Terms in this set (20)
Sexually transmitted infection
Characterized by painful genital ulcers and inguinal adenitis
Common cause of genital ulcers in patients in developing countries
Organisms are carried from the site of entry through the lymphatics to regional lymph nodes, resulting in node swelling.
The incubation period typically ranges from 4 to 10 days but may be as long as 35 days.
The initial lesion is a papule that ulcerates within days. (See Chancroidal lesion.)
Untreated infections disseminate to other organs, causing systemic inflammation and specific organ dysfunction.
Haemophilus ducreyi , a short, nonmotile, gram-negative bacillus
Poor personal hygiene
Multiple sex partners
The incidence of chancroid is difficult to determine but has declined in the United States since 1987.
This disease is more common in males than in females.
Chancroid may occur at any age but is most common in younger sexually active individuals
Phimosis and urethral fistulas in men
Inguinal adenitis and formation of buboes
May report unprotected sexual contact with an infected person or with unknown or multiple partners
Pain from ulcers and lymphadenopathy
Headaches and malaise
Genital area initially with single or multiple papules surrounded by redness that rapidly become pustular and then ulcerate
Ulcers nonindurated with ragged edges, a base of granulation tissue, and bleed easily; range from 1 mm to 5 cm in diameter
Lesions on the tongue, lip, or breast
Suppuration with bubo formation in the untreated patient; rupture of abscess may follow
Tender, fluctuant inguinal nodes
Diagnostic Test Results-Laboratory
Cultures from the lesion may show H. ducreyi . (However, cultures are commonly unreliable because of contamination by multiple organisms; (See Criteria for diagnosis.)
Gram stain reveals a "school of fish" "railroad track," or "fingerprint" pattern.
Aspiration of fluid-filled nodes if greater than 5 cm
Careful personal hygiene
Evaluation of patient for syphilis, herpes simplex virus, and human immunodeficiency virus (HIV)
Abstinence from sexual activity until genital lesions are healed
Antibiotics such as azithromycin, ceftriaxone sodium (I.M.), ciprofloxacin hydrochloride, or erythromycin
Surgical drainage for large abscess or fluctuant lymph nodes.
Nursing Considerations-Nursing Diagnoses
Disturbed body image
Impaired skin integrity
Ineffective sexuality patterns
Risk for infection
Nursing Considerations-Expected Outcomes
report decreased levels of pain
communicate feelings about changes in body image
regain skin integrity with decrease in size of chancroids
voice feelings about changes in sexual activity
experience no further signs or symptoms of infection.
Nursing Considerations-Nursing Interventions
Follow standard precautions.
Give prescribed drugs such as oral antibiotics (single-dose azithromycin or ceftriaxone, ciprofloxacin twice daily for 3 days, or erythromycin three times daily for 7 days) or I.M. ceftriaxone as a single dose. deep into a large muscle mass.
Wash the affected area with soap and water.
Apply soaks to the affected area as ordered.
Dry the affected area thoroughly.
Report all cases of chancroid to the local board of health.
Prepare the patient for possible drainage of large abscesses.
Appearance of lesions
Response to treatment
Adverse effects of medications
Compliance with treatment regimen
Signs and symptoms of further infection or complications
Nursing Considerations-Associated Nursing Procedures
Sexually provocative patient, care of
Wound specimen collection
disorder, diagnosis, possible causes, and recommended treatment
appropriate hygiene measures, including cleansing of the genitalia
technique for soaks using prescribed solution
signs and symptoms of healing
signs and symptoms of progression of infection and the need to notify a practitioner
importance of avoiding creams, lotions, or oils on or near the genitalia or other lesion sites
need to abstain from sexual contact until follow-up shows that healing is complete
importance of treating sexual partners if they have had sexual contact with patient within 10 days of symptom presentation even if the partner is not symptomatic
need for syphilis testing as a baseline, with follow-up testing in 3 months
recommendations for HIV testing as a baseline and then again in 3 months because chancroid is an established risk factor for acquiring HIV infection
importance of following safer sex practices and need for all sexual partners to be treated
need for follow-up examination in 3 to 7 days after therapy is started, with close follow-up until all signs of infection have resolved.
Patient Teaching-Discharge Planning
Refer the patient and affected sexual partners for treatment.
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