Reproductive & Sexual Health: Nursing Assessment, STI Management, and Patient Education

What are the three objectives of the Reproductive & Sexual Health lecture?

Discuss the nurse's role, examine common reproductive concerns, and identify STI risk factors.

What is the nurse's role in reproductive and sexual health?

Obtain a health history, perform a physical assessment, complete a sexual health assessment, assess patient knowledge, and evaluate psychosocial/emotional responses.

Which Healthy People initiative addresses reproductive and sexual health goals?

Healthy People 2030.

Who should receive annual breast and pelvic examinations?

Assigned females age 21 years or older and sexually active individuals regardless of age.

Why should nurses explain the examination before beginning?

To reduce anxiety and promote understanding.

What should the patient do before a pelvic examination?

Empty the bladder and provide a urine specimen if ordered.

What is the purpose of a sexual health assessment?

To obtain subjective and objective information that promotes sexual health.

What type of information should a sexual assessment include?

Both subjective and objective data.

How should sensitive sexual health questions be introduced?

Move from less sensitive to more sensitive topics.

What should the nurse do before discussing sexual health?

Ask the patient's permission.

What assumption should never be made during a sexual assessment?

A patient's sexual preferences.

Why is asking about meaningful relationships preferred over marital status?

It is more respectful and less offensive.

What model is used to promote sexual and reproductive health?

The PLISSIT Model.

What does the 'P' in the PLISSIT Model stand for?

Permission.

What does the 'LI' in the PLISSIT Model stand for?

Limited Information.

What does the 'SS' in the PLISSIT Model stand for?

Specific Suggestions.

What does the 'IT' in the PLISSIT Model stand for?

Intensive Therapy.

What sexual health issue involves alteration of the external female genitalia?

Female genital mutilation (FGM) or cutting.

Which type of violence should always be considered during a sexual health assessment?

Intimate partner violence.

Which childhood experiences should be assessed because they affect adult sexual health?

Incest and childhood sexual abuse.

Which populations require special consideration during sexual health assessments?

Women with disabilities, LGBTQ individuals, and older adults.

What is endometriosis?

Benign endometrial tissue growing outside the uterus.

What are the major complications of endometriosis?

Chronic pelvic pain and infertility.

What causes infertility in endometriosis?

Fibrosis, adhesions, and scar tissue.

How is endometriosis commonly treated?

Oral contraceptives for symptom relief and surgery if needed to reduce pain or improve fertility.

What is a sexually transmitted infection (STI)?

A viral, bacterial, or parasitic infection spread primarily through sexual contact.

Are the terms STI and STD used interchangeably in the lecture?

Yes.

Approximately how many Americans develop an STI each year?

About 20 million.

Which age group accounts for about 50% of STIs?

Ages 15-24.

Can a person have an STI without symptoms?

Yes.

What are the three major categories of organisms that cause STIs?

Viral, bacterial, and parasitic organisms.

What is the nurse's first priority when caring for a patient with an STI?

Protect confidentiality.

What are the 'Five P's' of an STI assessment?

Partners, Prevention of pregnancy, Protection from STIs, Practices, and Past history of STIs.

Why should communication during an STI assessment be culturally and emotionally sensitive?

To encourage honest communication and clarify terminology when needed.

What should the physical examination include for a patient with a suspected STI?

Skin, rashes, lesions, drainage, inguinal nodes, genitals, rectum, mouth, and throat.

What additional examination is recommended for women with a suspected STI?

An abdominal and uterine examination.

Why is partner history important during an STI assessment?

It helps identify exposure risk and the need for partner notification.

Why is prevention of pregnancy discussed during STI counseling?

To address reproductive health and family planning.

Why should protection from STIs be assessed?

To determine condom use and other protective practices.

Why should sexual practices be discussed?

To identify specific risk factors and guide testing.

Why should a past history of STIs be obtained?

Previous infections increase the risk of future infections.

What are common symptoms that may suggest an STI?

Rashes, lesions, drainage, pain, or swollen inguinal lymph nodes.

Which body areas should be examined because STIs may occur outside the genital region?

Mouth, throat, and rectum.

Why is early identification of STIs important?

Many infections are asymptomatic but still transmissible.

Why is patient education an essential part of STI care?

To reduce transmission and prevent reinfection.

Why is confidentiality especially important when caring for patients with STIs?

It promotes trust and encourages honest disclosure.

What should the nurse assess in addition to the physical examination?

The patient's knowledge and emotional response.

What should the nurse clarify if a patient does not understand sexual health terminology?

