“Clostridium Tetani” plus 3 more nursing article(s): NursingCrib.com Updates
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| Clostridium Tetani Posted: 15 Dec 2010 09:43 PM PST 
Clostridium Tetani DESCRIPTION 
- Large, gram (+), obligate anaerobic, motile bacilli with terminally located spore
- Have peritrichous flagella; maybe in chains or arrange singly
- Grow best in plain liquid or semi-solid media containing thioglycollic acid; also in milk and blood agar media incubated under anaerobic conditions
- Plain agar media at pH 7 to ph 7.5 growth occurs within 48 hours at 37oC with production of carbon dioxide and methylmercaptan
- Produce colonies which are smooth and rough, with compact center surrounded by fine filaments
- Remain alive for several years especially if protected from light
- Toxin produced by the bacilli is destroyed by heat at 650C for 5 minutes, by formalin and by proteolytic enzymes of the digestive tract
- Common inhabitants of the soil, street dust and feces or manure of herbivorous animals
- Producers of toxins and enzymes:
- Fibrinolysin
- Tetanolysin/hemolysin: destroys RBC; injures the heart
- Tetanospasmin
- Causes tetanus
TETANUS - An acute disease induced by toxin of the tetanus bacillus growing anaerobically at the site of an injur y.
- Incubation period is variable, ranging from a few days to weeks.
- The length of incubation period is directly related to the distance of the primary wound infection from the central nervous sytem.
RISK FACTORS/CAUSES A deep punctured wound containing: - Dead or necrotic tissue
- Calcium salts
- Pyogenic infection from other organisms
- Dirt
- Other objects like pieces of glass, splintered wood, etc.
SIGNS AND SYMPTOMS - painful muscular contractions, primarily of neck muscles, secondarily of trunk
- rigidity is sometimes confined to the region of injury
TYPES AND CATEGORIES Three Clinical Forms: 1. Generalized tetanus - Most common form involving the masseter muscles (trismus, or lockjar is the usual sign in a majority of patients)
- Sardonic smile characteristic of sustained trismus is known as "risus sardonicus"
- Other early signs include drooling, sweating, irritability and persistent back spasms (opistothonus)
- In severe cases, symptoms may involve the autonomic nervous system, with cardiac arrhythmias, fluctutations in blood pressure, profound sweating, and dehydration
2. Localized tetanus - The disease remains confined to the musculature at the site of primary infection; prognosis is good
3. Cephalic tetanus - A variant of localized tetanus where the primary site of infection is the head; prognosis is very poor
PREVENTION - Immunization of tetanus toxoid in every child is recommended. It must be followed by booster doses every two to three years.
- Among adults full course of three injections of antitetanus should be given at intervals of six weeks and six months.
- A booster dose of tetanus toxoid is usually given whenever an injury is sustained that might cause tetanus infection to bring the victim's immunity up to a maximum potential.
- An injection to neutralize tetanus poison may be given after a major injuryActive immunity by administration of tetanus toxoid; passive by tetanus antitoxin. Active immunity wears off in 3 to 4 years; passive immunity in 2 weeks.
MANAGEMENT - Administration of tetanus antitoxin intravenously in large doses.
- Intramuscular injection of large doses of penicillin or tetracycline or clindamycin as alternative drug.
- Surgical removal of necrotic tissues.
- Administration of muscle relaxants, sedatives and proper ventilation.
- Administration of barbiturates or diazepam for mild tetanospasms.
- Paralyze patient's muscles by use of curare-like agent so that respiratory function may be maintained by positive-pressure breathing apparatus in case of sever tetanospams.
- Tracheostomy should be performed after onset of the first tetanospasm in order to minimize respiratory complications.
- Good supportive care should include control of the environment to reduce auditory and visual stimuli if tetanospasms are frequent and severe.
Photo credits: www.netterimages.com Related posts: - Neonatal Immune System Adaptation Processes
- Leptospirosis
- Comparison of Pediatric Cancers and Adult Cancers
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| Serum Albumin Posted: 15 Dec 2010 08:14 PM PST 
Serum Albumin - Along with total protein, its primary function is the maintenance of the colloidal osmotic pressure in the vascular and extravascular spaces.
- It is a source of nutrition and a part of the buffer system.
- It is a "negative" acute-phase reactant.
- It decreases in response to acute inflammatory infectious processes.
- It is used to evaluate nutritional status, albumin loss in acute illness, liver disease and renal disease with proteinuria, hemorrhage, burns, exudates or leaks in the GI tract.
Normal Values: Children: 2.9 – 5.5 g/dL or 22 – 55 g/L Adults: 3.5 – 4.8 g/dL or 35 – 38 g/L Procedure: - This is done by obtaining 5 mL of serum in a tube.
- Fasting is not necessary.
- Low levels are associated with edema. Assess patient for signs and symptoms.
Clinical Implications: - Not associated with any naturally occurring condition.
- The only cause is decreased plasma water such as in dehydration.
- acute and chronic inflammations and infections
- cirrhosis, liver disease, alcoholism
- nephrotic syndrome, renal disease
- Chron’s disease, colitis
- congenital analbuminemia
- burns, severe skin disease
- heart failure
- starvation, malnutrition, malabsorption, anorexia
- Cushing’s disease, thyrotoxicosis
Interfering Factors: - Pregnancy (last trimester, owing to increased plasma volume)
- Oral birth control (estrogens)
- Prolonged bed rest
- IV fluids, rapid hydration, overhydration
Nursing Implications: - Check the albumin level from the protein electrophoresis results. Many clinical problems are the result of a serum albumin deficit.
- Assess for peripheral edema in the lower extremities when the albumin level is decreased. Albumin is the major protein compound responsible for plasma colloid osmotic pressure. With a decreased albumin level, fluid seeps out of the blood vessels into the tissue spaces.
- Assess for urinary output. Renal and collagen (lupus) diseases occur with abnormal protein fractions. Urine output should be 25mL/h or 600mL/24 hours.
Photo credits: www.proteinpower.com Related posts: - Serum Creatinine
- Hepatic Failure
- Mannitol – Drug Study
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| December 2010 Nursing Board Exam Room Assignments – Iloilo Posted: 15 Dec 2010 05:46 PM PST |
| December 2010 Nursing Board Exam Room Assignments – Davao Posted: 15 Dec 2010 05:42 PM PST |
