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Nursing Care of the Client: Sexually Transmitted Diseases

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Presentation on theme: "Nursing Care of the Client: Sexually Transmitted Diseases"— Presentation transcript:

1 Nursing Care of the Client: Sexually Transmitted Diseases
NVOC 22C Eliza Rivera-Mitu, RN, MSN

2 What are STDs? Those diseases that are transmitted or passed from one person to another primarily through sexual contact. Also known as venereal disease.

3 Chlamydia Known as the silent STD Symptoms:
males % show no symptoms; watery or milky discharge from penis, burning sensation upon urination: females - 70% show no symptoms; abnormal vaginal discharge &/or bleeding, abnormal cramping, abdominal pain, fever, painful urination. Oral - sore throat: Rectal - inflammation, itching Incubation: 1 to 4 weeks

4 Chlamydia Organism: Chlamydia trachomatis & Ureplasma urealyticum, bacteria Infectivity: people can infect other when they have symptoms & some times when they do not, the partner is infected in approximately 33% of the sexual contacts with an infected partner Chlamydia can now be tested in men through a simple urine test. In women a culture swab of the cervical mucus is required. This can be done in conjunction with a Pap test. Tests are about 90% accurate.

5 Chlamydia - Symptoms In prepubertal girls, chlamydia it can cause a mild vaginal discharge and odor (called vaginitis); in postpubertal women it can cause an off-white discharge and odor which comes from an infected cervic. In women, it can be especially dangerous because it can silently linger for months and progress to Pelvic Inflamatory Disease (PID. which can lead to infertility, chronic pain, and even death. Even babies can get this infection: one half of all babies being delivered through the birth canal of an infected women will develop a Chlamydial conjunctivitis (pink eye) a week after birth. About a quarter of babies passing down the infected birth canal will get a Chlamydia pneumonia. Chlamydia symptoms in men: 50% of men have no symptoms Swollen and tender testicles Pain or burning during urination Pus (discharge from the penis)

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7 Chlamydia Treatment: can be cured with antibiotics – Doxycycline is tx of choice If Untreated: males - inflammation of testicles, infected prostate females - pelvic inflammatory disease, ectopic pregnancies both sexes - sterility fetus/newborns -pneumonia, death, eye & ear infections

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9 What are the Nursing Implications?
Chlamydia Prevention: limit the number of sexual partner & use condoms & spermicides What are the Nursing Implications? See Table 32-1, p. 868

10 Gonorrhea Symptoms: males - discharge of pus from penis, burning sensation upon urination, blood in urine & around 10% show no symptoms especially with the first infection

11 Gonorrhea Females - foul smelling vaginal discharge &/or bleeding, abnormal cramping &/or painful urination Both sexes – rectal - itching, pain, discharge with blood or pus; oral - sore throat & swollen glands

12 Gonorrhea Incubation: 2 to 7 days
Organism: Neisseria gonorrhoae, a bacterium Infectivity: people can infect others when they have symptoms & some times when they do not; women are more easily infected by men than vice versa; the partner is infected in approximately 25% of the sexual contacts with an infected partner

13 Gonorrhea Treatment: can be cured with antibiotics If Untreated:
Most effective: Single dose of Cipro, followed by a 7-day course of oral Doxycycline (Vibramycin) If Untreated: males - blockage of urethra, problems with erection;

14 Gonorrhea females - pelvic inflammatory disease, ectopic pregnancies, fetus/newborns - premature birth, still birth & eye infection; both sexes - sterility, arthritis, heart problems, blindness Ophthalmia neonatorum (gonococcal conjunctivitis) The most common gonorrhea untreated risk, however, is pelvic inflammatory disease (PID), a serious infection of the female reproductive organs that occurs in an estimated 1 million American women each year. PID can scar or damage cells lining the fallopian tubes, resulting in infertility in as many as 10 percent of women affected. In others, the damage prevents the proper passage of the fertilized egg into the uterus. If this happens, the egg may implant in the tube; this is called an ectopic or tubal pregnancy and is life threatening to the woman if not detected early.

