Podcast
Questions and Answers
What is the most common bacteria associated with toxic shock syndrome?
What is the most common bacteria associated with toxic shock syndrome?
Which of the following is NOT a common laboratory finding in toxic shock syndrome?
Which of the following is NOT a common laboratory finding in toxic shock syndrome?
What is the primary goal of medical management for toxic shock syndrome?
What is the primary goal of medical management for toxic shock syndrome?
What is the most important nursing implication for a client with toxic shock syndrome?
What is the most important nursing implication for a client with toxic shock syndrome?
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Which of the following is a key patient education recommendation for clients using tampons?
Which of the following is a key patient education recommendation for clients using tampons?
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What is the primary cause of endometriosis?
What is the primary cause of endometriosis?
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Which of the following is NOT a common clinical manifestation of endometriosis?
Which of the following is NOT a common clinical manifestation of endometriosis?
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What is the primary purpose of using high-dose antiovulatory medications in the treatment of endometriosis?
What is the primary purpose of using high-dose antiovulatory medications in the treatment of endometriosis?
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What is the most common surgical intervention for severe and chronic endometriosis?
What is the most common surgical intervention for severe and chronic endometriosis?
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Which of the following is NOT a recommended nursing intervention for managing discomfort or pain in clients with endometriosis?
Which of the following is NOT a recommended nursing intervention for managing discomfort or pain in clients with endometriosis?
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What is the most significant risk factor for Toxic Shock Syndrome?
What is the most significant risk factor for Toxic Shock Syndrome?
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Which symptom typically occurs first in Toxic Shock Syndrome?
Which symptom typically occurs first in Toxic Shock Syndrome?
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What is a common manifestation of Toxic Shock Syndrome?
What is a common manifestation of Toxic Shock Syndrome?
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Which diagnostic test definitively confirms Toxic Shock Syndrome?
Which diagnostic test definitively confirms Toxic Shock Syndrome?
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Who is most at risk of developing Toxic Shock Syndrome?
Who is most at risk of developing Toxic Shock Syndrome?
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What physical assessment should be performed to help diagnose Toxic Shock Syndrome?
What physical assessment should be performed to help diagnose Toxic Shock Syndrome?
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What is a potential consequence of leaving a tampon in place for too long?
What is a potential consequence of leaving a tampon in place for too long?
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What is one of the key signs of septic shock in Toxic Shock Syndrome?
What is one of the key signs of septic shock in Toxic Shock Syndrome?
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What might a healthcare provider ask about in the subjective assessment of a patient with suspected Toxic Shock Syndrome?
What might a healthcare provider ask about in the subjective assessment of a patient with suspected Toxic Shock Syndrome?
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Why is asking about tampon use important in assessing for Toxic Shock Syndrome?
Why is asking about tampon use important in assessing for Toxic Shock Syndrome?
