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Chapter 23 Infection

Chapter 23 Infection. Common Infections. Urinary tract infections Prostatitis Pneumonia Influenza Tuberculosis Vaginitis. Common Infections (cont.). Herpes zoster Scabies HIV and AIDS Antibiotic-resistant microorganisms. Causes of UTIs. Poor hygienic practices

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Chapter 23 Infection

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  1. Chapter 23Infection

  2. Common Infections • Urinary tract infections • Prostatitis • Pneumonia • Influenza • Tuberculosis • Vaginitis

  3. Common Infections (cont.) • Herpes zoster • Scabies • HIV and AIDS • Antibiotic-resistant microorganisms

  4. Causes of UTIs • Poor hygienic practices • Improper cleansing after bowel elimination • Predisposition created by low fluid intake and excessive fluid loss • Hormonal changes • Debilitated states

  5. Gerontological Nursing Interventions for Infections • Prevention • Early identification • Adequate treatment

  6. Signs and Symptoms of UTIs • Early indicators include burning, urgency, and fever. • Some elders develop incontinence and delirium with UTIs. • Many UTIs in older adults seem asymptomatic. • Bacteriuria greater than 105 CFU/mL confirms the diagnosis of UTI. • As a UTI progresses, retention, incontinence, and hematuria may occur.

  7. Treatment of UTIs • Establish adequate urinary drainage. • Control the infection through antibiotic therapy. • Note fluid intake and output. • Force fluids. • Observe for new symptoms.

  8. Signs and Symptoms of Prostatitis • Acute: systemic symptoms of fever, chills, and malaise. • Chronic: these symptoms are uncommon. • Both types: • Urinary symptoms of frequency, nocturia, and dysuria • Varying degrees of bladder obstruction secondary to an edematous, enlarged prostate • Lower back and perineal pain

  9. Treatment of Prostatitis • Identify pathogen with urinalysis. • Use antibiotic therapy. • Chronic prostatitis does not respond as well to antibiotics.

  10. Pneumonia • Incidence • One of the leading causes of death in the elderly. • Contributing Factors • Age-related changes to respiratory system • High incidence of debilitating conditions • Hospitialization • Symptoms • Restlessness, confusion, and behavioral changes

  11. Influenza Facts • Most deaths from influenza occur in the older population. • Influenza A is the most frequent cause of serious illness and death in elders. • Age-related changes cause older persons to be highly susceptible to influenza. • Symptoms include fever, myalgia, sore throat, and nonproductive cough.

  12. Preventive Measures for Influenza • Annual influenza vaccinations • Daily vitamin and mineral supplements • Avoiding people with respiratory infections

  13. Tuberculosis • Classic symptoms may not be demonstrated: • Anorexia, weight loss, and weakness may be the primary symptoms. • Night sweats may not occur because of reduced diaphoresis with advanced age. • Fever may not be detected because of alterations in body temperature in late life. • Screening for tuberculosis should be performed for all patients entering institutions.

  14. Treatment for Tuberculosis • Rest • Good nutrition • Medications

  15. Symptoms and Treatments for Vaginitis • Symptoms • Soreness, pruritus, burning, and a reddened vagina • Clear, brown or white vaginal discharge • Can cause bleeding and adhesions • Treatment • Local estrogens in suppository or cream

  16. Herpes Zoster • Symptoms • Pain and itching of the skin • In several days, the formation of vesicles • Treatment • Analgesics, corticosteroids, and topical preparations to dry the lesions.

  17. Vaginitis: Age Related Considerations • Vaginal epithelium thins. • Tissue elasticity lessens. • Secretions become alkaline and of lesser quantity. • The flora changes.

  18. Symptoms of Scabies • Intense pruritus that worsens at night • Excoriation of the skin • Rash with a burrow • Diagnosis is made by scraping the lesions with a scalpel and examining the material.

  19. Initial Symptoms of HIV • Low-grade fever • Headache • Sore throat • Fatigue • Nausea • Rash

  20. Symptoms That Can Develop Years After HIV Invades the Body • Persistent fever • Drenching night sweats • Headaches • Fatigue • Chronic diarrhea • Thrush • Persistent vaginitis

  21. Symptoms That Can Develop Years After HIV Invades the Body (cont.) • Herpes zoster • Lymph node swelling • Meningitis • Palsies • Pain • Dementia

  22. MRSA • Staphylococcus aureus can cause infections. • Minor (e.g., boils; pimples) • Serious (e.g., pneumonia; septicemia) • Resistance of Staph to antibiotics progressed throughout the years. • Linezolid (Zyvox) and the combination of quinupristin with dalfopristin (Synercid) are treatment options.

  23. Vancomycin-Resistant Enterococcus (VRE) • VRE is a significant nosocomial infection. • VRE infections tend to be resistant to most previously used drugs. • At present, Zyvox and Synercid are the only drugs effective against VRE.

  24. Persons Affected by VRE • Those who are severely ill • Debilitated persons • Immunosuppressed persons • Those having had major surgical procedures • Those having an indwelling urinary or central venous catheter • Those on antibiotic therapy

  25. Source • Eliopoulos, C. (2005).  Gerontological Nursing, (6th ed.).  Philadelphia: Lippincott, Williams & Wilkins (ISBN 0-7817-4428-8).

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