Wounds, fungal and protozoa infection Flashcards
Fluid for wound healing
A high fluid intake is needed to replace loss from perspiration and exudate formation
Higher metabolic rate with injury increases fluid loss
For every 1% increase in temperature above 37.8 metabolism increases by __
13%
Nitrogen balance should be
0
Why are carbs required for healing
Needed to increase metabolic rate
For inflamm and healing
If carbs are deficient the body will break down Protein and fats for energy.
What minerals are used for healing
Fats in moderation
Vit C for capillery formation + infection resistance
B-Complex vit to metab fats
Vit A for epithelization, collagen synthesis and tensile strength of wounds.
Zinc helps the body synthesize proteins and develop collagen
Which pts most at risk for systemic fungal infections?
Immunocomprised
Characteristics of fungal infection
Not super common
Grow slowly
Superficial infections
infections affect integument, mucous membranes, mouth and vagina
Super infection
Coming AFTER an infection is treated
Fungi don’t normally exist in the body T or F
Some fungi are part of the normal flora of the skin, mouth, intestines, vagina
Mycoses infection
Fungi
Systemic fungal infections characteristics
Affecting lungs, brain and GI organs
Often orginating from lungs through spore inhalation
Can be fatal for immunocompromised
Require aggressive PO or parental meds for weeks to months to ensure infection is gone
Amphotercin B
Broad spectrum drug
DRUG OF CHOICE for SEVERE systemic Mycoses
Also used prophlycaticly for immunocomp.
Given IV
Amphotercin B how does it work?
Binding to Ergosterol in Fungal cell membranes, breaking them down and allowing for cell to permeate and break down
Noteable normal AE of Amphotercin B
N/V/Anorexia common at begininign of tx
Phlebitis common
- Monitor IV site
Notable SAE of Amphotercin B
Cardiac arrest/probs
- Monitor ECG
Hypokalemia
Blood abnormalities
- Monitor labs
Nephrotoxicity
- Will damage 80% of pts kidneys
Hepatotoxicity
- Monitory kid/liv test
Nursing considerations before begining antifungal tx
Obtain hx and allerigiees
Baseline VS (BP and pulse)
- ADMINISTER SLOWLY TO avoid CVS collapse
Baseline renal,liver, electorylte testss
Culture and sensitivity
How are AE of Amphotercin B reduced?
Antihistamine and antipyretic given before
IV infusion in most distal veins
Azoles
BROAD SPECTRUM Largest and most versatile group of antifungals
Used for systemic AND superficial fungal infections
Topical (Usually) Or systemic via PO/IV
Flucanazole
Of the Azole class
Tx of yeast infections and those ressitant to other antifuncgals
Interfers with ergosterol synthesis
Flucanazole AE/SAE
NVD
SJS
Superfical Fungal infections
can occur in any patient, commonly occurring on Skin, Mucous mems mouth and vagina
tx for superficial fungal infections
Ususally OTC topical drugs
Severe infections treated PO meds
SUperficial antifungal drugs safer than systemic counterparts
Nystatin
For tx of superficial mycoses infec. (Candida)
Binds to ergosterol in the fungal cell membrane, creating pores in membrane and allowing intracellular components to leak out of cell
AE of Nystatin
Vary by route of admin
Topical can cause minor irritation or burning
PO
NVD
What type of dressing is avoided when dealng with superficial funga linfections
Avoid use of occlusive dresssing since this supports presence of moisture which supports fungal growth
How is PO Nystatin administed
Should be swished around the mouth after eating ( not before or during) for the best contact with mucous membranes.
Can swish and spit if GI distress occurs.
Protozoa characteristics
SIngle cell in water, soil, or animal hosts
Thrive in dense population and poor sanitization
Only a few are pathogenic
Spread via vectors
Protozoan life cycle
Trophozoite - Active, growing stage
- Organism feeds
- More likely to be killed
Cysts- Protective capsules in which org is dormant for periods, harder to kiill
Most common protozoan infections
Malaria
Amebiasis
NOn-Malaria protozoan infections
- spread by drinking contaminated water, food
90% people asymptomatic
Can cause ulcerations, abdom pain, distention, cramping, bloody diarrhea
Metronidazole
Used to treat protozoan infections + has antibiotix activity, Crohns and colitis
Binds to DNA preventing synthesis and causing cell death
One of few antiprotozoal drugs with abx activity
- used in serious bone, resp, skin, and CNS infections
AE of Metronidazole
NVD anorexia
Seizures, periph neuropathy
Significant interactions metronidazole can have?
With alcohol can cause NVD, abdom issues, syncope, tachyC, flushing etc.
Labs to monitor with Metronidazole
CBC for reduced WBC
