Medical-Surgical Nursing: An Integrated Approach, 2E Chapter 32 NURSING CARE OF THE CLIENT: SEXUALLY TRANSMITTED DISEASES

Sexually Transmitted Diseases (STDs) Those diseases that are transmitted or passed from one person to another primarily through sexual contact. Another term that was used for STDs is venereal disease.

Anatomy and Physiology The major system affected by the sexually transmitted diseases is the reproductive s system. Men are generally more symptomatic than females and will seek health care more readily since the signs of disease on the external genitalia are more visible. In addition to the reproductive system, an area of sexual contact, such as oral and rectal areas, may also exhibit signs and symptoms of the disease process.

Common Diagnostic Tests for STDs

Chlamydia Caused by spherical bacterial organism. Mode of transmission must be through intimate body contact. Most infections are asymptomatic. Known as the “silent STD” for this reason. If left untreated, can cause tissue inflammation, ulceration, and scar tissue formation in both men and women.

Gonorrhea A serious bacterial infection, spread through vaginal, anal, or oral intercourse. Symptoms in men are burning on urination and a purulent discharge from the penis. Many women are asymptomatic. If a women is infected with gonorrhea, the infection may be transmitted to the newborn’s eyes as the baby travels through the birth canal.

Syphilis Almost eradicated after the discovery of antibiotic therapy in the 1940s, it is now on the upswing again. Causative organism is a spirochete. Transmission either through sexual contact or congenitally (mother to child).

Stages of Syphilis Incubation period, with development of chancre, a clean, painless ulcer which usually is present at site of body contact. Secondary stage: client has skin rash of penny- sized brown sores, low-grade fever, headache, sore throat. Tertiary stage: bacteria damages heart, eyes, brain, nervous system, bones, joints, or any other parts of the body. May result in heart disease, blindness, neurologic problems, and death.

Genital Herpes Caused by herpes simplex virus type 2. Usually acquired through sexual contact with infected person. Itching or burning sensations; pain in genital area, legs, or buttocks; vaginal discharge; abdominal pressure. Lesions follow.

Cytomegalovirus Another virus in the herpesvirus family, found in saliva, urine, and often in semen and vaginal secretions. Incurable. People are infected for life.

Genital Warts May occur in urogenital, perineal, or anal areas, and may be internal or external. Population at risk seems to be teenage girls or young women in their 20s. Genital warts are usually painless, soft fleshy growths appearing most commonly in genital area. Causes a predisposition to cervical cancer.

AIDS Incurable, ultimately fatal. Persons at risk are those who have multiple sexual partners, IV drug users who share needles, and persons with hemophilia.

Trichomoniasis Caused by a parasitic protozoan, this very common STD is seen frequently in combination with gonorrhea. Vulval and vaginal pruritis is most common symptom, with a vaginal discharge of frothy, copious yellow-green mucus.

Hepatitis B Clients with Hepatitis B experience anorexia, vague abdominal discomfort, nausea, vomiting, fatigue, and jaundice. Fever may be mild or absent. Symptoms may progress to chronic liver disease, hepatic cancer, hepatic failure, and death.