15 What are the nursing implications?
Gonorrhea Prevention: limit number of sexual partners & use condoms & spermicides What are the nursing implications? See Table 32-1, p. 869

16 Syphilis Symptoms: both sexes
primary stage: small painless sore (chancre) where organism entered body, genital, oral or rectal ( in women can't be seen internally) secondary stage: rash on palms & soles, open painless sores often in mouth late stage: neurological damage, blindness, death Primary syphilis Approximately three to four weeks after sexual contact with an infected, contagious partner, a chancre (a superficial skin ulcer with well-defined edges and an inflamed base up to 1,0cm in diameter) may appear at the site of the microbe’s entry. The chancre is typically painless (this is in contrast with genital herpes which causes painful ulcers). There may be associated swollen lymph nodes(small painless lumps that are centers of immune system activity) in the inguinal region (groin). It is contact with such a syphilitic chancre that the infection is transmitted. This initial chancre routinely heals itself spontaneously within three to eight weeks. Secondary syphilis If syphilis is left untreated, the infection will evolve and manifest itself, several weeks after the primary stage, with a skin and mucus membrane eruption (red lesions), fever, fatigue, headaches and muscular aches and pains. Once again, if left untreated, these symptoms will resolve on their own…but the infectious microbe remains behind. It is at this point that syphilis passes into its latent phase. This « silent period » may last for many years and permits the infection to evolve without any obvious external symptoms. At this point, the only method of detecting the presence of syphilis is via a blood test specific for syphilis. Tertiary syphilis After many years, even as long as ten to thirty years, syphilis may progress to the point where it may result in serious organ system complications including skin, bone and vital nervous system or cardiovascular system maninfestations.

17 Syphilis

18 Syphilis Incubation: Organism: Treponema pallidum, a bacterium
primary stage - 10 to 70 days, 21 days in most people; secondary stage - weeks to a year; late stage – years Organism: Treponema pallidum, a bacterium

19 Syphilis Infectivity: people can infect others when they have symptoms & possibly when they do not, the partner is infected in approximately 50% of the sexual contacts with an infected person Treatment: can be cured with penicillin & other antibiotics

20 Syphilis If Untreated:
males - inflammation of testicles, infected prostate; females - pelvic inflammatory disease; ectopic pregnancies; both sexes - sterility; fetus/newborns - blindness, deafness, early death due to syphilis Prevention: limit number of sexual partners & use of condoms & spermicides may reduce transmission Nursing Implications? p. 869

21 Genital Herpes Symptoms: rash & itching; painful, fluid filled blisters, fever, fatigue (similar in both sexes), & vaginal discharge(females only); symptoms go away but reappear since the virus stays in the body Incubation: 4 to 10 days

22 Genital Herpes Organism: Herpes simplex II (90% of cases) & Herpes simplex I, viruses Infectivity: people can infect others when they have symptoms & some times when they do not

23 Genital Herpes Treatment: use Betadine on lesions to dry & prevent secondary infections, however, Acyclovir (Zovirax) eases symptoms & lessens reoccurrence but is not a cure If Untreated: in fetus/newborns there is a risk of spontaneous abortion; neonatal herpes; mental retardation, death Prevention: limit number of sexual partners and using condoms & spermicidal foam may reduce transmission Nursing Implications? p 869

24 CMV - Cytomegalovirus Found is saliva, urine, semen, and vaginal secretions symptoms include pharyngitis, malaise, fever and lymphadenopathy, heterophil antibody negative, blood smears may show atypical lymphocytes may be fatal to those patients with AIDS A member of the herpes virus family, it is mainly aquired as an infection in childhood and carried for life in a latent form.  The infection typically remains quiet until the T-lymphocyte-mediated immunity is compromised.  CMV is transmitted through blood to blood and intimate contacts and organ transplants and is found in saliva, breast milk, urine and semen.

25 CMV Treatment: most resolve spontaneoulsy
therapy is often required for immunosuppressed patients Ganciclovir

26 Genital Warts Symptoms: warts on genitals, rectum or throat (not always easy to see) & (similar in both sexes) Incubation: 1 to 20 months; usually about 4 months

27 Genital Warts Organism: Human Papilloma Virus HPV
Infectivity: people can infect others when they have lesions & sometimes when they do not; 66% of people who have sexual contact with a partner who has genital warts will develop genital warts, usually within 3 months Treatment: chemical treatments such as podophyllum in tincture of benzoin, electrocoagulation ("burning"), cryotherapy ("freezing"), laser surgery, & excision are all used with variable success

28 Genital Warts If Untreated: both sexes - warts grow & obstruct infected body openings, pre-cancerous lesions of the cervix, vulva, & penis have been linked to some types of HPV. Prevention: limit number of sexual partners & use of condoms & spermicides may reduce transmission

29 HIV (Human Immunodeficiency Virus) AIDS (Acquired Immunity Deficiency Syndrome)
HIV is NOT the same as having AIDS, it is only the virus that causes AIDS. Currently there is NO cure but drug therapies "show great promise in managing HIV infection". "HIV infected people are healthy and do not realize they have been infected. HIV primarily infects certain white blood cells that manage the operation of the immune system.

