Nursing Guide to Genital Warts: Nursing Diagnosis, Interventions, & Care Plans

Genital Warts Definition

Condyloma acuminata, or more commonly known as genital warts, is a highly infectious sexually transmitted disease (Centers for Disease Control and Prevention [CDC], 2021). The human papillomavirus (HPV) is the causative virus responsible for genital warts. About 50 different HPV types affect the genital organs, even though there are about 150 total HPV types known (CDC, 2021). Specifically HPV types 6 and 11 are attributed to cause genital warts. 

Genital warts are considered the most commonly spread sexually transmitted disease in the world. It is estimated that most sexually active people have been infected with some form of HPV infection in their lifetime (World Health Organization, 2020). Genital warts diagnoses are more prevalent in women than men. 

Unprotected vaginal, anal, and oral sex can lead to contracting and transmitting genital warts. HPV can gain access to infect the cells of the basal layer of the epidermis through impaired skin and mucosa of the genital area (Ghadishah, 2018). Besides the genital organs, lesions can occur in the trachea, oropharynx, and larynx, and trachea. 

Risk factors include (Ghadishah, 2018): 

• Smoking 
• Multiple sex partners 
• Oral contraceptives 
• Sexual activity at an early age 

Genital Warts ICD-10 Code (venereal): A63.0

Genital Warts Diagnosis 

Genital warts can be diagnosed by (CDC, 2021): 

• Physical examination 
• Biopsy 

HPV testing is not recommended; testing only confirms the presence of the HPV in the system, not that the wart was caused by it. This could lead to misdiagnosis of warts or lesions with another causative infection. 

Management & Treatment of Genital Warts

HPV infections can be self-limiting and symptoms can subside within a few months to 2 years without seeking treatment. There is no way to clear or cure HPV, however the warts can be treated. Treatment method can be determined by: 

• Symptoms: Discomfort, pain, and itching 
• Demographics: Location, size, number of warts 
• Textures: Non-keratinized (soft) or keratinized (hard) 
• Comorbidities: Cancer, pregnancy, diabetes, HIV, etc. 

There are multiple treatment options that may be used alone or in combination with more than one method. Treatment options include (CDC, 2021): 

• Direct topical creams or liquids 
  • Bichloracetic acid (BCA) 
  • Trichloroacetic acid (TCA) 
  • Imiquimod 
  • Podofilox 
  • Podophyllin 
  • Sinecatechins 
• Surgical removal 
  • Electrocautery 
  • Cryotherapy 
    • Liquid nitrogen 
    • Cryoprobe 
  • Laser therapy 
  • Excision 

It is important to note that treatment of genital warts is not a cure. The warts can and often do return, due to the HPV infection that is still present. Treating the wart alone does not clear the actual HPV infection. 

Complications can occur from genital warts including (CDC, 2021): 

• Some forms of cancers 
  • Almost all cervical cancers 
  • Vulvar 
  • Vaginal 
  • Penile 
  • Anal 
  • Oropharyngeal 
• In pregnancy 
  • Obstruction of birth outlet 
  • Excessive bleeding 
• Resistance to treatment 
• Frequent reoccurrences 

Genital Warts Nursing Care Plans

Use the nursing process to develop a plan of care for individuals. The nursing assessment (with common findings listed), diagnoses, interventions, expected outcomes, and education for genital warts are listed below. 

Assessment 

A thorough history should be taken: 

• Past and present health condition 
• Current symptomology 
• Sexual history and practices 

Upon physical assessment for genital warts, the individual may present with warts on the labia, vagina, cervix, penis, scrotum, buttocks, and/or anus. Genital warts can present as: 

• Singular or clustered 
• Pink or flesh colored 
• Smooth or rough 
• Soft or hard 
• Flat or raised 
• Various sizes and shapes 

The individual may report the warts are itchy, painful, burning, and/or tender. 

Nursing Diagnosis/Risk For 

The individual is at risk of the following nursing diagnosis related to genital warts: 

• Risk for acute pain 
• Risk for impaired skin 
• Risk of infection and spread of infection 
• Risk of deficient knowledge of disease and disease processes 
• Risk for infection transmission 
• Risk for body image disturbance 

The individual may feel stigmatized due to the diagnosis of genital warts. This can lead to emotional and psychological distress and can have a negative impact on the quality of life, interpersonal, and sexual relationships. Nursing diagnosis related to these factors must also be explored: 

• Risk for ineffective coping 
• Risk for anxiety 
• Risk for depression 
• Risk for low self-esteem 

Interventions 

Interventions should include measures to increase comfort and decrease spreading of warts: 

• Keep lesions clean and dry 
• Avoid: 
• Scratching, picking, or disturbing any warts 
• Shaving the area 
• Attempting to remove with over-the-counter wart removers (may cause burns and skin damage) 

Expected Outcomes 

The individual will report: 

• Decrease in symptoms 
• Decrease in reoccurrences from reinfection 
• Use of safe sex practices 
• Open communication about diagnosis with sexual partners 
• Effective coping and management of psychosocial effects 

Individual/Caregiver Education 

The individual should be educated on preventive measures including: 

• Infection process, symptoms, and management 
• Importance of not shaving, scratching, or picking at the warts to reduce the risk of spreading the infection 
• Practicing safe sex (emphasizing that condoms are not 100% effective against transmission, as contact with areas outside of the condom can also lead to infection) 
• HPV vaccine and reduction of cervical cancer risks 
• Cancer risks related to HPV infections 
• Support systems and/or groups 

Content Release Date 

4/1/2022

Content Expiration

12/31/2025

Course Contributor 

The content for this course was created by Tameka N. Warren, MSN, RN, CLC. 

Tameka N. Warren, MSN, RN, CLC, earned her Bachelor and Master of Science in Nursing degrees from Indiana University School of Nursing at IUPUI, and her Associate of Science in Nursing from Ivy Tech College. She has over 16 years of nursing experience in public health, regulation, home health, education, maternal child community health, and long-term care environments. Tameka served as a Public Health Nurse Surveyor (Home Health & Hospice) certified by the Centers for Medicare & Medicaid Services, or CMS, a maternal and infant mortality advocate, an ALPP Certified Lactation Counselor, and an Adjunct Clinical Professor. Tameka’s passion is to serve the most vulnerable populations affected by health disparities and to inspire a new generation of nurses to do the same successfully. 

Resource 

• CDC HPV Resource Page https://www.cdc.gov/hpv/index.html 

References 

• Centers for Disease Control and Prevention. (2021). Sexually transmitted diseases treatment guidelines. https://www.cdc.gov/std/treatment-guidelines/STI-Guidelines-2021.pdf 
• Ghadishah, D. (2018). Genital warts. https://emedicine.medscape.com/article/763014- overview#showall 
• World Health Organization. (2020). Human papillomavirus (HPV) and cervical cancer. https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical- cancer