Pathophysiology/Nursing interventions
What is an anthrax infection caused by? (hint** this is treated by a variety of antibiotics)
What is Anthrax: Anthrax is caused by the gram-positive bacterium Bacillus anthrasis. This naturally occurring bacteria lives in the soil in spore form throughout the world. It replicates and releases toxins.
The primary clinical manifestation of a cutaneous anthrax infection is...
What are skin lesions? The most common infection leads to edema with pruritis and macule or papule formation, which leads to ulceration; with 1-3 mm vesicles, painless eschar develops, which breaks off within 1-2 weeks. (Show cutaneous pic)
This common antibiotic must be started within 24 hours of exposure to treat anthrax effectively
what is Penicillin?
What is a common test done to determine a type of bacteria? (Often get it x2 or x3)
Blood cultures.
This is to determine the type of bacteria causing the anthrax infection and contribute to the diagnosis of anthrax.
How can we teach patients to prevent antibiotic resistance?
Take the antibiotics as prescribed.
It's important for patients to take medication as the provider prescribes, even if they feel better. If treatment stops too soon and they become sick again, the remaining bacteria may become resistant to the antibiotic that they've taken.
The three main methods of infection are?
What are Skin contact (cutaneous), gastrointestinal, and Ingestion/Inhalation? These methods of infection have different incubation periods. Cutaneous infections have the best survival rate and are the leading method of infection.
The main symptoms of anthrax infection are.
What are Fever, respiratory distress, stridor, hypoxia, cyanosis, diaphoresis, hypotension, and shock
(Go over other symptoms listed as subjective & Objective)
This antibiotic is widely used for both treatment and prophylaxis of anthrax and requires 60-day regimen
What is Ciprofloxacin?
What is the main treatment for anthrax? (medication)
Antibiotics.
Ciprofloxacin and doxycycline are commonly used antibiotics used to treat anthrax. These antibiotics may be prescribed for about 60 days for inhalation anthrax and about 7-10 days for cutaneous anthrax.
What are some common side effects of antibiotics that patients should be aware of?
Diarrhea, n/v, rash, yeast infections
What would the nurse do FIRST if you or someone you know suspects this infection?
What is the CDC? The nurse must notify the CDC immediately, utilize standard/contact precautions (gown, gloves..), and pt. Must be put in an isolated room.
Contact precautions are utilized when draining cutaneous lesions due to the infection.
A chest Xray with an anthrax infection would show
What is hemorrhagic mediastinitis?
The hallmark finding of the disease is a widened mediastinum visualized on a chest x-ray. (Show picture)
Life-threatening and severe infection
This antibiotic is an alternative to ciprofloxacin for treating anthrax but is not typically recommended for long-term prophylaxis
what is Levofloxacin?
What types of tests are used to diagnose anthrax? (there are 2)
Chest x-ray or CT scan.
These tests may reveal an enlarged mediastinum due to enlarged lymph nodes, pleural effusions, and sometimes mediastinal hemorrhage.
How can an individual avoid getting gastrointestinal anthrax?
Proper handling meat and fully cooking food
Death recommendations include a variety of standard protocols if a loved one passes from anthrax. Name a practice that nurses can recommend to protect against future infection. (hint** Would we cremate or bury the person as is?)
What is cremation? Cremation is utilized after the death has occurred from an anthrax infection. Spores can survive for decades, hence the cremation.
Many complications arise from an anthrax infection, including...
What is hemorrhagic mediastinitis?
What is meningitis with subarachnoid hemorrhage?
What is Septic shock? It is an extreme reaction to inflammatory markers in the body that overwhelms the body and causes a dramatic drop in blood pressure, which can damage the lungs, kidneys, liver, and other organs.
What is death (approximately 24-36 hours after onset of respiratory distress)
Mortality rate: 100% (especially for inhalation/ingestion)
along with ciprofloxacin, this antibiotic can also be used for a 60-day treatment and prophylaxis plan following anthrax exposure
what is Doxycycline?
What type of test involves the doctor inserting a needle into the spine and withdrawing fluid for testing?
A spinal tap (lumbar puncture).
This test is recommended anytime doctors suspect someone has anthrax due to the possibility of meningitis.
What is the preventive measures for anthrax?
Vaccination- specifically for high-risk occupational exposure to anthrax, such as lab workers, people who work with animals, and military
If a pt. has a suspected anthrax infection and is having SOB/dyspnea, what is the nurse's priority?
What is oxygen/intubation? Oxygen is used along with auscultation of lungs, monitoring O2 sats, elevating HOB, intubation, corticosteroids, antibiotics, and gathering blood arterial gases.
There are other complications such as...
What are GI bleeding, diarrhea, and bacteria that target the ilium and cecum?
Diarrhea: leads to low intravascular volume and low fluid (hypovolemia)
GI bleeding: loss of blood in the body (must be treated)
these two antibiotics are the only ones recommended for 60 days as both treatment and prophylaxis of anthrax infections
what are ciprofloxacin and doxycycline?
What type of precautions are used especially on the first day of treatment for anthrax?
Contact precautions.
This is because the spores could be in the patient's hair, clothing, and skin and could transfer easily to those who come into contact with them.
When a patient is exposed to anthrax, who should we report this to?
CDC- Anthrax is recognized as the most likely weaponized biological agent available and has been identified as a highly debilitating agent for centuries.