Orolabial Herpes and Burn Care Quiz

Adult Health Nursing-2 (NUR351)

• Course offered by the College of Applied Medical Sciences, Shaqra University.
• Focuses on integumentary disorders and management.
• Includes study of the anatomy and physiology of the integumentary/skin system.

Integumentary System

• Consists of the skin and its accessory organs.
• Includes different layers: epidermis, dermis, and hypodermis.
• Layers within the epidermis: stratum corneum, lucidum, granulosum, spinosum, and basale.
• Dermis contains papillary and reticular layers.
• The hypodermis is also known as superficial fascia.
• Key functions: protection, sensation, thermoregulation, metabolism (vitamin D), and excretion.

Herpes Simplex

• A common skin infection.
• Two types: Type I (oral herpes) and Type II (genital herpes).
• Both types can occur in either location.
• Stages: redness and tingling, liquid-filled blisters, bursting blisters and scabs.

Orolabial Herpes

• Characterized by clustered vesicles on the lips.
• Often preceded by a prodrome of tingling or burning pain.
• Primarily transmitted via oral-to-oral contact causing oral herpes (HSV-1).

Genital Herpes

• A sexually transmitted infection (HSV-2).
• Presents with grouped vesicles on an erythematous base, affecting the vagina, rectum, or penis.
• New lesions might appear for 7-14 days.
• Often accompanied by regional lymphadenopathy, fever, and flu-like symptoms.
• Recurrences sometimes involve a prodrome of burning, tingling, or itching before blister appearance.

Complications of Herpes Simplex

• Eczema herpticum: herpes spreading throughout eczema areas in patients with eczema. (Inflammation of skin)
• Herpes whitlow: Infection of a fingertip pulp caused by herpes simplex virus I or II.
• Neonatal infection: Herpes infection in newborns

Management of Herpes Simplex

• Topical antiviral creams or ointments for burning, itching, or tingling.
• Oral or intravenous antiviral medications can shorten outbreaks.
• Drugs: Acyclovir, famciclovir, and valacyclovir.

Burns

• Introduction:
• One of the most painful injuries, involving nerve damage and intense pain.
• Complex injuries affecting many body functions (muscles, bones, nerves, blood vessels).
• Respiratory system damage (airway obstruction possible) and body electrolyte balance issues are common effects.
• Emotional and psychological issues can be substantial.
• Causes:
• Thermal (flame, heat from fire, steam, hot liquids, objects).
• Chemical (acids, bases, caustics).
• Electrical (electrical current, lightning).
• Radiation (sources such as nuclear, ultraviolet).
• Prevention:
• Keep matches, lighters out of reach of children.
• Never leave children unattended around fires or bathrooms.
• Install and maintain smoke detectors.
• Practice home exit fire drills with the family.
• Set water heater temperature no higher than 120°F.
• Do not smoke in bed or fall asleep while smoking.
• Don't put flammable liquids on fires.
• Be careful when using electrical equipment outdoors, and store flammable liquids away from fires.
• Pathophysiology:
• Energy transfer from a heat source to the body.
• Categorized (thermal, electrical, radiation, or chemical).
• Deep tissue damage (including internal organs), possible fluid loss, infection, hypothermia, scarring, and changes in function.
• Classification:
• Superficial Thickness ("First-Degree"): involves the epidermis. Clinical findings: erythema, minor pain, lack of blisters.
• Partial Thickness ("Second-Degree", superficial and deep): superficial - clinical findings include blisters, clear fluid, and pain. Deep: involves deeper dermis, can display whiter appearance, reduced pain, and difficulty distinguishing from full thickness.
• Full Thickness ("Third- or Fourth-Degree"): clinical findings of hard, leather-like eschar, lack of sensation, possibly affecting skin deep layers (fascia, bone, or muscle).
• Assessment:
• Rule of Nines (adults and infants/children).
• Lund and Browder Method (accounts for varying body surface areas).
• Palm Method (for scattered burns; palm size to estimate 1% of BSA area burns).
• Management:
• Emergent/Resuscitative phase:
• Scene care: ensure victim is not overcooled, do not move objects adhered to the wound. Do not remove sticking objects, do not burst blisters.
• Lay the casualty down, protect the burned area from hard surfaces. Douse the skin with copious amounts of cold water; 10 minutes minimal. Check airway, breathing, and circulation.
• Carefully remove any clothing not adhered, but remove any rings, watches, belts, and shoes before swelling begins, etc...
• Cover the injury with clean absorbent material and transport to medical care.
• Acute/Intermediate phase (begins after 48-72 hours):
• Continuous monitoring and maintenance of respiratory and circulatory status, fluid electrolyte balance, and gastrointestinal function. Prevent infection.
• Wound care, pain management, and nutritional support.
• Infection prevention, wound cleaning using hydrotherapy (showers), wound dressing (applying antiseptic agents and dressings).
• Methods to prevent infection:
• Wear appropriate PPE.
• Take tissue specimen (swab, biopsy) cultures regularly.
• Utilize systemic antibiotics if sepsis or other positive cultures evident.
• Use hydrotherapy and topical antibacterial agents.
• Types of wound debridement (mechanical and surgical).
• Grafting the wound:
• Coverage of deep wounds or extensive burns to promote healing by utilizing grafts (autograft).
• Occlusive dressings are often used immediately after grafting to immobilize the graft and reduce risk for infection.
• Pain Management:
• Use analgesics prior to wound care procedures.
• Employ quick, gentle, and skillful procedures, and utilize techniques like opioid bolus doses (often morphine). Employ patient-controlled analgesia (PCA).
• Psychological Issues and Scars:
• Provide psychological support for the patient and family.
• Reconstruction:
• Reconstructive surgery, therapy, and guidance may be required to address body appearance and function.
• Focus on maintaining fluid and electrolyte balance and improving nutrition. Prevent hypertrophic scarring, which may lead to contractures.

This quiz covers key concepts related to orolabial herpes, including its causes, symptoms, and the distinctions between herpes simplex types. Additionally, it addresses important guidelines for the care of severe burns, emphasizing safety protocols and skin structure knowledge. Test your understanding of these topics with this informative quiz!