women with inverted, cracked nipples, and problems with breast feeding Traumatic blow to the breasts Occurs most frequently in obese women

84 Chronic Mastitis Signs & Symptoms Tender, painful, and palpable cysts
Usually unilateral

85 Chronic Mastitis Treatment Same as for Acute Mastitis
Keep breasts clean Application of warm packs Support Well fitting bra Systemic antibiotics

86 Breast Cancer Etiology/Pathophysiology Unknown cause
Usually adenocarcinoma Factors that influence formation Exposure to heavy radiation Immunodeficiency Estrogen therapy Diet high in fat Fibrocystic breast condition

87 Breast Cancer High Risk Factors Gender Age Race Genetics Menarche
Female Age Over 40 Race Caucasian Genetics Women whose mother and sisters have breast cancer Menarche Occurred before age 12 Parity Decreased for women who gave birth before age 18 Increased for women who are not sexually active, infertile or became pregnant after age 35. Menopause after age 55 Other - Cancer of the uterus, ovaries, colon, breast

88 Breast Cancer Signs & Symptoms
Small, solitary, irregular-shaped, firm, nontender, and nonmobile tumor Change in skin color Puckering or dimpling of tissue Nipple discharge Retraction of nipple Axillary tenderness

89 Breast Dimpling & Nipple Retraction

90 Breast Cancer Treatment Depends on the Stage Stage I Stage II
Tumor is 1-2 cm or smaller No nodal or metastatic involvement Stage II Tumor is 2-5 cm With or without nodal involvement and no metastasis Stage III Tumor is 5-10 cm Usually with lymph node involvement and no metastasis Stage IV Indicates the presence of metastatic spread, regardless of tumor size or lymph node involvement

91 Breast Cancer Surgery Lumpectomy Partial mastectomy
Removal of a circumscribed area along with the tumor Partial mastectomy The quadrant of the breast in which the tumor is located is removed. Subcutaneous mastectomy Removal of malignant breast tissue, leaving the skin surface and nipple in place. Simple mastectomy Removal to the entire breast Modified radical mastectomy All breast tissue, overlying skin, nipple, and pectoralis minor muscles are removed with samples of axillary nodes.



94 Modified Radical Mastectomy

95 Breast Cancer Nursing Interventions Reach to Recovery Post-op
Preop if possible Post-op Monitor vital signs Assess for s/s of shock and hemorrhage Hemovac drain Assess dressings for drainage TCDB Analgesics Elevate arm on affected side

96 Breast Cancer No procedures involving the arm on the affected side
B/P, injections, IV’s, drawing of blood Exercises to restore muscle strength Page 535; figure 12-17 Psychological support Prosthesis Gels, molded silicone, saline Match remaining breast Breast reconstruction Breast implant Silicone or saline implant under skin Latissimus dorsi flap graft Flap of muscle, fat and skin is transferred to breast area from latissiumus dorsi area Transabdominal island flap Section of abdominal skin and fat and part of the rectus abdominis muscle are transferred to the breast area.

97 Prostatitis Etiology/Pathophysiology
Acute or chronic infection of the prostate gland E. coli, Klebsiela, Proteus, Pseudomonas, Streptococcus, and Staphyloccoccus

98 Prostatitis Signs & Symptoms Chills and fever
Urgency and frequency of urination Dysuria Cloudy urine Perineal fullness Lower back pain Arthralgia Myalgia Tenderness, edema and firmness of the prostate gland

99 Prostatitis Treatment Antibiotics Digital massage of the prostate
Increased flow of infected secretions Sitz baths Monitor I&O

100 Epididymitis Etiology/Pathophysiology Infection of the epididymis
The cord like excretory duct of the testicle S. aureus, E. coli, Streptococcus, N. gonorrhoeae Associated with urethral strictures, cystitis, and prostatisis

101 Epididymitis

102 Epididymitis Signs & Symptoms Scrotal pain Edema “waddling gait”
Pyruia Chills and fever

103 Epididymitis Treatment Bed rest Elevate scrotum Cold compresses
Antibiotics I&D for abscess

104 Phimosis Etiology/Pathophysiology
Prepuce is too small to allow retraction of the foreskin over the glans. Usually congenital; may be due to inflammation or disease

105 Phimosis

106 Phimosis Signs & Symptoms Infection of foreskin and glans penis.
Occasionally causes obstruction of urine flow

107 Phimosis Treatment Circumcision

108 Hydrocele Etiology/Pathophysiology
Accumulation of fluid between the membranes covering the testicle and the membrane enclosing the testicle May be caused by trauma, orchitis, or epididymitis

109 Hydrocele

110 Hydrocele Signs & Symptoms Enlargement of the scrotum Pain

111 Hydrocele Treatment Aspiration of fluid
Surgical removal of testicular sac Bed rest Elevate scrotum Cold compresses

112 Varicocele Etiology/Pathophysiology
Dilation of scrotal veins causing obstruction and malfunction of circulation

113 Varicocele Signs & Symptoms Engorgement and elongation of the scrotum
Pulling sensation in scrotum Dull aching pain

114 Varicocele Treatment Surgery Bedrest Elevate scrotum Cold compresses
Removal of obstruction Bedrest Elevate scrotum Cold compresses

115 Cancer of the Testis Etiology/Pathophysiology Cause unknown High risk
Cryptorchidism Undesended testes Testicular atrophy Scrotal trauma

116 Cancer of the Testis Signs & Symptoms Enlarged scrotum
Firm, painless, smooth mass Feeling of heaviness

117 Cancer of the Testis Treatment Radical inguinal orchiectomy Radiation
Removal of the testis, epididymis, a portion of the gonadal lymphatics, and their blood supply. Radiation Chemotherapy Teach testicular self-examination

