Cellulitus Flashcards
What is cellulitus?
Most common infectious cause of limb swelling
Cellulitis can occur as a single isolated event or a series of recurrent events
How does cellulitus occur?
When an entry point through normal skin barriers allows bacteria to enter and release their toxins in the subcutaneous tissues; invasion into compromised outer layers of the skin such as from a laceration, cracked or dry skin, a puncture wound, or folliculitis
Clinical manifestations of cellulitus
Localized pain Erythema Edema, Heat Fever Chills Sweating Redness may not be uniform and often skips areas Lymphadenopathy
Mild cases of cellulitis can be treated on an outpatient basis with _______ and severe cases are treated with _________
oral antibiotics; IV antibiotics
The key to preventing recurrent episodes of cellulitis lies in
adequate antibiotic therapy for the initial event and in identifying the site of bacterial entry
The patient is instructed to elevate the affected area __ to ___ inches above heart level and apply warm, moist packs to the site every _ to _ hours.
3, 6 and 2, 4
Warm moist compressions causes
vasodilation
What types of patients should use caution when applying warm packs?
Patients with sensory and circulatory deficits, such as those caused by diabetes and paralysis; burns can occur
Risk factors of cellulitus
Venous insufficiency, surgical incisions, lacerations, insect and animal (especially cat) bites, and trauma.
Patients with diabetes and peripheral vascular disease are at greater risk
Cellulitus is most common on the _______ extremities
lower
What is periorbital cellulitis?
Bacterial infection of the eyelids and tissue surrounding the eye; may gain entry to the skin via an abrasion, laceration, insect bite, foreign body, or impetiginous lesion
Most common implicated bacteria in periorbital cellulitus
Staphylococcus aureus, Streptococcus pyogenes, and Streptococcus pneumoniae
clinical manifestations of periorbital cellulitus
Redness
Swelling
Infiltration of the skin by the inflammatory mediators occur
Assessment of periorbital cellulitus
Note the onset and duration of symptoms, as well as any treatment used so far. Document any history of fever.
The child may complain of pain around the eye as well as restricted movement of the eye area. Inspect the eye, noting marked eyelid edema as well as a purplish or red color of the eyelid
Usually the conjunctivae are clear and no discharge is present. If the extent of the edema allows the child to open the eye, assess visual acuity, which should be normal.
therapeutic management of periorbital cellulitus
intravenous antibiotic administration during the acute phase followed by completion of the course with oral antibiotics
Apply warm soaks to the eye area for ____ minutes every _ to _ hours.
20 and 2, 4
Instruct parents to call the physician or nurse practitioner or have the child evaluated again if
The child is not improving.
The child reports inability to move the eye.
Visual acuity changes.
Proptosis (eye bulging) occurs.
Complications of periorbital cellulitus
Bacteremia and progression to orbital cellulitis, which is a more extensive infection involving the orbit of the eye.
signs of progression to orbital cellulitus
conjunctival redness change in vision pain with eye movement eye muscle weakness paralysis, or proptosis.
skin findings for nonbullous impetigo
Papules progressing to vesicles, then painless pustules with a narrow erythematous border
Honey-colored exudate when the vesicles or pustules rupture, which forms a crust on the ulcer-like base
treatment for nonbullous impetigo
Limited amount: treat topically with mupirocin ointment.
If numerous lesions, oral first-generation cephalosporin is indicated.
Clindamycin may be needed for MRSA.
Remove honey-colored crust with cool compresses twice
Strict handwashing; not sharing wash cloths, make-up, pillows
Wash linens and towels in hot water
