...following: Increasing pain in the general area of a minor cut, abrasion, or other skin opening. Pain that is worse than would be expected from the appearance of the cut or abrasion. Redness and warmth around the wound, though symptoms can begin at other areas of the body. Flu-like symptoms such as diarrhea, nausea, fever, dizziness, weakness, and general malaise. Intense thirst due to dehydration. More advanced symptoms occur around the painful infection site within three to four days of infection. They include: Swelling, possibly accompanied by a purplish rash. Large, violet-colored marks that transform into blisters filled with dark, foul-smelling fluid. Discoloration, peeling, and flakiness as tissue death (gangrene) occurs. Critical symptoms, which often occur within four to five days of infection, include: severe drop in blood pressure toxic shock unconsciousness HOW IS IT DIA GNOSED ? Necrotizing fasciitis progresses very rapidly, making early diagnosis crucial.Unfortunately, that does not always occur. The early symptoms of an infection with flesh-eating bacteria are similar to other conditions like the flu or a less serious skin infection. The early symptoms are also similar to common post-surgical complaints, such as: severe pain , inflammation , fever, and nausea. Diagnosis is often based on advanced symptoms, such as the presence of gas bubbles under the skin. Laboratory analysis of fluid and tissue samples is done to identify...
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...$320.00 per week which equals $1,376.00 per month. This is over the $1070.00 amount that Social Security has set in place for substantial gainful activity. Therefore, he would be denied benefits in step 1 of the SSA’s five step Sequential Evaluation Process for Determining Disability. Step 2: Severity Test- Does the claimant have a severe impairment that significantly limits his or her ability to do basic work activities and that also meets the duration requirements? Johnny Superton does have a severe impairment that significantly limits his ability to do basic work activities. Because of his accident, the doctors had to amputate his right leg just below the knee due to an uncontrollable MRSA infection, amputate his left foot due to gangrene. Although he has prosthetics, he is unable to use them because they do not fit well. The injury occurred on March 1, 2013 which also means he is within the duration requirements. Step 3: Medical Listing Test-Does the condition meet the SSA’s medical listings, or is the condition equal in severity to one found on the medical listings? Section 1.04 of the Disability Evaluation Under Social Security is disorders of the spine. In his accident Johnny’s L5-S1 disc burst and is now compressing on his nerve rood which is included under Section 1.04 (A) which is evidence of nerve root compression characterized by neuro-anatomic distribution of pain, limitation of motion of the spine, motor loss accompanied by sensory or reflex loss, and if...
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...There are various types of necrotizing fasciitis: type I or polymicrobial, type II or group A streptococcal, or type III gas gangrene. These three types vary in the way of being transmitted into a person. Type I is saltwater necrotizing fasciitis which can be acquired by a minor skin wound containing vibrio species (Edlich). Type II or group A streptococcal and type III are frequent in initiating infecting bacteria whether it is anaerobic or aerobic pathogens like bacteroides, clostridium, or e coli (Edlich). It comes to show that it can be acquired by either breathing in the pathogen or infecting an individual directly. The treatment of necrotizing fasciitis depends on which type a person has as well as how far long has it been attacking the...
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...Pathophysiology Processes & Consequences of Noma Chamberlain College of Nursing NR283: Pathophysiology May 2016, Professor (Name Here) Pathophysiology Processes & Consequences of Noma Noma disease, commonly referred to as cancrum oris, fusospirochetal gangrene, necrotizing ulcerative stomatitis, and stomatitis gangrenosa is a devastating disease that is famously quoted as “the face of poverty”. This rare disease with high prevalence in Sub-Saharan countries is lethal and has been linked to acute and rapid disease progression in persons that are immunocompromised. Evidence based research suggests a high prevalence of the disease is observed in populations experiencing extreme poverty, malnourishment, and exposure to infectious diseases, while living in a continued state of poor hygiene. This gangrenous infection has a microbial origin, often found in the mouth. It is exacerbated by poor hygiene that give rise to the bacterial micro-organisms responsible for aggressive manifestations observed on individuals infected. Etiology of Noma The exact etiology of Noma disease is unknown. However, it is believed to be multifactorial in nature (Ashok, Tarakji, Darwish, Rodrigues , & Altamimi, 2016). The spread of the disease is due to deteriorating sanitation and inadequate nutrition, most common in underdeveloped countries. Noma is an opportunistic infection, which typically show dominance after a weakened immune system is present, preceding multiple risk factors...
