1 / 29

Chapter 05 Promoting Reproductive Health Through an Understanding of Sexually Transmitted Diseases

Chapter 05 Promoting Reproductive Health Through an Understanding of Sexually Transmitted Diseases. Human Immunodeficiency Virus/ AIDS. HIV – entry via percutaneous /genital routes Plasma viremia → organ dissemination Progression → acquired immunodeficiency syndrome (AIDS)

yamal
Download Presentation

Chapter 05 Promoting Reproductive Health Through an Understanding of Sexually Transmitted Diseases

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Chapter 05Promoting Reproductive Health Through an Understanding of Sexually Transmitted Diseases

  2. Human Immunodeficiency Virus/ AIDS • HIV – entry via percutaneous/genital routes • Plasma viremia → organ dissemination • Progression → acquired immunodeficiency syndrome (AIDS) • Most women infected by exposure to infected men

  3. Screening Recommendations • CDC – opt-out testing, all patients • ACOG – routine for women ages 19–64 • Provide and document post-test counseling • Conform to HIPAA regulations

  4. HIV + Women: Special Concerns • Psychosocial issues • Gynecologic problems related to immunocompromise • Vulvovaginalcandidiasis • Human papillomavirus • Herpes simplex virus

  5. Chlamydia Trachomatis • Most common bacterial STD • Leading cause of preventable infertility • Complications include ectopic pregnancy, pelvic inflammatory disease • Usually asymptomatic in women

  6. Chlamydia Trachomatis (cont’d) • Diagnosis • Culture • Direct immunofluorescence • Nucleic acid hybridization/amplification (NAAT) • Enzyme immunoassay • Treatment • Antibiotics (e.g., doxycycline, azithromycin)

  7. Gonorrhea • Causative bacterium: Neisseria gonorrhoeae • Second most commonly reported STD • Women often asymptomatic • May progress to pelvic inflammatory disease

  8. Gonorrhea (cont’d) • USPSTF, CDC: Annually screen all sexually active women ages 25 and younger • Testing: culture, nucleic acid hybridization, NAAT (cervical or urine sample) • Treatment: antibiotics (cefixime, ceftriaxone); include partners

  9. Trichomoniasis • Causative protozoan: Trichomonas vaginalis • Most common curable STD in U.S. • May be asymptomatic • Symptoms: frothy vaginal discharge (gray, green) with foul odor

  10. Trichomoniasis (cont’d) • Diagnosis • Wet mount (+ motile trichomonad parasites) • Rapid trichomoniasis test, affirm VP III test • Treatment • Metronidazole; tinidazole • Treat partners simultaneously

  11. Pelvic Inflammatory Disease • Acute infection of uterus, fallopian tubes • May cause scarring, adhesions, blockage • Common causative organisms: C. trachomatis, N. gonorrhoeae • Symptoms: pain, bleeding, N & V • Treatment: combined drug therapy

  12. Human Papillomavirus • Cause of condylomata acuminata • Over 100 viral types identified • Usually asymptomatic, sub-clinical • Vaccine available for certain types • Treatment of external warts: topical chemical agents, cryotherapy, laser surgery, electrosurgery

  13. Herpes Simplex Virus 1 and 2 • HSV-1 associated with cold sores • HSV-2 associated with genital lesions • Occurs more frequently in women • Primary infection: flu-like symptoms, pain, appearance of multiple blister-like lesions • Recurrent outbreaks less severe • Transmission possible during viral shedding

  14. Herpes Simplex Virus (cont’d) • Diagnosis: viral culture, serum testing • Treatment goal: hasten healing, reduce symptoms • Antiviral medications • Complementary care measures • Patient education

  15. Syphilis • Causative spirochetal bacterium: Treponema pallidum • Transmission: sexual intercourse, transplacental (maternal-fetal) • Increased incidence since 2001

  16. Syphilis (cont’d) • Primary: chancre • Secondary: fever, rash, malaise, headache, weight loss, condylomata lata • Tertiary: gummas, joint disease, neurosyphilis, C-V syphilis • Treatment: penicillin G, doxycycline, tetracycline

  17. Hepatitis • Leading cause of liver cancer • Most common reason for liver transplantation • May be caused by Hepatitis A virus (HAV), Hepatitis B virus (HBV), or Hepatitis C virus (HCV)

  18. Hepatitis A Virus • Formerly known as “infectious hepatitis” • Incidence highest in developing countries • In U.S., primarily contracted during overseas travel to affected countries • No specific treatment • Vaccine available

  19. Hepatitis B Virus • Highest incidence in persons 20–49 years • More contagious than HIV • Causes liver disease, may be fatal • Transmission: sexual intercourse, blood-to-blood contact, maternal-fetal transfer

  20. Hepatitis B Virus (cont’d) • Symptoms: fever, fatigue, anorexia, jaundice, N & V, dark-colored urine • Most adults recover completely; 25% become chronically infected • Screen all pregnant women, individuals at high risk • Vaccines available

  21. Hepatitis C Virus • Most common bloodborne infection in U.S. • Formerly called “non-A, non-B hepatitis” • Primarily transmitted via blood-blood contact • Most infected individuals progress to chronic viral hepatitis

  22. Hepatitis C Virus (cont’d) • Newly acquired infection often asymptomatic • Various serum screening tests available • After diagnosis, evaluate liver functioning • Consider Hepatitis B vaccination • Combination therapy for chronic infection

  23. Hepatitis D Virus • Only occurs in individuals already infected with HBV • Clinically indistinguishable from other hepatitis types • Transmitted via body fluids • Perinatal transmission rare

  24. Women With Chronic Hepatitis: Nursing Implications • Education, counseling • Maintain excellent hygiene • Avoid contact with all blood sources • Intimate partners use condoms • Nutritional strategies • Avoid alcohol, tobacco, hepatotoxic medications • Referrals

  25. Chancroid • Causative streptobacillus: Haemophilus ducreyi • Symptoms: painful lesion on labia, dysuria, dyspareunia, inguinal adenopathy • Diagnosis: culture or biopsy • Treatment: antibiotics

  26. Lymphogranuloma Venereum • Causative bacterium: Chlamydia trachomatis • Stage 1 – painless genital ulcer • Stage 2 – lymphadenopathy • Symptoms: cervicitis, salpingitis, fever • Treatment: doxycycline, erythromycin

  27. Granuloma Inguinale • Causative bacterium: Klebsiella granulomatis • Symptoms: painless ulcerative lesions on labia, perineum (no lymphadenopathy) • Diagnosis: history, tissue biopsy • Treatment: doxycycline

  28. Pthirus Pubis • Primarily spread through sexual contact • Typically found attached to pubic hair • Do not transmit disease • Feed on human blood • Treatment: permethrin lotion • Teach patients strategies for lice control

  29. STD Education and Counseling • Create a therapeutic environment • Provide information appropriate to patient circumstances (e.g., age, drug use) • Include partners when possible • Teach strategies to promote genital health

More Related