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Medical-Surgical Nursing Chapter 43 with 100% correct answers

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Contact dermatitis a delayed allergic response involving cell-mediated immunity. On contact with the skin, the allergen is bound to a carrier protein and forms a sensitizing antigen. Contact Isolation: Skin Disorders that require Contact Precautions • Diphtheria, cutaneous • Furunculosis, group A Streptococcus • Herpes simplex, disseminated, severe primary, or neonatal • Herpes zoster (varicella-zoster) • Varicella (chickenpox) • Impetigo • Infection or colonization by bacteria with multiple drug resistance (any site) • Pediculosis • Scabies • Skin wound or burn infection, major (draining and not covered by dressing, or dressing does not adequately contain purulent material), including those infected with Staphylococcus aureus • Vaccinia (generalized and progressive eczema vaccinatum) private room In general, patients infected with the same type of organism may share a room. •Gloves are worn when entering the room. Change gloves after contact with infective material, such as wound drainage or feces, and before treating a different location on the body. Perform hand hygiene before donning clean gloves. •Remove gloves when leaving the room, and perform hand hygiene using an antimicrobial agent. •Gowns are indicated if soiling is likely, particularly if there is drainage from an uncovered wound or the patient is incontinent. •Articles contaminated with infective material should be discarded in a biohazard waste receptacle or bagged and labeled before being sent for decontamination and reprocessing. •Patient care equipment should be used only for the one patient and should be left in the room until no longer needed. Brainpower Read More Acne: acne rosacea and acne vulgaris. Rosacea: 30-50 (age) Vulgaris (adolesdolescents) is related to increased release of sex hormones Acne is a disorder of the skin characterized by papules and pustules over the face, back, and shoulders. Some types of acne are related to cosmetics or to chemicals in the environment Acne Rosacea is treated by avoiding the triggers for flare-ups and with topical antibiotics, metronidazole (MetroGel), and retinoids. Sometimes oral antibiotics are prescribed. Isotretinoin (13-cis-retinoic acid) or ACCUTANE can cause birth defects. used only for severe cystic acne that is resistant to all other treatment. There are serious adverse side effects, including organ damage and mental problems. Psoriasis a noncontagious, chronic, and recurring skin disorder that typically appears as inflamed, edematous skin lesions covered with adherent silvery white scales psoriatic arthritis. In some cases the skin eruptions of psoriasis are accompanied by inflammation of the joints, especially those of the fingers and toes. cellulitis an infection of the dermis and subcutaneous tissue and is generally caused by Staphylococcus. It may occur as an extension of a skin wound, as an ulcer, or from furuncles or carbuncles. Furuncles (boils) inflammations of hair follicles. The organism responsible is usually Staphylococcus aureus. Any skin area with hair can be affected. Initially there is a deep, firm, red, painful nodule 1 to 5 cm in diameter. The nodule changes to a large and tender cystic nodule accompanied by cellulitis. The lesion may drain large amounts of pus and necrotic tissue. Carbuncles a collection of infected hair follicles and most often occur on the back of the neck, the upper back, and the lateral thighs. It begins as a firm mass and evolves into an erythematous, painful, swollen mass. It may drain through many openings in the mass. Abscesses may develop with fever, chills, and malaise. Stevens-Johnson syndrome Stevens-Johnson syndrome (SJS) is an allergic reaction with skin manifestations. It is usually triggered by a medication. Herpes Simplex : s and Symptoms An infection with HSV-1 appears as lesions on the lips and nares that are commonly called cold sores or fever blisters. As with other types of herpesvirus infections, no drug will completely cure the infection. Herpes simplex virus type 2 (HSV-2) is most often associated with genital herpes, whereas herpes simplex virus type 1 (HSV-1) lesions are primarily nongenital (Figure 43-2). Either type can cause lesions in the genital area as well as other regions of the body. Autoinoculation of the virus is possible by direct contact, for example, lips to fingers to genitals or lips to fingers to eyes. Herpes Zoster : herpes varicella-zoster. The virus causes chickenpox (varicella), mostly in young children, and shingles (herpes zoster) in all ages. In herpes zoster, the herpesviruses replicate in the peripheral nerve ganglia, where they lie dormant until reactivated by trauma, malignancy, possibly stress, or local radiation ( Pregnant woman should not care for a patient with chickenpox or herpes zoster. The virus is highly contagious and can harm a fetus.The vesicles eventually change from small blisters to scaly lesions and are accompanied by pain and itching. The lesions usually affect only one side of the body or face. The pain of shingles often is quite severe. Pain can persist for several days or weeks after the skin lesions are completely healed.

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