Professional Documents
Culture Documents
11th Lecture
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dr.Shaban
Clinical Features
Acute lower UTIs (Urithritis and cystitis): Infection of anterior urethral tract , Cystitis : Infection of urinary bladder Rapid sudden onset of: - Dysuria (burning pain on passing urine) - Urgency (the urgent need to pas urine) - Frequency of micturition; suprapubic pain Normal serum WBC, Upper UTIs (Pyelonephritis): Infection of kidney Gradual onset Fever; Elevated WBC - Chills; N&V; lion pain - Dysuria; Urgency - Frequency of micturition,
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Vaginitis
Inflammation of the vagina occurs when the natural PH (acidity) or vaginal flora is destroyed Causes include Use of Antibiotics Poor hygiene Diabetes mellitus Wearing tight and synthetic clothing Infection from a STI Signs & symptoms Increased vaginal discharge; Irritation and itching Frequent or painful urination; Low grade temperature; Reddened vaginal wall
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2. Monoliasis or Candidiasis
Yeast like fungal vaginal infection BY Candida
albicans
Occurs in diabetics,Corticosteroid therapy; Antimicrobial therapy; Poor hygiene; High-dose estrogen contraceptives; Pregnancy; IUD S&S include thick, curdy, white cottage cheese like vaginal discharge, small ulcers on vagina, abnormal Pap test; marked redness of vulva (Erythema), extreme pruritus, External dysuria and dyspareunia Treatment includes use of antifungal medications and avoiding sex during therapy Only topical (usually for 7 days)
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3. Trichomoniasis
Parasite infection of the genital area by Trichomonas vaginalis. Sexually transmitted, use of antibiotics or contamination from feces S&S include vaginal soreness, burning, itching, yellowdr.Shaban
Strawberry appearance of cervix;Dysurea, dysparunia Treatment includes treating both partners with antibiotics and avoiding sex during treatment Can be cured with Metronidazole, if pregnant topical clotrimazole used. If untreated, it may lead to complications during pregnancy (PTL, PROM)
(Do not douche ) Observe the area for: Erytherma; Edema; Discharge Describe symptoms Odor; Itching; Burning; Dysuria Prep vaginal smear Test pH of discharge
Examine
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Nursing Interventions
Admin. meds Sitz baths Cornstarch powder Educate patient Douching discouraged Loose fitting underwear = good Tight, synthetic, non-absorbent, heat-retaining underwear = bad
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Maternal infections
TORCH infections: Diseases that cross the
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STD Transmission
Sex Vaginal Anal Oral
Blood Exposure Injecting Drugs Tattooing Body Piercing: toothbrushes and razors that have touched infected blood
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dr.Shaban
test
T-oxoplasmosis
Toxoplasmosis is a disease caused by parasite called Toxoplasma gondii. Toxoplasmosis has been found in virtually all warmblooded animals including most pets. There are 3 principal ways Toxoplasmosis is transmitted: 1.Directly from pregnant mother to unborn child when the mother becomes infected with Toxoplasmosis during pregnancy. 2.Consumption and handling of undercooked or raw meat from infected animals. 3.Ingestion of food or water or inhalation of dust contaminated with a very resistant form of Toxoplasmosis called the oocyst.
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Avoiding toxoplasmosis
only eat meat which has been thoroughly cooked. Toxoplasma in meat can be killed by cooking at 152F (66C) or higher or freezing for a day in a household freezer. wash hands, chopping boards and utensils thoroughly after preparing raw meat wash all fruit and vegetables thoroughly to remove all traces of soil dont drink unpasteurised goats milk or eat dairy products made from it
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Others-Chlamydia
Most common of all bacterial STDs. Although chlamydia is usually asymptomatic in women, it may present with inflammation of the cervix. Symptoms may occur from two to six weeks after initial exposure to the bacteria.When symptoms do occur they include abnormal genital discharge and burning with urination; vaginal bleeding after intercourse or between menstrual periods; pain during intercourse If untreated, it may lead to pelvic inflammatory disease ( PID), tubal pregnancies, and infertility. Pre-term labour, PROM, Endometritis Treated by Erythromycin 500 mg qid for 7 days or Amoxicillin 500 mg three times daily for 7 days Infant can suffer conjunctivitis.
