Transcript 5. Describe assessment, treatment & teaching for STDS

5. Describe assessment, treatment &
teaching for STDS
• Chlamydial Infection-caused by virus
“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 asithromyacinZithromax, or 7 day course of
Vibromyacin(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
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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