PEDS 602 Infectious_diseases_burns_ATI_Update - Chamberlain College of Nursing | PEDS602 Infectious_diseases_burns_ATI_Update

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PEDS 602 Infectious_diseases_burns_ATI_Update - Chamberlain College of Nursing INFECTIOUS DISEASESTERMINOLOGY ¡ Host – supports growth of another ¡ Virulence- potential to produce disease ¡ P... athogens –agents that cause disease ¡ Infection/Colonization – presence and multiplication of organisms ¡ Microflora – harmless, helps with digestion and vitamin(K) synthesis ¡ Opportunistic Pathogens – microorganisms produce disease if host is immunocompromisedSYMPTOMATOLOGY ¡ Collection of signs and symptoms expressed by the host during the course of the disease – an inflammatory and immune response How many ways could you have become infected today???? ¡ Specific – at site of infection ¡ Nonspecific –present in many diseasesSTAGES OF AN INFECTION ¡ The incubation stage? replication by pathogen without symptoms ¡ The prodromal stage? first symptoms in host, vague malaise ¡ The acute/active stage? maximum impact of specific symptoms, rapid proliferation of pathogen, toxins, ¡ The convalescent stage? infection contained, repair damaged tissue ¡ The resolution stage? pathogen eliminated- no symptomsPREVENTION OF INFECTION AND TRANSMISSION ¡ Hand washing ¡ Standard precautions ¡ Avoid exposure to infected individuals ¡ Isolation practice ¡ Community outbreaks ¡ Educate ¡ Promote immunizationsPEDIATRIC INFECTIOUS DISEASE: ¡ Nursing Assessment ¡ History – onset, duration, location ¡ Physical exam- skin, eyes, ears, mucosa, tonsils ¡ Labs - CBC, CRP, Lumbar Puncture ¡ Nursing Diagnosis: ¡ Hyperthermia ¡ fever is beneficial! ¡ Risk for impaired skin integrity r/t scratching from itch ¡ Social isolation - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ¡ Pathophysiology: ¡ Lice live and reproduce only on humans ¡ Bite human and release toxin that causes itchingHEAD LICE (CONT) ¡ Clinical Manifestations: ¡ Intense itching – feel the crawl ¡ Therapeutic Management: ¡ Medicated lotion and shampoo ¡ Repeat treatment in 7-12 days ¡ Nix, Rid Shampoos ¡ pediculocide lotionSCABIES ¡ Contagious skin condition caused by the mite Sarcoptes scabiei ¡ Pathophysiology: ¡ Females burrow into skin and lay eggs ¡ Eggs hatch and lead to inflammatory response ¡ Clinical Manifestations: ¡ Itching ¡ Burrow tracks ¡ Therapeutic Management: ¡ Scabicidal lotion ¡ Antihistamines ¡ Treat all family members ¡ Treat belongings- vacuum, scrub, wash with hot waterBED BUGS ¡ Resistant to sprays and extermination except Heat to 180 degrees x 3 days ¡ Live off blood of humans “bite” ¡ Lay eggs/hibernate for up to 2 years in cracks/nail holes of furniture, carpet, curtainsTINEA ¡ Fungal infection that affects skin, nails and scalp ¡ Types: ¡ Tinea capitis ¡ Tinea corpis ¡ Tinea pedis ¡ Tinea cruris ¡ Therapeutic Management: ¡ Griseofulvin ¡ Topical ointments (lotrimin) ¡ clean & dry *treat pets too!!PIN WORMS (ENTEROBIUS VERMICULARIS) ¡ Parasitic infection ¡ Who’s at Risk? Warm climate ¡ Pathophysiology: ¡ Pinworm eggs ingested/inhaled ¡ Hatch in upper intestines ¡ Travel through the intestines ¡ Clinical Manifestations: ¡ Itching ¡ Insomnia Therapeutic Management: ¡ Anti-helminth medication ¡ Nursing Management: ¡ Treat entire family ¡ Repeat medication in 2 weeksBurns & the Pediatric PopulationSTRUCTURES OF THE SKIN ¡ Epidermis ¡ Dermis ¡ Subcutaneous Tissue ¡ Skin Appendages ¡ Sweat Glands ¡ Sebaceous Glands ¡ Hair ¡ NailsTYPES OF BURNS Thermal – most common, dry heat – flames or moist heat – hot liquids/steam, cell destruction with nerve, muscle and vascular damage. Chemical – direct contact/inhalation of alkaline or acidic agents – decreased tissue perfusion, necrosis Electricity – follows path of least resistance (muscle, bone, vessels, nerves) – depends on duration & amount of voltage – may stop heart Radiation – sunburn or Rx for Cancer, usually superficial – but large body surfaceBURN CLASSIFICATION ¡ 3rd Degree ¡ 4th DegreeBURN: CLINICAL MANIFESTATIONS Superficial: ¡ Erythema ¡ Tenderness ¡ Blanches under pressure Partial Thickness: ¡ Red, blistered ¡ Tender or painful Full thickness: ¡ Skin is tough and leathery Or waxy or pearly whiteSTOP THE BURN! ¡ Remove any smoldering clothing asap ¡ Remove constricting items ¡ Sterile technique ¡ Prevent heat loss ¡ Reassure child pain is not a punishmentBURNS Major or Minor Burns Minor Burns Partial or full thickness <10% Child > 5 years No burns on hands, feet, genitals, face, respiratory, or circumferential Major, Large, Extensive Burns < 5 years – it is all major!! Full thickness >10% – Burns on hands, feet, genitals, respiratory, and/or circumferential Systemic body response, all systems affected requires extensive fluid resuscitation!! Burns and Children Very young children = higher mortality rate ¡ Lower temps and shorter exposure = causes more damage in children than adults ¡ Severe burns = increased risk for….. ¡ fluid and heat loss, dehydration, metabolic acidosis ¡ protein and calorie deficiency d/t small muscle mass and less body fat ¡ in- - - - - - - - - - - - - - - - - - - - - - -n thin layer over open wound and covered with a dressing ¡ Sulfadiazine applied in thin layer over open wound and covered with dressing – not with renal function issues! ¡ H2-receptor antagonists – ulcer prevention ¡ Ranitidine ¡ Famotidine Wound Management¡ Figure 36-23 A, Pressure garment used to reduce hypertrophic scarring from a burn to the chest and upper arms. ¡ Figure 36-23 (continued) B, Hypertrophic scar on the chest. Source: Courtesy of Martin R. Eichelberger, MD, and Lisa Ring, RN, PNP, Children’s National Medical Center, Washington, DC. [Show More]

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