Deck 73: Care of Patients With Sexually Transmitted Disease

Question 1

A 39-year-old gay man has been diagnosed with a chlamydial infection and provided with treatment for the infection. After learning how the infection is transmitted, he states that he and his partner "broke up" briefly 3 months ago and he wonders if his partner became involved with someone who transmitted the infection to him. One week later, the patient and his partner return to the health care center. The partner states that he "slept with another man" during the break-up. As the nurse, you explain that medication treatment is available with expedited partner therapy (EPT) for the person the partner became involved with during the break-up. The patient becomes angry and tells his partner, "I don't want you ever speaking to him again!"
What is the best therapeutic approach for working with this patient and his partner?

Answer 1

According to the given case, the patient is diagnosed with the Chlamydia infection (sexually transmitted disease). The patient got break up with his male partner by briefly 3 months ago; and the patient doesn't have any other sexual partner. So, the patient got the infection from his sexual partner, who broke up the relationship.
One week later, the meeting with the patient and his partner revealed the information about, the partner is slept with another man. So, the partner might transmit the Chlamydia infection to another individual also. Hence, the infection is possible to all the three individuals.
Therefore, EPT (Expedited Partner Therapy) is the exact approach for working with this patient and his partner.
The Expedited Partner Therapy is a clinical practice for treating the sexually transmitted diseases like Chlamydia and gonorrhea. The treatment involves, following the medications from the health care provider by the patient, is also followed by the partners without meeting the healthcare provider.

Question 2

The nurse gives a client an IM dose of penicillin G for primary syphilis. Which client statement indicates a need for further teaching?

A) "I will wait in the clinic for 30 minutes to be sure I do not have a reaction."
B) "When I get home, I will call my partner to tell them about my diagnosis."
C) "If I have sex with someone, I do not have to worry about spreading the disease."
D) "I plan to return to see my primary care provider for follow-up in 6, 12, and 24 months."

Answer 2

The penicillin G (antibiotic) produces some allergic reactions like skin rashes, edema, shortness of breath, and chest tightness. So , after the penicillin injection, every patient has to stay for next 30 minutes in the healthcare facility for the observation of allergy manifestations. Penicillin allergy is the immediate reaction; 30 minutes of staying in the healthcare facility is more than enough for the observation and treatment.
According to the given case, the client is diagnosed for primary Syphilis, and given an Intramuscular injection of Penicillin G. So, staying for next 30 minutes in the clinic is a recommended approach, and no need for further teaching.
Hence, the option (A) is not the correct answer.
Syphilis is the Sexually Transmitted Disease (STD). An individual, who is diagnosed for the syphilis, should have the discussion about his/her diagnosis with their partner. Such discussions will help the partner, to undergo the diagnosis and treatments; and reduces the disease complications. So, discussion with the partner about the diagnosis of syphilis is a valuable approach ; and no need for further teaching.
Hence, the option (B) is not the correct answer.
Syphilis is classed in to Primary, Secondary, latency and tertiary. The primary syphilis lasts around 6 months, and the secondary will continue to 12 months. Here, the patient is diagnosed for the primary syphilis. Hence, Meeting with the primary care provider for follow up in 6, 12, 24 months is a recommended approach; so no need for further teaching.
Hence, the option (D) is also not the correct answer.
The patient is diagnosed for primary syphilis, indicates the syphilis bacterium in body can able to transmit to the other peoples through sexually. So, the patient who diagnose for the syphilis should avoid the sexual activities until the complete cure. The patient approach described in the option (C), representing that, he/she will sex with someone, and do not worry about transmitting the disease, is not a recommended approach ; so, further teaching is required.
Hence, the correct answer is option (C)

Question 3

A 39-year-old gay man has been diagnosed with a chlamydial infection and provided with treatment for the infection. After learning how the infection is transmitted, he states that he and his partner "broke up" briefly 3 months ago and he wonders if his partner became involved with someone who transmitted the infection to him. One week later, the patient and his partner return to the health care center. The partner states that he "slept with another man" during the break-up. As the nurse, you explain that medication treatment is available with expedited partner therapy (EPT) for the person the partner became involved with during the break-up. The patient becomes angry and tells his partner, "I don't want you ever speaking to him again!"
How will you further explain to this couple the need for EPT for the other person?

Answer 3

According to the given case, the patient is diagnosed with Chlamydia infection, transmitted from his partner. In addition, after break up in relationship, the partner has the relationship with another male individual. So, the infection is possible for all the three peoples. So, the better treatment approach for curing the peoples is EPT ( Expedited Partner Therapy ).
On the counseling with the patient and his partner, the explanation about the disease transmission and the Expedited Partner Therapy is essential.
The explanation about the Expedited Partner Therapy is given below.
The Expedited Partner Therapy is a clinical practice for treating the sexually transmitted diseases like Chlamydia and gonorrhea. The treatment involves, following the medications from the health care provider by the patient, is also followed by the partners without meeting the healthcare provider.
So, without meeting the healthcare provider, the new partner of the partner gets the medication.

Question 4

A client with pelvic inflammatory disease returns to her primary care provider's office 3 days after starting treatment with oral antibiotics. Which symptom does the nurse recognize that requires immediate intervention?

A) Mild nausea
B) Temperature of 101° F
C) Report of two diarrheal stools daily after starting antibiotic
D) Expression of anxiety that her partner will "catch" the infection

Question 5

A 39-year-old gay man has been diagnosed with a chlamydial infection and provided with treatment for the infection. After learning how the infection is transmitted, he states that he and his partner "broke up" briefly 3 months ago and he wonders if his partner became involved with someone who transmitted the infection to him. One week later, the patient and his partner return to the health care center. The partner states that he "slept with another man" during the break-up. As the nurse, you explain that medication treatment is available with expedited partner therapy (EPT) for the person the partner became involved with during the break-up. The patient becomes angry and tells his partner, "I don't want you ever speaking to him again!"
In your presence, the patient tells his partner that he cannot imagine ever talking with "that jerk you slept with." What emotional feelings is this patient experiencing? How will you respond to the patient's statement?

Question 6

A 39-year-old gay man has been diagnosed with a chlamydial infection and provided with treatment for the infection. After learning how the infection is transmitted, he states that he and his partner "broke up" briefly 3 months ago and he wonders if his partner became involved with someone who transmitted the infection to him. One week later, the patient and his partner return to the health care center. The partner states that he "slept with another man" during the break-up. As the nurse, you explain that medication treatment is available with expedited partner therapy (EPT) for the person the partner became involved with during the break-up. The patient becomes angry and tells his partner, "I don't want you ever speaking to him again!"
Develop a collaborative plan of care for this patient to ensure that the needs of all involved parties will be met.