30 HIV (Human Immunodeficiency Virus) AIDS (Acquired Immunity Deficiency Syndrome)
Eventually, the virus can disable the immune system, leaving the person with HIV infection vulnerable to a number of life-threatening illnesses. People who have HIV infection may not have symptoms for many years, especially if they receive good medical care and effective therapies" (American College Health Association [ACHA] , 2001).

31 HIV (Human Immunodeficiency Virus) AIDS (Acquired Immunity Deficiency Syndrome)
"When symptoms do develop, they are usually similar at first to those of common minor illnesses, such as the "flu", except that they last longer and are more severe. Persistent tiredness, unexplained fevers, recurring night sweats, prolonged enlargement of the lymph nodes, and weight loss are all common.

32 HIV (Human Immunodeficiency Virus) AIDS (Acquired Immunity Deficiency Syndrome)
People with HIV infection can transmit the virus to others - even if they have no symptoms and even if they do not know they have been infected. HIV can be transmitted (1) by sexual contact (anal, vaginal, & oral); (2) by direct exposure to infected blood; and (3) from an HIV-infected woman to her fetus during pregnancy or childbirth, or to her infant during breastfeeding" (ACHA, 2001).

33 HIV (Human Immunodeficiency Virus) AIDS (Acquired Immunity Deficiency Syndrome)
Prevention: "make careful choices about sexual activity, communicate assertively with your sexual partner and negotiate for safer sexual practices, remove alcohol and drugs from sexual activity," and "use latex condoms for intercourse" (ACHA, 2001).

34 Trichomoniasis Symptoms:
Most men with trichomoniasis do not have signs or symptoms; some men may temporarily have an irritation inside the penis, mild discharge, or slight burning after urination or ejaculation.

35 Trichomoniasis Symptoms
frothy, yellow-green vaginal discharge with a strong odor discomfort during intercourse and urination, irritation and itching of the female genital area. lower abdominal pain Incubation: 4 to 10 days

36 Trichomoniasis Organism: Trichomoniasis is caused by the single-celled protozoan parasite, Trichomonas vaginalis.

37 Trichomoniasis Infectivity: The vagina is the most common site of infection in women, and the urethra (urine canal) is the most common site of infection in men. The parasite is sexually transmitted through penis-to-vagina intercourse or vulva-to-vulva (the genital area outside the vagina) contact with an infected partner. Women can acquire the disease from infected men or women, but men usually contract it only from infected women.

38 Trichomoniasis Treatment: Trichomoniasis can usually be cured with the prescription drug, metronidazole, given by mouth in a single dose. If Untreated: increases a woman's susceptibility to HIV infection if she is exposed to the virus. Pregnant women with trichomoniasis may have babies who are born early or with low birth weight (less than five pounds). Prevention: limit number of sexual partners and using condoms & spermicidal foam may reduce transmission Nursing Implications? Trichomoniasis can usually be cured with the prescription drug, metronidazole, given by mouth in a single dose. The symptoms of trichomoniasis in infected men may disappear within a few weeks without treatment. However, an infected man, even a man who has never had symptoms or whose symptoms have stopped, can continue to infect or re-infect a female partner until he has been treated. Therefore, both partners should be treated at the same time to eliminate the parasite. Persons being treated for trichomoniasis should avoid sex until they and their sex partners complete treatment and have no symptoms. Metronidazole can be used by pregnant women. Having trichomoniasis once does not protect a person from getting it again. Following successful treatment, people can still be susceptible to re-infection. The genital inflammation caused by trichomoniasis can increase a woman's susceptibility to HIV infection if she is exposed to the virus. Having trichomoniasis may increase the chance that an HIV-infected woman passes HIV to her sex partner(s). The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected. Latex male condoms, when used consistently and correctly, can reduce the risk of transmission of trichomoniasis. Any genital symptom such as discharge or burning during urination or an unusual sore or rash should be a signal to stop having sex and to consult a health care provider immediately. A person diagnosed with trichomoniasis (or any other STD) should receive treatment and should notify all recent sex partners so that they can see a health care provider and be treated. This reduces the risk that the sex partners will develop complications from trichomoniasis and reduces the risk that the person with trichomoniasis will become re-infected. Sex should be stopped until the person with trichomoniasis and all of his or her recent partners complete treatment for trichomoniasis and have no symptoms. p 869


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