olds’ maternal-newborn nursing & women’s health across the lifespan, 8/e michele davidson,...

Olds’ Maternal-Newborn Nursing &Women’s Health Across the Lifespan, 8/eMichele Davidson, Marcia London, and Patricia Ladewig

Copyright ©2008 by Pearson Education, Inc.

Chapter 6

Women’s Health: Commonly Occurring Infections


Bacterial Vaginosis (BV)

• Overgrowth of normal vaginal flora

• Thin, watery, white-gray discharge

• “Fishy” odor

• Treatment: Flagyl


Clue Cells


Vulvovaginal Candidiasis (VVC)

• Fungal or yeast infection

• Thick, white vaginal discharge

• Severe itching, dysuria, and dyspareunia

• Treatment: miconazole cream, Diflucan


Hyphae-Candida Albicans


Trichomoniasis

• Bacterial organism: Trichomonas vaginalis

• Transmission: sexual intimacy

• Asymptomatic or mild symptoms:– Yellow-green, frothy, odorous discharge– Vulvar itching

• Treatment: metronidazole


Trich


Chlamydia

• Bacteria organism: Chlamydia trachomatis

• Transmission: vaginal sex

• Symptoms: 70% of women are asymptomatic.

• Treatment: azithromycin or doxycycline


Gonorrhea

• Bacterial organism: Neisseria gonorrhoeae

• Transmission: vaginal, anal, or oral sex

• 80% of women are asymptomatic

• Treatment: antibiotic therapy


Herpes Simplex

• Viral organism: HSV-1 and HSV-2

• Transmission:– Vaginal, anal, or oral sex– Skin-to-skin contact with an infected site


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


Syphilis

• Bacterial organism: Treponema pallidum

• Transmission:– Vaginal, oral, or anal sex– Exposure to exudate from infected individual– Transplacental

• Treatment: penicillin G


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


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


Condylomata acuminata


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


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


Health Strategies to Prevent STIs

• ????


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


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


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


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


Symptoms of PID

• Bilateral sharp, cramping pain in the lower quadrants

• Fever greater than 101oF, chills

• Mucopurulent cervical or vaginal discharge

• Irregular bleeding

• Cervical motion tenderness during intercourse

• Malaise, nausea, and vomiting


Cystitis: Risk Factors

• Sexual intercourse

• Use of a diaphragm and a spermicide

• Delayed postcoital micturition

• Pregnancy

• History of a recent UTI


Cystitis

• Symptoms:– Dysuria, urgency, and frequency– Suprapubic or low-back pain– Low-grade fever – Hematuria

• Treatment: antibiotic therapy


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


Pyelonephritis: Treatment

• IV antibiotics

• IV hydration

• Urinary analgesics such as Pyridium

• Pain management and medication to manage fever


Hepatitis A

• Transmission: fecal-oral, contaminated food or water

• Incubation: 15–50 days

• Not chronic

• Immunization available


Hepatitis B

• Transmission: blood/body fluids


• Chronic

• Immunization available


Hepatitis C

• Transmission: blood/blood products


• Chronic

• Immunization not available


Hepatitis D

• Transmission: blood/body fluids


• Chronic



Hepatitis E

• Transmission: fecal-oral


• Not chronic



Resources

• Center for Disease ControlThis site provides screening, treatment, and prevention guidelines for sexually transmitted infections. Also included are presentation slides available for downloading.

• Healthy Devil OnlineOperated by Duke University, this site offers guidelines for safer sex, a risk assessment profile, and information on the various sexually transmitted infections.


Resources

• I Wanna KnowProvides information related to teen sexual health including puberty, sexually transmitted infections and sexuality.

• American Social Health AssociationEasy-to-understand information is provided about sexually transmitted infections including statistics, transmission methods, symptoms, diagnosis, treatment and prevention. A glossary is also included.


Resources

• Safe Sex and HIV PreventionThis site offers AIDS information on prevention, treatment, policy, and activism, and continuing education for patients and health professionals.

• Urinary Tract InfectionsBasic facts are provided about symptoms, treatment, and prevention of UTIs. The site content is reviewed by a medical doctor.


Resources

• The Urology ChannelThis site provides a wide range of detailed information about a variety of urology conditions including traditional medical treatment and naturopathic treatment.

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