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...Aeromonas Hydrophila: The Improbable Culprit Edwin Myrick Abstract This study examines the structure and influences of Aeromonas Hydrophila, as a stand-alone bacterium and as it contribute to Necrotizing Fasciitis. Aeromonas Hydrophila impacts both aquatic life and humans, although the infection is not commonly known. This study examines those influences and explores medical case studies where individuals experienced illness, amputation, and even death. Aeromonas Hydrophila: The Improbable Culprit As the summer months begin to elevate the mercury level, nature’s creeks and streams provide cooling entertainment from the elements. People have long used these waterways for recreation activities, such as fishing, walking, swimming, and canoeing; unsuspecting of the dangers. Most bacteria are harmless, but certain types can cause complications and disease. The flesh eating bacteria Aeromonas Hydrophila, can create unthinkable devastation through minor cuts and scratches; causing sickness, amputation, and even death. The world has thousands of micro-living organisms called bacteria, these unicellular microorganisms have cell walls, but no structured nucleus, some of these microorganisms can cause disease (Hogan, 2005). Thousands of bacteria inhibit our environment every day, many of them unidentified but not all of them are unhealthy. Bacterial cells consist of shapes; spherical, rodlike, spiral, helical, and comm-shaped (Lerner, 2005). The...
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...Q.1. Describe in detail the nursing care necessary to provide for the needs of the patient with a diagnosis of hypothermia during the first 24 hours of their hospital admission. [100Marks] Q.2. List at least four clinical signs of dehydration. (20 marks) Describe the care of a patient with an indwelling catheter. (80 marks) [100 Marks] Q.3. Mrs. Mary Smith is and 80 year old widowed lady who lives alone in an inner city terraced house. She has been admitted to hospital presenting with abdominal pain and distension. The home help who visits her for one hour per day has noticed that Mrs. Smith had reduced mobility and episodes of constipation the past number of weeks. Describe the nursing care Mrs Smith will require under the following: (a) Communication (30 marks) (b) Eating and drinking (40 marks) (c) Mobility (30 marks) [100 Marks] Q.4 Describe the role of the nurse in preventing cross-infection in the ward setting. [100 Marks] Q.5 Describe the role of the nurse in the assessment of a patient with a respiratory problem. Q.1. Describe the nursing care and management of a patient with hypothermia. [100 Marks] Q.2. Describe the assessment of a patient requiring mouth care on a daily basis. [100 Marks] Q.3. (a) Define the term ‘standard precautions’. (10 Marks) (b) Describe the principles of infection control. (90 Marks) [100 Marks] Q.4. (a) List 5 factors that may affect the accuracy of a blood pressure recording. (10 Marks) ...
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...Necrotizing Fasciitis Necrotizing fasciitis is a rare disease which is characterized by the bodies inflammatory response initiated by the immune system. Necrotizing fasciitis quickly spreads throughout the body (WebMD 2014). The inflammatory response is followed by necrosis of fascial planes and surrounding tissue. Trauma usually ensues after the infection. The infection is usually triggered when an injury occurs. Minor abrasions or lesions are enough to allow susceptibility of this bacterial infection (Bellapianta et al., 2009). What is the causative agent? There are two factors that are crucial in developing necrotizing fasciitis. These include exposure to bacteria of the group A Streptococcus and the susceptibility of an individual to the bacteria. The genus Streptococcus belongs to a group of Gram-positive bacteria. Group a streptococci are mostly facultative anaerobes and some are strictly anaerobes. This genus has also been associated with the following medical conditions; scarlet fever, rheumatic heart disease, glomerulonephritis, and pneumococcal pneumonia. The microbe, Streptococcus pyogenes, is the causative agent of necrotizing fasciitis, it is also referred to as the flesh eating bacteria. The S. pyogenes capsule is composed of hyaluronic acid. Hyaluronic acid is also found in the connective tissue of human. Thus, the bacterium is regarded as antigenic. The cytoplasmic membrane of S. pyogenes has a semblance to the antigen of the human...
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...Medicare and a Never-Event Involving a Patient Transfer Case Week #7 Application MMHA-6205: Health Law and Ethics August 19, 2013 Introduction Who would have imaged the Centers for Medicare & Medicaid Services’ (CMS) initiative would increase the exposure risk to both physician and health care facility alike because of the term “never events”. Never events are inexcusable medical errors that should never occur; the initial list of 28 events defined as “adverse events that are serious, largely preventable, and of concern to both the public and health care providers for the purpose of public accountability” was compiled by the National Quality Forum in 2001 (Sohn, 2011); pressure ulcers or bedsores was included on the initial list. As for the increased risk exposure for physicians/health care facility, it comes in two forms, the risk of; not being reimbursement by the government and other health care providers; unknowingly file a claim for payment to the government as a result of a never event, as well as; increased medical liability along with the added expense of defensive medicine, which cost the US on average approximately $89 billion per year. CMS (the Centers for Medicare & Medicaid Services is a federal agency within the US Department of Health and Human Services that administers the Medicare program and works in partnership with state governments to administer Medicaid and other health related insurance programs (Tavenner, 2011)) “never event” to raise...
