NURS 623 Review Guide Exam 1

NURS 623 Review Guide Exam 1 Folliculitis: Superficial to deep infection of the hair follicle. Description: Small pustules surrounded by erythema located over base of the hair follicle. A hair in the center of pustule sometimes perforates the lesion. “bumpy rash” located on face, eyelid, scalp, back of earlobes, neck, shoulder, buttock, torso, or extremities. Diagnostic: Gram stain and culture of purulent discharge. Fungal culture, if fungal is suspected. Treatment: -Gentle cleaning twice a day with antibacterial soap. -Mupirocin (Bactroban) 2-4 times a day for 10 days. -MRSA: Altabax BID x2weeks. Follow-up: If doesn’t respond to therapy. Patient Education: -Good hand washing and personal hygiene. -Friction can predispose them to recurrence of folliculitis. -Electric shaver may cause fewer breaks in skin. Avoid old razor blades. Impetigo: Highly contagious bacterial infection usually caused by Group A Strep or Staph aureus or a mix of both (Gram Postitive). Common in children 2-5yo. Surface organisms entering skin through abrasions, bites, or minor trauma. Can be transferred by skin or lesions in the upper resp. tract. Located on face or extremities. Description: Discrete red, purulent vesicles that rupture and crust over. Can be nonbullous or bullous (blister). Lesions heal slowly and leave depigmented areas. Moist honeycrust. Diagnostics: Gram stain and culture of purulent discharge. Patient febrile/systemic symptoms obtain CBC with diff. Treatment: Without treatment, usually heals within 2-3 weeks. Few lesions -Mupirocin 2% (Bactroban/Centany) TID x7days. -Retapamulin (Altabax) BID x5days: impetigo caused by MRSA. -with combination of cleansing (chlorhexidine) and debridement of lesions. Multiple lesions; Fever or toxicity. -Dicloxacillin, Amoxicillin-clavulanate, Cloxacillin -First/second generation cephalosporin. Cephalexin for children. -MRSA bacteria: Clindamycin, Vancomycin, and Bactrim (not for children <11yo) Follow-up: -Uncomplicated: 10 days-2weeks. -Fever/toxic follow closely, consult/refer with physician.