CJ Exam 3

What STI is a precursor for cervical cancer

HPV

If you have precancerous cervical cells with HPV above the age of ___, you are at the highest risk for cervical cancer

30

Risk factors for HPV

sexual activity, oral contraceptives, smoking, other STIs

HPV is usually

asymptomatic

What is main symptom of HPV

genital warts

HPV warts often have a ___ like apperance andf cause itching burning and tnederness

cauliflower

How do you screen for HPV

pap smear

Tests for abnormal cell growth in the cervix

Pap smear

How long does a pap smear take to get results

48 hours

If there is an abnormal pap smear, the provider will likely order a ___ to get a closer look at the cervix, vulva, and vagina

colposcopy

How often should you get a pap smear if you have received an abnormal pap in the past

1-3 years

How often should you get a pap smear with a normal result at 21-29

3 years

How often should you get a pap smear with a normal result at 30-65

5 years

How often should you get a pap smear with 3 normal results at 65+

no more needed

Noncancerous HPV is called

nononcogenic

Treatments for HPV warts

creams, cryotherapy, surgical excision

Probe in cancerous cells using high pressure waves to remove the cells painlessly

LEEP

Main ways to remove high risk HPV lesions

LEEP, ablation, excision, laser

using burning or freezing to remove a lesion

ablation

You can have the HPV vaccine at ___ years old

9

Target age of the HPV vaccine

11-12

HPV vaccinations for before 15 yo

2 shots

HPV vaccinations for after 15 yo

3 shots

Should you recomend the HPV vaccine to a client who has had HPV?

yes (protect from other strains)

Main targets of syphillis

25-29, gay, sex workers, incarcerated

The first stage of syphilis is called

primary

Main symptom of primary syphilis

canker sore of tip of penis

The canker sore from primary syphillis should appear

firm and round

Main symptoms of secondary syphillis

rash, genital lesions, malaise (widespread)

How to diagnose syphillis

blood sample or swab

First line of medication use for syphillis

penicillin

Second line of use for syphilis

tetracyclines

Syphilis can quickly become a widespread infection, meaning it is important to watch

neurological status

What is the most common BACTERIAL STI

chlamydia

Chlamydia is also transferrable through

childbirth

Chlamydia often is diagnosed with

gonorrhea

Chlaymydia occurs more in females or males

females

Chlamydia diagnois

Swab, NAAT

Chlamydia symptoms in females

painful peeing and sex, vaginal bleeding, proctitis, abdomen pain

Inflammation fo the rectum/anus

proctitis

Chlamydia symptoms in men

painful peeing, discharge, inflammation, proctitis

First lione of medication treatment for chlamydia if not pregnant

doxycycline

Medication treatment for pregnant chlamydia

azithromycin

Chlamydia complications

pelvic inflammatory disease (infection moves up genital tract to reproductive organs) (PID)

Your chlamydia patient's fever has spiked and she now complains that her pain has moved up her abdomen,it is likely she has developed

pelvic inflammatory disease (PID)

Second most common bacterial STI

gonorrhea

Gonorrhea symptoms for females

Vaginal discharge, bleeding between cycles, anorectal discomfort, pain when peeing, and inflammation of the cervix

Gonorrhea symtoms for males

pain when peeing, purulent discharge, rectal pain

Gonorrhea is usually tested for with

chlamydia

Gonorrhea diagnosis tools

NAAT, gram staining

Medications to treat gonorrhea

cephalosporins and azithromycin

Why do you use azithromycin to treat gonorrhea

in case of chlamydia

cephtriaxone

cephalosporin

Gonorrhea complications

PID, ectopic pregnancy, infertility

Are UTIs more common in women or men

women

Most common ages for UTIs

20s, 65+

Why are the elderly so susceptible to UTIs

high sexual activity, incontinence

Why can diabetes cause an increased risk of UTIs

infection loves sugar

Why can an estrogen deficiency increase risk of a UTI

dry, irritated tissue

UTI symtoms

bladder irritability, dysuria, urinary frequency and urgency, blood in urine

Describe the urinary schedule of a UTI patient

frequent urinations of small amounts

Visible blood in the urine

gross hematuria

Nonvisible blood in the urine

microhematuria

UTI diagnosis tools

symptoms, urinalysis, urine culture

What should you look for in a urinalysis for a UTI patient

WBCs

UTI medication treatment

antimicrobial therapy and bladder analgesic

methoprim/sulfamethoxazole

bactrim (for UTI)

nitrofurantoin

macrobid (for UTI)

What should you educate a patient on phenazopyridine on

short term med, orange urine

Complications of a UTI

drug resistance, pyelonephritis

For how long should you give a UTI patient a bladder analgesic

2-3 days

Why should you increase fluid intake for a UTI patient

flush bacteria

Why is incontinence more common in pregnancy and elderly

pelvic muscles weaken

Causes of stress incontinence

childbirth, menopause, smoking, obesity

Urine leakage with coughing, laughing, lifting and excercise

stress incontinence

Cause of urge incontinence

bladder irritants

Strong urge to urinate followed by uncontrolled leakage

urge incontinence

Mixed incontince is a combination of

stress and urge

Frequent urination due to a flaccid or enlarged bladder due to an OBSTRUCTION, spinal cord injury, stroke, diabetes, or neurological disease

overflow incontinence

Bladder muscles contract on their own, due to a disorder impacting nervous impulses, leading to varying control of sphicters

reflex incontinence

inability to get to the toilet or communicate the need to do so

functional incontinence

What tool can you use to tell which type of incontinence your patient has

voiding diary

To treat incontinence, you should start with pharm or nonpharm

nonpharm

Nonpharm treatments for stress incontince

pelvic floor exercises

Nonpharm treatments for urge incontinence

eliminate bladder irritants, prompted voiding, fluid control

Nonpharm treatments for reflex incontinence

straight cath, reflex voiding

Nonpharm treatments for overflow incontinence

straight cath, indwelling cath, double voiding, fluid control

Nonpharm treatments of functional incontinence

time toileting, mobility devices

Pharm treatments for incontinence

anticholinergics, antidepressants, alpha blockers, estrogen, beta agonist

What drug class helps restore tone to urethral and vaginal areas to treat stress incontinence

topical estrogen

Incontinence surgery that provides support for urethra, and is used for bladder prolapse; often for women with stress incontinence

suburethral sling

Incontinence surgery that often restores urinary control for men with a pump in the scrotum to cause urination

artificial urinary sphincter

Incontinence complications

skin breakdown, renal disease

Main important teaching point for incontinence treatment

straight cath technique (must demonstrate)

Why is GERD so prevalent in western countries

diet

What 3 main things increase GERD risk

decreased lower esophageal sphincter function, increased abdominal pressure, high gastric acid production

How can a hiatal hernia put a patient at risk for GERD

increased abdominal pressure

How can an NG tube put a client at risk for GERD

increased gastric acid production

How can tobacco use increase risk of GERD

increase gastric acid production

What is the first and primary way to treat and diagnose GERD if it works

PPI