____________________________________________________ Chapter 51Sexually Transmitted Infections 15
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 51.1
Activities
Classroom Choose from below to make 30 minutes
Online
1
ASSESS BASELINE
• Have the class complete the Pretest. Collect
their work and use the results to guide how
you teach the class.
DISCUSS
• Discuss the principles behind serologic
tests.
PRACTICE
• Divide the class into two groups. Group 1 is
serologic tests and Group 2 is smears and
cultures. Call out names of different STIs
(gonorrhea, HSV, HIV, chlamydia, syphilis,
trichomoniasis, and hepatitis C). The group
whose tests diagnose the infection must
ASSESS BASELINE
• Post the Pretest and the Background
Assessment online and have your class
complete them. Use the results to guide how
you teach the class.
POST AND COMMENT
• Post the following discussion topic online
collected. What terminology will you use?
Ask students to provide constructive
comments on each other’s posts.
2
DISCUSS
• Discuss the obligations of a health
professional for reporting sexually
PRACTICE
• Invite a representative from the health
department to speak to the class about the
POST AND COMMENT
• Post the following discussion topic online
and have students comment. Discuss how a
being invaded. Ask students to post
constructive comments on each other’s
posts.
16 Chapter 51Sexually Transmitted Infections _____________________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 51.1
3
DISCUSS
• Discuss which sexually transmitted
infections occur most frequently.
• Discuss which infections may occur more
frequently in certain age or cultural groups.
PRACTICE
• Have students write down as many STIs as
they can in 5 minutes. Each student will then
____________________________________________________ Chapter 51Sexually Transmitted Infections 17
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 51.1
4
DISCUSS
• Discuss signs and symptoms of chlamydial
and gonorrheal infection and any common
complications.
• Discuss the various stages of syphilis and
how the stage affects the choice of medical
treatment.
• Discuss the signs and symptoms of genital
PRACTICE
• Divide the class into four groups, and assign
each one of the following:
• Chlamydial infection
• Syphilis stage 2
• HSV-2
POST AND COMMENT
• Post the following discussion topic online
and have students comment. Compare and
contrast gonorrheal infections with
chlamydial infections. Focus on signs and
symptoms and treatments.
• Post the following discussion topic online
and have students comment. Provide ideas
18 Chapter 51Sexually Transmitted Infections _____________________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 51.1
5
DISCUSS
• Discuss how to help the patient deal with the
psychosocial aspects of a sexually
transmitted infection.
• Discuss the nursing care for a patient
dealing with anxiety associated with having
a serious or potentially fatal sexually
transmitted infection.
PRACTICE
• As a class, discuss ways for nurses to
approach patients with sexually transmitted
infections in order to reduce patient anxiety,
increase patient self-esteem, deal with
ineffective coping mechanisms, provide
effective patient teaching, and protect the
nurse from infection.
POST AND COMMENT
• Post the following discussion topic online
and have students comment. Reflect on how
you would feel if diagnosed with an STI.
How would you expect to be treated? What
are ways for nurses to work with a patient
recently diagnosed with an STI? Ask
students to provide constructive comments
Critical Thinking Question
The 22-year-old son of a patient asks the nurse if he can talk to her privately. In private, the
son says, “I have this yellow pus coming out of my penis. It burns when I urinate. The tip is
swollen and sore. Do you think I have the clap?” How should the nurse respond? How
should the nurse instruct him about the diagnosis and treatment of gonorrhea?
Discussion Guidelines: The nurse should present a nonjudgmental approach and assure the
young man that any conversation is confidential. Next, the nurse should explain that the symptoms
Instructor Notes/Student Feedback
____________________________________________________ Chapter 51Sexually Transmitted Infections 19
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 51.2
• Assemble materials and supplies needed for each lesson as indicated below.
Textbook Objectives Covered
7. Identify data to be collected when assessing a patient with a sexually transmitted infection.
9. Design a teaching plan on the prevention of sexually transmitted infections.
Lesson Preparation Checklist
• Prepare lecture from TEACH lecture slides available on Evolve.
