Term 3 ch 55 sti

What is the difference between STI and STD?

STI (infection) may or may not have symptoms. STD (disease) implies recognizable signs and symptoms.

Why must nurses be non-judgmental when caring for patients with STIs?

Judgmental behavior discourages patients from seeking care, and stigma can affect the quality of care provided.

What is a key nursing consideration before administering any antimicrobial for an STI?

Always assess for a history of drug allergies.

What is Expedited Partner Therapy (EPT)?

Providing a prescription or medication for a patient's sexual partner(s) without examining the partner, to prevent reinfection and spread.

Which STIs are generally curable?

Syphilis, gonorrhea, chlamydia, and trichomoniasis (caused by bacteria or parasites).

Which STIs are generally NOT curable?

HIV, Herpes Simplex Virus (HSV), Hepatitis B, and Human Papillomavirus (HPV) (viral infections).

What is the most important nursing action when you have an order for both a culture specimen and an antibiotic?

Collect the specimen for culture before administering the first dose of the antibiotic.

Why are some STIs (like HIV, syphilis, gonorrhea) reportable to the health department?

To identify and treat contacts, slow transmission, and track public health trends.

What are common diagnostic methods for STIs?

Serologic blood tests (for antibodies/antigens) and smears/swabs/cultures of discharge or lesions.

What is the preferred diagnostic test for Chlamydia trachomatis?

Nucleic Acid Amplification Test (NAAT) on a urine sample or swab from cervix/urethra.

What does NAAT stand for and why is it important?

Nucleic Acid Amplification Test. It's a highly effective diagnostic tool for organisms like chlamydia and gonorrhea.

What is the most common bacterial STI in the U.S.?

Chlamydia (caused by Chlamydia trachomatis).

What is a major reason chlamydia is so common?

Many infected people have NO symptoms (asymptomatic).

What are possible complications of untreated chlamydia?

Sterility (infertility) in men and women, Pelvic Inflammatory Disease (PID), ectopic pregnancy, and increased risk of HIV transmission.

What is the typical medical treatment for chlamydia?

Single dose of azithromycin or a 7-day course of doxycycline.

What is the preferred diagnostic test for Neisseria gonorrhoeae (gonorrhea)?

Nucleic Acid Amplification Test (NAAT) on a urine sample or swab from the site of infection (cervix, urethra, rectum, throat).

What bacterium causes gonorrhea?

Neisseria gonorrhoeae.

Why is drug resistance a major concern with gonorrhea?

The bacteria have developed resistance to many antibiotics, making treatment harder.

What is a common symptom in men with gonorrhea?

Whitish or greenish discharge from the penis and burning during urination.

What is the typical medical treatment for gonorrhea?

A single intramuscular dose of ceftriaxone PLUS oral azithromycin or doxycycline.

What are the two main types of blood tests for syphilis?

1. Non-treponemal screening tests (VDRL, RPR). 2. Treponemal confirmation tests (FTA-ABS).

What do the non-treponemal screening tests (VDRL, RPR) detect?

They detect antibodies to cardiolipin, a substance released during tissue damage caused by the syphilis bacterium. They are used for screening and monitoring treatment.

What do the treponemal confirmation tests (FTA-ABS) detect?

They detect antibodies specifically against Treponema pallidum itself. They confirm the diagnosis after a positive screening test.

What bacterium causes syphilis?

Treponema pallidum (a spirochete).

What is the first sign of primary syphilis?

A chancre (a painless, red ulcer) at the site of infection.

What is the Jarisch-Herxheimer reaction?

A transient reaction to treatment (esp. with penicillin) causing headache, fever, chills, and muscle aches. It usually resolves within 24 hours.

What are the four stages of syphilis?

Primary, Secondary, Latent, and Late (Tertiary).

How is a diagnosis of genital herpes often initially suspected?

Based on the characteristic appearance of painful, clustered vesicles or ulcers on the genitals.

What laboratory tests are used to confirm an HSV diagnosis?

Viral culture of fluid from a fresh vesicle, or NAAT (more sensitive) on a swab from the lesion. Blood tests can detect HSV antibodies (serology).

What is a key characteristic of herpes viruses?

They become latent, remaining inactive in the body and can reactivate later.