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...Paula Kain Undertake agreed pressure Area care (HSC2024) Unit 4222-229 Outcome 1 1) The skin is the largest organ of the body, covering and protecting the entire surface of the body. The total surface area of skin is around 3000 square inches or roughly around 19,355 square cm depending on age, height, and body size. The skin, along with its derivatives, nails, hair, sweat glands, and sebaceous glands forms the integumentary system. Besides providing protection to the body the skin has a host of other functions to be performed like regulating body temperature, immune protection, sensations of touch, heat, cold, and pain through the sensory nerve endings, communicating with external openings of numerous other body systems like digestive system, urogenital system, and respiratory system via mucous membranes. The skin is primarily composed of three layers. The skin, which appears to be so thin, is still itself divided into epidermis, dermis, and subcutaneous layer or hypodermis. Each layer has its own function and own importance in maintaining the integrity of skin and thereby the whole body structure. Pressure sores or decubitus ulcers are the result of a constant deficiency of blood to the tissues over a bony area such as a heel which may have been in contact with a bed or a splint over an extended period of time. The surface of the skin can ulcerate which may become infected. Eventually subcutaneous and deeper tissues are damaged. Besides the heel, other areas commonly involved...
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...JAN ORIGINAL RESEARCH Pressure ulcers and their treatment and effects on quality of life: hospital inpatient perspectives Karen Spilsbury1, Andrea Nelson2, Nicky Cullum3, Cynthia Iglesias4, Jane Nixon5 & Su Mason6 Accepted for publication 5 September 2006 Karen Spilsbury PhD RN Research Fellow Department of Health Sciences, University of York, York, England, UK Andrea Nelson PhD RN Reader School of Healthcare, University of Leeds, Leeds, England, UK Nicky Cullum PhD RN Professor Department of Health Sciences, University of York, York, England, UK Cynthia Iglesias PhD Research Fellow Department of Health Sciences, University of York, York, England, UK Jane Nixon PhD RN Deputy Head Clinical Trials Research Unit, University of Leeds, Leeds, England, UK Su Mason PhD RN Principal Research Fellow Clinical Trials Research Unit, University of Leeds, Leeds, England, UK Correspondence to Karen Spilsbury: e-mail: ks25@york.ac.uk 6 5 4 3 2 1 SPILSBURY K., NELSON A., CULLUM N., IGLESIAS C., NIXON J. & MASON S. ( 2 0 0 7 ) Pressure ulcers and their treatment and effects on quality of life: hospital inpatient perspectives. Journal of Advanced Nursing 57(5), 494–504 doi: 10.1111/j.1365-2648.2006.04140.x Abstract Title. Pressure ulcers and their treatment and effects on quality of life: hospital inpatient perspectives Aim. This paper reports a study exploring patients’ perceptions and experiences of the impact of a pressure ulcer and its treatment on their health and quality...
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...A. Identify a current nursing practice within your healthcare setting that requires change. DEVELOPING OR CREATING AN INDEX TO MINIMIZE RISKS OFPRESSURE SORE 1. Describe the current nursing practice. An instrument specifically designed to aid health care workers evaluate the dangers of pressure sores that a patient faces is called the Braden Scale. After assessment, the victim is categorized depending on six aspects: capability of physical activity, hydration and nutrition status, capacity to alter position, the ability to respond after sensing discomfort related to pressure, shearing or exposure of the skin to friction during locomotion, and skin exposure to moisture. If the overall score is lower it means the risk of pressure sore is higher (Changing Practice, Changing Lives: 10 Landmark Nursing Research Studies, n.d). Prior to this Change, Skin assessment was based on non- formalized risk assessment which varies with each clinical practice. 2. Discuss why the current nursing practice needs to be changed Using non-formalized risk assessment in Predicting pressure ulcer resulted in non-uniformity and personal clinical judgement which varies from one person to another. Using Clinical judgement is more effective where the staffs are experienced and their experience assist in appropriate predictability, but with novice staff, the use of clinical judgment is inappropriate. In a multisite trial, Braden scale was tested by clinics bringing together skilled nursing facilities...
