Are you reviewing sexually transmitted infections (STIs) for your nursing exams? This article breaks down Trichomoniasis (Trichomonas vaginalis), which is an important topic for the NCLEX and clinical nursing practice.
Don’t forget to take the free nursing quiz at the end to test your knowledge.
What Is Trichomoniasis?
Trichomoniasis (often called “Trich” which is pronounced as the word trick) is a sexually transmitted infection caused by a protozoan parasite called Trichomonas vaginalis. It primarily infects the urogenital tract and can affect both men and women, though women are more likely to show symptoms.
Transmission and Risk Factors for Trichomoniasis
A person can get trichomoniasis through:
- Unprotected vaginal intercourse with an infected partner
- Vertical transmission during childbirth when a baby passes through an infected birth canal
- During delivery, the newborn may develop congenital conjunctivitis, or the infection can lead to low birth weight or preterm labor before birth.
High-Risk Populations
Screening is especially important for individuals who:
- Have multiple sexual partners
- Currently have or recently had another STI
- Are incarcerated
- Use drugs
STI Nursing Lecture on Trichomoniasis
Trichomoniasis Symptoms (Remember the Mnemonic: “TRICH”)
Use this nursing mnemonic to remember the signs and symptoms of Trichomoniasis:
- T: Thick, foamy discharge Foul-smelling, greenish-yellow discharge
- R: Redness Inflamed genital area; cervix appears “strawberry-like” on exam
- I: Itching Intense vaginal or urethral itching
- C: Cramping Lower abdominal or pelvic pain
- H: Hurts Pain during intercourse (dyspareunia) or urination (dysuria)
Screening Recommendations
According to the CDC guidelines, routine screening for trichomoniasis is not recommended for the general population. However, screen symptomatic patients or those at high risk based on the factors above. Early identification and treatment are key to preventing complications and reinfection.
Treatment and Nursing Considerations for Trichomoniasis
Medication: Metronidazole (Flagyl) is the first-line treatment for both pregnant and non-pregnant patients. It targets and kills Trichomonas vaginalis, curing the infection.
Patient Education: Nurses play a crucial role in patient teaching. Emphasize the following:
- Avoid alcohol while taking metronidazole and for 72 hours after the last dose.
Combining alcohol with this medication can cause a disulfiram-like reaction (flushing, nausea, vomiting, and severe headache). - Abstain from sexual activity until seven days after completing the full course of treatment.
- Inform all sexual partners so they can be tested and treated to prevent reinfection.
- Use condoms consistently to prevent future STI transmission.
- Retest in three months after treatment to confirm the infection is cleared.
Complications of Untreated Trichomoniasis
If left untreated, trichomoniasis can cause:
- Pelvic inflammatory disease (PID) in women
- Infertility
- Preterm labor or low birth weight in pregnancy
- Increased risk of acquiring or transmitting HIV
NCLEX Nursing Tip
- When you see frothy green discharge plus a strawberry cervix, think Trichomoniasis (Trichomonas vaginalis).
- When you see “no alcohol with metronidazole,” think Flagyl teaching.
Test Your Knowledge
Take the free Trichomoniasis Nursing Quiz linked below to check your understanding of key concepts, symptoms, and nursing interventions for this STI.
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References:
American College of Obstetricians and Gynecologists. (2023). How to prevent STIs. https://www.acog.org/womens-health/faqs/how-to-prevent-stis
Centers for Disease Control and Prevention. (2021). Sexually transmitted infections treatment guidelines, 2021. U.S. Department of Health and Human Services. https://www.cdc.gov/std/treatment-guidelines/default.htm
Kizior, R. J., & Hodgson, K. (2023). Saunders nursing drug handbook (12th ed., p. 771). Elsevier. ISBN 9780323930765
U.S. Food and Drug Administration. (2018). Metronidazole injection, USP [FDA label]. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/018890s052lbl.pdf
World Health Organization. (n.d.). Sexually transmitted infections (STIs). Retrieved November 22, 2024, from https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)