STIs/HIV-Nursing III-Test 3

What is the difference between an STI and an STD?

STIs focus on the microorganisms transmitted by sex, and STD focuses on when those microorganisms multiply and create a disease

Most STDs can be prevented with ________-

latex condom use

The Five Ps are a method for taking a sexual history to help prevent sexually transmitted infections (STIs): what are they?

•Partners: Who are your partners, and what is their gender?

•Practices: What types of sexual activity do you have?

•Protection from STIs: Do you use condoms or other barrier methods consistently?

•Past History of STIs: Have you ever been diagnosed with an STI? When was it? Did you get treatment?

•Pregnancy Intention: Do you want to have children? When do you think that might be?

What STDs do not need to be reported to the department of health?

HPV and HSV

Genital herpes is caused by a

VIRUS

HSV 1 is associated with:

cold sores

HSV 2 is associated with ________, which can be transmitted during _______ or _______

genital herpes, sex, during childbirth from an infected woman

Manifestations of genital herpes include ________, and herpes spreads when ________

painful red vesicles, the blisters break and shed the virus

true or false: someone can get herpes from sharing a towel with someone who has herpes

false-it needs to be direct skin to skin contact

Diagnosis of herpes is mainly ________. The only time we can test for the virus is if ______

visualizing the blisters, there is fluid in the blisters to swap

pharmacologic therapy for herpes includes:

antivirals (acyclovir/zovirax, and valacyclovir/valtrex)

the herpes virus can be spread sexually even if the person is

asymptomatic

nonsexual ways the herpes virus can be spread includes:

-contact with infected skin

-herpes transmission from mother to child

-risk of spread in healthcare setting

majority of individuals infected with HPV are:

asymptomatic

HPV is transmitted by:

genital contact

the main sign of HPV is

genital warts which are painless, soft, and flesh colored

HPV is prevented through:

vaccines

When is the HPV vaccine usually given to boys and girls?

around middle school age

HPV is the causative agent in many:

cancers, largely cervical cancer

A patient with genital herpes asks when it is safe to have sexual intercourse again. The nurse should respond:

A. “When the sores have healed and you’re symptom-free.”

B. “Once you start taking antiviral medication.”

C. “When your partner also has herpes.”

D. “There are no restrictions if you use condoms.”

correct answer is A

Chlamydia is a:

bacterial infection

2/3 of chlamydia infections occur in:

15-24 year olds

chlamydia can cause:

infertility and newborn blindness

most patients with chlamydia are:

asymptomatic

Chlamydia can be present for months or years with no symptoms, but the main symptom is:

urinary burning or mild discharge

if left untreated, chlamydia can cause:

pelvic inflammatory disease

ectopic pregnancy

infertility

chlamydia is diagnosed through a:

Nucleic acid amplification test (urine swap up urethra)

treatment of chlamydia includes:

antibiotics (azithromycin, doxycycline, or levofloxacin)

-minimum of 7 day abx regimen, must abstain from sex while on it

gonorrhea is a:

bacterial infection

gonorrhea is transmitted through:

sexual fluid

the main symptom of gonorrhea is ____________, but it can also cause _______

a greenish/grey discharge, dysuria, irregular menses, urinary frequency

if gonorrhea is left untreated in men, it can cause

epididymis and prostatitis, which can lead to sterility

if gonorrhea is left untreated in women, it can cause:

PID, endometriosis, pelvic peritonitis

gonorrhea can also create anorectal symptoms, which include:

itching, rectal discharge, painful bowel movements, constipation

gonorrhea can also manifest as a pharyngeal infection, with symptoms of:

sore throat, enlarged lymph nodes, fever

high schools can think they are having a strep throat outbreak, when really they are having an outbreak of:

gonorrhea

having gonorrhea increases an adults risk of contracting _______, because __________

HIV, there is a patent portal of entry through the dysuria

to treat gonorrhea, patients are given:

1 dose of ceftriaxone and 1 dose azithromycin, which are administered at the same time

-both antibiotics are broad spectrum, given to cover gram negative and gram positive organisms

syphilis is caused by:

bacteria

the main sign of syphilis is:

chancres/open lesions

syphilis is transmitted through:

chancres during sexual contact, and it spreads through the blood and lymph

what is congenital syphilis?

when syphilis is transferred to the fetus through the placenta

Syphilis can infect almost any __________

body system or organ

syphilis has 4 stages if left untreated, and a person is highly contagious in the ________ and _______ stages, even if they are asymptomatic

primary, secondary

if untreated, syphilis can lead to:

blindness, paralysis, mental illness, cardiovascular damage, deaths

symptoms of primary syphilis:

-chancre (can go unnoticed in women, disappearing in 3-6 weeks)