Explain terms using clear, understandable language.

Why should partners be considered during STI management?

They may require testing and treatment to prevent reinfection.

What is the overall nursing goal when caring for patients with STIs?

To provide comprehensive care and support.

What is vaginitis?

Inflammation of the vagina.

What causes candidiasis?

A fungal (yeast) infection.

What organism causes bacterial vaginosis (BV)?

Gardnerella vaginalis.

What organism causes trichomoniasis?

Trichomonas vaginalis.

Which vulvovaginal infection is fungal?

Candidiasis.

Which vulvovaginal infection is bacterial?

Bacterial vaginosis.

Which vulvovaginal infection is parasitic?

Trichomoniasis.

What is the most common sexually transmitted infection (STI)?

Human papillomavirus (HPV).

Approximately how many Americans are affected by HPV?

More than 79 million.

Are most HPV infections symptomatic or asymptomatic?

Asymptomatic.

What can low-risk HPV strains cause?

Condylomata (genital warts).

What can high-risk HPV strains cause?

Cervical changes and anogenital cancers.

How are high-risk HPV strains commonly detected?

Pap smear.

What is the primary goal of HPV prevention?

Prevent HPV infection and HPV-related cancers.

Which HPV vaccines are listed in the lecture?

Gardasil, Gardasil 9, and Cervarix.

At what age can HPV vaccination begin?

As early as 9 years old.

How is the HPV vaccine administered?

Three intramuscular (IM) doses.

Up to what age was HPV vaccination approved according to the lecture?

Up to 45 years old.

What virus causes genital herpes?

Herpes simplex virus (HSV).

What is a characteristic feature of genital herpes?

Recurrent painful lesions.

What bacterium causes gonorrhea?

Neisseria gonorrhoeae.

How is gonorrhea transmitted?

Genital, oral, and anal sexual contact.

Is gonorrhea often symptomatic or asymptomatic?

Often asymptomatic.

What are common complications of untreated gonorrhea?

PID, infertility, ectopic pregnancy, sepsis, and neonatal blindness.

How is gonorrhea diagnosed and treated?

Diagnosed by NAAT (vaginal swab or urine); treated with IM ceftriaxone and partner treatment with safe-sex counseling.

What bacterium causes syphilis?

Treponema pallidum.

If untreated, how many stages does syphilis progress through?

Four stages.

What is the hallmark lesion of primary syphilis?

A painless chancre.

What bacterium causes chlamydia?

Chlamydia trachomatis.

What is the most common bacterial STI?

Chlamydia.

Which age group is most commonly affected by chlamydia?

Women ages 15-24.

Are most women with chlamydia symptomatic?

No, most are asymptomatic.

What symptoms may occur with chlamydia if present?

Purulent cervical discharge.

What symptoms may occur in men with chlamydia?

Burning with urination and penile discharge.

What are the major complications of untreated chlamydia?

PID, infertility, and ectopic pregnancy.

Should sexual partners be treated for chlamydia?

Yes.

What are common symptoms of gonorrhea?

Vaginal/penile discharge, dysuria, and cervicitis.

What test diagnoses gonorrhea?

NAAT (vaginal swab or urine).

What is the recommended treatment for gonorrhea?

IM ceftriaxone.

What education should accompany gonorrhea treatment?

Treat partners and reinforce safe-sex practices.

What is pelvic inflammatory disease (PID)?

Infection of the upper female reproductive tract.

What are common complications of PID?

Infertility, ectopic pregnancy, and chronic pelvic pain.

Approximately what percentage of people living with HIV are women?

About 25%.

What education should be provided to patients with HIV?

Safer-sex practices and the dangers of unprotected sex.

Why is HIV testing recommended during pregnancy?

To reduce perinatal transmission.

How do antiretroviral medications affect pregnancy?

They significantly reduce perinatal HIV transmission.

What pediatric factors increase the risk of STIs?

Female anatomy, feelings of invincibility, unprotected intercourse, short-term relationships, barriers to healthcare, and neonatal infection risks.

What are common risk factors for vulvovaginal infections?

Low estrogen, pregnancy/oral contraceptives, poor hygiene, tight clothing, frequent douching, antibiotics, allergies, diabetes, infected partner, oral-genital contact, and HIV.

What are common triggers for recurrent genital herpes outbreaks?

Stress, immunosuppression, sunburn, dental work, inadequate rest, and poor nutrition.

Why may a cesarean delivery be performed in a patient with genital herpes?

To reduce neonatal HSV transmission.