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Study Notes
Toxic Shock Syndrome
- Acute bacterial infection caused by Staphylococcus aureus
- Risk factors:
- Using tampons with fingers instead of the inserter
- Chronic vaginal infections
- Genital herpes
- Recent childbirth
- Surgery
- Internal medical packing
- Can occur in non-menstruating women
- Most commonly occurs in women using tampons
- When a tampon is left in place for too long, bacteria proliferate and release toxins into the bloodstream
Clinical Manifestations
- Begins with flu-like symptoms within the first 24 hours, then worsen between days 2-4
- Symptoms:
- Elevated temperature up to 102 degrees
- Vomiting
- Diarrhea
- Dizziness
- Headache
- Myalgia
- Sore throat
- Red macular palmar or diffuse rash followed by desquamation of the skin
- Decreased urinary output
- Disorientation
- Elevated blood urea nitrogen (BUN)
- Hypotension and other signs of septic shock
- Pulmonary edema
- Inflammation of mucous membranes
Assessment
- Subjective:
- Tampon use and how long she used a single tampon before changing it
- Myalgia
- Sore throat
- Headache
- Fatigue
- Objective:
- Assess palms and soles of feet for erythematous rash
- Check for edema and signs of shock such as hypotension
- Level of consciousness
Diagnostic Tests
- No definitive test
- Cervical/vaginal smear (S. Aureus present 90% of the time)
- Blood, urine, and throat cultures
- Blood tests:
- Leukocytosis
- Thrombocytopenia
- Elevated bilirubin
- Blood urea nitrogen/creatinine
- Alanine aminotransferase (SGPT)
- Aspartate aminotransferase (SGOT)
- Creatinine phosphokinase (CPK)
Medical Management
- Antibiotics dependent on results of culture and sensitivity
- Parenteral fluids to maintain fluid balance and correct electrolyte imbalances
- Monitor renal labs
- Monitor liver function tests
Nursing Implications and Patient Teaching
- Client is hospitalized:
- Bedrest
- Administer antibiotics
- Monitor vitals and fluid status
- Oxygen therapy if needed
- Patient & Family Teaching:
- Advise client not to use super absorbent tampons
- Alternate tampons with pads
- Inspect tampon for defects before insertion
- Change tampons frequently (every 4 hours)
- Insert tampon using inserter to avoid abrasions
- Wash hands thoroughly before and after inserting tampon
- Observe for signs of toxic shock syndrome if using tampon
- Sudden high fever with vomiting or diarrhea
- Remove tampon and seek immediate medical attention
Endometriosis
- Endometrial tissue appears outside the endometrial cavity
- Tissue may be found on:
- Ovaries
- Fallopian tubes
- Uterus
- Abdominal cavity
- Vagina
- Pelvic cavity
- Spread of tissue is believed to be through:
- Lymphatic circulation
- Menstrual backflow to the fallopian tubes and pelvic cavity
- Congenital displacement of endometrial cells
Risk Factors
- Sister or mother has it (7x greater risk)
- Highest incidence of endometriosis in among Caucasian women
- 25 to 35 years of age who are in the higher socioeconomic classes
- Who postpone childbearing until the later reproductive years
Clinical Manifestations
- Dysmenorrhea
- Lower abdominal and pelvic pain with or without pain in the rectum
- May be unilateral or bilateral and may radiate to the lower back/legs/groin
- Symptoms may worsen with menstruation
Assessment
- Subjective:
- History of symptoms
- Dysmenorrhea
- Aching cramping
- Bearing down-sensation in the pelvis or lower back
- Dyspareunia
- Menstrual irregularities (amenorrhea)
- Objective:
- Noting signs of symptoms of abnormal uterine bleeding
- Infertility
Diagnostic Tests
- Ultrasound to identify cysts and large areas of endometrial tissue outside of the uterus
- Laparoscopy with biopsy of lesions may confirm the diagnosis
- Regular pelvic examinations to monitor progress
Medical Management
- Occasionally disappears spontaneously
- Some are asymptomatic after pregnancy
- Medications:
- High dose antiovulatory medications to inhibit ovulation and induce a state physiologically similar to pregnancy
- Synthetic androgen (male hormone) such as danazol (Danocrine) or a Gonadotropin-releasing hormone
- Surgery:
- Laparoscopy can be used to remove small areas of endometrial tissue & relieve adhesions
- Laser may be used to vaporize the small implants of endometrial tissue
- Extensive and chronic endometriosis may require drastic surgical treatment, such as panhysterectomy or oophorectomy
Nursing Implications and Patient Teaching
- Manage discomfort/pain:
- Use of medications
- Heating pads
- Acupuncture
- Transcutaneous electrical nerve stimulation (TENS)
- Yoga
- Eating a balanced diet and physical activity may be beneficial
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Description
Explore the key information about Toxic Shock Syndrome, an acute bacterial infection caused by Staphylococcus aureus. Learn about the etiology, pathophysiology, risk factors, and clinical manifestations of this condition.
