SEXUAL TRANSMITTED DISEASE

DEFINITION:
Sexually transmitted diseases (STDs), or sexually transmitted infections (STIs), are infections
that are passed from one person to another through sexual contact. They are usually spread
during vaginal, oral, or anal sex. But sometimes they can spread through other sexual contact
involving the penis, vagina, mouth, or anus. This is because some STDs, like herpes and HPV,
are spread by skin-to-skin contact.

STIs don't always cause symptoms. A person can get sexually transmitted infections from
another person who seems healthy and may not even know they have an infection.

CAUSES/ETIOLOGY:
Sexually transmitted diseases (STDs) are caused by sexually transmitted infections (STIs).
They are spread mainly by sexual contact. STIs are caused by bacteria, viruses or parasites.

 Bacteria. Gonorrhea, syphilis and chlamydia are examples of STDs that are caused by
bacteria.
 Parasites. Trichomoniasis is an STD caused by a parasite.
 Viruses. STDs caused by viruses include human papillomavirus (HPV), the herpes
simplex virus, and the human immunodeficiency virus (HIV), which causes AIDS.

PATHOPHYSIOLOGY:
RISK FACTORS:
Factors that may increase the risk of getting an sexually transmitted infection include:

Having unprotected sex. Vaginal or anal sex with an infected partner who isn't wearing a
condom (latex or polyurethane) greatly increases the risk of getting an STD. Not using condoms
properly or not using them each time also can increase risk.
Oral sex may be less risky. But sexually transmitted infections can still spread if a person
doesn't use a condom (latex or polyurethane) or a dental dam.
Having sexual contact with many partners. The more people you have sexual activity with,
the greater your risk.

Having a history of STIs. Having one sexually transmitted infection makes it much easier for
another STI to take hold.

Being forced to engage in sexual activity. See a health care professional as soon as possible
to get screening, treatment and emotional support.

Misuse of alcohol or use of recreational drugs. Substance misuse can inhibit your judgment,
making you more willing to take part in risky behaviors.

Injecting drugs. Sharing a needle while injecting drugs can spread many serious infections.
Examples are human immunodeficiency virus (HIV), hepatitis B and hepatitis C.

Being young. People age 15 to 24 report high levels of STIs compared to those who are older.

Spread from mothers to infants

During pregnancy or delivery, some sexually transmitted infections can be passed from mother
to infant. Examples are gonorrhea, chlamydia, HIV and syphilis. STIs in infants can cause
serious problems or even death. All pregnant women should be screened for STI infections and
treated as needed.

CLINICAL MANIFESTATIONS:
STDs can have a range of symptoms, including no symptoms. That's why sexually transmitted
infections may go unnoticed until a person has complications or a partner is diagnosed.

STI symptoms might include:

 Sores or bumps on the genitals or in the oral or rectal area.

 Painful or burning urination.
 Discharge from the penis.
 Unusual or odorous vaginal discharge.
 Unusual vaginal bleeding.
 Pain during sex.
 Sore, swollen lymph nodes, particularly in the groin but sometimes more widespread.
 Lower abdominal pain.
 Fever.
 Rash over the trunk, hands or feet.
Sexually transmitted infection symptoms may appear a few days after exposure. But it may take
years before you have any noticeable problems, depending on what's causing the STI.
LABS/DIAGNOSTIC EXAM:
Blood or Urine Tests
Most blood and urine tests check for bacterial or viral infections, including HIV, gonorrhea,
chlamydia, and syphilis.

Pap smears
Women who contract human papillomavirus (HPV) very frequently are at risk of cervical cancer.
Pap smears are an effective diagnostic tool for that. A general pap smear test can ascertain if
the patient has an STD or not.

Fluid samples
In patients with open genital sores, the doctors might prescribe fluid sample testing to ascertain
what kind of STD the patient has.

Physical examination
Lastly, in patients with prominent symptoms, a series of physical examinations can support the
diagnosis. This kind of lab testing is prevalent in patients with herpes and genital warts.

