Unit 3: Spider Bites Flashcards
The Brown Recluse spider
- venom contains multiple enzymes that make it hemotoxic
- bites can sometimes progress to extensive local necrosis
- initially painless bite to painful blistering that occurs within 2 to 8 hours of the bite and then to a more serious ulceration within 72 hours; necrosis can form
- bite then slowly heals over several weeks to months
Black Widow Spider
- releases neurotoxic venom
- causes diffuse muscle pain, spasms and rigidity, and extreme stomach pain
- can include, arthralgias, fever, hypertension, vomiting, and hyperreflexia
- latrodectism (the illness caused by the bite of Latrodectus spiders) resolves in 3 to 7 days
The Hobo Spider
- bite can result in extensive derma necrosis and permanent scarring (think of gross hobo)
- completely painless initial bite, progressing to painful induration and erythema within 30 minutes, then multiple small blisters within 15 to 35 hours, and then finally progressing to serous exudate encrusting a cratered wound within 72 hours
- lesions heal spontaneously
- severe headache, vomiting, weakness, fatigue, and vision impairment within 10 hours of the bite
Medical Management
- oral or IV analgesics
- antihistamines and antibiotic tx for secondary wound infections
- tetanus vaccine suggested for prophylaxis b/c spider bites can become infected w/ tetanus spores
Treatment for a Brown Recluse Bite
-CBC
-Serum glucose
-Platelet count
-BUN and creatinine
-PT and a PTT
-Fibrinogen
-Renal function tests
-Urinalysis
>these studies are aimed at identifying signs of hemolysis and intravascular coagulation
-Treatments: oral corticosteroids, dapsone, colchicine, or hyperbaric oxygenation (work to reduce effects of the dermonecrosis)
-antibiotics if signs of infection
Treatment for Black Widow Bite
- CBC, Blood glucose, CK, and urinalysis; often identify leukocytosis, elevated CK and proteinuria
- Treatment: opioids or muscle relaxants
- calcium gluconate 10% IV may relieve muscle rigidity
Treatment for Hobo Bite
- symptomatic
- excision of the necrotic tissue as indicated
Nursing Management: Assessment and Analysis
- venom of the brown recluse and hobo spiders contain enzymes that are hemotoxic and result in local tissue necrosis
- black widow venom is neurotoxic and causes diffuse pain
Nursing Diagnoses
- Impaired skin integrity
- Pain
- Ineffective airway clearance
Nursing Assessments
- Vital Signs
- Pain Assessment
- Skin assessment; color, size, and drainage
Assessment: Vital Signs
-black widow spider bite may result in hypertension (pain)
Assessment: Pain
-spider bites can result in severe pain at the site
Assessment: Skin assessment; color, size, and drainage
may help identify type of spider involved
Nursing Actions
- Cleanse wound thoroughly; minimize infection
- Apply cold compresses and elevate affected extremity; minimizes swelling
- Administer medications; Antivenin if available, pain medications, antibiotics, and tetanus
Antivenin
- given if available
- counteracts the neurotoxic and hemotoxic effects of venom spider bites
Patient Teaching
-wound care; keeping the wound clean and reporting any changes or worsening immediately to provider
Evaluating Care Outcomes
- successful tx of a spider bite requires prompt intervention, administration of antivenin if available, and symptom management
- well-managed patient is discharged home hemodynamically stable with pain under control and clear wound care instructions
Connection Check: The nurse is caring for a patient who presents 4 hours after a spider bite to the hand. The hand is slightly swollen, and there are areas of redness and painful blistering. The nurse correlates these symptoms with what type of spider bite? A. Brown recluse B. Black widow C. Hobo Spider D. Tarantula
A. Brown recluse
