OB E1 - STI - .... PDF

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OB E1 – Sextually Transmitted Infections ChGroups at High Risk for STIs African American youths  Abused youths  Homeless youths  Young men having sex with men  Gay, lesbian, bisexual, and transgendered youthsSTIs Define  How is it transmitted  Curable versus incurable o Incurable: HIV, hepat...

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OB E1 – Sextually Transmitted Infections Ch5

Groups at High Risk for STIs     

African American youths Abused youths Homeless youths Young men having sex with men Gay, lesbian, bisexual, and transgendered youths

STIs  Define  How is it transmitted  Curable versus incurable o Incurable: HIV, hepatitis B, herpes simplex virus (HSV or herpes), , and HPV o Curable: Chlamydia, syphilis, gonorrhea, and trichomoniasis  Safer-sex practices  The problem of STIs has still not been tackled adequately on a global scale, and until this is done, numbers worldwide will continue to increase.

Factors Placing Teenagers at Risk for STIs  Females’ anatomy predisposing them to STIs (columnar epithelial cells sensitive to invasion)  Teenagers’ feelings of invincibility  Unprotected intercourse  Partnerships of limited duration  Obstacles to using the health care system

Manifestations of Common STIs  Chlamydia: The majority of women (70% to 80%) are asymptomatic, dysuria, urinary frequency, dyspareunia, cervical discharge, endocervicitis, inflammations of the rectum and lining of the eye, can infect throat  Gonorrhea: may be asymptomatic, dysuria, urinary frequency, vaginal discharge, dyspareunia, endocervicitis, arthritis (long term effect), PID, rectal infection o Males will see a leak from penis o Females may be asymptomatic, but can lead to PID and infertility in females  Genital herpes: blister-like genital lesions, dysuria, fever, headache, muscle aches, malaise  Syphilis: disease is divided into four stages: o Primary: chancre on place of bacteria entrance o Secondary: maculopapular rash, sore throat, lymphadenopathy, flu-like symptoms o Latent: no symptoms; can be infective first 1–2 years of latency, some will go on to develop tertiary infections o Tertiary: tumors of the skin, bones, and liver, CNS symptoms, CV symptoms; all the tertiary s/s are usually NOT reversible  Trichomoniasis: may be asymptomatic, dysuria, urinary frequency, vaginal discharge, dyspareunia, irritation of genital area  Genital warts: wart-like lesions that are soft, moist, or flesh colored and appear on the vulva and cervix and inside; also surrounding the vagina and anus, sometimes appear in cauliflower-like clusters, and are either raised or flat, and small or large

Most Common Causes of Vaginitis  Candida: fungus  Trichomonas: protozoan  Gardnerella: bacterium

Vulvovaginal Candidiasis  Candidiasis is one of the most common causes of vaginal discharge  also referred to as yeast, monilia, and a fungal infection  not considered as STI Nursing management  Teaching preventive measures o Wear 100% Cotton underwear o Avoidance of irritants o Good body hygiene  Wash with a mild, unscented soap and dry the genitals gently. o Avoidance of douching or super-absorbent tampons o Reduce dietary intake of simple sugars and soda. o Avoid tight pants

Chlamydia  Most common bacterial STI in the United States; majority asymptomatic  Cause: Chlamydia trachomatis (intracellular parasite)  majority asymptomatic, dysuria, urinary frequency, dyspareunia, cervical discharge, endocervicitis, inflammations of the rectum and lining of the eye, can infect throat  an important preventable cause of infertility Therapeutic management  Antibiotics (doxycycline, azithromycin)  Combination regimen if gonorrhea also present  Problems with chlamydia and gonorrhea is that some strains are not reacting to the regular antibiotics  Screening  HCP should encourage annual chlamydia screening for all sexually active females aged >25 years Nursing assessment  Risk factors: adolescence, multiple sex partners, new sex partner, sex without condom, oral contraceptive use, pregnancy, history of another STI  Manifestations: mucopurulent vaginal discharge, urethritis, bartholinitis, endometritis, salpingitis, dysfunctional uterine bleeding  Urine testing or swab specimen culture, immunofluorescence, EIA, or nucleic acid amplification

Gonorrhea  Second most commonly reported infection in the United States  Highly contagious and reportable to health departments  Gonorrhea increases the risk for PID, infertility, ectopic pregnancy, and HIV acquisition and transmission  Cause: aerobic gram-negative intracellular diplococcus  Site of infection: columnar epithelium of endocervix  Almost exclusively transmitted via sexual activity  Therapeutic management: antibiotic therapy (dual therapy) Nursing assessment  Risk factors: o low socioeconomic status, o urban living o single status o inconsistent use of barrier contraceptives o age...