The nurse is caring for a patient with syphilis. In which order should the nurse explain the disease process to the patient?
Choice 1. appearance of a chancre and regional enlargement of lymph nodes
Choice 2. localized development of gummas
Choice 3. asymptomatic period
Choice 4. skin rash on palms and feet
Correct Answer: 1, 4, 3, 2
Syphilis is generally characterized by three clinical stages: primary, secondary, and tertiary. Each stage has characteristic manifestations. The primary stage is characterized by the appearance of a chancre. The chancre will appear at the site of inoculation. Secondary syphilis may occur any time from two weeks to six months after the first chancre disappears. The symptoms may include a skin rash on the palms of the hands or soles of the feet. These symptoms will disappear in two to six weeks and a latency period will begin. During the latency period, the patient may be asymptomatic and the disease is not transmissible by sexual contact, although it can be transmitted by the patient's infected blood. The tertiary stage is characterized by localized development of infiltrating tumors (gummas) in skin, bones, and liver. The disease can be treated at this stage, but much of the cardiovascular and central nervous system damage is irreversible.
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