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Nurs G140 Exam 2 (MS) > Cellulitis > Flashcards

Cellulitis Flashcards

1
Q

What is the most common infectious cause of limb swelling?

A

cellulitis

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2
Q

Cellulitis is caused by a deeper bacterial infection of the ___,___, and ___,

A

dermis, subcutaneous tissue, and possibly muscle tissue

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3
Q

What are the most common bacteria to cause cellulitis?

A

streptococcus and staphylococcus

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4
Q

What are the ways the bacteria can invade the skin and cause cellulitis? (4)

A
  • wounds
  • animal or insect bites
  • trauma
  • IV drug use
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5
Q

What are the s/s of inflammation? (5)

A
  • warm
  • erthyema
  • edema
  • tenderness
  • pain
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6
Q

Risk factors of cellulitis (6)

A
  • pre-existing skin disorders (i.e. dermatitis)
  • obesity
  • Immunocompromised
  • diabetes
  • peripheral vascular disorders
  • fungal infection
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7
Q

steps of inflammation

A

vascular response –> cellular response –> formation of exudate –> healing

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8
Q

vascular response –> think of what

A

blood vessels

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9
Q

Vascular response steps

A

injury occurs –> local vasoconstriction –> release of kinins, histamines, and prostaglandins –> local vasodilation and hyperemia –> increased capillary pressure and permeability –> fluid exudate from capillaries to tissue spaces leading to edema

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10
Q

Cellular response –> think of what

A

think WBCs

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11
Q

Cellular phase steps

A

chemotaxis begins –> WBCs rush in to help –> neutrophils and monocytes migrate through capillary walls to the site of injury –> macrophages signal the immune response

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12
Q

What other cells may be released during inflammation?

A
  • eosinophils
  • lymphocytes
  • basophils
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13
Q

when are eosinophils released?

A

allergic response

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14
Q

What do lymphocytes do?

A

help develop immunity

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15
Q

What do basophils do?

A

carry histamine and heparin

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16
Q

Cellulitis clinical manifestations (4)

A
  • acute onset swelling
  • localized redness and pain
  • possible regional lymph nodes tenderness and swelling
  • systemic s/s (not always present): fever, chills and sweating
17
Q

How to treat mild cellulitis

A
  • tx with oral antibiotics

- outpatient tx

18
Q

how to treat moderate to severe cellulitis

A
  • hospitalized

- treat with IV antibiotics

19
Q

What is the key to treatment of cellulitis?

A
  • identify site of bacterial entry

- complete full course of antibiotics

20
Q

Cellulitis nursing management (8)

A
  • elevate affected area 3-6 inches above the heart
  • cool, moist packs to site every 2-4 hours until inflammation is resolved
  • transition to warm moist packs (caution in patients with sensory and circulatory deficits [diabetics])
  • assess area
  • administer antibiotics
  • monitor lab results
  • prevention of recurrent infection
  • Identify site of entry
21
Q

What is skin marking?

A

the infection is outlined to see if it gets worse at all

22
Q

Cellulitis patient education (5)

A
  • complete antibiotic treatment
  • prevention of recurrence
  • self skin and foot care for PVD and diabetic patients
  • IV substance abusers: referral and support
  • notify provider for worsening s/s
23
Q

Quick risk for sepsis assessment (10 signs of infection)

A
  • increased RR
  • Increased HR
  • decreased BP
  • decreased output
  • possible increase/decrease bowel sounds
  • possible increase/decrease temperature
  • Increased neutrophils
  • possible increase or decrease WBC
  • decreased O2 sat
  • altered mental status
24
Q

qSOFA score what is measured?

A
  • systolic blood pressure at or below 100 mmHg
  • respiratory rate at or above 22
  • any change in mental status
25
Q

What qSOFA score is an increased risk of mortality or extended ICU stay? What lab level?

A

score of 2 or 3

serum lactate level > 2 suggests hypoperfusion

26
Q

What is the current clinical criteria for septic shock?

A

persistent hypoperfusion after fluid resuscitation requiring vasopressors to maintain MAP > 65 mmHg and/or serum lactate level > 2mmol/L

27
Q

If the sepsis wheel or qSOFA indicate clinical deterioration possible related to infection what does the nurse do?

A
  1. call for help (CAT, RRT)- transfer to tele or ICU
  2. NS bolus to quickly improve BP
  3. broad spectrum ABx
28
Q

Diagnosis for DKA

A
  • glucose >250 mg/dL
  • pH < 7.30
  • bicarb level 18 mEq/L or less
29
Q

How to help DKA pt while waiting for help (6)

A
  • maintain airway
  • hourly monitoring of serum glucose, kidney function, and electrolytes
  • fluids (lower serum Glucose and improve metabolic acidosis)
  • IV regular insulin drip (5-7 units/hour)
  • K+ supplementation during drip
  • bicarb IV if pH < 7
30
Q

cardinal signs of inflammation (5)

A
  • heat
  • redness
  • swelling
  • pain
  • loss of function

Nurs G140 Exam 2 (MS) (6 decks)

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