1. Olds’ Maternal-Newborn Nursing & Women’s Health Across the Lifespan, 8/e Michele Davidson, Marcia London, and Patricia Ladewig Copyright ©2008 by Pearson Education, Inc. Chapter 6 Women’s Health: Commonly Occurring Infections

2. Copyright ©2008 by Pearson Education, Inc. Bacterial Vaginosis (BV) Overgrowth of normal vaginal flora Thin, watery, white-gray discharge “Fishy” odor Treatment: Flagyl

3. Copyright ©2008 by Pearson Education, Inc. Clue Cells

4. Copyright ©2008 by Pearson Education, Inc. Vulvovaginal Candidiasis (VVC) Fungal or yeast infection Thick, white vaginal discharge Severe itching, dysuria, and dyspareunia Treatment: miconazole cream, Diflucan

5. Copyright ©2008 by Pearson Education, Inc. Hyphae-Candida Albicans

6. Copyright ©2008 by Pearson Education, Inc. Trichomoniasis Bacterial organism: Trichomonas vaginalis Transmission: sexual intimacy Asymptomatic or mild symptoms: –Yellow-green, frothy, odorous discharge –Vulvar itching Treatment: metronidazole

7. Copyright ©2008 by Pearson Education, Inc. Trich

8. Copyright ©2008 by Pearson Education, Inc. Chlamydia Bacteria organism: Chlamydia trachomatis Transmission: vaginal sex Symptoms: 70% of women are asymptomatic. Treatment: azithromycin or doxycycline

9. Copyright ©2008 by Pearson Education, Inc. Gonorrhea Bacterial organism: Neisseria gonorrhoeae Transmission: vaginal, anal, or oral sex 80% of women are asymptomatic Treatment: antibiotic therapy

10. Copyright ©2008 by Pearson Education, Inc. Herpes Simplex Viral organism: HSV-1 and HSV-2 Transmission: –Vaginal, anal, or oral sex –Skin-to-skin contact with an infected site

11. Copyright ©2008 by Pearson Education, Inc. Herpes Simplex (cont’d) Symptoms: primary outbreak –Single or multiple blister like vesicles –Difficult urination and urinary retention –Enlargement of inguinal lymph nodes –Flu like symptoms, genital pruritus, or tingling Treatment: oral acyclovir

12. Copyright ©2008 by Pearson Education, Inc. Syphilis Bacterial organism: Treponema pallidum Transmission: –Vaginal, oral, or anal sex –Exposure to exudate from infected individual –Transplacental Treatment: penicillin G

13. Copyright ©2008 by Pearson Education, Inc. Syphilis (cont’d) Symptoms: early stage –Chancre appears, fever, weight loss, malaise Symptoms: secondary stage –Condylomata lata on vulva, acute arthritis –Enlargement of liver and spleen, enlarged lymph nodes –Chronic sore throat with hoarseness

14. Copyright ©2008 by Pearson Education, Inc. Genital Warts Viral organism: human papilloma virus (HPV) Transmission: vaginal, oral, or anal sex Symptoms: –Painless genital warts –Pruritus Treatment: client or provider therapies for wart removal

15. Copyright ©2008 by Pearson Education, Inc. Condylomata acuminata

16. Copyright ©2008 by Pearson Education, Inc. Pediculosis Pubis Parasite: Phthirus Transmission: intimate sexual contact, shared towels and bed linens Symptoms: –Itching in pubic area Treatment: 1% permethrin cream; wash and dry linens, towels, and clothing

17. Copyright ©2008 by Pearson Education, Inc. Scabies Parasite: Sarcoptes scabiei Transmission: intimate sexual contact in adults Symptoms: –Itching and erythematous, papular lesions or furrows Treatment: 5% permethrin cream; wash and dry linens, towels, and clothing

18. Copyright ©2008 by Pearson Education, Inc. Health Strategies to Prevent STIs ????

19. Copyright ©2008 by Pearson Education, Inc. Health Teaching Planning ahead and developing strategies to say no to sex Limiting the number of sexual contacts and practicing monogamy Using a condom and negotiating condom use with a partner Reducing high-risk behaviors such as used of alcohol and recreational drugs

