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week 2 DB response : see attachment  | Nursing

see attachment  Week2DBresponse--.pdf Infe ctio n Description Presentation Causes/Risk Factors Treatment per CDC Additional Info Can dida Fungal infect

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see attachment  Week2DBresponse--.pdf Infe ctio n Description Presentation Causes/Risk Factors Treatment per CDC Additional Info Can dida Fungal infection (yeast) Vulvar itching, thick white discharge Antibiotics use, diabetes, pregnancy, tight clothes Fluconazole 150 mg PO single dose Not sexually transmitted BV Bacterial vaginosis Thin gray discharge, fishy odor Douching, multiple partners, new sex partner Metronidazole 500 mg PO BID x 7 days Not an STI, but related to sexual activity Chl amy dia Bacterial STI Often asymptomatic, discharge, dysuria Unprotected sex, <25 yrs, multiple partners Doxycycline 100 mg BID x 7 days Screen all sexually active females <25 Gon orrh ea Bacterial STI Purulent discharge, pelvic pain Same as chlamydia Ceftriaxone 500 mg IM + doxycycline Often co-infected with chlamydia Tric hom onas Protozoan STI Frothy yellow-green discharge, odor Unprotected sex, multiple partners Metronidazole 2g PO single dose Treat both partners Cer vicit is Inflammation of cervix often due to STI Bleeding, discharge, pelvic pain Chlamydia, gonorrhea Treat based on causative organism Can lead to PID PID Infection of upper reproductive tract Pelvic pain, fever, cervical motion pain Untreated STIs Ceftriaxone + doxycycline + metronidazole Risk for infertility HIV Virus affecting immune system Fever, fatigue, weight loss Needle sharing, sex, mother-to- child Antiretroviral therapy (ART) Lifelong management Syp hilis Bacterial STI (Treponema pallidum) Chancre, rash, systemic symptoms Sexual contact with infected person Penicillin G benzathine IM Multiple stages; test with RPR/ VDRL Table 2: STI Knowledge Questions SOAP Note – Tina, 27-year-old Female Subjective: Chief Complaint (CC):
 “My vagina is burning, and I have painful blisters.” HPI (OLDCARTS): Hep B Liver infection due to HBV Fatigue, jaundice, nausea Sexual contact, needle use Supportive, antivirals for chronic cases Vaccine available Hep C Liver infection due to HCV Often asymptomatic, may cause fatigue Blood-to-blood contact, needle sharing Direct-acting antivirals (DAAs) No vaccine; chronic if untreated HS V Herpes simplex virus (type 1 or 2) Painful vesicles/ ulcers, fever Sexual contact Acyclovir, Valacyclovir Recurrent; no cure, only symptom management Question Answer Name 10 Risk Factors for contracting STIs and HIV Unprotected sex, multiple partners, new partner, age <25, MSM, history of STIs, drug use, sex work, inconsistent condom use, partner with STI Name 5 safer sex practices Use condoms, limit partners, regular testing, mutual monogamy, avoid sex under influence Can HIV be transmitted through sweat, saliva, and tears? No. HIV is not transmitted through sweat, saliva, or tears due to insufficient viral load Name 2 types of intercourse at highest risk for contracting HIV Anal sex (receptive), vaginal sex (receptive) Why are women more susceptible to HIV in male-to- female transmission? Larger mucosal surface area exposed, higher viral load in semen, potential microtears during sex • The patient presented with a C/C of vaginal burning and painful blisters that began 3 days ago. The area of concern is in her left labia minora. The patient describes that blisters as painful and having a burning sensation with visible fluid-filled vesicles. Friction, urination, and tight clothing worsen the pain. The patient describes relief with cool compresses, and loose clothing. The discomfort is constant with intermittent sharp pain. She rates the pain a 6/10. Medical History: • no previous medical history • no known allergies to drugs, food, or environmental factors • no recent illnesses or hospitalizations • vaccinations are up to date Surgical History: • No prior surgical history Social History: • #2 sexual partners in the last 6–12 months • Use of protection (condoms) • Tobacco, alcohol, recreational drug use, x2 a month socially • sexual practices (oral, vaginal, anal) Medications: • Currently not on any medication Allergies: • NKDA (No Known Drug Allergies) Objective: Vital Signs: • Temp: 98.6°F • HR: 76 bpm • BP: 112/70 • RR: 16/min • SpO₂: 98% RA Physical Exam: • Genital Exam: Multiple small grouped vesicles on an erythematous base noted on the left labia minora, tender to palpation. No foul-smelling discharge. No cervical motion tenderness. No inguinal lymphadenopathy. • Other Systems: Normal Point of Care Testing (POCT): • HSV PCR swab from lesion: High sensitivity and specificity for HSV-1 and HSV-2 (CDC, 2021) • HIV rapid test: Recommended for new STI evaluation • Urine NAAT for gonorrhea and chlamydia: Evaluate for co-infections • Syphilis RPR and Hepatitis B/C screening: Per CDC recommendations for STI screening Assessment/Diagnosis: Presumptive Diagnosis: • Genital Herpes Simplex Virus (HSV) Infection – ICD-10: A60.9 Rationale: • Classic presentation of painful, fluid-filled vesicles on erythematous base, localized on labia minora, recent unprotected sex, no previous known episodes. Differential Diagnoses: 1. Contact Dermatitis: Less likely—symptoms typically bilateral and not vesicular. 2. Chancroid: Rare in the U.S.; painful ulcers with ragged borders, not grouped vesicles. 3. Syphilis (Primary): Typically a painless chancre; not vesicular. Plan: Pharmacologic Treatment (Assuming HSV PCR Positive): • Acyclovir 400 mg tablet PO TID for 10 days Patient Education: • Medication Use: Take all medication as prescribed, even if symptoms improve early. • Side Effects: May include nausea, headache, dizziness. • Transmission: Avoid sexual activity until lesions are fully healed. HSV can be transmitted even when asymptomatic. • Safe Sex: Use condoms consistently to reduce recurrence transmission risk. • Partner Notification: Partners should be informed and may need testing. • Chronic Management: Discuss suppressive therapy if recurrences occur frequently (>6/ year). Non-Pharmacologic Management: • Keep area clean and dry. • Use sitz baths and loose clothing. • Apply cool compresses to soothe discomfort. Follow-Up: • Return to clinic in 1–2 weeks or sooner if symptoms worsen. • Retesting or management for other STI test results as they return. Complications of Non-Treatment: • Increased risk of HIV transmission • Severe and prolonged outbreaks, especially in immunocompromised patients • Psychological distress • Neonatal HSV transmission risk in future pregnancies Table 2: STI Knowledge Questions SOAP Note – Tina, 27-year-old Female Subjective: Objective: Assessment/Diagnosis: Plan: Pharmacologic Treatment (Assuming HSV PCR Positive): Patient Education: Non-Pharmacologic Management: Follow-Up: Complications of Non-Treatment:

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