Exam 6: Sexual Health

Gonorrhea (type of infection, treatment, curable?)

• bacterial infection ‘

• grows in warm moist places

• Antibiotics

• can be cured

Gonorrhea (symptoms)

• Women

  • very few symptoms → not tested leads to further issues

  • Untreated causes inflammation and scar tissue

    • Tubal pregnancy

    • chronic pelvic pain

    • infertility

• Men

  • easier to spot

  • dysuria

  • profuse, purulent (not clear) urethral discharge

  • pain in testicles

  • Untreated causes prostatitis

Dysuria

pain, burning, or discomfort during urination

What should clients avoid during STI treatment?

sex and alcohol

Chlamydia (type of infection, treatment, curable?)

• bacterial

• antibiotics

• can be cured

Untreated STIs cause what in woman and men

• Pelvic inflammatory disease (W)

• Ectopic pregnancy (W)

• infertility (W&M)

• Increase risk of contracting HIV

Chlamydia (symptoms)

• largely underreported because lack of symptoms

• Men

  • inflammation: urethritis, proctitis

  • dysuria

  • Penis discharge (more clear, compared to Gonorrhea)

  • rectal discharge

  • pain during defection

  • overall pain and tenderness

• women

  • inflammation: cervicitis, urethritis

  • mucopurulent discharge (mucus)

  • dysuria

  • frequent urination

  • pyuria (pus in urine)

Trichomonas (type of infection, treatment, curable?)

• parasite → not bacterial or viral

• Flagyl

• can be cured

Trichomonas symptoms

• think, frothy, yellow-green malodorous discharge

• burning and itching

• vaginal and cervical redness

Bacterial Vaginosis (BV) (type of infection and treatment)

• not considered an STI but can increase risk of obtaining one

• bacterial

• antibiotics

Bacterial Vaginosis (BV) (symptoms and spread)

• thin white/grey discharge with fishy order

• dysuria

• itching

• burning

• can not spread to man but can spread to female partners

Bacterial Vaginosis (BV) (risk)

• douching

• not using condoms

• multiple sex partner

Genital Herpes (HVS) (type of infection, treatment, curable?)

• viral, can’t be cured

• antivirals to decrease outbreaks

HSV 1 vs HVS 2

• 1 → infection above waist but can have 1 pop up on genitals from oral sex

• 2 → below the waste

HVS symptoms

• sometimes painful raised bumps filled with fluid

• can spread even if there is no symptoms

• flare ups

Human Papillomavirus (HPV)/ Genital warts (type of infection, treatment, curable?)

• viral

• not curable

• preventative vaccine

HPV is usually seen in what age group?

sexually active young adults, highly contagious

HPV warts appearance

• single or many

• gray-pink flesh colored

• flakey and hard looks like cauliflower

• usually painless

HPV biggest concern

higher risk of cancer, specially cervical

syphilis (type of infection, treatment, curable?)

• bacterial

• antibiotics (penicillin)

• it is curable

syphilis symptoms (stages)

• primary: painless lesions

• secondary: chancre (ulcer), flu like symptoms, spreading rash (mostly palms and soles)

• tertiary: if left untreated can cause cardiac and neurological issues

BV diagnostic test

vaginal swab

Chlamydia/Gonnorrhea diagnostic test

urine or swab, but swab preferred

Syphilis diagnostic test

blood

HPV diagnostic test

• swab/pap smear (W)

• visual exam (M&W)

HSV diagnostic test

• Swab for active lesion

• Blood for dormant

Trichomoniasis diagnostic test

swab and urine, swab preferred

BPH (why, who, what)

• enlargement of prostate gland

• 60% of men ages 60-70

• semen and urine excretion issues due to compression of urthera

oliguria VS anuria

• Oliguria: little amounts of urine

• Anuria: no urine

BPH symptoms

• trouble starting stream

• decrease strength of urine stream

• dribbling after urination

• dysuria

• Nocturia

• frequency

• urgency

Diagnosing BPH

• increased risk 50 or older

• Digital Rectal Exam (DRE) → should not feel prostate

• Urinalysis

• PSA level: 4.0 or above is bad

TURP: Transurethral Resection of the Prostate

• removes excess prostate tissue goes into the penis to do so

• BPH treatment

• pain management

TUIP: Transurethral incision of prostate

• incision to reduce pressure, not removing tissue

• infection risk and ED due to muscle damage

• BPH treatment

Laser surgery

• laser prostate tissue

• BPH treatment

Open surgery

• if gland is very enlarge

• risky

• BPH treatment

Is BPH a risk factor for prostate cancer?

NO

Testing for diagnosis required what

biopsy!!

TRUS: transrectal ultrsonography

ultrasound that allows visualization of prostate

prostatitis

• infection/inflammation of the prostate

• needs antibiotics

• trouble peeing → emergency

• blood may be in urine: hematuria

Orchitis (def, symptoms, cause)

• inflammation of testes

• painful, tender, swollen

• elevated WBC

• can occur due to bacterial, viral, or parasites

Epididymitis (def, symptoms, cause)

• acute and painful inflammation of epidimythis

• pain

• gonnorrhea/chlamydia

Hydrocele

• fluid in scrotum

• painless

• surgical excision or needle aspiration

Varicocele

• enlarged veins in scrotum

• often no symptoms can cause low sperm production leading to decreases quality and infertility

What is the prepuce?

foreskin

Phimosis

• inability to retract foreskin

• very painful

Paraphimosis (def, concerns, symptom)

