Med-Surg - Reproductive System, part 6: Sexually Transmitted Infections
by Cathy Parkes December 20, 2022 Updated: August 10, 2023 4 min read
Full transcript and video captions coming soon!
Hi. I'm Cathy with Level Up RN. In this video, I will be covering a number of sexually transmitted infections, including chlamydia, gonorrhea, syphilis, as well as HPV. I will also be talking about pelvic inflammatory disease in this video as well. And at the end of the video, I'm going to give you guys a little quiz to test your knowledge of some of the key points I'll be covering, so definitely stay tuned for that. And if you have our Level Up RN Medical-Surgical Nursing Flashcards, pull those out so you can follow along with me. Pay close attention to the bold red text on these cards because those are going to be particularly important points that are highly tested on. And the good news is this will wrap up our cards in the reproductive system.
Chlamydia and gonorrhea are sexually transmitted bacterial infections that, left untreated, can result in pelvic inflammatory disease as well as infertility and preterm labor complications. These infections are typically asymptomatic, which means people don't know they're infected and unknowingly infect other people. When symptoms are present, they can include dysuria, which is painful urination, as well as discharge from the vagina or penis, and possibly, the patient could have symptoms of pelvic inflammatory disease, which includes pelvic pain. Diagnosis of these infections can be done with a urine test. We can also collect a specimen by swabbing the female cervix or the male urethra. Treatment includes the administration of antibiotics, so this is typically doxycycline for chlamydia and cephalosporins for gonorrhea. In terms of nursing care, you're going to need to complete disease reporting requirements as these are reportable infections. In addition, you need to provide patient education regarding the importance of abstinence during treatment, the need for partner notification and treatment, and the importance of safe sex practices. In addition, the patient will need to be rescreened about three months after treatment is completed.
Let's now talk about pelvic inflammatory disease. So as I mentioned before, this is a key complication that can result from a chlamydia or gonorrhea infection. With PID, sexually transmitted bacteria spreads from the vagina to the uterus, fallopian tubes, and/or ovaries, and this can lead to infertility as well as sepsis and death. So PID is often asymptomatic, but when symptoms are present, they can include lower abdominal pain, pelvic pain, menstrual irregularities, as well as painful urination, and possibly a fever. So treatment includes the administration of antibiotics as well as analgesics for pain and comfort measures such as a heating pad. In terms of nursing care, just like with chlamydia and gonorrhea, we want to provide important patient teaching, including the importance of abstinence during treatment, the importance of partner notification and treatment, the importance of safe sex practices, and the need for follow-up appointments.
The next sexually transmitted infection we're going to talk about is syphilis. This is a bacterial infection that, left untreated, can result in systemic complications as well as death. So this infection develops in four stages. During the primary stage, we have the appearance of a genital chancre. This is an ulcer that is typically nontender. Then during the secondary stage, the patient will have flu-like symptoms such as fever, sore throat, and muscle aches, and they may also have a rash on their hands and feet. Then during the latent phase, there are no visible signs or symptoms of the infection, but during the late or tertiary phase, the patient can have severe neurological and cardiovascular damage, including vision loss, hearing loss, as well as damage to the heart and blood vessels. Diagnosis of syphilis can be done through a blood test or from taking a swab from the chancre, and then treatment involves the administration of antibiotics such as doxycycline. So syphilis is a nationally notifiable disease, so as the nurse, you're going to need to perform disease reporting requirements, and then you need to provide patient education about the importance of abstinence during treatment and the need for partner notification and treatment as well, and the importance of rescreening.
The last sexually transmitted infection we're going to talk about is HPV, which is human papillomavirus. This is the most common sexually transmitted infection. So certain strains of HPV can cause genital warts and others can lead to cancer. So HPV is the primary risk factor for cervical cancer. HPV is preventable with vaccination, so vaccines should be administered prior to first sexual contact. The first dose is typically given around age 11 to 12, and the second dose is given 6 to 12 months later. So HPV is typically asymptomatic, which means that people unknowingly spread it to others, which makes it super common. For HPV strains that cause genital warts, signs and symptoms may include white or flesh-colored growths in the anogenital region or the oral cavity. HPV is diagnosed using a Pap test. For patients who are positive for HPV, a colposcopy and cervical biopsy can be used to assess for cancerous or precancerous cells in the cervix. There is no cure for the virus. Wart removal can be done using prescription creams or methods such as cryotherapy. In addition to providing patient teaching regarding the importance of partner notification and safe sex practices, you also want to notify your patient that more frequent Pap tests are likely going to be necessary going forward, so instead of every three years, your patient may need to have them done annually or even more frequently.
All right. It's time for a quiz. I've got three questions for you. First question. What disorder is commonly caused by a chlamydia or gonorrhea infection and can cause infertility? The answer is pelvic inflammatory disease. Question number two. A genital chancre is a sign of what sexually transmitted infection? The answer is syphilis. And then question number three. What sexually transmitted infection is the primary risk factor for cervical cancer? The answer is HPV.
All right. That is it for this video. I hope you did well on that quiz. Definitely let me know in the comments. Take care, and good luck with studying.
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