Nurse prescribing in family planning.
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Biomedical subjects
Publications and source records attributed to Felicity Young.
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The number of syphilis cases has been increasing in the UK, partly because of localised outbreaks. The sharpest rises have been among men having sex with men, but the incidence among heterosexuals has also risen. Blood-test screening for syphilis is an important part of sexual health, and includes routine screening of pregnant women at the first antenatal visit. Prompt treatment with penicillin in the earlier stages can stop the progression of the disease. Unfortunately, public awareness of syphilis and its potentially serious consequences is low. It is important for health professionals to be alert for signs of the disease and to initiate tests if there is a likelihood that a patient has or is at risk for the disease.
Trichomoniasis is a common but less well known sexually transmitted infection affecting men and women. In men it is often asymptomatic and goes undetected. In women it can produce a profuse, frothy, unpleasant-smelling vaginal discharge with pruritus and soreness which is sometimes confused with vulvo-vaginal candidiasis (thrush) and bacterial vaginosis. Women often mistakenly treat themselves for thrush with no result. Diagnosis is by laboratory culture and treatment is with metronidazole. Partner notification and treatment should be undertaken. Trichomoniasis often coexists with chlamydia and gonorrhoea. It can have consequences for reproduction, including low birth weight and preterm labour, and has been found to be a co-factor in the transmission of HIV. It is therefore mandatory to ensure prompt and appropriate treatment for all patients diagnosed with trichomoniasis.
As the number of infected people increases, more nurses outside the specialist sexual health services are being called upon to provide advice and clinical care for genital chlamydial infection. This article provides non-specialist nurses with practical information on the diagnosis, treatment, management and follow-up of clients with genital chlamydial infections.
Under the National Strategy for Sexual Health and HIV, most patients seeking or requiring routine sexual health care are now offered the option of being treated by the primary health care team, rather than a specialised genito-urinary medicine clinic. Taking a sexual history and making a risk assessment is a key skill for making a diagnosis and care plan. This article offers a structured approach to this task, particularly for nurses, midwives and other community health professionals. It also describes the often sensitive core questions that the professional may need to ask in order to obtain an effective sexual history and determine the risks for a particular patient.
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The diagnosis and management of bacterial vaginosis are discussed, including the role of the nurse and midwife in testing and treatment.