Maternal & Newborn Nursing

A female patient has been advised that laboratory tests confirm genital warts (HPV) recurring many times.

The nurse should teach the patient that a Papanicolaou test (Pap smear) is recommended:

  1. A Once every 6 months
  2. B Once every year Correct answer
  3. C Once every 3 years
  4. D Once every 5 years

Explanation

Core Concept: Women with a history of recurrent genital warts (caused by HPV) or those who are immunocompromised (e.g., HIV positive) are at a significantly higher risk for cervical dysplasia and cervical cancer. For these high-risk populations, guidelines often recommend more frequent cervical cancer screening, typically an annual Pap smear, rather than the standard 3-5 year interval.

Clinical Presentation:

  • Recurrent anogenital warts (condylomata acuminata).
  • Potential for concurrent high-risk HPV strains causing cervical intraepithelial neoplasia (CIN).

Diagnosis:

  • First-line diagnostic plan: Annual Pap smear (cervical cytology).
  • Most accurate (gold standard) test: Co-testing with Pap smear and high-risk HPV DNA testing, followed by colposcopy if results are abnormal.

Management:

  • Acute management: Perform the annual Pap smear and counsel the patient on the link between HPV and cervical cancer.
  • Gold standard long-term management: Treat visible warts. Encourage smoking cessation (which increases cervical cancer risk) and ensure the patient receives the HPV vaccine if age-appropriate.

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