MEDICAL-SURGICAL INTERVENTIONS:
MEDICAL
Antibiotics can treat STDs caused by bacteria or parasites. There is no cure for STDs caused by
viruses, but medicines can often help with the symptoms and lower your risk of spreading the
infection.
SURGICAL
HPV: Procedures to remove HPV genital warts include cryotherapy (freezing),
electrocautery (burning), interferon injection into warts, laser treatment, and surgery.

Hepatitis: In some cases, significant liver damage can occur from hepatitis infections, and a
liver transplant may be needed.

MEDICATION:

There are several medications available by prescription for the treatment of viral STIs:

 Herpes: Acyclovir, famciclovir, valacyclovir

 Hepatitis B: Interferon alpha-2b or pegylated interferon, adefovir, entecavir, tenofovir,
lamivudine
 HIV/AIDS: Antiretroviral medications are used to treat HIV and AIDS.
NURSING DIAGNOSIS:
Disturbed Body Image
Patients diagnosed with HIV infection often develop anxiety disorders, depression, and low self-
esteem. Disturbed body image is often associated with poor self-care behaviors, poor ART
adherence, and risky behaviors.

Imbalanced Nutrition: Less Than Body Requirements

HIV infection affects the body’s ability to effectively absorb nutrients due to various infections.

Ineffective Protection

The decreased number of CD4 cells depresses immune function, causing the patient to be at
higher risk of acquiring infection.

Ineffective Sexuality Pattern

The patient may experience concerns or dysfunction surrounding their sexuality following the
diagnosis of HIV.

Risk for Infection

HIV infection causes immunosuppression, placing patients at risk for illness.

NURSIING INTERVENTIONS:
 Promote skin integrity. Patients are encouraged to avoid scratching; to
use nonabrasive, nondrying soaps and apply nonperfumed moisturizers; to perform
regular oral care; and to clean the perianal area after each bowel movement with
nonabrasive soap and water.
 Promote usual bowel patterns. The nurse should monitor for frequency and
consistency of stools and the patient’s reports of abdominal pain or cramping.
 Prevent infection. The patient and the caregivers should monitor for signs of infection
and laboratory test results that indicate infection.
 Improve activity intolerance. Assist the patient in planning daily routines that maintain
a balance between activity and rest.
 Maintain thought processes. Family and support network members are instructed to
speak to the patient in simple, clear language and give the patient sufficient time to
respond to questions.
 Improve airway clearance. Coughing, deep breathing, postural drainage, percussion
and vibration is provided for as often as every 2 hours to prevent stasis of secretions and
to promote airway clearance.
 Relieve pain and discomfort. Use of soft cushions and foam pads may increase
comfort as well as administration of NSAIDS and opioids.
 Improve nutritional status. The patient is encouraged to eat foods that are easy to
swallow and to avoid rough, spicy, and sticky food items.
COMPLICATIONS:
Possible complications of sexually transmitted infections include:

 Pelvic pain.
 Pregnancy complications.
 Eye inflammation.
 Arthritis.
 Pelvic inflammatory disease.
 Infertility.
 Heart disease.
 Certain cancers, such as HPV-associated cervical and rectal cancers.

REFERENCES:
https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/symptoms-
causes/syc-20351240
https://medlineplus.gov/sexuallytransmitteddiseases.html
https://www.slideshare.net/binuenchappanal/sexually-transmitted-infections-237364480
https://redcliffelabs.com/myhealth/lifestyle/overall-health/sexually-transmitted-diseases-lab-
tests-to-diagnose-stds/
https://medlineplus.gov/sexuallytransmitteddiseases.html
https://www.verywellhealth.com/std-treatment-4014305#:~:text=Medical%20and%20surgical
%20procedures%20are,%2C%20laser%20treatment%2C%20and%20surgery.
https://www.verywellhealth.com/std-treatment-4014305
https://nurseslabs.com/hiv-aids/#h-nursing-interventions
https://www.slideshare.net/binuenchappanal/sexually-transmitted-infections-237364480