Transcript 5. Describe assessment, treatment & teaching for STDS

5. Describe assessment, treatment &
teaching for STDS
• Chlamydial Infection-caused by virus like
bacteria “chlamydial trachomatis”
S/s Men
• penile discharge
• Painful and frequent urination
Cont.
• S/s woman
• Vaginal discharge & lower abdominal pain
• No symptoms may be experienced
Assessment & Treatment
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Take sexual hx
Chlamydial antigen test
Cell tissue culture
Treatment-single dose azithromyacinZithromax, or 7 day course of
Vibramyacin(doxycycline)
chlamydia
Chlamydia Vaginitis
Gonorrhea
• Caused by neissara gonorrhoeate
• S/s male
• d/c from penis that is white or green
• Burning on urination
Gonorrhea
• S/s female
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Vaginal discharge
Redness swelling of external genitalia
Burning on urination
Abdominal pain
Abnormal menstruation
Treatment
• Single dose of Rocephin IM, Cipro IM or
Orthoflex IM followed by 7 days of oral
vibromyacin
• If untreated, can cause sterility
• Person remains infectious if untreated, even
though symptoms disappear after 3-4 weeks
Gonorrhea
Syphillis
• Caused by a spirochete Treponoma
Pallidum.
• Can be passed through placenta causing
congenital syphilis
• S/s progress in 4 stages
First stage
• Chancre-may last from 1 to 5 weeks
• Disappears and becomes a painless red
ulcer that may last from 1-5 weeks
Primary syphilis-chancre
Primary syphilis - chancre
Primary syphyilis
Second Stage
• Occurs 6 weeks from contact
• Rash on extremities hands and trunk
Third Stage-Latent stage
• No Symptoms
• Disease may be spread by blood contact
• Major organs being invaded
Fourth Stage-Late stage
• S/s: BLINDNESS
• MENTAL ILLNESS
• PARALYSIS
• HEART DISEASE
Diagnosis and Treatment
• Dx based on blood confirmation of
organism
• Treatment of choice Pen G injections
• patients allergic to penicillin may be treated
with doxycycline 300mg daily for 21 days
or oral amoxycillin 3gm twice daily with 1
gm of probenecid for 2 weeks.
Herpes Simplex
• Type II
• transmitted by sexual contact
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Painful itching sores around genitals
Rash ,then blisters
Flu-like symptoms and burning on urination
Appearance and lab tests used to dx
Herpes Simplex
• Women
Men
Treatment for Herpes
• No cure
• May keep in check with antivirals
Trichomonis
• Caused by the parasite Trichomonas
Vaginalitis
• Usually transmitted sexually but can live on
damp clothes and towels
S/s women
• blood spotting in vaginal discharge
• heavy, yellowish-green or gray, frothy vaginal discharge
• infection in the urethra
• the tube that carries urine from the bladder out of the body
• itching, burning or pain in the vagina
• lower abdominal pain
• musty vaginal odor
• pain and/or burning when urinating
• pain or discomfort during sexual intercourse (dyspareunia)
• swelling in the groin
• swollen and irritated vagina and cervix
• urinating more than usual
• vaginal or vulval redness
• worsening symptoms when menstruating
Trichomoniasis
• S/s men
• Few or no symptoms
• infection of the urethra or prostate gland, which is
involved in semen production
• painful and/or difficult urination
• thin, whitish discharge from the penis
• tingling inside the penis
• Treatment
• Flagyl is drug of choice
• Diagnostics by microscopic study and cultures
Trichomoniasis
Condylomata Acumulata
• Venereal warts
• Treatment-removing visible parts of warts
for symptom relief High reoccurrance rate
Condylamata
Condylamata
Vulva
Bacterial Vaginosis
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Caused by Gardenella Vaginalis
S/s are grey discharge and fishy odor
Treatment is Flagyl
Client teaching-no alcohol when taking
meds as can have a rx with vomiting,
tachycardia and hypotension
 Note! Flagyl is contraindicated during pregnancy
so a menstrual history or pregnancy test should be
obtained before administration
Vaginitis
 Etiology:
 bacteria
 protozoa
 viruses
 yeasts
 The acidic environment (pH less than
5.0) of the vagina inhibits the growth
of many pathogens. Several factors
increase risk for infection.
Factors that increase Risk
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Skin diseases
Skin irritation
Perfumes
Nylon underwear
antibiotics
 Diagnosis made from description of
symptoms and identification of
pathogens in sample of vaginal
discharge
 Types of vaginitis
 candidiasis caused by Candida
albicans, a fungus
 trichomoniasis, caused by
Trichomonas vaginalis, a protozoan
Ways to decrease risk
• Avoidance or irritants-chemicals, dyes,
soaps
• Cotton underwear, nonrestrictive clothing
• Frequent cleansing with neutral agents
• Heat in the form of sitz baths or irrigation
• Avoid sexual intercourse during course of
treatment