Week 2 Flashcards
Name 6 types of dressings for burn wounds.
Silver impregnated (antimicrobial) - common & effective against staph
Alginate - moderate to high exudate
Hydrocolloid & foam - moderate to low exudate
Light dressings over joints - allows ROM and minimises compartment syndrome
Paraffin gauze
Antimicrobial impregnated - skin grafts, left on 3-5 days
What are the early signs of wound infection?
Pain
Redness
Oedema
Heat
What are the 4 wound classifications?
Acute/chronic*
Damage (burns)
Stages (pressure sores)
Colour
- Acute refers to surgical or traumatic injury, the wound is not usually colonised with bacteria
Chronic refers to long term wound; e.g. Leg ulcer. Microbial colonisation
What are the 2 principal layers of the skin?
Dermis and epidermis
When conducting an integumentary assessment, what questions are asked regarding the patients health history?
Allergies Previous skin conditions Family Hx of skin conditions Presenting problem Symptoms Medical Hx (cardiac and respiratory) Current medications Nutritional status
When assessing the skin, what is the nurse looking for?
Skin colour (general appearance, buccal mucosa, tongue, lips, nails)
Cyanosis
Erythema
Petechiae
Pallor
Jaundice
Alopecia to lower limbs
Nail clubbing (indicates endocarditis, COPD, cancer, cirrhosis of liver, hyperthyroidism)
What is herpes simplex, the signs and symptoms, treatment and management?
True primary infection
Type 1 - mouth (cold sores)
Type 2 - genital area
Signs and symptoms are pain, itchiness, burning, tingling, appearance of vesicles
Treatment and management
Type 1 - topical antiviral agent
Type 2 - dependent on severity, frequency and psychological impact of recurrence. Immunosuppressant therapy is effective in 85% of patients
What is herpes zoster, the signs and symptoms and treatment?
Shingles caused by the varicella-zoster virus.
Red coloured rash Swelling to rash area Pain Malaise GI upsets
Patient is contagious until rash develops cysts.
Oral or IV antiviral medication Analgesia Corticosteroids for neuralgia Pain management Dressings Patient education on dressings, ointment and hand hygiene
Prevention - varicella virus vaccination
What is the usual dose of vancomycin?
For specific infections
125 - 500mg four times a day PO
15-20mg/kg
Endocarditis
500mg four times a day or 1g BD
What is the route of administration for vancomycin?
Typical route is IV
Oral route used for clostridium defficile
What are the precautions and side effects of vancomycin?
Allergy to tecioplanin
Inflammatory GI conditions (affect absorption/can cause toxicity)
Renal impairment (increase the dose interval, reduce dose or both)
Surgery (GA increases adverse effects)
Elderly (toxicity)
Pregnancy (B2 drug category)
Breastfeeding (can cause loose bowel motions in baby)
Oral route - indigestion, nausea, vomiting, diarrhoea, chills
IV - local pain, thrombophlebitis, interstitial nephritis, serious skin reactions, chemical peritonitis, nausea, hypersensitivity (fever, chills, itch, rash, Steven-Johnsons syndrome, toxic epidermal necrolysis)
Why are specific infection control procedures required when MRSA+ve patients are hospitalised?
Prevent transmission to unaffected patients who may be at risk of opportunistic infection (eventually leading to death)
Why are limited antibiotics available for MRSA+ve patients?
Due to bacteria being resistant to most antibiotics traditionally used to treat infection (penicillin, methicillin, flucoxacillin)
What medication is used for MRSA+ve and how does it work?
Vancomycin; stops growth of bacteria
What is the treatment for a burns patient?
Fluid resuscitation (rule of nines) Early wound debridement and resurfacing Specialised dressings Antibiotics Nutrition/fluid balance Analgesia Surgical intervention (grafts)
