sti

• Dyspnareunia

  pain during intercourse
• How can STI's be transmitted?

  -from one person to another through oral, vaginal, and anal intercourse

  -exposure to infected blood

  - fecal to oral

  -intrauterine transmission to fetus

  -perinatal transmission to neonate.
• What are risk factors of STI's?

  -more than one sexual partner

  - had more than one sexual partner in the past

  -engage in sexual activity w/ someone who has an STI

  -history of STI

  -use intravenous drugs

  -partner who uses intravenous drugs

  -engage in anal, vaginal, or oral sex without a condom

  -have sex while using drugs or alcohol.
• What are curable pathogens linked to STI?


  -Syphilis

  -gonorrhea

  -chlamydia

  -trichomoniasis
• What are incurable pathogens linked to STI's?


  -Hepatitis B

  - Herpes simplex virus (HSV)

  - Human immunodeficiency virus (HIV)

  - Human papillomavirus (HPV).
• What are ethical/ legal considerations for STI's?

  -notify health authorities

  -recognize those at risk

  - advocate

  - human trafficking

  - interview person alone
• What are reportable STI's?

  - Chlamydia

  - Gonorrhea

  - Syphilis

  - HIV/ AIDs
• Who is at greater risk for STI'S?

  Females are more at risk, as the vagina consists of very vascular and large surface area of membranes.
• What are complications caused by STI's?

  - salpingitis, infertility, and ectopic pregnancy

  - Puerperal infection

  - Perinatal infection

  - Cancer of genital area

  - Male urethritis

  - Vulvovaginits

  - Cervicitis

  - Proctitis

  - Hepatitis

  - Dermatitis

  - Genital ulceration or warts
• How do you asses history of present illness?

  - CHief concern

  - Time of onset

  - Symptoms by quality and quantity, precipitating and palliative factors

  - any treatments taken and whether they have been helpful
• What should you assess in a patients past medical history?

  - Major health problems, including any history of STI's , PID, or immunosuppression

  - Surgeries; obstetric and gynecologic- circumcision
• What should you assess in a pts current health status?

  - menstrual history for irregularities

  - sexual history

  -type and frequency of sexual activity

  - number of sexual partners

  - sexual orientations

  -contraception history

  - lifestyle risks; drugs, alcohol
• What are preventative health are practices?

  - papanicolaou (pap) tests

  - regular STI screening

  - use barrier contraceptives
• What should you assess in a pts physical exam?

  - vital signs

  - oropharyngeal findings

  - abdominal findings

  - genital or pelvic findings

  - anorectal findings
• What labs should you assess?

  - urinalysis

  - hematology

  - ESR or CRP if PID

  - cervical, urethral, oral, rectal specimen

  - lesion samples for microbiology and virology

  - pregnancy testing
• Focused assessment for STI's steps.

  1- assess history of present illness

  2- asses past medical history

  3- assess current health status

  4- assess preventative health care practices

  5- assess physical exam findings

  6 - assess lab data
• what is genital herpes?

  GENITAL HERPES (GH )IS AN ACUTE, RECURRING, COMMON VIRAL DISEASE.
• What us genital herpes considered?

  incurable
• Type 1 (HSV-1)

  - most non- genital lesions

  - transmitted via oral- oral contact
• Type 2 (HSV-2)

  - cause most genital lesions

  - recur and shed asymptomatic
• What is the incubation period for genital herpes?

  2- 20 days
• What are complications of genital herpes?

  - neonatal transmission

  - increased risk for HIV infection
• What is the diagnosis of herpes based on?

  It is based on the pts history and physical exam and it is confirmed through culture of lesions
• What is herpes confirmed through?

  confirmed through culture of lesions
• What to look for when assessing for Herpes

  - itching / tingling 1-2 days before breakout

  - vesicles in clusters

  - rupture leaving ulcerations

  - lesions resolve within 2- 6 weeks

  -dormant state

  - recurs when triggered by stress, fever, poor nutrition, menses, sexual activity
• How do you manage genital herpes?

  - admin sitz bath

  -encourage fluid intake

  - pour water over genitalia while voiding

  - keep skin dry and clean

  - wash hands after contact with lesions

  - admin oral analgesics

  - apply local anesthetic

  -apply ice or compresses
• What is the desired outcome for patients infected with genital herpes?

  - decrease pain from ulceration

  - promote healing without secondary infection

  - decrease viral shedding

  - prevent infection transmission
• Interventions for genital herpes

  - guidance for stress management

  - antiviral drugs- acyclovir which decreases severity and frequency + begin at appearance of lesions

  - abstain from sexual activity while lesions are present

  - urge condom use

  -encourage discussion with current and new partners
• What is the time period for primary syphilis?

  10 - 90 days after infection
• What are symptoms of primary syphilis?

  painless ulcer ( chancre) on the genitals or mouth, typically heals on its own within 3 - 6 weeks
• What is the time period for secondary syphilis?

  varies, typically 4-10 weeks after primary stage
• WHat are symptoms of secondary syphilis?

  - full body rash

  - flu like symptoms ( fever, headache , sore throat)
• What is the time period for latent syphilis?

  after untreated secondary syphilis
• What are symptoms of latent syphilis?

  no symptoms but the infection is still present, can still be transmitted congenitally
• What is the time period for tertiary syphilis?

  years or decades after initial infection
• What are symptoms of tertiary syphilis?

  may cause damage to the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints

  can be life-threatening
• What are the stages of syphilis?

  - primary

  - secondary

  - latent

  - tertiary
• What is neurosyphilis?

  (infection of the brain and spinal cord) can occur at any stage and can cause meningitis, stroke, hearing loss, blindness, paralysis, and dementia
• In what stage is syphilis very contagious?

  Primary and secondary
• Assessment of a patient for signs and symptoms of syphilis begins with what?

  it begins with gathering a history about ulcers or rash