A 26-year-old client with multiple sexual partners is being ...

[karen]

A 26-year-old client with multiple sexual partners is being assessed for symptoms of dysuria and vaginal discharge. Because the results from the culture of the cervical cells are not available, the client will be treated for both Chlamydia and gonorrhea.
 
  Which explanation by the nurse is best?
  a.
  This early treatment will prevent obstruction to the fallopian tubes.
  b.
  Only azithromycin (Zithromax) is prescribed for both sexually transmitted diseases.
  c.
  The treatment will prevent aortic valve disease and aneurysms.
  d.
  Oral antibiotic treatment will prevent frequent occurrences of meningitis.

Question 2

An African-American female with blisters on the vagina is being treated with acyclovir (Zovirax) for genital herpes. She is angry at her partner for transmitting the infection. Which action by the nurse is best?
 
  a. Encourage the client to engage in sexual activity since she is on medication.
  b. Be sensitive to the client's feelings and refer her to a support group.
  c. Reinforce that the disease can no longer be spread to other partners.
  d. Reassure the client that sexual activity will not be painful while on acyclovir.

[Juro]

Answer to Question 1

ANS: A
Both gonorrhea and Chlamydia can cause pelvic inflammatory disease and scarring of the fallopian tubes, resulting in infertility problems. Azithromycin is the treatment of choice for both sexually transmitted diseases, but ceftriaxone (Rocephin) is also recommended for treatment of gonorrhea. Aortic valve disease and aneurysms usually occur with tertiary syphilis. Meningitis occurs rarely with a gonorrhea infection and is usually treated with intravenous antibiotic therapy in the hospital setting.

Answer to Question 2

ANS: B
The nurse needs to be sensitive and supportive of the client since infected clients may feel angry, lonely, and isolated. Allow the client to verbalize her feelings and refer her to a local support group, such as the National Herpes Resource Center. Sexual activity should not occur while the lesions are present because of discomfort and viral transmission. Genital herpes is an incurable viral disease, and the antiviral drugs minimize the infection but do not cure it. Condoms should be used to avoid the spread of the disease.