N-Trivia

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• Neisseria Gonorrhea
• Candida Albicans
• Staphylococcus Albus / Staphylococcus Epidermidis
• Acute Pancreatitis

Neisseria Gonorrhea Posted: 03 Jan 2011 07:27 PM PST Neisseria Gonorrhea Features Gram (-), kidney or coffee-bean shaped intracellular diplococci Usually killed when outside the human body Inhabits the eyes and genitor-urinary tract of both males and females Transmitted through sexual intercourse with an infected partner; via infected birth canal of infected mothers during delivery; indirectly transmitted via contaminated hands, fomites contaminated with purulent discharges; directly also via oral sex Causes gonorrhea Gonorrhea It is an acute, inflammatory and infectious disease of the mucus membrane of the genito-urinary tracts of both men and women as well as the eyes of the newborn. Incubation period is 3-5 days after contact with an infected partner. Signs and Symptoms Urethritis – among the males, a few days after exposure. Lymphadenitis (swelling of lymphnodes) Ophtalmia neonatorum Gonorrheal ophthalmia Gonorrheal vulvovaginitis Gonococcal pharyngitis Anal gonorrhoea Dysuria Urethral discharge Prostatitis Inguinal lymphadenitis Pelvic pain Fever Treatment Penicillin is the drug of choice; triple sulphonamides; and tetracyclines Modes of action of the drugs: 1.      Penicillin G – inhibits cell wall synthesis 2.      Triple sulphonamides –bacteriostatic; interferes with some enzymes in the affected bacterial cells 3.      Tetracyclines – inhibits protein synthesis 4.      Aqueous procaine penicillin G given intramuscularly together with probenecid by mouth just before injection – for acute genital infection 5.      Local application of 0.5% erythromycin ophthalmic ointment or 1% tetracycline to the conjunctiva of the new born – for gonococcal ophthalmia 6.      Instillation to the affected eyes of 1% silver nitrate or 0.5% erythromycin (CREDE's PROPHYLAXIS) – for ophthalmia neonatorum Prevention and Control Avoid sexual promiscuity or multiple sexual partner. Abstinence from casual sex or suppression of commercialized prostitution. Health and sex education Urination before and after sexual intercourse. Rapid treatment of sick persons Crede's prophylaxis for all newborns to prevent ophthalmia neonatorum. Facilities for early diagnosis and treatment of the disease. Eradicating infection by early diagnosis and treatment. Use of mechanical prophylaxis (condoms) although it provide only partial protection Disinfection of rectal thermometers Photo credits: www.embryology.med.unsw.edu.au Related posts: Drug Study – Erythromycin Chlamydial Infection Impetigo

Candida Albicans Posted: 03 Jan 2011 07:27 PM PST Candida Albicans is another form of an opportunistic fungi, along with Aspergillus fumigates. It is the most pathogenic among the other four Candida species.  C. Albicans causes Candidiasis . 1. Candidiasis is a fungal disease among people having diabetes mellitus; those immunosuppresed; those with indwelling and intravenous catheter; those who have prolonged antimicrobial and corticosteroid therapy and general debility which alter the normal body flora caused by C. Albicans. Candidiasis comes in different forms which include: 2. Vulvovaginitis It is a yeast invasion of the vaginal mucosa which is characterized by pruritus, irritation and vaginal discharges. This condition is often present in pregnant women, women who are diabetics, or those taking antimicrobial drug that alters the local acidity, normal flora and secretions in women. Usually C. Albicans thrives in secretions with alkaline pH. 3. Oral Thrush It occurs usually on the tongue, gums, palate and lips of patients. It appears as white patches consisting largely of pseudomycelium and desquamated epithelium with erosions of the memebrane. This is common among immunosuppressed patients ( with AIDS,  and on corticosteroid treatment) and those taking antibiotics. It is commonly present on extremes of age, the infant and elderly. 4. Cutaneous Candidiasis It occurs in skin that is weakened by trauma, macerations or burns. It is present in moist, warm parts of the body such as the axilla, groin and intergluteal folds which is common in obese and diabetics. 5. Onychomycosis It is a reddened, painful swelling of the nail fold which looks like a pyogenic paronychia which can obliterate the nail. 6. Systemic Candidiasis It is usually caused by the presence of indwelling and intravenous catheters, and surgery. Systemic candidiasis is often linked to corticosteroid therapy and those with hematologic diseases. Candidal endocarditis happens when there are deposition and growth of yeast and pseudohyphae on prosthetic heart valves. Oral thrush and other mucocutaneous diseases are treated with topical Nystatin and oral Fluconazole. To treat vulvovaginitis, parahydroxybenzoic acid esters, sodium propionate, candicidin and 2% miconazole is used.  In cases of systemic candidiasis, amphotericin B is used in conjunction with 5-fluorocystosine. Nursing Considerations Candidiasis is not a contagious disease. In order to prevent its occurrence, the normal flora of the body should be maintained.  As a nurse, her responsibility is to administer antibiotics as ordered by the doctor without prolonging the therapy so as not to disturb the normal flora of the body. When patient is on indwelling catheter, ascertain as to when the catheter should stay with the client.  In the use of intravenous catheter, always check the site for presence of redness, tenderness, swelling or pain. Also watch out for occurrence of fever for this may signal an infection in the body. Photo credits: www.christinas-home-remedies.com Related posts: Staphylococcus Albus / Staphylococcus Epidermidis Sputum Culture Throat Culture Procedure