What is the main difference between HSV-1 and HSV-2?

HSV-1 typically causes oral lesions (cold sores). HSV-2 typically causes genital lesions and is classified as an STI.

Are antiviral drugs for HSV (like acyclovir) a cure?

No. They help control symptoms and reduce the frequency/severity of outbreaks but do not eliminate the virus.

What is a major complication for pregnant women with genital herpes?

Risk of transmitting the virus to the baby during delivery, which can be severe.

How is Trichomoniasis typically diagnosed in women?

Microscopic examination ("wet mount") of vaginal discharge to see the motile Trichomonas parasites. NAAT on vaginal swabs is also highly accurate.

What type of organism causes trichomoniasis?

A protozoan parasite (Trichomonas vaginalis).

What is a classic sign in women with trichomoniasis?

Frothy, yellowish, foul-smelling vaginal discharge.

What is the drug of choice for treatment?

Tinidazole (or metronidazole as an alternative).

Why must sexual partners be treated simultaneously?

To prevent "ping-pong" reinfection.

How are visible genital warts (condylomata acuminata) typically diagnosed?

By visual clinical inspection. A biopsy is done if the diagnosis is uncertain, the lesions are atypical, or in immunocompromised patients.

How is high-risk HPV infection of the cervix detected?

Through cervical cancer screening: HPV DNA testing (often co-testing with a Pap smear) to identify the presence of high-risk HPV types.

Why is HPV infection significant?

It is the most common STI. High-risk types can cause cancers (cervical, anal, etc.). Low-risk types cause genital warts.

What are two available HPV vaccines?

Gardasil (protects against 4 types) and Cervarix (protects against 2 types).

How are visible genital warts treated?

With patient-applied topical agents (podofilox, imiquimod) or provider-administered methods (cryotherapy, surgery). Treatment removes warts but not the virus.

What is a key preventive screening for women with HPV?

Annual Pap tests (Pap smears) to detect cervical cell changes early.

What are the Amsel criteria used to clinically diagnose Bacterial Vaginosis?

At least 3 of 4 must be present: 1) Thin, gray discharge. 2) pH >4.5. 3) Positive "whiff test" (fishy odor with KOH). 4) Clue cells on wet mount microscopy.

Is Bacterial Vaginosis (BV) always considered an STI?

No, it's not clear if it's sexually transmitted. It's linked to an imbalance of normal vaginal bacteria.

What are common signs of BV?

Thin gray vaginal discharge with a fishy odor.

What is a critical instruction for patients taking metronidazole (Flagyl) for BV?

Do NOT consume alcohol, as it can cause a severe disulfiram-like reaction (vomiting, tachycardia).

What does HAART stand for?

Highly Active Antiretroviral Therapy (combination drug therapy for HIV).

What is an "opportunistic infection"?

An infection that thrives when the immune system is weakened, such as in advanced HIV/AIDS.

According to the "safe sex" chart, what is an example of a SAFE practice?

Mutual masturbation, closed-mouth kissing, using your own sex toys.

According to the "safe sex" chart, what is an UNSAFE practice?

Vaginal/anal intercourse without a condom, oral sex without a barrier, multiple partners.

What is a key teaching point for condom use?

Use latex condoms, leave a 1-inch space at the tip, use only water-based lubricants, and withdraw carefully after ejaculation.

What is a Dental Dam used for?

As a barrier during oral-vaginal or oral-anal sex to prevent STI transmission.

What should be included in a focused health history for a suspected STI?

Reason for visit (pain, discharge), sexual history, number/treatment of partners, past STIs, drug use, OB history.

What is a major nursing concern for the psychosocial health of a patient with an STI?

Low self-esteem and anxiety due to stigma, shame, and fear of rejection.

What is a primary nursing goal for "Ineffective Management of Condition"?

Patient will accurately describe the disease, treatment, and preventive measures (like safe sex).

Why is patient teaching about completing antibiotic courses crucial?

To prevent relapse, antibiotic resistance, and serious complications (like PID or sterility).

Why might a patient with one STI be tested for others, including HIV?

Because having one STI increases the risk of having another (co-infection). STIs that cause ulcers (like syphilis, herpes) also increase the risk of HIV transmission if exposed.