118 Cancer of the Penis Etiology/Pathophysiology Very rare
Usually in men over 50 yrs High risk Uncircumcised Poor personal hygiene STD’s

119 Cancer of the Penis Signs & Symptoms
Painless, wartlike growth or ulceration, usually on the glans penis

120 Cancer of the Penis Treatment Surgery Removal of tissue
Partial or total amputation of the penis Metastisis may require more radical surgical procedures

121 Herpes Genitalis (Herpes Simplex Virus Type II)
Etiology/Pathophysiology Infectious viral disease Usually acquired sexually

122 Herpes Genitalis (Herpes Simplex Virus Type II)
Signs & Symptoms Fluid-filled vesicles Cervix, labia, rectum, vulua, vagina, glans penis, foreskin, and penile shaft. Eventually rupture and develop shallow, painful ulcers Ulcers are erythematous with edema and tenderness

123 Herpes Genitalis (Herpes Simplex Virus Type II)
Initial lesion Lasts 3-10 days Recurrent lesions Last 7-10 days Fever Malaise Dysuria Leukorrhea (female)

124 Herpes Genitalis (Herpes Simplex Virus Type II)
Exacerbation Fever Stress Emotional upset Intense heat

125 Herpes Genitalis (Herpes Simplex Virus Type II)
Treatment No cure; treat symptoms acyclovir (Zovirax) Oral, IV, topical Sitz baths Local anesthetic Lidocaine Analgesics Keep lesions clean and dry

126 Herpes Genitalis (Herpes Simplex Virus Type II)
GOOD handwashing No sexual contact while lesions are present Encourage use of condoms May be spread even if lesions are not present

127 Syphilis Etiology/Pathophysiology Treponema pallidum organism
Transmission occurs primarily through sexual contact Infection from mother to fetus may occur Can penetrate intact skin as well as openings

128 Syphilis Signs & Symptoms 5 Stages Incubation Period Primary Stage
Secondary Stage Latent Stage Tertiary Stage (Late) 10-60 days after contact no symptoms

129 Primary Stage Chancre Headaches Enlarged lymph nodes
Painless erosion or papule that ulcerates superficially Will disappear in 3-4 weeks, with or without treatment Headaches Enlarged lymph nodes VDRL may be negative Highly contagious

130 Syphilis Secondary Stage Rash on palms of hands and soles of feet
Generalized enlargement of lymph nodes S/S may disappear and reoccur for as long as 2 years

131 Syphilis Latent Stage Tertiary or Late Stage No symptoms
Lesions in skin, bones, liver, larynx, testes, eyes, heart, and central nervous system May be fatal 5-20 years after infection

132 Syphilis Treatment Penicillin Tetracycline or erythromycin
IV Tetracycline or erythromycin If allergic to penicillin May be treated in any stage; damage will not be reversed. Treat all sexual contacts.

133 Gonorrhea Etiology/Pathophysiology N. Gonorrhoeae
Transmitted by sexual contact Most common communicable disease in the US Primarily affects the genital or rectal mucosa; can involve mouth and throat

134 Gonorrhea Signs & Symptoms (According to location) Vaginal (female)
Urinary frequency and pain Yellowish discharge Nausea and vomiting Urethra (male) Urethral discomfort Yellowish discharge containing pus (“the drip”) Red and swollen meatus Dysuria

135 Gonorrhea Rectal (male & female) Pharyngitis (male & female)
Perineal discomfort Purulent rectal discharge Pharyngitis (male & female) Sore throat and swallowing discomfort Edema of the throat

136 Gonorrhea Treatment Penicillin Rocephin Doxycycline or Tetracycline
Some may be resistant Rocephin Penicillinase-resistant cephalosporin Doxycycline or Tetracycline Will treat co-infection of chlamydia TREAT ALL SEXUAL CONTACTS

137 Trichomoniasis Etiology/Pathophysiology T. vaginalis protozoan
Usually sexually transmitted

138 Trichomoniasis Signs & Symptoms Most are asymptomatic Male Female
Urethritis, dysuria, frequency, pruritus, and purulent exudate Female Frothy, gray, green or yellow malodorous discharge Pruritus Edema Tenderness of vagina Dysuria & Frequency Spotting Menorrhagia Dysmenorrhea

139 Trichomoniasis Treatment metronidazole (Flagyl)
No alcohol Urine may be dark brown TREAT ALL SEXUAL CONTACTS

140 Candidiasis Etiology/Pathophysiology C. albicans & Candida tropicalis
Fungal infection Normal flora of GI tract, mouth, vagina and skin Infection occurs Lowered resistance; carcinoma High blood glucose; DM Radiation Immunosuppressant drugs Hyperalimentation Antibiotic therapy Oral contraceptives

141 Candidiasis Signs & Symptoms Mouth Nails Vaginal Edema White patches
Edematous Darkened, erythematous nail base Purulent exudate Vaginal Cheesy, tenacious white discharge Pruritus Inflammation of the vulva and vagina

142 Candidiasis Penis Systemic Purulent exudate Chills Fever
General malaise

143 Candidiasis Treatment Treat underlying condition nystatin (Mycostatin)
ointment, spray, creams, suppositories Topical amphotericin B skin and nail infections

144 Chlamydia Etiology/Pathophysiology Chlamydia trachomatis Causes
Cervicitis Urethritis Epididymitis PID

145 Chlamydia Signs & Symptoms Usually asympomatic Male Female
Scanty white or clear exudate Burning or pruritus Urinary frequency Mild dysuria Female Vaginal pruritus or burning Dull pelvic pain Low-grade fever Vaginal discharge Irregular bleeding

146 Chlamydia Treatment Tetracycline Doxycycline Zithromax
Erythromycin for pregnant patients TREAT ALL SEXUAL CONTACTS

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