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INTEGUMENTARY Nursing care

INTEGUMENTARY Nursing care. PN 124. INFECTIOUS DISORDERS. OBJECTIVES Discuss signs and symptoms or infectious disorders of the skin Define the nursing management of the client with infectious disorders of the skin

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INTEGUMENTARY Nursing care

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  1. INTEGUMENTARY Nursing care PN 124

  2. INFECTIOUS DISORDERS • OBJECTIVES • Discuss signs and symptoms or infectious disorders of the skin • Define the nursing management of the client with infectious disorders of the skin • Discuss common diagnostic tests used as diagnostic tools for infectious disorders of the skin • Discuss treatment used for infectious disorders of the skin

  3. VIRAL DISORDERS • Herpes Simplex • Type 1 Herpes Simplex • Type 2 Genital Herpes • Herpes Zoster (Shingles) • PityriasisRosea

  4. HERPES SIMPLEx • Herpes virus hominis • Type 1 • Cold sore • Often associated with febrile conditions • Self limiting • No cure • Type 2 • Genital herpes

  5. Assessment • Subjective data • fatigue • pruritis • burning pain in the • Objective data • Edema • erythema

  6. Herpes simplex

  7. Diagnostic Tests • Inspection • Health history • Laboratory assessment of cultures from the lesions Tzanck smear

  8. Genital Herpes

  9. Medical Management • No cure • Acyclovir (Zovirax) • Nursing implications • Use gloves • Cover lesions completely • Adequate hydration • Iv doses over 1 hour

  10. Nursing Interventions • Treatment of symptoms • Prevention of spread

  11. Prognosis • Type 1 healing within 10-14 days • Type 2 lesions usually present 7 – 14 days

  12. HERPES ZOSTER (SHINGLES) • Caused by herpes varicella • An inflammation of the spinal ganglia • Erythematous rash of small vesicles • May affect a single nerve

  13. Clinical Manifestations • Eruption of vesicle is preceded by pain • Unilaterally along trunk, thorax or face • Vesicles rupture and form a crust • Serous fluid may become purulent • Painful 7 to 21 days • Tenderness and pruritus

  14. Herpes Zoster

  15. Assessment • Subjective data • Sharp, burning pain usually only on one side • Severe pruritis • General malaise • History of chickenpox • Objective data • Evidence of skin excoriation • Patches of vesicles • Tenderness to touch • fever

  16. Diagnostic tests • Culture that isolates the herpes varicella virus • Physical exam • Thorough health history

  17. Medical Management • Controlling pain • Prevention of secondary complications • Medications • Kenalog, Lidex lotions to relieve pruritis • Corticosteroids to relieve pruritis and inflammation (Kenalog, Lidex) • Zovirax to reduce pain and duration of virus

  18. Nursing Interventions • Directed at relieving symptoms • Treat associated anxiety • Treat with analgesics • Medicated baths • Warm compresses

  19. Prognosis • Generally good • Older adults more susceptible to post therapy neuralgia • Can infect others who have not had chickenpox with it

  20. PITYRIASIS ROSEA • Affects people between 6 and 30 • A single, pink scaly patch resembles ringworm • 1 – 3 inches in diameter • Viral • Disappears without treatment

  21. PITYRIASIS ROSEA • Manifestations • Scaly, raised border and pink center • 7-14 days multiple lesions • Rash generally on chest, abdomen, back, groin and axila • Assessment • Inspection • Objective data

  22. PITYRIASIS ROSEA • Medical management • General, no treatment • Prevent secondary infections • Moisturizing cream • Hydrocortisone cream • Ultraviolet light shortens the course

  23. PITYRIASIS ROSEA • Nursing interventions • Symptomatic relief • Aveno baths • Analgesics • Antihistamines • Topical steroids • Sun exposure • Prognosis • Self-limiting resolves in a few weeks

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