• tightness of foreskin, making it unable to pull down

• concerns about circulation and infection

• very painful

ED

• inability to attain or maintain an erect penis

• can happen to anyone

• age range 40-70 y/o

ED risk factors

• vascular issues → think lack of blood flow

• drug induced → bp medications, those with high bp would be at risk

  • also hydrochorothazide

• Endocrine → periferal effects

• neurological → stroke

• psychological → emotional

• obesity

Menorrhea

• medical term for menstruation

• the shedding of the uterine lining if not conceived

• occurs about every 28 days

Primary Dysmenorrhea

• normal

• abdominal cramping or discomfortable related to period

• lower back pain

• pain is caused by contractions

Menorrhagia

Experience longer or heavier than typical menstrual flow

• more than 80 mL

Treatment for Dysmenorrhea

• NSAIDS

  • careful for those on blood thinners, GI issues, and liver problems)

• exercise

• heat

Secondary Dysmenorrhea (def, cause, symptoms)

• not normal, more severe

• occurs usually 30-40

• cause: endomterosis, PID, uterine Fibroids

• S/S: Dyspareunia, painful defecation,

  irregular bleeding other than

  menstruation

Dyspareunia

pain during intercourse

Primary Amenorrhea (def, cause)

• no period during reproductive years, like ever or yet

• young girls, those with no uterus, athletes/gymnast

Secondary Amenorrhea(def, cause)

• had a period before but then it stopped

• large weight loss like GLP-1

• or pregnancy, birth control, hysterectomy

Testing for Menorrhagia

• pad count → how many pads are you saturating in a short period?

• period more than 7 days

• check bp it will decrease with blood loss

Metrorrhagia (def, causees)

• irregular bleeding between periods

• stress, birth control, spontaneous abortion, ectopic pregnancy

Menopause (def, what decreases?)

• ovaries stop releasing eggs and period slows down and eventually stops

• production of estrogen and progesterone stop

Menopause symptoms

• hot flashes

• night sweats

• heart pounding/racing

• mood changes → depression, anxiety, irritability

• trouble sleeping

• uncomfortable intercourse

Menopause treatment

• medication

• limit caffeine and alcohol

• exercise → also avoid osteoporosis

• relaxation

• fans

• Calcium and Vit D

Vaginal changes in menopause

• walls less el and thinner

• shorter vagina

• labia thin and pale

• less lubrication

Possible complications of menopause

• bone loss and osteoporosis

• heart disease risk

  • change in cholesterol levels: LDL increases, HDL decreases heart

Ways to reduce menopause symptoms

• calcium and vit D for bones

• no fatty/fried foods

• do not smoke

• control BP → heart failure risk

• exercise

Pelvic inflammatory disease (def, symptoms, CAUSE)

• infection in the uterus: antibiotics

• very painful → lower abdomen or pelvis

• vaginal drainage or bleeding

• dyspareunia: painful intercourse

• cannot get pregnant

• Untreated/recurring STI is a huge risk specifically gonorrhea/chlymadia

• multiple sex partners, IUD

dyspareunia

painful intercourse

Septic Shock labs

• low bp

• high hr, wbc, temp

• CPR: reactive protein: above 3

Treatment for pelvic inflammatory disease

• antibiotics

• does partner have STI?

• cease intercourse

• corticosteroids

• pain med

Endometriosis (def, location, cause, diagnosis)

• slow and progressive painful disease, menstruation backs up → blood cant escape

• can occur in pelvic cavity but in other parts such as lungs

• cause is unknown

• pelvis ultersound or laparoscopy (imaging)

Endometriosis symptoms

• pain before/during periods

• pain with sex

• infertility

• fatigue

• pain with urination/ bowel movement during periods

• GI upset

catamenial dysuria

pain with urination during periods

Leiomyomas (uterine fibroids) definition and risk

• small tumors caused by estrogen

• increased BMI, african american, family history, client who has NOT been pregnant

Leiomyomas (uterine fibroids) symptoms

• pain/pressure, dysmenorrhea, constipation , urination frequency, trouble getting pregnant, excessive bleeding

Uterine prolapse stages

• first: cervix is at the lower part of the vagina

• second: cervix is at vaginal opening

• third: uterus protrudes out of the vaginal opening

Uterine prolapse and Cyctocele risk

• old age

• multiple pregnancy

• lifting heavy

Cyctocele defintion and symptoms

• bladder shifting down towards vagina

• incontinence and uti risk

Rectocele defintion, symptoms, and diet

• upward pushing of rectum towards the vaginal wall

• constipation

• increase fluid fiber and exercise

What can prevent prolapse and other issues?

Kegel exercises

what is the gellhorn pessary used for?

device inserted to help the prolapsing of uterus or bladder

postoperative nursing actions for gellhorn pessary insertion

• sitz bath

• no heavy lifting

• stool softeners

• measure urine output

Benign vs malignant breast disorders

• benign → non cancerous

• malignant → cancer

What to look for on breast

• size/ symmetry

• color

• venous pattern

• thickening

• edema

• nipples

when do you do a breast exam?

AFTER period, period can change the breast

How to do breast exam

• laying down supine

• check armpits!!

• circular motion around the breast

breast abnormalities

• lumps/bumps

• dimples

• puckers

• ridges

• pain

• rashes

• abdnormal discharge

Peau d’orange symptoms and cause

• orange peel appearance on the breast

• edema and pitting

• enlarged skin pores

• thick and hard breast

• inflammatory breast cancer

• blockage of drainage

What is a mammography and who gets them

• breast cancer screening (does not say its cancer or not)

• for those over 45 or older

• those with abnormalities

What is a breast ultrasound used for regarding breast?

• takes pictures of the tissue

• if something is found during palpation or the mammogram this can be done

Fine needle biospy for breast

• take fluid from the lump

• done if ultrasound finds something

• test if its cancerous

Fibrocystic breast

• noncancerous bumps/lumps in the breast

• caused by estrogen

• clients who are 30-50 are more at risk