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What is the etiology and pathophysiology of Gas Gangrene?
Gas Gangrene is caused by an anerobic gram positive clostridum that enters through a deep wound. (Clostridium perfringens, C. welchii, C, novyi)
Bacilli colonize in muscle tissue around wound; occurs 2 to 5 days after injury
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What are the clinical findings of Gas Gangrene?
Subjective: pain, apprehension, anorexia, chills
Objective: Bronzed or blackened wound tissue; crepitus; sweetish, foul-smelling watery exudate; necrosis of muscle tissues. Pallor; diarrhea; vomiting, temperature elevation (may be slight). Presence of Clostridia on culture, low hemoglobin (Hgb) value
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What are some therapeutic interventions of Gas Gangrene?
- 1. Multiple incisions for decompression and drainage
- 2. Complete removal (extripation) and debridement of involved tissue followed by copious irrigations
- 3. Penicillin G, tetracycline, chloramphenicol, or erthromycin, depending on the C&S
- 4. Amputation
- 5. Hyperbaric oxygenication
- 6. Whole blood, packed RBCs, or plasma transfusions to combat hemolysis and profound anemia
- 7. Antitoxin therapy may be started
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What precautions should be taken with an individual with Gas gangrene?
Standard and contact precautions also prevent further infection from fecal contamination (organism is found in feces). Monitior fluid, electrolyte, and cardiovascular status
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What is the etilogy and pathophysiology of TOXOPLASMOSIS?
1. caused by protozoan (Toxoplasma gondit), a prasite
2. contracted by eating raw meat containing cysts or exposure to contaminated cat feces
3. most common opportunistic CNS infection of those with AIDS
4. During pregnancy can cause congenital anomalies or death of fetus even though mother may be asymptomatic
5. leading cause of encephalitis in immunosuppressed clients
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What are the Clinical findings with the infectious disease Toxoplasmosis?
subjective: malaise, fatigue, headache
objective: fever; seizures; cognitive and motor impairment, lymphadenopathy; positive cultures; brain abscesses
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What are some therapeutic interventions with individuals with toxoplasmosis?
Pregnant women and immunosuppressed individuals may be treated with: pyrimethamine (Daraprim), azithromycin (Zithromax), sulfadiazine (Microsulfon), clindamycin (Cleocin), and leucovorin (Wellcovorin).
Usually no treatment required for otherwise healthy adults
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