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Others-Gonorrhea
Bacterial infection of the genital area (gram-negative coccus Neisseria gonorrhoeae). When symptoms do occur they include burning during urination, green or yellowish discharge, abnormal vaginal bleeding, or pelvic pain. dysuria, dyspareunia Pre-term labour, PROM, Chorioamniionitis, Endometritis; It can be passed from an infected mother to her infant during birth causing an eye infection (Opthalmia neonatorum: blindness). Antibiotics can cure the infection (Cephalosporin )
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Hepatitis B
Viral infection primarily affecting the liver. Up to eight weeks after exposure to the virus, some people experience flu-like symptoms including: fatigue, achiness, nausea, vomiting, loss of appetite, darkening of urine, abdominal tenderness, and yellowing of the skin and whites of eyes. Can be treated with antibiotics, but some people are contagious for the rest of their lives.
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Herpes Simplex
Caused by herpes simplex virus (HSV) caused painful recurrent blisters of the genital area Transmission by direct contact with oral and genital lesions Increases the chance of transmission of other STDs such as HIV and Hepatitis B There is no cure for herpes, but medication can be used to reduce the frequency of future outbreaks (Zovirax). Herpes can be transmitted even when medication is used ;C/S birth is indicated for a women with active herpes Diagnosed by Enzyme-linked Immunosorbent Assay (ELISA) Sitz baths and applying warm moist tea bags relieve the pain Condom used to prevent infection to the partner.
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Syphilis
A systemic disease caused by bacteria that spread throughout the body Stage 3 can result in (Treponema pallidum) damage to the brain, heart, nervous system, Appears in stages. and death. Stage 1 symptoms are painless sores on the genitals If untreated, it may lead to complications during or mouth ( chancre). pregnancy. Stage 2 symptoms are a rash VDRL ,Venereal on the palms of the hands, Disease Research soles of the feet, or genital Laboratory is preformed area. to diagnose syphilis
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Syphilis
Treatment of all stages is Penicillin After treatment all women are positive for VDRL for 8 months From an infected mother to her fetus, which can result in fetal death or congenital syphilis (causing birth defects) Infected newborn may remain positive for 3 months
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CytoMegaloVirus
DNA virus Infection may remain asymptomatic in pregnant women, and the prognosis is favorable. The risk of transmission to the fetus and of congenital abnormalities is highest when acute infection occurs in the first 22 weeks of pregnancy. 5-10% of those infected show clinical illness at birth Neonatal MR - 20-30% 90% of survivors get late complications
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dr.Shaban
to four weeks after exposure, some infected individuals may experience mild flu-like symptoms that last a few weeks then disappear. For most people, symptoms dont emerge until years after exposure. Once the immune system is weakened, the following may develop: Frequent fever Joint or muscle pain Persistent skin rashes Swollen glands, Sore throat Fatigue or lack of energy Headaches, Rapid, unexplained weight loss Nausea, vomiting, or diarrhea
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AIDS
Maternal Effects Vag candidiasis PID Genital herpes HPV
Fetal Effects
Asymptomatic at birth Candidal diaper rash Thrush Diarrhea Recurrent bacterial infections FTT Development delay
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AIDS- Treatment:
Women
are monitored at each prenatal visit for signs of complications. Also for serologic evidence of progression of the disease Weekly non-stress testing of the fetus begun at 32 weeks ZDV (zidovudine) in pregnancy, labor (and 1st 6 weeks for baby) and Cesarean at 38 weeks decreases transmission Avoid breastfeeding Follow up testing for the newborn
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Nursing Care
Counseling Teach S/S of progression of disease Always practice universal precautions Facilitate use of social services as social isolation the most important nursing diagnosis.
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In Summary
Diseases that cross the placenta and affect the fetus during pregnancy are collected in term TORCH Infection harmful if present at the time of birth Gonorrhea; Candidiasis; Chlamydia; Hepatitis B. Chlamydia, gonorrhea, syphilis, trichomonas, and bacterial vaginitis (BV) can be treated and cured with antibiotics during pregnancy. There is no cure for viral STDs, such as genital herpes and HIV, but medication may reduce symptoms in the pregnant woman
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