NUR 223 FINAL EXAM (PART 2) GRADED A+
Family Planning Answer - *Most effective- abstinence
*Least effective- calendar rhythm method OR pull out method (coitus
interruptus)
*Male condoms- do not store in hot conditions
Oral Contraceptives Answer - S/E: dizziness, nausea, mood changes, HTN,
blood clots, MI, CVA, irregular bleeding, wt gain, increased risk for ectopic
pregnancy
Contraindications- pregnancy, hx DVTs, liver disease, estrogen depending
carcinomas, heavy smoking, gallbladder disease, DM, hyperlipidemia
Early signs of complications for OC users: Answer - A: Abdominal pain may
indicate gallbladder/liver problems
C: Chest pain or SOB may indicate PE
H: Headaches may indicate HTN or impending CVA
E: Eye problems may indicate HTN
S: Severe leg pain may indicate a thromboembolic event
Primary Syphillis Answer - *Chancre develops- 1st sign of syphilis
*Begins as small papule, then breaks down in 3-7 days into a PAINLESS,
indurated (hard), smooth, weeping lesion
*Without tx- chancre will disappear within 6 wks but organism is scattered
throughout body
,Secondary Syphilils Answer - *Develops 6 weeks-6 months after chancre
disappears
*Symptoms- copper colored rash (esp palms & soles), sore throat, flu-like
symptoms, joint pain/tenderness, flat lesions, hair loss
*Symptoms disappear in 4-12 weeks
Latent Syphilis Answer - *Begins about 1-2 yrs after infection & can last up to
50 yrs
*Early latent- during 1st yr after infection
*Late latent- year 2 up to 50, not infectious except to the fetus of a pregnant
woman (may not have active serology test)
*NO symptoms; not transmittable by sexual contact --but can still be
transmitted VIA BLOOD
-Only 30% of people with latent syphilis get tertiary syphilis
Tertiary Syphilis Answer - *Can occur from 4 yrs up to 20 yrs
*May be evidenced by tumors (benign lesions or gummas) in the skin, mucus
membranes, bones and liver
-Also seen in a diffuse inflammatory response which targets the nervous and
cardiovascular systems: seizures, hemiplegia, ataxia, constricted pupils, slurred
speech, personality changes, aneurysms, aortic insufficiency, coronary artery
stenosis
Syphilis Diagnostic Tests Answer - *Physical exam
*Laboratory tests: cultures, serology tests (looking for antibody VDRL serum
test & more rapid RDR; if VDRL is positive then a more specific test such as FTA-
ABS or MHA-TP will be used to confirm infection); CBC
*Can only be seen with a dark field microscope
, Syphilis Tx Answer - *ATB- Penicillin-G IM is drug of choice (tetracycline or
doxycycline if allergic to PCN)
*Wait in facility for 30 min after tx to assess for allergy
*Identify & treat partner; pt education
*Jarisch Herxheimer rxn may occur d/t the sudden destruction of spirocetes &
release of toxins: onset within 2 hrs, peaks in 4-8 hrs & gone in 24 hrs
S/S- generalized aches/pain at injection site, hypotension, vasodilation, fever;
treat with analgesic/antipyretics
Genital Herpes Answer - *Primary infection- usually most severe & lasts 2-3
wks
*Subsequent recurrent infections are often less severe & last 1 wk
*In between infection (latency) the virus lies dormant in nerve ganglia
S/S: lesions on genitals (papules form blisters with clear fluid which contains
virus), itching/tingling 1-2 days before lesions (prodromal SY), lesions rupture &
leave painful erosions, headache, fever, malaise, dysuria & retention, vaginal
discharge
Genital Herpes Dx & Tx Answer - *Dx- culture from blisters & clinical
manifestations
*Tx- Acyclovir or other anti-viral drugs (partially controls SY, outbreaks &
speeds healing), NO CURE
Nursing Care: education on preventing spread, chronic illness, ice packs/warm
compresses, sitz baths, loose clothing, encourage fluids
