Medical-Surgical Nursing: Concepts & Practice 3rd edition Chapter 40 Care of Patients with Sexually Transmitted Infections Copyright © 2017, Elsevier Inc. All rights reserved.

Healthy People 2020 Goals Increase efforts to promote responsible sexual behaviors. Strengthen community capacity and increase access to quality services to prevent STIs and their complications. Prevent HIV infection and its related illness and death.

Common Infections of the Female Reproductive Tract Pelvic inflammatory disease Candidiasis Bacterial vaginosis

Signs and Symptoms PID: severe abdominal and pelvic pain and fever; foul discharge Candidiasis: includes itching, burning on urination, and a white, cheese-like discharge. Bacterial vaginosis: grayish-white discharge that has a fishy odor

Gonorrhea Symptoms in men and women See Table 40-1 on pp. 946-950.

Sexually Transmitted Infections Risk factors Human papillomavirus vaccine Lesions of STIs Reporting STIs and CDC regulations Transmission

Transmission of Sexually Transmitted Infections Intimate contact Blood contact (HIV or hepatitis B or C)

Stages of Syphilis Three stages Primary Secondary Tertiary See Table 40-1 on p. 950.

Causes of Sexually Transmitted Infections Bacteria Viruses Yeasts and fungi Trichomonas vaginalis (trichomoniasis) See Box 40-1 on p. 945.

Common Diagnostic Tests Smears and cultures Biopsies Staining procedures

Assessment (Data Collection) Screening for potential STIs or risk Adolescents Fear Tact and sensitivity Physical examination

Expected Outcomes Patient will Verbalize knowledge of self-care to prevent recurrence or other STI. Be free from pain after treatment. Cope adequately with history-taking and physical examination. Have decreased fear of HIV diagnosis after examination and treatment. Comply with safer sex practices. Comply with treatment requirements.

Planning Manage treatment protocol and any pain. Provide patient education. Provide emotional support.

Implementation Symptom relief Prevention of spread Abstinence Condoms with a spermicide Limit sexual contacts

Prevention of STIs Early education of adolescents Education and counseling of people at risk Identification of asymptomatically infected people and symptomatic people unlikely to seek treatment Effective diagnosis and treatment of infected people See Box 40-2 on p. 954.

Prevention of STIs (Cont.) Evaluation, treatment, and counseling of sex partners of people who are infected with an STI Pre-exposure vaccination of patients at risk for vaccine-preventable STIs Follow-up of patients at risk or under treatment

Evaluation Behavior changes Follow-up cultures Health department Planned Parenthood and other community agencies