• Guest speaker: sex education teacher
• Student performance evaluation of all entry-level skills required for student comprehension of
principles underlying sexually transmitted infections, including:
Materials and Supplies
• computer and PowerPoint
projector
Key Terms
• chancre (p. 1170)
• pelvic inflammatory disease
• sexually transmitted infection
Student Preparation
Assignments 2 hours
6
READ – Textbook (pp. 1166-1176)
REVIEW
• Table 51-2: Drug Therapy: Drugs Used to Treat Sexually Transmitted Infections (pp. 1167-
1169)
ANSWER – Study Guide
• Part IIC: 8, 15, 19, 24, 25, 32, 36, 37 (pp. 346-348)
7
READ – Textbook (pp. 1176-1178)
REVIEW
• Box 51-1: Assessment of the Patient with a Sexually Transmitted Infection (p. 1178)
ANSWER – Study Guide
• Part IIIE: 3 (p. 350)
20 Chapter 51Sexually Transmitted Infections _____________________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 51.2
8
READ – Textbook (pp. 1166-1179)
REVIEW
• Nursing Care Plan 51–1: Patient with Gonorrhea (p. 1177)
ANSWER – Study Guide
9
READ – Textbook (pp. 1179-1180)
REVIEW
• Box 51-2: Comparative Safety of Various Sexual Practices to Prevent Transmission of
Infection (p. 1179)
ANSWER – Study Guide
• Part IIC: 9 (p. 346)
• Part IIID: 3, 4 (p. 349)
50-Minute Lesson Plan
Lecture Outline 20 minutes
6
–
8
Slide 35
TALKING POINTS:
• Some patients may lack knowledge about the reproductive system and sexual activity.
Assessment
• Discussion of sexual behavior can be awkward for nurse and patient
• Nurses must first be aware of their own feelings and values
• Privacy is essential for the patient interview
• Questions about sexuality should be addressed in straightforward manner
Slide 36
Assessment (cont.)
• History of present illness
• Patient’s reason for seeking medical care. With an STI, common reasons: pain, fever,
lesions, or genital discharge. Obtain a thorough description of the signs and
symptoms, including onset, duration, and severity
• Medical history
• Serious conditions or chronic illnesses; obstetric history may be significant
• If childbearing age, date of last menstrual period
• Recent/current medications and drug allergies
Assessment (cont.)
• Review of systems
• Elicits potentially significant signs and symptoms, including weight change; fever;
____________________________________________________ Chapter 51Sexually Transmitted Infections 21
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 51.2
Slide 38
Assessment (cont.)
• Functional assessment
• Frequency and variety of sexual behaviors, IV drug use, past infections with STIs, and
sexual contact with a person known to have an STI
• Determine if classified as at risk because age, sexual preference, or habits place
patient at a higher risk for acquiring STI
• Victims of sexual abuse (of all ages) may have been exposed to STIs
• Occupation significant if contact with infected body fluids
TALKING POINTS:
• What health care providers are at risk for exposure to STIs?
8
Physical Examination
• Skin for rashes and lesions
Slide 40
Physical Examination (cont.)
• In cases of sexual assault, it is especially important that the examiner be specially trained
• If discharge present, its color, amount, and consistency are recorded. Specimens may be
collected for laboratory study
Slide 41
Interventions
• Impaired skin integrity
• Pain
• Risk for injury
• Anxiety
Slide 42
Patient Teaching: Sexually Transmitted Infections
• Complete course of antibiotics
• Avoid sexual contact until infection cured and contact with high-risk individuals
• Condom use
Slide 43
Patient Teaching: Sexually Transmitted Infections (cont.)
• Knowledge does not guarantee compliance
• Determine what patient knows about the infection
• Provide information about the disease and treatment in terms patient can understand
• Stress importance of completing course of therapy; return for follow–up
• Evaluate the patient’s understanding and explore barriers
22 Chapter 51Sexually Transmitted Infections _____________________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 51.2
9
Condom Use
• Condoms do not provide 100% protection against disease transmission
• Latex preferred because some pathogens can pass through natural membrane condoms
Slide 45
Condom Use (cont.)
• Use only water-based lubricants; others can cause condom to break; spermicides may be
used
• To put a condom on, hold it by the tip and unroll it onto the penis. Leave a space of
about 1 inch at the tip for semen
• Withdraw penis carefully after ejaculation to keep condom from slipping off and spilling the
contents and to avoid unprotected contact
• Always discard used condoms
Activities
Classroom Choose from below to make 30 minutes
Online
6
DISCUSS
• Discuss common side effects of medications
used to treat sexually transmitted infections.
• Discuss why it is important for all sexual
partners of a person with a sexually
transmitted infection to seek medical
evaluation.
PRACTICE
• As a class, discuss the general
POST AND COMMENT
• Post the following discussion topic online
and have students comment. Prepare
information about selected drug therapy for
sexually transmitted infections. This
information should be prepared for
publication as an online resource. Each
student or group of students should be
assigned a different drug. The information
should be geared toward those with varied
7
DISCUSS
• Discuss why it is important for a nurse to
obtain a medical history from a patient being
assessed for a sexually transmitted
infection.
