Download Impetigo Outline (1)

Emily Gomez-Mrs. Horton
Sharlain Donaho-Mrs. McPherson
David Kramer-Mrs. Osborn
Amanda Menchaca-Mrs. Osborn
Alexandra Olfati-Mr. Morin
Amber Russe-Mr. Morin
Impetigo
Cause: Impetigo is a superficial infection of the skin caused by staphylococci,
streptococci, or multiple bacteria.
Types of Impetigo:
Bullous impetigo, a more deep-seated infection of the skin caused by S. aureus, is
characterized by the formation of large, fluid-filled blisters called bullae. The bullae
rupture, leaving raw, red areas.
Nonbullous impetigo accounts for approximately 70% of cases. This type of impetigo
tends to affect skin that has already been compromised by cuts, abrasions, bites, or other
types of trauma. S. aureus is also commonly implicated, including methicillin-resistant
Staphylococcus aureus (MRSA), as well as Streptococcus pyogenes
The areas of the body, face, hands, neck, and extremities are most frequently involved
due to being the most exposed. Impetigo is contagious and may spread to other parts of
the patient’s skin or to other members of the family who touch the patient or use towels
or combs that are soiled with the exudate of the lesions.
Impetigo is seen in people of all races and ages. It is particularly common in children
living in poor hygienic conditions.
Predispositions:
Chronic health problems, poor hygiene, and malnutrition may predispose an adult to
impetigo. It is more prevalent in warm, humid climates and is therefore more commonly
seen in the southeastern United States than in northern climates.
Clinical Manifestations:
Lesions are most commonly seen on the face or extremities which begin as small, red
macules (discolored spots on the skin), which quickly become discrete, thin-walled
vesicles that rupture and become covered with a loose adherent yellow crust. These crusts
are easily removed to reveal smooth, red, moist surfaces on which new crusts soon
develop.
Collaborative Care:
Lesions are first soaked or washed with soap solution to remove the site of bacterial
growth. Cleansing the affected area enables topical antibiotics to reach the infected site.
Topical antibacterial therapy is prescribed when the disease is limited to a small area. The
medication must be applied to the lesions several times daily for up to 7 days. After the
crusts are removed the prescribed topical antibiotic cream is applied to the site. Gloves
must be worn when providing patient care.
Topical antibacterial therapy is typically prescribed when the disease is limited to a small
area. The medication must be applied to the lesions several times daily for 5 to 7 days.
Lesions are first soaked or washed with soap solution to remove the central site of
bacterial growth, giving the topical antibiotic an opportunity to reach the infected site.
After the crusts are removed, the prescribed topical antibiotic cream is applied. Gloves
are worn when providing patient. Systemic antibiotic agents may be prescribed to treat
infections that are widespread or in cases where there are systemic manifestations (e.g., a
fever is present). These antibiotics are effective in reducing contagious spread, treating
deep infections, and preventing acute glomerulonephritis (kidney infection), which may
occur as a consequence of streptococcal skin diseases. Patients may also be referred to
dietary, dermatologic, and social services.
Nursing interventions:
The nurse educates the patient and family members to bathe at least once daily with
bactericidal soap and implements cleanliness and good hygiene practices help to prevent
the spread of the lesions from one skin area to another and from one person to another. In
particular, patients and family members must be educated to practice hand hygiene every
time after a lesion is touched. Each person should have a separate towel and washcloth.
Because impetigo is a contagious disorder, infected people should avoid contact with
other people until the lesions heal.
Prevention:
If a family member already has impetigo, specific measures will prevent the spread of
infection. The prevention regimen should include cleansing the affected areas with mild
soap and water and covering lightly with gauze. Maintain an infected person’s clothes
and refrain from sharing with others. Wear gloves when applying antibiotic ointment and
wash hands thoroughly afterward. Cut an infected child's nails short to prevent damage
from scratching and maintain hand hygiene. Keep child home until the physician states
that the patient is no longer contagious.
Interrelated concepts:
Immunity is an interrelated concept of impetigo due to the disruption and compromise of
skin as the first line of defense. Thermoregulation is effected because intact skin
facilitates heat loss and cools the body. Fluid and electrolytes balance is effected as a
result of loss of water and electrolytes through non-intact skin. Constant scratching and
itching of the skin causes discomfort.
Nursing Diagnosis:
Impaired tissue integrity related to skin infection as manifested by puss filled blisters and
yellow crust.
Goal: Client will experience adequate tissue integrity as manifested by a decrease in
wound size at the end of one week.
Risk for infection related to skin wound.
Goal: Patient will remain free from infection as manifested by compliance with
antibiotic treatment at the end of one week.
Reference:
Ackley, B., & Ladwig, G. (2014). Nursing diagnosis handbook: An evidence-based
Guide to planning care (10th ed.). Maryland Heights, Missouri: Elsevier.
Hinkle, Janice L. and Kerry H. Cheever. Brunner & Suddarth’s Textbook of MedicalSurgical Nursing. 13th ed. Philadelphia: Wolters Kluwer Health | Lippincott
Williams & Wilkins, 2014. Web. 12 Nov. 2015.