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...Scott Lewis 2/28/2013 Dr. Satre BIO 251 Necrotizing Fasciitis One of the most common skin infections known are bacterial infections; they have a wide range of severity, from merely annoying to deadly. Most bacterial skin infections are caused by two bacteria: Staphylococcus aureus and a form of Streptococcus. In the case of Necrotizing Fasciitis, bacteria are usually the cause. Some of the bacteria that have been found to cause this infection include group A Streptococcus, which is group A strep, Klebsiella, Clostridium, E. Coli, Staphylococcus areus, and Aeromonas hydrophila. Because of its effect on skin, Necrotizing Fasciitis is sometimes called flesh-eating bacteria. This infection is very rare but also very serious; about 1 out of 4 people who come in contact with this infection die from it. It is important to always clean wounds and cover them after getting them because the most common way of getting Necrotizing Fasciitis is when the bacteria enter the body through a break in the skin such as a cut, scrape, burn, insect bite, or puncture wound. Symptoms may develop quickly, sometimes as soon as 24 hours after a minor skin injury. The rapid onset of symptoms that occurs is a very important clue that you may need to seek medical attention. It is more likely for people to be affected by this bacterial infection who have other health problems that may lower the body’s ability to fight infection. Many chronic health conditions that weaken the body’s immune system...
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...Introduction Pressure sores are very important health issue, and its management and impediment in both primary and secondary care is extreme on the clinical program. The pressure ulcers could be very major health issue, were perceived to increase hospital stays and resulted in ongoing treatments. Background of the study Pressures ulcers are number one misjudge circumstances in acutely ill patients. In spit of the institution of Clinical practice regulations and innovation in medical science; the occurrence in hospitalized patients, of pressure sores continues to rise. At presence, concord is missing on the risk aspects for pressure sores in critical care patients, and there are no risk measurement scale particularly for pressure sores in these patients is existing. Objective To decide the major risk elements that projective of pressure sore in adult critically ill persons. At present Braden scale is the most common method of risk assessment for pressure ulcers. Braden scale is covering only six components, which are sensory acuity, moisture, nutrition, activity, mobility, and friction/shear. Potential grade from 6-23; lower numbers reveal high risk. Numbers of 15-18 shows mild risk; average risk were 13-14; scores of ten to twelve denotes more danger; and scores of 9 or less means extreme danger.. Other elements which are not included in the Braden Scale, cause raise the level of risk for pressure ulcers in patients, which is why it is very important to determinants...
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...Reflective practice account Based on Gibbs reflective cycle Name Kielley Ann Myers Date 27th July 2012 When asked to do a self reflecting account on identifying a new skill achieved during the module, I could have chosen such accomplishments as VAC (Vacuum Assisted Closure) therapy, Maggot therapy or Nutrition and Dietetics. But I wanted to go back to basics and review and fully expand a skill that I knew of, which is Pressure Ulcers (also called pressure sores or bed sores). A stated by the NHS Choices website “It is estimated that in any given year fewer than half a million people in the UK will develop at least one pressure ulcer. About 1 in 20 people who are admitted to hospital with acute sudden illness will develop a pressure ulcer; this is usually people with underlying health conditions.” I have been a H.C.A (Health Care Assistant) for over 17 years to now, and I have always been aware of pressure ulcers, and how to try to avoid them but never really knew the complete details of What, How or When of them. I have been on many different courses for H.C.A’s through the years, but they have all really skimmed over the subject of pressure ulcers. I now work on a vascular ward of the hospital where many of the patients are bed or wheelchair bound due to lower limb amputations, caused by complication from diabetes mellitus to circulatory problems. So I thought that by widening...
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...BEATRISA SHEKHTER NRS 433-V Literature Search Wound Care is very important topic in modern medical field. Pressure ulcers are the major problem in the long term facilities. Having an understanding of the exact cause of pressure ulcers helps place the role of repositioning into context. Demographic and epidemiological data suggest that health-care demand will increase considerably in the future as a result of an ageing population and a rise in the prevalence of chronic diseases such as diabetes. This phenomenon has come to be referred to as the ‘health care time bomb’ in the popular press and political discourse. The authors seek to look beyond the headlines and political rhetoric to clarify the extent to which they reflect the likely future reality with a specific focus on wound management. The present-day burden that wounds and current wound management practices place upon the health-care system are detailed and clarified, and the potential future implications of increasing wound prevalence on the current picture are explored. Possible opportunities to enhance current wound management practice as identified in the analysis are discussed. Declaration of interest: Alistair Biel by is a contractor for Smith & Nephew. Richard Searle is and employee of Smith & Nephew. This project was supported by an unrestricted grant from Smith & Nephew. As such, a pressure ulcer is defined as localized injury to the skin and/or underlying tissue, usually over a bony prominence, as a result...
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