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

2. 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.

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

4. 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

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

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

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

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

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

10. Common Diagnostic Tests
Smears and cultures
Biopsies
Staining procedures

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

12. 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.

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

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

15. 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.

16. 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

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