Espino, Emilyn

BSN-III

UNIVERSITY OF LUZON
College of Nursing and Midwifery

INFECTIOUS AND INFLAMMATORY DISORDERS

CASE STUDY: THE PATIENT WITH A SEXUALLY TRANSMITTED DISEASE

A young woman comes to the STD clinic. She is defensive and seems disgusted as She
explains to the nurse that she believes she was exposed to an STD. She bases her belief
on something a friend told her, but she is reluctant to be more forth- coming about the
details, she currently denies symptoms.
She is also very angry about false accusations that people are making. The nurse
validates her decision to come in for examination and diagnosis.
1. The nurse explains that women have more health problems associated with STDs
than men. What should the nurse tell the patient? What are the health problems?
(tabulate)
 Infertility and increased risk of ectopic pregnancy
 Congenital infections
 Neurosyphilis
 Gonococcal meningitis
 Gonococcal arthritis
 Syphilis aortitis
 Human Immune Deficiency Virus-Related Complications

2. Explain why the patient could present with this angry and defensive behavior.
What can the nurse do?
STD is a very sensitive topic and maybe the patient does not want to disclose the
information because it might spread.
 Assure the patient that you will keep the information confidential
 Encourage the patient to be calm by doing first deep breathing exercises
 De-escalate client with a calm voice.
 Avoid arguing to the client
 Document incidents in an objective manner, stating factual information only.

3. What should be included in a nursing assessment of the patient with symptoms of

an STD? List and differentiate the STD and its symptoms (tabulate)
Syphilis is a bacterial infection usually spread by sexual contact. The disease starts as a
painless sore, typically on genitals, rectum, or mouth. Syphilis spreads from person to
person via skin or mucous membrane contact with these sores.
 In primary syphilis, chancre
  Secondary syphilis, chancre to generalized infection which includes
lymphadenopathy, arthritis, meningitis, hair loss, fever, malaise, and weight loss.
Rashes occur to the trunk, the extremities, palms of the hand and soles of the feet
 In tertiary syphilis, 20% to 40% of patients with syphilis does not exhibit signs and
symptoms. Most common manifestations include aortitis and neurosyphilis as
evidenced by dementia, psychosis, paresis, stroke, or meningitis.

Chlamydia Trachomatis and Neisseria Gonorrhoeae Infections- Coinfection with C.

Trachomatis often occurs in patients infected with N. gonorrhoeae.
The patient is assessed for:
 Fever
 Discharge (urethral, vaginal, or rectal)
 Signs of arthritis
 UTI
 Vaginitis

Trichomoniasis is a common sexually transmitted infection caused by a flagellated

protozoon.
Signs and symptoms include:
 Vaginal discharge that is thin, yellow to yellow-green, malodorous, and very
irritating
 Vulvitis which results to vulvovaginal burning and itching
 Assess for odor of discharge

Human Papillomavirus is a type of virus that can cause abnormal tissue growth (for
example, warts) and other changes to cells. Infection for a long time with certain types
of human papillomavirus can cause cervical cancer.
 Genital warts (condylomata) grows on the skin of vulva, vagina, cervix, or anus.

Herpes Virus Type 2 Infection is a recurrent and lifelong viral infection that can cause
herpetic lesions on the external genitalia and occasionally the vagina and cervix.
 Itching and pain
 Red and edematous (infected area)
 Macules and papules at first and may progress to vesicles and blisters mostly in
the labia. Although cervix, vagina and perianal skin may be affected
 Inguinal nodes are enlarged

Human Immune Deficiency Virus and Acquired Immune Deficiency Syndrome

After contracting HIV, the immune system mounts a response to the virus.
Signs and symptoms may include:
 Fatigue
 Headaches
 A low-grade fever
 Coughing
 Sneezing
 A runny nose or congestion
The symptoms above usually appear 2–6 weeks after contracting HIV, and they can last
anywhere from a week to a month.
These symptoms can resemble those of a cold or flu, so a person may not initially
associate them with HIV.
Many symptoms of an acute HIV infection are common in males and females. However,
some women may experience other symptoms, including:
 Swollen lymph nodes- Can be one of the earliest symptoms of HIV, after those of
an acute infection.

Following an acute HIV infection, the virus continues to multiply, but at a slower rate. A
person may or may not have symptoms.

4. What are six nursing responsibilities associated with the management of a patient
who is newly diagnosed with an STD?

 Increasing knowledge of the patient

 Preventing spread of disease
 Reducing anxiety
 Increasing adherence
 Monitoring potential complications
 Managing potential complications

5. The patient is reluctant to disclose the names of sexual partners or talk about
partners. What could the nurse do?

 By individualizing education, factual information applied to specific needs may

offer reassurance
 Explain that patient may need help in planning discussion with partner
 If the patient is especially apprehensive about this aspect, referral to a social
worker or other specialist may be appropriate
 6. The patient is diagnosed with Gonorrhea. What should be included in the patient
education material? What are your nursing interventions?
 Discuss feelings and concerns about the diagnosis of gonorrhea. Stress that such a
diagnosis does not reflect on one’s self-worth as a person
 Directions for taking medication and what to do about potential side
effects.
Reinforce the importance of abstinence
 Educate limiting the number of sexual partners
 Educate patient on how to talk with a future sexual partner about condom use

7. What should the nurse include in the patient teaching for a patient who was
prescribed oral antibiotics?
 It is important to take all of the medication prescribed to cure gonorrhea.
 Do not stop antibiotic unless told by the physician
 Finish all course of antibiotic prescribed by the physician
 If there is reoccurrence, mostly it is not associated with failure of the medicine
but a reinfection.