-regional lymph node involvement

-little or no pain

secondary syphilis

-is systemic

-occurs a few weeks after the chancre disappears and is still highly contagious

-rash on hands and feet

-flu like symptoms

-alopecia

-sore throat

latent syphilis

-develops after secondary lesions heal

-asymptomatic in this stage

-infection is not being transferred to other people, but is still affecting host and can still be passed through the placenta

-sexual transmission of disease is still possible in early part of this phase

-can last 1 year to a lifetime

tertiary syphilis

-can develop gummas

-can affect cardiovascular, nervous, eyes, liver, and bone systems

syphilis is usually diagnosed through:

blood tests

treatment of syphilis:

1 dose of penicillin G given IM

if patient is allergic to penicillin, they will be given oral doxycycline or tetracycline for 14 days

trichomoniasis is caused by a:

protozoa

trichomoniasis can be transmitted through:

sexual contact or sharing of sex toys through sexual fluid

trichomoniasis affects the:

vagina in women and urethra in men

the main symptom of trichomoniasis is ______, but symptoms can also be _________

-frothy, discolored urine

-itching and dysuria

trichomoniasis is diagnosed by:

examining fluid under a microscope

trichomoniasis is treated with:

single dose of metronidazole (flagyl) or tinidazole (tindamax) 

Trichomoniasis is mainly transmitted through sexual contact, but it can also be transmitted through:

sharing damp towels or bathing suits

where can the HIV virus be found?

in blood, semen, pre-seminal fluid, rectal fluid, vaginal/cervical secretions, CSF, breast milk, saliva

What are at risk behaviors for the transmission of HIV?

-unprotected sex

-sharing drug needles

How is HIV diagnosed?

rapid test, then the ELISA test to confirm reactive testing, which is the gold standard for testing.

-tests for HIV antibodies

-may be negative in early stages

-repeat to confirm positive resultHIV

HIV viral load tests are done after

confirmation through ELISA

-they measure the amount of actively replicating HIV

in HIV, we want the CD4 count to be _____ and the viral load to be ______

high, low

Pre-exposure prophylaxis (PrEP)

truvada taken once a day to block infection pathways

post exposure prophylaxis (PEP)

-this is for people who have been exposed to HIV

-must begin within 72 hours of exposure

-must take 2 or 3 antiretroviral therapy medications for 28 days

in an acute HIV infection (primary stage), the patient will present with

flu like symptoms

the primary stage of HIV occurs about __________ after initial exposure

2-4 weeksdu

during the primary stage of HIV, the person is highly

contagious

early onset of HIV in children can look like

lethargy

enlarged lymph nodes

recurrent fever

unexplained weight loss

GI bugs

late onset of HIV in children can look like:

kidney issues

lung infections

tumors

skin rashes

vaginal infections

learning and memory infections

the clinical latency stage of HIV is also known as the:

chronic or asymptomatic stage

in the clinical latency stage, HIV is:

dormant or reproducing at low levels, but  is still activet

the clinical latency stage occurs when the CD4 count is above

500

when the patient’s CD4 count is less than 500, they are at risk for:

opportunistic infections because there immune system is weak

When the CD4 count is below 200, the patient is diagnosed with:

AIDS

Without treatment, people with AIDS usually survive for about:

3 years

cytomegalovirus attacks the:

eyes

oral hairy leukoplakia

 a condition characterized by white, hairy-looking patches on the tongue. 

Causes: 

OHL is caused by the Epstein-Barr virus (EBV), which is also responsible for mononucleosis. It typically occurs in people with weakened immune systems, such as those with HIV/AIDS or those undergoing organ transplantation. 

Symptoms: 

The main symptom of OHL is white, corrugated patches on the tongue that may look like hair. These patches are usually painless and do not cause any other symptoms. 

Kaposi sarcoma

opportunistic infection (lesions or other forms of liver disease in AIDS patients, with KS appearing as dark, pigmented patches or nodules)

the focus of HIV treatment is:

•Suppress infection itself

•Provide prophylaxis of opportunistic infections

•Stimulate hematopoietic response

Treat infections and malignancies

true or false: patients don’t die from AIDs, they die from opportunistic infections

true

antiretroviral therapy

•Combination therapies (3 or 4 drugs)

•Reduce the incidence of drug resistance

•Increase likelihood of decreasing viral load, symptoms

•Does not eradicate HIV

most common side effect is hepatotoxicityl

less than perfect adherence to ART leads to

resistance

Side effects of ART include:

sulfonamide allergy

organ toxicity

neuropathy

insulin resistance

creating phosphokinase elevation

(SONIC)

garlic and st johns wart are shown to

decrease side effects of some medical treatments

what kind of precautions are HIV patients put in when in the hospital?

standard precautions

HIV patients should always use the same:

pharmacist