05.05 Nursing Care and Pathophysiology for Chlamydia (STI)

Hey there. It's meg again. Today we're going to discuss chlamydia with sexually transmitted infection.

So what is chlamydia? It is of course an STI. We often actually see patients have chlamydia and gonorrhea at the same time, so don't be surprised if you see the provider ordering to treat both at the same time. Chlamydia is often asymptomatic and that is so important for you to remember throughout this lesson. Without treatment, patients can end up with pelvic inflammatory disease in women or even blindness and some more serious cases. So let's go ahead. Let's dive more deeply into the risk factors and the way our patients with chlamydia are going to look.

Remember, so important. The chlamydia is often asymptomatic and even when a patient does have symptoms, they could have been contagious for a long time before they realized they were even infected. And this is why ultimately safe sex is so important because you never know who's infected, especially if the body isn't giving you any indication of an infection at all. Remember, the most common symptom for a patient with chlamydia is going to be no symptoms at all. If a patient does have symptoms, they might have cervical discharge that is white and milky and generally a little more watery than the prevalent discharge that we see with patients with gonorrhea. Let's go through this picture here really quick. So what you're looking at here, this is the vaginal wall and this ruby red super inflamed looking thing is actually the cervix. And then of course you can see this white milky discharge right there. So if you think about it, one of the only symptoms that a person might have is cervical inflammation, which is an internal organ. So how is your patient supposed to know that they have chlamydia if they can't even see it? Patients might also have painful urination and this is going to be for both men and women. Sometimes this is the only symptom that men have. And then also pain with sex, which again, if you think about it, if a woman's cervix is this inflamed pain with sex is actually makes a lot of sense.

The other type of chlamydia is going to be chlamydia, conjunctivitis, and this is infection of the eye. And actually historically, a few centuries ago, this would cause unexplained blindness in young people and it wasn't until the last century or so that we actually understood that this was chlamydia infection. Now we understand that it can also spread to the infant during vaginal delivery and childbirth and can result in blindness if untreated in both adults and children. Like any other type of conjunctivitis, it is highly contagious and it can spread by contaminated surfaces. So that could be a countertop, unwashed towels, pillows, you get the idea. So just like with any other type of conjunctivitis, we need to wash our hands. Yeah, got to wash your hands people. All right, so let's talk about treatment.

Whether it's chlamydia of the genitalia or chlamydia, conjunctivitis. We're going to treat it with a one time dose of Azithromycin and that is because the fewer the doses equals higher compliance. Not that long ago, we would actually treat this with a seven day a regimen of doxy cycling. And why we would find is that symptoms would go away by day four or five. And so patients wouldn't complete the regimen and then they would end up with a re-infection and not even realize it. So after this one time dose of Azithromycin, we also want our patients to abstain from sex for seven days. That is one whole week everyone. And that's because we don't want them to spread it while the body fights off the infection. And then remember gonorrhea and chlamydia are best butts. So we might be considering a gonorrhea coinfection and be treating that as well. So when we talk about health promotion with really any STI, we're going to talk about how we're screening for it. And then of course safe sex because chlamydia has some really serious side effects, but it often has no symptoms. It's one of the only ones that we actually screen for annually, especially for those people that are under 25 years old and sexually active. There's going to be some additional screening about three months after infection just to make sure that a patient doesn't have a re- infection. So we really want to encourage our patient's compliance with that and then of course safe sex. When it comes to health promotion. This is probably the most important thing that we can stress using a condom. It's not always a hundred percent effective and that's true for any STI, but it is still very much our best bet for protecting our patients from chlamydia and like other STDs. Our providers are going to encourage our patient to notify their sexual partners so that they can get treated too because guess what? Their partners probably don't have symptoms either. And then of course, like we mentioned in our last slide, we need to abstain from sex for seven days after treatment for a chlamydia infection.

Okay, so let's run through some nursing concepts for a patient with chlamydia real quick. Sexuality is first because of course this is spread by sexual contact, but it can also really have an impact on the dynamics between two sexual partners. If one of them gets an STI. Next we've got health promotion because we're going to encourage follow up compliance and safe sex and then infection prevention. We're going to encourage the notification of sexual partners and handwashing, especially in cases of chlamydia, conjunctivitis.

Okay, so let's wrap up with our key points here. Chlamydia is a sexually transmitted infection and it often has no symptoms at all. If it goes on treated, it can cause blindness in adults and neonates, as well as pelvic inflammatory disease in females, and as always, safe sex, always the way to go. All right, folks, that is all for this lesson on chlamydia. Now, let's go out and be our best selves today, and as always, happy nursing.