20. Copyright ©2008 by Pearson Education, Inc. Health Teaching (cont’d) Refraining from oral sex if partner has active sores in mouth, vagina, anus, or on penis Seeking care as soon as symptoms are noticed Understanding that disappearance of symptoms does not mean treatment is unnecessary Taking all prescribed medications completely Having more frequent Pap screening for certain genital infections

21. Copyright ©2008 by Pearson Education, Inc. Expedited Partner Therapy EPT The practice of treating the sex partners of persons with STIs without an intervening medical evaluation or professional prevention counseling. 1.May significantly reduce overall transmission 2.Be aware of individual state legal requirements when considering initiation of EPT

22. Copyright ©2008 by Pearson Education, Inc. Pelvic Inflammatory Disease PID Inflammation of upper female genital tract Chlamydia trachomatis and Neisseria gonorrhoea Post infection tubal damage associates with infertility Treatment: - IV fluids, pain medication, IV antibiotics

23. Copyright ©2008 by Pearson Education, Inc. Symptoms of PID Bilateral sharp, cramping pain in the lower quadrants Fever greater than 101 o F, chills Mucopurulent cervical or vaginal discharge Irregular bleeding Cervical motion tenderness during intercourse Malaise, nausea, and vomiting

24. Copyright ©2008 by Pearson Education, Inc. Cystitis: Risk Factors Sexual intercourse Use of a diaphragm and a spermicide Delayed postcoital micturition Pregnancy History of a recent UTI

25. Copyright ©2008 by Pearson Education, Inc. Cystitis Symptoms: –Dysuria, urgency, and frequency –Suprapubic or low-back pain –Low-grade fever –Hematuria Treatment: antibiotic therapy

26. Copyright ©2008 by Pearson Education, Inc. Pyelonephritis: Symptoms Sudden onset with chills, high temperature, and costovertebral angle tenderness or flank pain Nausea, vomiting, and malaise Frequency, urgency, and burning with urination Decreased urinary output Severe colicky pain, vomiting, dehydration, and ileus of the large bowel

27. Copyright ©2008 by Pearson Education, Inc. Pyelonephritis: Treatment IV antibiotics IV hydration Urinary analgesics such as Pyridium Pain management and medication to manage fever

28. Copyright ©2008 by Pearson Education, Inc. Hepatitis A Transmission: fecal-oral, contaminated food or water Incubation: 15–50 days Not chronic Immunization available

29. Copyright ©2008 by Pearson Education, Inc. Hepatitis B Transmission: blood/body fluids Incubation: 45–160 days Chronic Immunization available

30. Copyright ©2008 by Pearson Education, Inc. Hepatitis C Transmission: blood/blood products Incubation: 14–180 days Chronic Immunization not available

31. Copyright ©2008 by Pearson Education, Inc. Hepatitis D Transmission: blood/body fluids Incubation: 45–160 days Chronic Immunization not available

32. Copyright ©2008 by Pearson Education, Inc. Hepatitis E Transmission: fecal-oral Incubation: 15–60 days Not chronic Immunization not available

33. Copyright ©2008 by Pearson Education, Inc. Resources Center for Disease Control This site provides screening, treatment, and prevention guidelines for sexually transmitted infections. Also included are presentation slides available for downloading.Center for Disease Control Healthy Devil Online Operated by Duke University, this site offers guidelines for safer sex, a risk assessment profile, and information on the various sexually transmitted infections.Healthy Devil Online

34. Copyright ©2008 by Pearson Education, Inc. Resources I Wanna Know Provides information related to teen sexual health including puberty, sexually transmitted infections and sexuality.I Wanna Know American Social Health Association Easy-to-understand information is provided about sexually transmitted infections including statistics, transmission methods, symptoms, diagnosis, treatment and prevention. A glossary is also included.American Social Health Association

35. Copyright ©2008 by Pearson Education, Inc. Resources Safe Sex and HIV Prevention This site offers AIDS information on prevention, treatment, policy, and activism, and continuing education for patients and health professionals.Safe Sex and HIV Prevention Urinary Tract Infections Basic facts are provided about symptoms, treatment, and prevention of UTIs. The site content is reviewed by a medical doctor.Urinary Tract Infections

36. Copyright ©2008 by Pearson Education, Inc. Resources The Urology Channel This site provides a wide range of detailed information about a variety of urology conditions including traditional medical treatment and naturopathic treatment.The Urology Channel