Nrnp 6531 Care of Adults Across Lifespan

Nrnp 6531 Care of Adults Across Lifespan Impetigo - reddened macules progressing to water-filled vesicles. Strep infx usually the cause. Staph Aureus may cause small vesicle impetigo as well Impetigo treatment - good hygiene, system therapy to cover for MRSA Folliculitis - Lesions appear as yellowish pustules, the encircling thin band of erythema around hair follicles Folliculitis Treatment - Improved hygiene, mupirocin or bacitracin, systemic therapy to include anti-psuedomonal medication such as cipro Foruncle - a tender fluctuant lesion, with surrounding erythema Foruncle Treatment - Drainage. Abx not generally needed (with exception of immunocompromised pts) Carbuncle - a collection of furuncles, generally on the back of the neck in men older than 40yrs old. carbuncle treatment - drainage or debridement, systemic abx with MRSA coverage is often required Cellulitis - Spreading infection of the epidermis and subcutaneous tissues that generally begins following a break in the skin. Strep and Staph Aureaus Cellulitis Treatment - Pts with uncomplicated disease - systemic tx with coverage for MRSA. Bactrim, doxycycline Very ill will be hospital for IV abx. Tinea Capitis - fungal infection of the scalp tinea corporis - fungal infection of the body Tinea cruris - fungal infection of the groin; jock itch tinea pedis - athlete's foot Tinea Mannuum - Fungal infection of hands Tinea faciei - fungal infection of the face Tinea unguium (onychomycosis) - fungal infection of the nails Treatment for Fungal infections - Characteristic: annular erythema with scaling. Prevention: wearing loose undergarments, cotton socks, tight control of BS in DM pts, drying well between folds of skin. Management: oral antifungal, topical agents Candida Infection - Often associated with abnormalities of the epithelium or host immunologic system. Common sites Oral mucosa (thrush), Vaginal / Perineal (vulvovaginitis) Candida Treatment - Topical antifungal, thrush - nystatin oral suspension X10-14 days. Pediculosis and Mite Infestations - head lice, scabies, crab lice, body lice Prevention: All close contacts of ind'l infected. All clothing, bed linens and towels should be washed and dried on a hot cycle or dry cleaned. Education on hygiene is important Acne Vulgaris - Very common follicular d/o. Mild: non-inflammatory, comedones Moderate: inflammatory, papules and pustules Severe: nodular cysts Acne vulgaris treatment - Avoid excessive scrubbing. No picking or popping. Avoid makeup or moisturizers with oil. Smoking cessation if applicable. Mild/ Moderate: Benzoyl peroxide 1X a day. Tretinoin, adapalene, tazarotene Moderate: Topical with antibiotics. (tetracycline, minocycline, doxycycline). Oral contraceptives with low dose estrogen ( No progesterone). Diuretic spironolactone (anti-adrenergic). Severe: Try different combos. May consider retin-A Takes 4-8 weeks to start to see improvement.