PRACTICE
POST AND COMMENT
• Post the following discussion topic online
and have students comment. Ask students
to prepare a video of a nurse/patient
interaction, in which the nurse is obtaining
information needed on a patient with a
sexually transmitted infection. Each pair of
____________________________________________________ Chapter 51Sexually Transmitted Infections 23
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 51.2
8
DISCUSS
• Discuss how a nurse should perform a
physical examination of the patient and what
findings might be expected if the patient is
infected with gonorrhea.
PRACTICE
• Divide the class into three groups. Present
the following scenario to the groups:
• A 32-year-old man is admitted to the
discussion.
POST AND COMMENT
• Post the following discussion topic online
and have students comment. Discuss
several nursing interventions needed for
care of the patient with a sexually
transmitted infection. Ask students to
provide constructive comments on each
other’s posts.
9
DISCUSS
• Discuss how to advise a patient who has just
been diagnosed with a sexually transmitted
infection to prevent the spread of the
PRACTICE
• Invite a sex education teacher to describe
proper condom use or show a video of
proper condom application to the class. Ask
the class what they should consider teaching
• In small groups, have students discuss and
design patient teaching plans on preventing
sexually transmitted infections for the
following groups:
POST AND COMMENT
• Post the following discussion topic online
and have students comment. Ask students
to prepare a video intended for public view,
“rated PG.”
• Post the following discussion topic online
and have students comment. Provide
information intended for online distribution
on ways to prevent sexually transmitted
infections. Ask students to designate the age
24 Chapter 51Sexually Transmitted Infections _____________________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 51.2
Critical Thinking Question
A 26-year-old homosexual man who was not taking anti-HIV drugs is hospitalized with
complications of AIDS. He and his partner were just informed that the red and purple skin
discolorations on his nose and the lining of his mouth are Kaposi sarcoma. How should the
nurse offer support to them? What should the nurse explain to the patient and his partner
about Kaposi sarcoma?
Discussion Guidelines: The nurse should remain nonjudgmental and encourage the couple to
discuss their feelings about AIDS and Kaposi sarcoma. The nurse should also spend time with
them so that they do not feel alienated by the nursing staff. The nurse can also refer them to a local
Instructor Notes/Student Feedback
____________________________________________________ Chapter 51Sexually Transmitted Infections 25
Introduction to Medical-Surgical Nursing, 6th ed.
51
Assessments for
Sexually Transmitted Infections
CHAPTER OBJECTIVES
Lesson 51.1:
1. Describe tests used to diagnose sexually transmitted infections and the nursing considerations
associated with each.
3. List infectious diseases classified as sexually transmitted infections.
5. Explain the importance of the nurse’s approach when dealing with patients who have sexually
transmitted infections.
Lesson 51.2:
6. List nursing considerations when a patient is on drug therapy for a sexually transmitted infection.
8. Assist in developing a nursing care plan for a patient with a sexually transmitted infection.
9. Design a teaching plan on the prevention of sexually transmitted infections.
Assessments by Lesson & Objective
Lesson 51.1
1
Study Guide
• Part IIC: 1, 2, 7, 13, 27, 38 (pp. 346-348)
• Part IIID: 6 (p. 349)
Evolve Instructor Resources
• Test Bank: 13
• Open Book Quiz: 1
Evolve Instructor Resources
• Test Bank: 7, 25, 27
3
Evolve Student Resources
• NCLEX Review: 4
26 Chapter 51Sexually Transmitted Infections _____________________________________________________
Assessments by Lesson & Objective
4
Study Guide
• Part IA: 1-7 (p. 345)
Evolve Instructor Resources
• Test Bank: 1, 5, 9, 11, 12, 18
• Open Book Quiz: 2-4, 7
Evolve Student Resources
• NCLEX Review: 3
5
Study Guide
• Part IIID: 7 (p. 349)
Evolve Instructor Resources
• Test Bank: 3, 6
Evolve Student Resources
Lesson 51.2
6
Study Guide
• Part IIC: 8, 15, 19, 24, 25, 32, 36, 37 (pp. 346-348)
Evolve Instructor Resources
• Test Bank: 1, 4, 10, 14, 19-24, 26, 28
• Open Book Quiz: 5, 6, 8, 10
Evolve Student Resources
• NCLEX Review: 5, 8, 9
• Prioritization: 2-4
7
Study Guide
• Part IIIE: 3 (p. 350)
Evolve Instructor Resources
Evolve Instructor Resources
• Test Bank: 8, 17
Evolve Student Resources
• Prioritization: 1
____________________________________________________ Chapter 51Sexually Transmitted Infections 27
Introduction to Medical-Surgical Nursing, 6th ed.
Assessments by Lesson & Objective
9
Study Guide
• Part IIC: 9 (p. 346)
• Part IIID: 3, 4 (p. 349)
Evolve Instructor Resources
Instructor’s Notes/Student Feedback