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Learn about the assessment, treatment, and teaching for various STDs including Chlamydial infection, Gonorrhea, Syphillis, Herpes, Trichomonis, Condylomata, Bacterial Vaginosis, and Vaginitis.
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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 • Take sexual hx • Chlamydial antigen test • Cell tissue culture • Treatment-single dose asithromyacin-Zithromax, or 7 day course of Vibromyacin(doxycycline)
Gonorrhea • Caused by neissara gonorrhoeate • S/s male • d/c from penis that is white or green • Burning on urination
Gonorrhea • S/s female • 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
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
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 • S/s • 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
Condylomata Acumulata • Venereal warts • Treatment-removing visible parts of warts for symptom relief High reoccurrance rate
Bacterial Vaginosis • 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 • 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