Module 05 Written Assignment - Sexually Tr... Assignment Content Select a sexually transmitted infection (STI) and do research on it. Write a 3-5 page paper about the condition/issue. In the paper discuss the concepts below: • What is the pathophysiology of one STI • What is the etiology of the selected STI • What are the clinical manifestations of the selected STI • What is the treatment for the selected STI Use at least one scholarly source to support your findings. Examples of scholarly sources include academic journals, textbooks, reference texts, and CINAHL nursing guides. Be sure to cite your sources in-text and on a References page using APA format. You can find useful reference materials for this assignment/n Sexually Transmitted Diseases: Chlamydia Quick Lesson By: Tanja Schub, BS Cinahl Information Systems, Glendale, CA Patricia Lawrence, RN, MS, BSN, BS, CIC Cinahl Information Systems, Glendale, CA Edited by: Diane Pravikoff, RN, PhD, FAAN Cinahl Information Systems, Glendale, CA Chlamydia is a common infectious disease caused by the gram- negative bacterium Chlamydia trachomatis (C. trachomatis). Chlamydia is the most common sexually transmitted disease (STD) and the most common cause of acquired infertility in the United States; it is transmitted primarily by vaginal, anal, and oral sex, but can also be transmitted to a neonate while in the birth canal during vaginal delivery. When C. trachomatis is introduced into the rectum, oropharynx, or genital tract through sexual contact, it is engulfed by epithelial vacuoles. Avoiding lysosomal destruction, the bacteria survive and multiply, often producing no symptoms. Over time, the infection can spread to surrounding tissues and organs. Inflammation and related damage can lead to serious effects on reproductive and genitourinary health. Complications of untreated chlamydia in women include pelvic inflammatory disease (PID) and subsequent tubal infertility, genital tract infection, lymphogranuloma venereum, ectopic pregnancy, and chronic pelvic pain. Acute perihepatitis, or Fitz-Hugh-Curtis syndrome, is an unusual outcome of PID and is believed to develop as a result of chlamydia or gonorrheal infection. In pregnant women, infection can lead to pre-eclampsia, premature delivery, and infection in the newborn. In men, chlamydia can cause urethritis, epididymitis, and prostatitis. Studies suggest a likely relationship between chlamydial infection in males and infertility. Reactive arthritis-a complication of chlamydial infection consisting of arthritis, urethritis, and conjunctivitis -can affect both genders but is more prevalent among men. Chlamydial infection increases the risk for contracting and transmitting human immunodeficiency virus (HIV) infection in both women and men. In the neonate, chlamydial infection can lead to pneumonia, nasopharyngitis, chlamydial conjunctivitis, and chronic trachoma (i.e., infection of the eye; for more information, see ) that can lead to blindness. Diagnosis is based on clinical presentation, patient history, and results of nucleic acid amplification tests (NAATS) or bacterial culture; NAATS are the test of choice. The differential diagnosis includes gonorrheal infections and nongonococcal urethritis. Treatment is curative, involving a short course of antibiotics. Education on adherence to medical treatment and the practice of safe sex are important public health components of the treatment plan. Worldwide, chlamydia is the most common bacterial sexually transmitted disease, with prevalence estimated over 140 million infected individuals. In 2016, approximately 1.6 million new cases of chlamydia were reported to the CDC, which corresponds to a rate of 497.3 cases per 100,000 people. In the U.S., the highest chlamydial infection rates are seen in young people; the incidence in 2016 was 1,929.2 cases per 100,000 in those aged 15-19 years and 2,643.8 cases per 100,000 in those aged 20-24 years. The incidence of chlamydia is substantially higher in females than in males (657.3 cases per 100,000 vs. 330.5 cases per 100,000), but at least part of this disparity is thought to be because of increased screening among in women. Approximately, 25% of infected males and 80% of infected females are asymptomatic. Antibiotic treatment is effective in 95% of cases of chlamydia. Without treatment, 10-20% of females with chlamydia develop pelvic inflammatory disease (PID) and 5 −10% of those will develop Fitz-Hugh-Curtis syndrome. PID can cause infertility, ectopic pregnancy, and chronic pelvic pain. Sexually active individuals, especially those with multiple sexual partners, are at risk for acquiring chlamydia. Chlamydia occurs most frequently in adolescents, women under the age of 25 years, and individuals who engage in unprotected sex. The use of oral contraceptives and IV drugs, cervical displacement, having a new sexual partner, frequent douching, being non-White (i.e., Black, Hispanic, Native American, Alaskan Native ethnicity), being unmarried, having a history of sexually transmitted diseases, and early age of first sexual experience have all been associated with an increased risk for acquiring chlamydial infection. For additional information on risk factors for chlamydial infection, see Evidence-Based Care Sheet: Sexually Transmitted Diseases: Chlamydia -- Risk Factors. Known as the "silent disease," chlamydia is often asymptomatic. If symptoms occur, they usually appear 1-3 weeks after exposure. In women, the clinical presentation includes a yellow, purulent vaginal discharge, difficult or frequent urination, postcoital bleeding, abdominal or pelvic pain, and irregular uterine bleeding. Signs and symptoms in men include urethritis, painful or difficult urination, discharge, scrotal pain or tenderness, and urethral burning or itching. Both genders can experience conjunctivitis, pharyngitis, or both from oral sex. Individuals who engage in receptive anal sex can experience proctitis with rectal pain, discharge, and/or bleeding. • Patient History • Review sexual history, including age at first sexual experience, number of sexual partners, history of sexually transmitted diseases, and HIV infection status o Ask if the patient uses protection and/orever has unprotected sex • Laboratory Tests o NAATS (e.g., polymerase chain reaction [PCR]), or nucleic acid hybridization tests will identify Chlamydia Trachomatis bacteria; NAAT results can remain positive up to 3 weeks after completion of antibiotic therapy; in general, NAAT should not be used to test-for-cure, except when monitoring treatment efficacy in pregnant women. The incubation period (1-5 days) for Chlamydia Trachomatis should be observed before getting tested ■ Swab culture (e.g., endocervical, rectal, pharyngeal, urethral) samples will identify Chlamydia Trachomatis bacteria; it grows on columnar cells found in the urethra and cervix; pooled vaginal secretions should not be utilized for swabbing ▪ Direct fluorescent antibody (DFA) testing of swab culture (e.g., urethral, rectal, neonates conjunctival, endocervical) samples will identify Chlamydia Trachomatis ▪ Urine sample testing can identify Chlamydia Trachomatis bacteria; patients should not urinate for an hour before providing sample and female patients should not clean labia before providing sample o A positive Enzyme-linked immunosorbent blood test (ELISA) indicates a new infection O o Cytologic analysis of ocular fluid can be ordered for patients with ocular complaints for whom conjunctivitis or ocular trachoma are suspected o An elevated CBC level indicates infection • Other Tests of interest o CT and ultrasonography can be ordered if Fitz-Hugh-Curits syndrome is suspected o Ultrasonography can be ordered to assess for tubo-ovarian abscess o Chest X-ray can be ordered for patients with difficulty breathing to assess for pneumonia • Administer Prescribed Medications and Monitor Treatment Efficacy o Assess vital signs and all physiologic systems (especially reproductive and urinary systems); notify the treating clinician of laboratory test results once available • Assess for pain using a facility-approved pain assessment tool; administered prescribed analgesics, as ordered o Administer prescribed antibiotics (e.g., doxycycline, azithromycin, ofloxacin), as ordered Erythromycin or amoxicillin can be prescribed in pregnancy o Monitor for and educate on potential adverse effects of

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