Pre-test

Which statement made by a client with a furuncle in the groin indicates

to the nurse that teaching about the care needed for this problem has
been effective?

A.I will wear tight jeans to keep the infection from spreading to other
areas.

B.I will shower with an antibacterial soap before applying the topical
ointment.

C.I will squeeze the lesion until it opens so I can remove all the pus
and other material.
Pre-test
In which order do you don personal protective equipment?

A. Hand washing, mask, goggles, gown, gloves

B. Hand washing, gown, goggles, mask, mask

C. Hand washing, mask, goggles, gloves, gown

D. Hand washing, gown, mask, goggles, gloves

Pre-test
What are some alternatives to soap to cleanse the skin when infected
with folliculitis? Select all that apply.

A.Hydrogen peroxide

B.Dermol

C.Alcohol wipes

D.Hibiclens

E.Aloe Vera

F. Oilatum Plus

G.Bath & Body foaming hand cleanser

Pre-test
A common treatment/ treatments for herpes zoster is
(select all that apply):
A. Valacyclovir (Valtrex)
B. Tetracyclines
C. Zanamivir (Relenza)
D. Acyclovir (Zovirax)
E. Peramivir (Rapivab)
Pre-test
Type 1 herpes simplex virus presents as:
A. Recurring genital warts
B. A superficial boil on the buttocks
C. Recurring cold sores
D. A deep connective tissue infection
 Bacterial & Viral
Skin Infections
Tissue Integrity TBL

Abriana, Dominic, Kanamu, Karl

Introduction
Bacterial Viral
Folliculitis Herpes Simplex

Furuncle Herpes Zoster (Varicella Zoster)

Cellulitis
Folliculitis
Etiology

Caused by staphylococcus and is a superficial infection. The infection involves the

upper portion of the follicle and presents as a raised, red rash may manifest into
pustules.

Clinical Manifestations

Single or grouped isolated red pustules often with hairs from the center of lesion.

Little or no associated discomfort

No residual scarring.

Distributed in area with hair growth, around buttocks, thighs, beard area, and scalp.

Treatments
Furuncle (boil)
Etiology

Boils that are caused by Staphylococcus infection, but is much deeper in the follicle.

Clinical Manifestations

Small, tender, erythematous nodules become pus filled and more tender over time.

Lesions may be single or multiple and also recurrent.

Regional lymphadenopathy is sometimes present; fever is rare.

Occasional scarring results.

Treatment - Home Care

Apply warm compresses and soak the boil in warm water.Once the boil comes to a head, it will
burst with repeated soakings. When the boil starts draining, wash it with an antibacterial soap
until all the pus is gone and clean with rubbing alcohol. Apply a medicated ointment (topical
Cellulitis
Etiology

Cellulitis is an infection involving the deeper connective tissue and occurs as a

generalized infection that may be caused by either Staphylococcus or
Streptococcus.

Predisposing factors are skin wounds, edema from any cause and systemic factors
(diabetes, immunosuppression).

Clinical Manifestations

A non- purulent cellulitis infection will present with localized erythema, pain, swelling,
and warmth.

Fever, chills, and malaise may indicate a more severe infection.

A skin sore or rash that appears and grows quickly

A tight, glossy, swollen appearance of the skin

 Herpes Simplex Virus
Etiology Type 1

Spread by contact with lesion or virus- Classic recurring cold sore

containing fluid (saliva, respiratory
Type 2
droplets)
Recurrent genital warts
Remains dormant in nerve ganglia with
no manifestations Most common viral infection for
adults
Virus travels to skin when activated by
stressors Severity increases with age or in
immunocompromised
Dry lips
Manifestations
Sunburns
isolated or grouped painful
vesicles on a red base
Trauma
Herpes zoster (shingles/varicella-zoster
virus)
Etiology

INFECTION caused by reactivation of the varicella-zoster virus (VZV) in patients who have previously
had chickenpox.

Herpes zoster occurs most often in older people or in anyone who is immunosuppressed for any
reason.

It is contagious to people who have not previously had chickenpox and have not been vaccinated
against the disease.

Keeping patients with fluid-filled blisters separated from other patients until the lesions have crusted
reduces the risk for transmitting the virus to others.

Manifestation

Lesions are similar in appearance to herpes simplex and also progress with weeping and crusting.

Grouped lesions present unilaterally along a segment of skin following the pathway of a spinal or
cranial nerve (dermatomal distribution).
 Assessment
Patient History Bacterial

Assess risk factors for each type of

Recent skin trauma?
infection
Recent staph. or strep. infection?
Nutrition status

Family history Living conditions/home sanitation

Current health problems Personal hygiene habits

Physical assessment of skin Leisure or sports activities

Clinical manifestations presented Fever or malaise present?

