olds’ maternal-newborn nursing & women’s health across the lifespan, 8/e michele davidson,...
TRANSCRIPT
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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
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Bacterial Vaginosis (BV)
• Overgrowth of normal vaginal flora
• Thin, watery, white-gray discharge
• “Fishy” odor
• Treatment: Flagyl
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Clue Cells
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Vulvovaginal Candidiasis (VVC)
• Fungal or yeast infection
• Thick, white vaginal discharge
• Severe itching, dysuria, and dyspareunia
• Treatment: miconazole cream, Diflucan
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Hyphae-Candida Albicans
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Trichomoniasis
• Bacterial organism: Trichomonas vaginalis
• Transmission: sexual intimacy
• Asymptomatic or mild symptoms:– Yellow-green, frothy, odorous discharge– Vulvar itching
• Treatment: metronidazole
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Trich
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Chlamydia
• Bacteria organism: Chlamydia trachomatis
• Transmission: vaginal sex
• Symptoms: 70% of women are asymptomatic.
• Treatment: azithromycin or doxycycline
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Gonorrhea
• Bacterial organism: Neisseria gonorrhoeae
• Transmission: vaginal, anal, or oral sex
• 80% of women are asymptomatic
• Treatment: antibiotic therapy
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Herpes Simplex
• Viral organism: HSV-1 and HSV-2
• Transmission:– Vaginal, anal, or oral sex– Skin-to-skin contact with an infected site
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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
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Syphilis
• Bacterial organism: Treponema pallidum
• Transmission:– Vaginal, oral, or anal sex– Exposure to exudate from infected individual– Transplacental
• Treatment: penicillin G
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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
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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
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Condylomata acuminata
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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
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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
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Health Strategies to Prevent STIs
• ????
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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
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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
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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
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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
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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
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Cystitis: Risk Factors
• Sexual intercourse
• Use of a diaphragm and a spermicide
• Delayed postcoital micturition
• Pregnancy
• History of a recent UTI
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Cystitis
• Symptoms:– Dysuria, urgency, and frequency– Suprapubic or low-back pain– Low-grade fever – Hematuria
• Treatment: antibiotic therapy
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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
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Pyelonephritis: Treatment
• IV antibiotics
• IV hydration
• Urinary analgesics such as Pyridium
• Pain management and medication to manage fever
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Hepatitis A
• Transmission: fecal-oral, contaminated food or water
• Incubation: 15–50 days
• Not chronic
• Immunization available
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Hepatitis B
• Transmission: blood/body fluids
• Incubation: 45–160 days
• Chronic
• Immunization available
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Hepatitis C
• Transmission: blood/blood products
• Incubation: 14–180 days
• Chronic
• Immunization not available
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Hepatitis D
• Transmission: blood/body fluids
• Incubation: 45–160 days
• Chronic
• Immunization not available
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Hepatitis E
• Transmission: fecal-oral
• Incubation: 15–60 days
• Not chronic
• Immunization not available
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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.
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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.
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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.
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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.