NUR3219C
Sexually Transmitted
Infections
Learning Objectives
• Identify factors contributing to sexually transmitted infections (STIs).
• Describe the etiology, clinical manifestations, complications, diagnostic studies, and
interprofessional care for chlamydial infections, gonococcal infections,
trichomoniasis, genital herpes (HSV), genital warts (HPV), and syphilis.
• Distinguish between primary, secondary, and tertiary syphilis.
• Describe the assessment, interprofessional care, and nursing management of
women with pelvic inflammatory disease (PID).
• Prioritize nursing interventions for managing acute STIs.
• Summarize the nursing role in the prevention and control of STIs.
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Overview: Sexually Transmitted
Infections (STIs)
• Infectious diseases spread through sexual contact with the penis,
vagina, anus, mouth, or sexual fluids of an infected person
• Easily treated but still a serious health threat due to potential
complications which include infertility and cancer
• Affects well-being, relationships, and sex life
• Nursing roles: education, counseling, and referral
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Sexually
Transmitte
d
Infections
• Bacterial infections
• Chlamydia
• Gonorrhea
• Syphilis
• Parasitic/protozoan infections
• Trichomoniasis
•Viruses
• Genital herpes
• HIV
• Hepatitis B and C
• HPV
• Molluscum
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Transmission
• STIs can also be spread
• Skin-to-skin (HPV)
• Via blood or blood products (HIV or mother to baby)
• Autoinoculation (spread through touch of infection)
• Not typically transmitted from inanimate objects or casual contact
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Background
• Rates of STIs are at an all-time high
• Nearly 26 million (1 in 5 adults) new infections occur in the United
States each year; $16 billion in health care costs
• All sexually-active persons are at risk
• Contributing to increased risk are socioeconomic factors, decreased
condom use, cuts to STD programs across the country
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Reporting
• In the United States, all cases of gonorrhea, syphilis, and chlamydia must
be reported to public health authorities for surveillance and partner
notification
• Attempt to prevent and control the spread
• Only a small percent of new STIs are reported
• 2 million cases reported annually; does not represent actual number
of infections
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Risk Factors for STIs
• High-risk behaviors
• High-risk medical history
• Trends in contraception
• High-risk populations
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Nursing Management: STIs
Assessment
• Subjective data
• Sexual health history
• Sexual activity with
individuals with STIs
• Past history of STIs
• Multiple sexual partners
• Unsafe sexual practices
• Medications: allergy to antibiotics
• Functional health patterns
• Objective data
• General
• Integumentary
• GI
• Urinary
• Reproductive
• Diagnostic findings
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Nursing Management: STIs Assessment
• Awareness topics for HCPs
• Gender identity, current anatomy
• Risk history and sexual behaviors
• Number of partners in last month? Year?
• Types of partners; men, women, both?
• Type of birth control; condoms, barrier methods
• History of STI
• Drug/alcohol use
• Exchange of sex or drugs or money
• Risk for violence and personal safety
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Nursing Management: STIs
Assessment
• Interpersonal skills
• Respect
• Compassion
• Nonjudgmental attitude
• Tailor counseling to individual
• Do not assume:
• Heterosexual, MSM, WSW, or
same sexual practices due to
appearance
• Older people are not at risk
• Psychologic support
• Emotional responses include
embarrassment, shame, guilt,
anger, vengeance
• Provide counseling and support
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Implementation
• Health promotion
• Discuss safer sex and harm reduction
• Sexual abstinence is the only certain method of avoiding
all STIs
• Established, monogamous relationships have lower risk of
STIs
• Address issues related to drug and alcohol dependence
• Address issues of special populations
• Encourage HPV vaccination
• Give parents accurate and current information to
decrease fears
• Reinforce cancer prevention
• Screening programs
• Effective for identifying, treating, preventing transmission
and controlling the spread of STIs
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Implementation
• Measures to prevent infection
• Proper condom use
• Refusal of sex without condom is
safe and legitimate
• Educate on the availability of HIV PreExposure Prophylaxis (PrEP) and postexposure prophylaxis (PEP)
• Help patients be aware of specific signs
and symptoms of infection of
themselves and their partners
• Remind that most STIs may have no
symptoms
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Questions?
Please post to the discussion board in Canvas or reach out to your course instructor!