1. Need to report to Health department
    • Chlamydial infection
    • Gonorrhea
    • syphilis
    • chancroid
    • HIV
    • Hepitsis
  2. Candidiasis (fungus)
    Eitology: yeast like fungus, caused by the change in the vaginal pH (Candida albicans)

    • Common causes:
    • pregnancy, diabetes mellitus, oral contraceptive, antibiotic theapy
    • Symptoms: vaginal and perineal itching, inflamation, burning on urination, vaginal discharge white with a typical cottage cheese appearance

    Treatment: may be with butoconazole, miconazole, clotrimazole, nystatin, terconazole by vaginal application for 3 to 5 days

    Reoccurent yeast infections that resist treatment are assoicated with diabetes melllitus or HIV infections
  3. Women are twice as likely to contact STD's because?
    vagina and microscopic tears in mucosa feom intercourse provide favorable conditions for infection
  4. Trichomoniasis (bacterial)
    • Caused by trichomonas vaginalis
    • Symptoms: purulent vaginal discharge that is thin or frothy malodorous, and yellow-green or brownish. May have itching, edema, and redness
    • Diagnosics: wet mount
    • Treatment: Metronidazole (Flagyl) or tenidazile (tindamax) in a single oral dose.
    • Teaching: do not drink alchol for 24 hours prior to or after discontinuing medication, refrain from sex until a cure is established, reoccurance if partner is not treated
  5. Bacterial Vaginosis (Bacterial)
    Causes: are not known although tissue trauma and vainal intecourse have been identified as probale causes Multiple partners, douching

    Symptoms: thin, grayish white vaginal discharge that has a fisy odor

    Dignostics: saline wet mount

    Treatment: matronidazole or clindamcin to restablish normal flora

    Teach: refrain from sex until cured or use a condom, do not drink alchol for 24 hours prior to or after discontinuing medication
  6. Chlamydial infection (bacterial)
    • Causes: Chlamydia trachomatis
    • high in sexually active teens

    • Symptoms: usually asymptomatic may exibit symptoms of yellowish vaginal discharge and painful urination
    • Gonorrhea and chlamydia usually coexist
    • If untreated leads to scaring of the fallopian tubes and is the primary cause of PID, infertility or ectropic pregnancy

    Treatment: usually directed at both chlamydial infection and gonorrhea. azithromycin (Zithromax), doxycycline (Vibramycin),ofoxacin (floxin), lavofloxacin (Levaquin), and erythromycin.

    Teach: must treat partner and use a condom until cure is established
  7. Gonorrhea (bacterial)
    Causes: Neisseria gonorrhoeae

    • Symptoms: often asymptomatic in women may include purulent discharge, dysuria, and painful intercourse
    • If left untreated associated with PID, scaring of the fallopian tubes and is the cause of infertility or ectropic pregnancy

    Dignostics: positive culture

    Treatment: cefixime (suprax), ceftriaxine (rocephin), and ciprofloxaxin (cipro)

    Teach: all partners should be treated simultaneously, intercourse should be avoided or use a condom
  8. Syphilis (bacterial)
    • Causes: Treponema palidum
    • Three stages:
    • 1) Primary syphilis is painless chancre that develops on the genitalia, anus, or lips, or in the oral cavity, treated with one dose of penicillin
    • if untreated the chancre heals in about 6 weeks the disease is highly infectious at the primary stage

    about 2 months after the initial infection the symptoms of

    2) secondary syphilis, including enlargement of the spleen and liver, headache, anorexia, and a generalized maculopapular skin rash called condlomata lata may develop on the vulva. Condlomata resemble warts and are highly contagious. Treated with two doses of penicillin

    • latent phase may last for several years
    • 3) tertiary stage heart, blood vessels and central nervous system general paralysis and psychosis

    Diagnostics: VDRL, RPR, FTA-ABS

    Treatment: of all stages is penicillin G, Ceftriaxone and doxycycline is used for people who can not use penicillin
  9. Herpes Genitalis (virus) HSV
    • Two types
    • type 1 usually oral pharyngeal infection
    • type 2 usually genital lesions
    • transmission occutrs through direct contact with an infected person

    with in 2 to 12 days after primary infection blisters (vesicles) may cause pain, tenderness, dyspareunia (pain during intercourse), flu like symptoms, these blisters rupture within 1 to 7 days and form ulcers that take an average of 7 to 10 says to heal

    the virus remains dormant in the nerve ganglia and reactivates periodically (stress, fever, and menses may cause reoccurance)

    Diagnositcs: clinical symptoms confirmed by viral culture of fluid from the blisters (vesicles)

    Treatment: antiviral drugs acyclovir, famciclovie, and valacyclovir help reduce symptoms, shedding, and recurrent episodes however there is no cure

    Teach: abstain from sex while lesions are present and until they are culture negitive due to shedding that may occur during this time
  10. HPV (virus)
    Veneral and genital warts

    Symptoms: dry, wartlike growths may be small, discrete and asymptomatic or they may cvluster and resemble cauliflower

    colposcopy, pap smear are usually done to detect abnormal growths and tissue displasia

    • Treatment: Goal is to remove the warts and is determined by the site and extent of the warts
    • 1) application of medication podpphyllin solution or gel
    • 2) cryo theropy, electrodesiccation, electrocautery or laser
    • 3) interfeon, an antineoplastic drug some times used in women over are 18

    CDC recommends immunizing girls and women age 9-26 and immunocomprimised males
  11. HIV (virus)
    Causes: direct contact with body fluids of infected person

    HIV testing is routine for all pregnant women

    STD's is an implication that a person should be tested

    no cure
  12. Nurses part in preventing the spread of sexually transmitted diseases
    treating specific infections

    teach the signs and symptoms that require medical attention

    • explain diagnositc or screening tests
    • reinforce information for effective treatment and prevention
  13. PID
    Etiology: primary sources are Chlamydial infections, gonorrhea (bacteria) untreated cause tubal scarring and may lead to ectopic pregnancy or infertility

    Manifestations: asymptomatic or have subtle mild symptoms. others may have pelvic pain, fever, purulent vaginal discharge, nausea, anorexia, and irregular vaginal bleeding

    Assessment: abdominal tenderness, and pain of the uterus and cervix when they are moved during bimanual examination urinalysis is needed to rule out urinary tract infection. cultures for Chlamydial infection, gonorrhea or other infections to determine the course of treatment

    Treatment: intravenous combinations of antibiotics cefoxitin of cefotetan plus doxycyline or clindamcin plus gentamicin usually be changed to oral within 48 hours for a duration of 14 days

    Prevention: avoid exposure to diseases or preventing reoccuring infections. Limit sexual partners, use barrier methods of birth control

    secondary prevention: preventing lower genital tract infections,seek medical attention promplty after having unprotected sex with someone suspected of having a STD and when unusual discharge or lesions appear, take medications as perscribed, periodic medical evaluations
Card Set
Manifestations and treatments