Skin infections are contagious Viral

Use precautions to prevent the
Usually present on lips, mouth, or
spread of infection
groin
Personal Protective Equipment (PPE)
PPE is used as an integral part of infection
control and prevention that protects
workers from exposure to blood, body
fluids, and other potentially infectious
materials.

PPE such as gowns, gloves, masks, and

goggles provide physical barriers that
prevent the hands, skin, clothing, eyes,
nose, and mouth from coming in contact
with infectious agents.

PPE ORDER
Labs
Swab and culture of purulent material

Blood cultures if fever and malaise present

White blood cell count (WBC) with differential

Elevated leukocytes

Elevated immature neutrophils (shift to the left)

Elevated erythrocyte sedimentation rate (ESR)

Prevention Methods
Before infection
Personal hygiene

Proper handwashing

Avoid sharing shavers, razors, washcloths and other personal items

Urge family members to shower daily and use antibacterial soap.

Staff & Patient Education
Educate patient to complete antibiotic medications as prescribed to
prevent development of antibiotic-resistant bacteria.

Keep infected skin covered with clean and dry bandages.

Change the bandage whenever drainage seeps through it.

Place soiled bandages in a plastic bag and seal it closed before

placing it in a regular trash and wash your hands with soap and
warm water before and after touching infected area and bandages.

Sleep in a separate bed from others until infection is cleared.

Nursing Diagnosis
Topic: Folliculitis

Dx: Risk for infection related to impaired skin integrity as evidenced

by red pustules in beard area.

Interventions:
Assess for the signs of infection.

Purulent drainage from lesions indicates infection.

May have elevated temperature with severe infections.

Apply topical antibiotics

Patients with folliculitis have a decreased ability to generate protective

substances on the skin.
Test
Which statement made by a client with a furuncle in the groin indicates
to the nurse that teaching about the care needed for this problem has
been effective?

A.I will wear tight jeans to keep the infection from spreading to other
areas.

B.I will shower with an antibacterial soap before applying the topical
ointment.

C.I will squeeze the lesion until it opens so I can remove all the pus
Test
Which statement made by a client with a furuncle in the groin indicates
to the nurse that teaching about the care needed for this problem has
been effective?

A.I will wear tight jeans to keep the infection from spreading to other
areas.

B.I will shower with an antibacterial soap before applying the topical
ointment.

C.I will squeeze the lesion until it opens so I can remove all the pus
and other material.
Test
In which order do you don personal protective equipment?

A. Hand washing, mask, goggles, gown, gloves

B. Hand washing, gown, goggles, mask, mask

C. Hand washing, mask, goggles, gloves, gown

D. Hand washing, gown, mask, goggles, gloves

Test
In which order do you don personal protective equipment?

A. Hand washing, mask, goggles, gown, gloves

B. Hand washing, gown, goggles, mask, mask

C. Hand washing, mask, goggles, gloves, gown

D. Hand washing, gown, mask, goggles, gloves

Test
What are some alternatives to soap to cleanse the skin when infected
with folliculitis? Select all that apply.

A.Hydrogen peroxide

B.Dermol

C.Alcohol wipes

D.Hibiclens

E.Aloe Vera

F. Oilatum Plus

G.Bath & Body foaming hand cleanser

Test
What are some alternatives to soap to cleanse the skin when infected
with folliculitis? Select all that apply.

A.Hydrogen peroxide

B.Dermol

C.Alcohol wipes

D.Hibiclens

E.Aloe Vera

F. Oilatum Plus

G.Bath & Body foaming hand cleanser

Test
A common treatment for herpes zoster is (select all
that apply):
A. Valacyclovir (Valtrex)
B. Tetracyclines
C. Zanamivir (Relenza)
D. Acyclovir (Zovirax)
E. Peramivir (Rapivab)
Test
A common treatment for herpes zoster is (select all
that apply):
A. Valacyclovir (Valtrex)
B. Tetracyclines
C. Zanamivir (Relenza)
D. Acyclovir (Zovirax)
E. Peramivir (Rapivab)
Test
Type 1 herpes simplex virus presents as:
A. Recurring genital warts
B. A superficial boil on the buttocks
C. Recurring cold sores
D. A deep connective tissue infection
Test
Type 1 herpes simplex virus presents as:
A. Recurring genital warts
B. A superficial boil on the buttocks
C. Recurring cold sores
D. A deep connective tissue infection
References
Gulanick, M., & Myers, J. (2014). Nursing care plans: Diagnoses, interventions, and outcomes (8th ed., pp. 680-684).
Philadelphia, PA: Elsevier

Ignatavicius, D. D., Workman, M. L. (2013). Medical-surgical nursing: Patient-centered collaborative care (7th ed). St. Louis, MO:
Elsevier.

Kenny, T. (2014). Folliculitis. Health information. Retrieved from http://patient.info/health/folliculitis-leaflet