learning Objectives - Describe various sexually transmitted diseases. Demonstrates skills in syndromic management of sexually transmitted diseases.
Hours - 5
Teaching and Learning Activities - Lecture cum discussion Video
Assessment Methods - Short answer Objective type Essay type
Content of the chapter
a) Assessment
– History
– Physical examination
– Diagnostic tests
b) Sex health and hygiene
c) Syndromic Management of sexually
transmitted disease
– Gonorrhea
– Syphilis
– Granuloma Venerium
– Chanchroid granuloma
– AIDS
– Genital herpes
Nursing Management of Patients with Sexually Transmitted Diseases (STDs)
Sexually transmitted diseases are infections transmitted primarily through sexual contact, caused by bacteria, viruses, or parasites. Nursing care focuses on early detection, treatment, prevention, education, and psychosocial support.
a) Assessment
History
- Sexual history: number of partners, type of sexual activity, use of protection
- Onset, duration, and type of symptoms: discharge, genital sores, pain, itching, ulcers
- Past STD infections or treatments
- General health, immunization status (e.g., HPV vaccine), comorbidities
- Social and psychological aspects: stigma, relationships, counseling needs
Physical Examination
- Inspection of genital area: ulcers, warts, lesions, discharge
- Palpation for lymph node enlargement, inguinal swelling
- Examination of other body areas for systemic involvement
Diagnostic Tests
- Bacterial STDs: gram stain, culture & sensitivity, PCR tests
- Viral STDs: serological tests for HIV, herpes simplex virus, syphilis (VDRL, RPR)
- Screening tests: Hepatitis B surface antigen (HBsAg), HPV testing
- Urine tests: for chlamydia, gonorrhea
b) Sex Health and Hygiene
- Educate about safe sexual practices: use of condoms, limiting multiple partners
- Proper genital hygiene: regular cleaning, avoiding irritants
- Regular screening and early testing for high-risk individuals
- Counseling on partner notification and treatment to prevent reinfection
- Encourage HPV vaccination for prevention of genital warts and cervical cancer
c) Syndromic Management of STDs
1. Gonorrhea (Neisseria gonorrhoeae)
- Symptoms: purulent urethral discharge, dysuria, pelvic pain, vaginal discharge
- Nursing care: administer prescribed antibiotics (e.g., ceftriaxone), monitor for complications, educate on partner treatment
2. Syphilis (Treponema pallidum)
- Stages: primary (chancre), secondary (rash, mucous patches), tertiary (cardiovascular, neurological)
- Nursing care: penicillin therapy, patient education, monitor for Jarisch-Herxheimer reaction
3. Granuloma Venereum (C. trachomatis)
- Chronic ulcerative lesions, lymph node swelling
- Nursing care: doxycycline or azithromycin therapy, hygiene maintenance, sexual abstinence until healed
4. Chancroid (Haemophilus ducreyi)
- Painful genital ulcers, inguinal lymphadenopathy
- Nursing care: antibiotics (azithromycin or ceftriaxone), wound care, patient counseling
5. AIDS (Acquired Immunodeficiency Syndrome – HIV)
- Opportunistic infections, weight loss, fatigue
- Nursing care: antiretroviral therapy (ART), infection prevention, psychosocial support, patient and partner counseling
6. Genital Herpes (HSV-2)
- Painful vesicular lesions, recurrent outbreaks
- Nursing care: antiviral therapy (acyclovir), pain management, hygiene, safe sexual practices, counseling about recurrence and transmission
Nursing Responsibilities Across STDs
- Patient Education: modes of transmission, prevention, treatment adherence
- Psychosocial Support: address stigma, anxiety, and relationship issues
- Partner Management: testing and treatment to prevent reinfection
- Infection Control: safe handling of specimens, use of gloves, and hand hygiene
- Monitoring for Complications: infertility, pelvic inflammatory disease (PID), neurological or cardiovascular involvement in advanced infections
Conclusion
Nursing management of STDs involves a holistic approach combining:
- Comprehensive assessment and early diagnosis
- Medication administration according to syndromic management guidelines
- Health education, hygiene counseling, and sexual health promotion
- Psychosocial support to reduce stigma and ensure treatment adherence
- Prevention strategies including vaccination, partner notification, and safe sexual practices