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Signs of Infection (Nursing)

by Rhonda Lawes

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      Slides 03-01 IntroToAntibiotics.pdf
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    00:01 Okay. Now, I know that's probably going to be so you'll see some pictures that might be hard to look at, but as you're looking at the picture, I want you to think about what are the signs of infection that every nurse should be watching for? Now, we're likely showing some ones that should have been caught a little earlier, so we want you to catch the signs of infection when you see something like fever.

    00:23 Now, fever is not always a bad thing. It kind of helps us defeat those cells.

    00:27 That's a sign that your patient has a healthy immune system and they can respond.

    00:33 People who are immunocompromised can't necessarily fight back with this fever.

    00:38 The other thing you want to look for is chills. If someone has fever and chills, like they're so warm and they just feel it, they feel really cold, that's what chills are.

    00:46 If they're sweating, that's a sign of a really advancing infection.

    00:50 When you look at the wound, you'll notice redness in the wound.

    00:54 Now, a little bit of redness is a good thing, right, because that tells us, "Hey, your immune system is kicking in, and it's really working well." So, a little bit of redness is okay, but as that advances, that becomes sign for alarm.

    01:06 If there's pain and swelling at the site, wow, things are starting to get really bad.

    01:11 And if the patient tells you they just feel all-over tired, these are all signs, as we put them together, are telling us that our patient is at risk for infection.

    01:21 Now we've got a few more to talk about because this is when the infections become really severe, a patient might experience weight loss.

    01:27 Yeah, and not the kind you want, right? This isn't the kind of weight loss that's going to make you look better on the beach.

    01:33 This is because their body is just becoming overwhelmed with the infection.

    01:37 Now, lab work that we can look at is a white blood cell count.

    01:41 So we would expect if the patient is experiencing infection and their immune system is responding, we would expect their white blood cell count to be elevated.

    01:51 Now, pus is one of the more graphic, nastier parts of infection, but that is definitely a sign that the wound has become infected. In fact, sometimes, we can't even really treat the wound effectively until we incise it and drain all that pus out so we can distribute that antibiotic and get it to the point of infection.

    02:13 Now, also keep in mind, the signs and symptoms can really vary widely based on where the infection is.

    02:20 If it's right on the outside of my skin, that's going to be easier for you to see the signs and symptoms.

    02:25 But I can also have infections deep and internal in my body, and I'm not going to necessarily see the external signs so easily.

    02:34 Another thing I want you to keep in mind, we've kind of touched on it, but older people, our geriatric population, or someone whose immune system isn't working very well -- an immunocompromised patient -- might not show you the signs of infection.

    02:47 Okay, let me give you an example.

    02:49 Let's say we have an elderly client who's in the nursing home.

    02:53 All of a sudden, they start acting really weird, kind of crazy and disoriented, and not like they normally would. I've seen patients come to be admitted to the hospital because they thought maybe they'd had a stroke.

    03:06 Do you know what they really had? They had a urinary tract infection.

    03:10 That's what made them act so crazy.

    03:13 They didn't show fever. They didn't show a white cell count that went up, but we know that the geriatric population, when they have a UTI, can have these kind of unusual neurological changes.

    03:23 So when we did a urine sample, we found out that's what it was, started the patient on an antibiotic, and things resolved and they went right back to normal.

    03:32 So, older people may not show you the normal signs of infection, but they will show you crazy.

    03:39 So always consider, if you have a geriatric client and things have changed like that, why are they acting that way? Might have been their blood sugar, but this patient wasn't diabetic.

    03:49 Might have been an infection, you start thinking about UTI, very common in the elderly population.

    03:54 So don't ever assume that an old person is just confused.

    03:59 Always ask yourself, "Why are they confused?" And remember, geriatric clients or immunocompromised clients will not show you the signs of infection of younger or people who have very strong immune systems.

    04:13 Okay, now, that is a killer picture, isn't it? And this is a great question.

    04:18 These antibiotics sound amazing, but how do they know how to attack bacteria, but not human cells? So pause the video for just a moment and see if you can remember back from your microbiology courses, why antibiotics can attack bacteria, but not human cells.

    04:40 Well, here's the answer to your question.

    04:42 Antibiotics don't kill human cells because bacteria cells are different than human cells.

    04:49 So, this is a really cool concept in antibiotics.

    04:52 It's called selective toxicity, and we'll talk about that in just a minute.

    04:56 But I want you to really look at these graphics first.

    04:59 Look at the difference between the human cell and the bacterial cell.

    05:05 Okay? Their walls are different.

    05:07 So we can use some different mechanisms of action to kill bacteria that leave the human cells alone.

    05:14 It would be amazing if we could get chemotherapy to do the same thing because if you look at selective toxicity -- there's a lot of words there, but essentially, it tells us that selective toxicity is the ability of the drug to injure the target cell or organism, and while not messing with the human cell.

    05:35 So, let me try that one more time for you.

    05:38 If something is selectively toxic, that means it will only kill the bacteria and not the human cell.

    05:45 See, when I talked about chemotherapy, chemotherapy, the cytotoxic cells of chemotherapy -- the cytotoxic activity is where it will kill all cells that have a high growth fraction; the cancer cells and the human cells.

    06:01 So chemotherapy can be very difficult to receive as a patient.

    06:05 But antibiotics have selective toxicity, meaning, they selectively kill bacteria and leave the human cells alone.


    About the Lecture

    The lecture Signs of Infection (Nursing) by Rhonda Lawes is from the course Anti-Infective Drugs in Nursing.


    Included Quiz Questions

    1. Weight loss
    2. Cyanosis
    3. Bradycardia
    4. Decreased pain
    1. A geriatric client
    2. A client with an open fracture
    3. A pediatric client
    4. A client on diuretics
    1. Selective toxicity
    2. Distribution
    3. Metabolism
    4. Excretion

    Author of lecture Signs of Infection (Nursing)

     Rhonda Lawes

    Rhonda Lawes


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