Infections Flashcards
Secondary lesions from Herpes Type II
Isolated or in groups
Small vesicles or pustules on an erythematous base
Crusts eventually form
Heal in about 1 week
Herpes Type II
Below waist usually
Occurs through: direct contact, respiratory droplets, fluid exposure from infected person
Client is asymptomatic
May be triggered by stressor
S&S of Herpes Type II
Prodromal Phase: burning/tingling at site Red and swollen Vesicles/pustules erupt in 1-2 days Painful, itchy lesions Contagious until scabs are formed
Complications of Herpes Type II
If present at vagina during childbirth, newborn may be infected with meningocephalitis or panvisceral
Herpes encephalitis (rare)
Western Blot can determine:
Antibodies for HSV-1 or HSV-2
Herpes Zoster: Shingles
Acute inflammatory infectious disorder
Painful vesicular eruption on bright red edematous plaques along nerves.
Unilateral most often
Cause of Shingles
Varicella Zoster Virus
Incubation period for shingles
7-21 days
S&S of Shingles
Vesicles and plaques Irritation Itching Fever Malaise Painful lesion
Treatment of Shingles
Aimed at controlling outbreak Reduce pain/discomfort Prevent complications Cold compresses or baths Topical agents Anticonvulsants Antidepressants Antiviral: best if within 72 hours of outbreak
Complications of Herpes
Post-hepatic neuralgia Persistent dermatonal pain Hyperparesthesia Ophthalmia herpes can affect eyesight (Cranial Nerve V) Facial and acoustic nerve involvement Scarring can occur
Prevention of Shingles
Zostavax
Varivax
Avoidance during contagious phase
Meningitis
Inflammation of brain and spinal cord
Organism enters CNS from respiratory tract or bloodstream
Cause of Meningitis
Bacterial or viral (aseptic)
Neisseria meningitis Streptococcus pneumonia Haemophilus flu type b (Hib) Fungal organisms Viral agents
Pathological Changes of Meningitis
Organism invades CNS Meningeal inflammation Increased ICP Hyperemia of Meningeal vessels Edema of brain tissue Generalized inflammatory reaction
Bacterial Meningitis
Medical emergency (fatal within 24-48 hours) Spread through direct contact
Risk factors of Bacterial Meningitis
Head trauma Significant fall Skull fracture Otitis media Sinus infection if left untreated Neurosurgery Living in confined place with others Traveler IV drug use
Viral Meningitis (Aseptic Meningitis)
More common Less severe Caused by numerous viruses Presents with flu-like symptoms Short duration (1-2 weeks)
S&S of Viral Meningitis
Onset sudden Fever Severe HA N/V Nuchal rigidity (+) Kernig's Sign (+) Brudzinski's Sign Photophobia Decreased LOC Increased ICP signs Chills Petechiae/ecchymotic rash
S&S of viral meningitis in infants
Bulging fontanel and high pitched cry Irritability Encephalopathy Lethargy Seizures
Complications of Viral Meningitis
Cranial nerve damage Hydrocephalus Thrombophlebitis Cerebral edema Opisthotonous (involuntary arching of back from muscle contractions)
Collaborative Care of Viral Meningitis
Rapid diagnosis based on PE and history
Antibiotic therapy instituted after collection of specimens
Examine fundus of eyes before lumbar puncture to identify increased ICP
Restore fluid and electrolyte balance
NI’s for Viral Meningitis
Vaccination against respiratory infections Early treatment of respiratory infections Careful recording of assessment Assist to comfortable position Pain medications Frequent neuro checks Darkened room Cool cover for eyes Observe for seizures Administer anticonvulsant Manage fever Frequent assessment for dehydration Strict I&O's Isolation
Lumbar Puncture
Contraindicated with increased ICP
Positioned on side with head and knees flexed at acute angle (usually)
EMLA cream for kids
Needle inserted at level L4-5/L5-S1 of spinal cord
Flat for several hours after procedure
Document ability to move extremities
