Cellulitis Flashcards
Cellulitis
Bacterial infection involving the skin and underlying subcutaneous tissue following a break in the skin.
Deep inflammation in the subcutaneous tissue occurs from the enzymes produced by bacteria.
Staphylococcus aureus and streptococci are the most common causative bacteria.
erythema, tenderness, edema.
Risk Factors for Cellulitis
damaged skin
poor circulation
diabetes mellitus
insect bites
use of corticosteroids
Wound Cultures
a wound culture may be ordered if there is uncertainty about the causative organism.
swabs should always be collected after the wound is cleansed.
aerobic cultures are collected by swabbing the surface of the wound or area of fresh drainage.
anaerobic cultures are collected using aspirates, swabs and tissue samples.
Methicillin Resistance in Saph. Aureus
major public health concern.
mutation of penicillin binding protein causes resistance to several antibiotics.
risk factors include recent hospitalization and antibiotic use, invasive procedures, new admission to a nursing home, long-term use of indwelling medical devices.
Culture and Sensitivity
ensures we treat the bacteria with the right antibiotic.
aids in the evaluation of the treatment regiment.
Nursing Assessment Prior to Antibiotic Initiation
baseline vitals, review bloodwork (WBC), wound assessment, patient hx (comorbidities, allergies, past antibiotic use), signs and symptoms of sepsis.
Treatment of Cellulitis
antibiotics - oral or IV.
corticosteroids - oral or IV
pain management - oral, IV, topical, administer analgesia prior to dressing changes.
Complications of Cellulitis
SEPSIS - hypotension, fever, tachypnea, tachycardia, confusion, disorientation.
BACTEREMIA - infection in the bloodstream.
ENDOCARDITIS - infection spreads to inner lining of heart chambers and valves.
OSTEOMYELITIS - infection spreads to bone, bone marrow, and surrounding soft tissues (highest risk in wounds overlying joints).
Antibiotic Patient Teaching
seek immediate medical attention if signs of allergic reaction occur.
notify healthcare provider if negative side effects occur (vomiting, rash).
alcohol should be avoided.
patients should finish full course of antibiotics even if their condition improves.
Cellulitis Prevention pt teaching
apply sunscreen and insect repellant when outdoors.
don’t pick or scratch skin.
don’t walk around barefoot.
keep skin moisturized.
avoid hot tubs and open bodies of water when you have an open wound.
manage modifiable risk factors - obesity, diabetes, lymphedema, injectable drugs, skin breakdown.
