Primary Nursing Diagnosis


OUTCOMES. Risk control: Sexually transmitted diseases INTERVENTIONS. Medication management; Teaching: Safe sex


Medical treatment for syphilis infection at any stage consists of antibiotic therapy to destroy the infecting bacteria. After treatment, patients are instructed to refrain from sexual contact for at least 2 weeks or until lesions heal and to return for serology testing in 1 month and then every 3 months for 1 year.

Carefully question patients about penicillin sensitivity before treatment. They should also be warned about the Jarisch-Herxheimer reaction, which is believed to be caused by toxins that are released from dying spirochetes. The reaction develops 6 to 12 hours after the initial penicillin dose and causes fever, headache, nausea, tachycardia, and hypotension. Instruct the patient to rest, drink fluids, and take antipyretics.

Tell the patient that the disease must be reported to the local health authority and that confidentiality will be maintained. Identifying and treating sexual partners of the infected patient is an important intervention. If the patient is treated in the primary or secondary stage, attempt to contact all sexual partners from the past 3 months. If the patient is in the later stages of the disease, contacts from the previous year are screened. Handle the "contact discovery" interview carefully, and if possible, have a public health professional conduct the interview.

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