Family Planning Answer - *Most effective- abstinence
*Least effective- calendar rhythm method OR pull out method (coitus
interruptus)
*Male condoms- do not store in hot conditions
Oral Contraceptives Answer - S/E: dizziness, nausea, mood changes, HTN,
blood clots, MI, CVA, irregular bleeding, wt gain, increased risk for ectopic
pregnancy
Contraindications- pregnancy, hx DVTs, liver disease, estrogen depending
carcinomas, heavy smoking, gallbladder disease, DM, hyperlipidemia
Early signs of complications for OC users: Answer - A: Abdominal pain may
indicate gallbladder/liver problems
C: Chest pain or SOB may indicate PE
H: Headaches may indicate HTN or impending CVA
E: Eye problems may indicate HTN
S: Severe leg pain may indicate a thromboembolic event
Primary Syphillis Answer - *Chancre develops- 1st sign of syphilis
*Begins as small papule, then breaks down in 3-7 days into a PAINLESS,
indurated (hard), smooth, weeping lesion
*Without tx- chancre will disappear within 6 wks but organism is scattered
throughout body
,Secondary Syphilils Answer - *Develops 6 weeks-6 months after chancre
disappears
*Symptoms- copper colored rash (esp palms & soles), sore throat, flu-like
symptoms, joint pain/tenderness, flat lesions, hair loss
*Symptoms disappear in 4-12 weeks
Latent Syphilis Answer - *Begins about 1-2 yrs after infection & can last up to
50 yrs
*Early latent- during 1st yr after infection
*Late latent- year 2 up to 50, not infectious except to the fetus of a pregnant
woman (may not have active serology test)
*NO symptoms; not transmittable by sexual contact --but can still be
transmitted VIA BLOOD
-Only 30% of people with latent syphilis get tertiary syphilis
Tertiary Syphilis Answer - *Can occur from 4 yrs up to 20 yrs
*May be evidenced by tumors (benign lesions or gummas) in the skin, mucus
membranes, bones and liver
-Also seen in a diffuse inflammatory response which targets the nervous and
cardiovascular systems: seizures, hemiplegia, ataxia, constricted pupils, slurred
speech, personality changes, aneurysms, aortic insufficiency, coronary artery
stenosis
Syphilis Diagnostic Tests Answer - *Physical exam
*Laboratory tests: cultures, serology tests (looking for antibody VDRL serum
test & more rapid RDR; if VDRL is positive then a more specific test such as FTA-
ABS or MHA-TP will be used to confirm infection); CBC
*Can only be seen with a dark field microscope
, Syphilis Tx Answer - *ATB- Penicillin-G IM is drug of choice (tetracycline or
doxycycline if allergic to PCN)
*Wait in facility for 30 min after tx to assess for allergy
*Identify & treat partner; pt education
*Jarisch Herxheimer rxn may occur d/t the sudden destruction of spirocetes &
release of toxins: onset within 2 hrs, peaks in 4-8 hrs & gone in 24 hrs
S/S- generalized aches/pain at injection site, hypotension, vasodilation, fever;
treat with analgesic/antipyretics
Genital Herpes Answer - *Primary infection- usually most severe & lasts 2-3
wks
*Subsequent recurrent infections are often less severe & last 1 wk
*In between infection (latency) the virus lies dormant in nerve ganglia
S/S: lesions on genitals (papules form blisters with clear fluid which contains
virus), itching/tingling 1-2 days before lesions (prodromal SY), lesions rupture &
leave painful erosions, headache, fever, malaise, dysuria & retention, vaginal
discharge
Genital Herpes Dx & Tx Answer - *Dx- culture from blisters & clinical
manifestations
*Tx- Acyclovir or other anti-viral drugs (partially controls SY, outbreaks &
speeds healing), NO CURE
Nursing Care: education on preventing spread, chronic illness, ice packs/warm
compresses, sitz baths, loose clothing, encourage fluids