Staphylococcus Albus / Staphylococcus Epidermidis Posted: 03 Jan 2011 06:03 PM PST Staphylococcus albus / Staphylococcus epidermidis gram-positive, coagulase-negative cocci that is a part of the skin’s normal flora resident bacteria usually present on human skin that can cause opportunistic infections occur singly, in pairs, or in short chains and have a strong tendency to form clusters grow rapidly on blood agar and other laboratory media; not hemolytic on blood-agar plates on solid culture, the bacterial colonies are often white or cream colored associated with  indwelling catheters and immunocompromised persons generally resistant to multiple antibiotics; an essential cause of serious nosocomial infections among patients Symptomatology Blood stream infection Endocarditis Cerebrospinal fluid (CSF) shunt infection Peritoneal dialysis catheter infection Urinary tract infections, especially with indwelling urinary catheters resulting to urinary tract complications Prosthetic joints infections Infection of vascular grafts Infection among newborns Eye infection after an eye surgery Infection of pacemakers  or implantable cardioverter-defibrillators Infection of breast implants Medical Management: highly resistant to most antibiotics drug of choice is vancomycin or rifampin newer dugs: gatifloxacin and moxifloxacin removal of implanted device Photo credits: www.rosacea-control.com Related posts: Candida Albicans Corynbacterium Diptheriae Nursing Care Plan – Diabetes Mellitus Type 2

Acute Pancreatitis Posted: 03 Jan 2011 05:47 PM PST Acute Pancreatitis inflammation of the pancreas, ranging from mild edema to extensive hemorrhage, resulting from various insults to the pancreas. defined by a discrete episode of abdominal pain and serum enzymes elevations function and structure usually return to normal after an acute attack Pathophysiology and Etiology excessive alcohol consumption biliary tract disease such as cholelithiasis, acute and chronic cholecystitis mortality is high because of shock, anoxia, hypotension or multiple organ dysfunction autodigestion of all or part of the pancreas is involved Clinical Manifestations abdominal pain, usually constant, midepigastric or periumbilical, radiating to the back or flank nausea and vomiting fever involuntary abdominal guarding, epigastric tenderness dry mucous membranes, hypotension, cold clammy skin, cyanosis or tenderness, tachycardia and mild to moderate dehydration shock with respiratory distress and acute renal failure purplish discoloration of the flanks (Turner’s sign) or of the periumbilical area (Cullen’s sign) Diagnostic Evaluation serum amylase, lipase, glucose, bilirubin, alkaline phosphatase, lactate dehydrogenase, AST, ALT, potassium and cholesterol may be elevated Serum albumin, calcium, sodium, magnesium and potassium may be low due to dehydration Abdominal x-ray to detect an ileus or isolated loop of small bowel overlying pancreas CT scan is the most definitive study Chest x-ray for detection of pulmonary complications Management Restoration of circulating blood volume with IV crystalloid or colloid solutions Maintenance of adequate oxygenation Pain control to alleviate pain and anxiety, which increases pancreatic secretions Rest of the GI tract Maintenance of alkaline gastric pH with H2-recepto antagonists and antacids to suppress acid drive of pancreatic secretions Nutrition provided through parenteral feedings Pharmacotherapy: electrolytes, insulin, sodium bicarbonate and antibiotics Surgical interventions for complications Complications Pancreatic ascites, abscess or pseudocyst Pulmonary infiltrates, pleural effusion, acute respiratory distress syndrome Hemorrhage with hypovolemic shock Acute renal failure Sepsis and multi-oran dysfunction syndrome Nursing Management Assist patient to comfortable position. Administer medications as ordered. Maintain patency of NGT. Maintain NOP status. Observe and measure abdominal girth. Administer oxygen supplementation. Instruct patient in coughing and deep breathing exercises. If due to alcoholism, emphasize the need for alcohol elimination. Photo credits: www.pennmedicine.org Related posts: Acute Peritonitis Acute Renal Failure Hepatic Failure

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