Question

19-year-old male who presents to the STD clinic because he’s had a sore on his penis for one week. • Last sexual exposure was three weeks prior, without a condom. • No history of recent travel. • Predominantly female partners (three in the last six months), and occasional male partners (two in the past year). • Last HIV antibody test (two months prior) was negative. Reports three children with two different women. Physical Exam • No oral, perianal, or extra-genital lesions. • Genital exam shows an uncircumcised penis with a lesion on the ventral side near the frenulum. Lesion is red, indurated, clean-based, and non-tender. • Two enlarged tender right inguinal nodes, 1.5 cm x 1 cm. • Scrotal contents are without masses or tenderness. • No urethral discharge. • No rashes on torso, palms, or soles. No alopecia. Neurologic exam within normal limits.

The results of stat laboratory tests showed the following:

• Darkfield examination of penile lesion—Positive for T. pallidum

Develop 2 Nursing Diagnoses and create a nursing care plan.

Answer 1

Two diagnosis test for T.pallidum are-

these cannot be grown in culture, there are many tests for the direct and indirect diagnosis of syphilis. Still, there is no single optimal test.

1)Direct diagnostic methods include the detection of T pallidum by microscopic examination of fluid or smears from lesions, histological examination of tissues or nucleic acid amplification methods such as polymerase chain reaction (PCR).

2)Indirect diagnosis is based on serological tests for the detection of antibodies. Serological tests fall into two categories: nontreponemal tests for screening, and treponemal tests for confirmation

Darkfield examination of penile lesion—Positive for T. pallidum shows the diagnosis of early syphilis currently requires dark-field microscopic or serologic demonstration of Treponema pallidum infection.

Syphilis progresses through distinct primary, secondary, latent and tertiary stages. The ulcers that appear in primary and secondary syphilis are rich in treponemes; venereal transmission occurs through direct contact with these lesions. The stage of the disease at which the patient presents has implications for diagnosis and treatment. In some stages, the disease may be asymptomatic, and there are problems in diagnosing very early syphilis, neurosyphilis,asymptomatic congenital syphilis and syphilis in intravenous drug users and persons coinfected with serologically cross-reacting agents and HIV.

The nurse will educated the patient on how syphilis is transmitted, what bacteria causes it, the side effects of not getting the disease treated, and how to further prevent being re-infected.

The patient will verbalize he will abstain from sexual contact with anyone until skin lesion is healed to prevent disease transmission.