Archive for the ‘Infection’ Category

Posted on December 7, 2011 - by Nurse Virginia

URINARY INFECTIONS MAY LEAD TO INCREASED CONFUSION IN THE ELDERLY

(Part II)

In the past when an elderly person experienced changes in behavior or increased confusion, the health care community collectively thought that this was normal; after all you’re getting old. How many times has a doctor said to a family member “What do you expect at his age, he’s getting old.”

Addressing the behavior or the increased confusion was the focus, not the underlying physical change in condition. Identifying that physical or pathological change will require the persistence to search for a cause and the ability to clearly communicate your findings.

Signs of a urinary tract infection:

• Going to the bathroom more frequently
• Complaining of a burning sensation on urination
• Increased temperature
• Bladder or kidney pain
• Blood or pus in the urine
• Concentrated, dark/cloudy urine
• Rambling talk, disorganized thinking
• Unstable emotions
• Increased problems with judgment or thinking

The elderly with dementia are more likely to be hospitalized for a fracture, lower respiratory infection, urinary infection or a head injury than an elder without dementia. Once admitted, the elder with dementia will usually remain in the hospital twice as long an elder without dementia. The elder with dementia will also be more likely to be re-admitted within 90 days after discharge than an elder without dementia.

Virginia Garberding R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance

www.pleasegettoknowme.com

Posted on December 5, 2011 - by Nurse Virginia

URINARY INFECTION MAY LEAD TO INCREASED CONFUSION IN THE ELDERLY

(PART I)

Marty was holding on to the handle of the car door threatening to “jump.” No matter what his wife Betty said, nothing seemed to be able to quiet Marty down. He had been pacing the small home they had lived in for the past 40 years, till Betty said, “Let’s go for a drive.” Thinking the car ride would be soothing for whatever was bothering Marty these last few days. He seemed to have a problem that he didn’t seem to be able to put into words. And now here he was threatening to jump from the car.

Marty had always been a very calm, dependable sort of man. Even when he started getting confused, he laughed it off never showing frustration or anger. This kind of outrageous behavior was so unlike the normal manner of this 78year old man. Not knowing what to do, Betty drove directly to their doctor’s office and luckily they took Marty right into an examination room.  Marty would not have been good at waiting, not today.

Marty was well known to the doctor and his staff and after what seemed only a short time to Betty the doctor started writing notes. Betty could just make out the doctor’s note reading it upside down. It read, Altered Mental Status, increased confusion probable cause urinary tract infection.

Urinary tract infections are the most common infections in the elderly and the most likely to lead to increased confusion. The second most likely infection to result in increased confusion is an upper respiratory infection or pneumonia. However just about any infection in an elderly individual may result in increased confusion. Many times the increase in confusion is the symptom that leads the caregiver or physician to the cause which may be infection.

Virginia Garberding R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance

www.pleasegettoknowme.com

Posted on March 8, 2011 - by Nurse Virginia

WHEN THE ELDER – OR ANYONE – ISN’T FEELING WELL, IS IT A COMMON COLD OR SOMETHING MORE SERIOUS?

Part II

EYE AND EAR INFECTION

Conjunctivitis (pink eye) is an inflammation of the membrane of the eye or eyelid. The symptoms cannot be due to trauma to the eye or due to allergy symptoms, in order to be Conjunctivitis. Once again the key to allergy is the fact that the secretions are clear with an allergy. Redness may result from rubbing the eye due to itching. In order to be considered Conjunctivitis you must have one of the following symptoms:

• Redness of the eye for at least 24 hours ( with or without pain or itching)
• Pus coming from the eye or both eyes for more than 24 hours.

Ear Infection

To be considered an ear infection the individual must have one of the following:

• Diagnosis by a physician of ear infection
• Pus like drainage from one or both ears with pain or redness.

GASTROENTERITIS – INFLAMMATION OF THE STOMACH AND INTESTINES

Intestinal problems may be caused by a non-infectious cause, such as medication changes or infectious causes such as contaminated foods, especially at buffets.(did you realize the dirtiest items at a buffet are the serving spoons – because everyone touches them) The symptoms are – you must have at least one of the following:

• Two or more watery or diarrhea like bowel movements within 24 hours.
• Two or more episodes of vomiting within 24 hours.

You must also be diagnosed with the following:

• Nausea, vomiting, diarrhea, abdominal pain or tenderness.
• Lab tests showing you positive for the diagnosis.

As always the best defense is good hand-washing.

 

Virginia Garberding, R.N.

Director of Education, The Wealshire. Lincolnshire, Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance

www.pleasegettoknowme.com

Posted on March 7, 2011 - by Nurse Virginia

WHEN THE ELDER – OR ANYONE – ISN’T FEELING WELL, IS IT A COMMON COLD OR SOMETHING MORE SERIOUS?

(PART I)

Many times a confused elder, much like a very small child, cannot tell the caregiver what is wrong when they are in fact ill. Knowing and identifying symptoms can go a long way toward shortening the duration of an infection.

What does the common cold look like?

You may or may not have a fever with a cold, symptoms are intense but short-lived. You must have at least two of the following symptoms:

• A runny nose or sneezing – your secretions from the nose will be yellow to green – clear/white secretions indicate an allergy.
• Nasal congestion or stuffy nose.
• Difficulty swallowing or sore throat.
• Dry non-productive cough
• Swollen or tender glands in your neck.

Flu like illness

The flu diagnosis is usually made during the “season,” the flu season from November through April is considered the “season.” Flu always has a temperature over 100 degrees Fahrenheit, and three of the following:

• Dry Cough
• Chills
• Sore throat
• Headache or pain around the eyes
• unpleasant feelings or discomfort
• loss of appetite
• muscle aches

Bronchitis looks like this –

Bronchitis is an infection of the lower respiratory tract and diagnosis will be made without a chest x-ray. You need to have at least 3 of the following symptoms:

• cough
• shortness of breath and breathing faster
• fever over 100F
• painful breathing
• physician can hear rales in lungs
• increase in lung secretions

 

 

Virginia Garberding, R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance

www.pleasegettoknowme.com

Posted on November 2, 2010 - by Nurse Virginia

ELDERLY AT INCREASED RISK FOR INFECTION REALLY DEPEND ON THEIR CAREGIVER

The elderly, when they become weak and frail are so dependent on others to keep them safe and healthy. The best friend an elderly person can have is a very alert caregiver. An infection that takes over the elder’s system can be life threatening in the extreme.

6 – Reasons the elderly are more susceptible to infection:

• Their immune system has aged and is not as effective
• The skin is the first line of defense against infection and the aging skin is thinner
• The elderly are usually less hydrated – especially their skin
• Many elderly retain urine – increasing the likelihood of urinary track infection
• The elderly have decreased ability to cough up secretions
• The use of medications that can suppress the elder’s ability to fight infection

The elderly don’t always show signs of infection the way a young healthy person might, with an increase in temperature and increased white cell.

8 – Changes in condition in the elderly that may indicate an infection:

• Increase in confusion
• Becoming incontinent of urine
• No longer being able to do a task they normally do with no problem
• Having problems walking
• Falling
• Breathing faster
• A change in their appetite
• Worsening of a medical condition they already have

As is always the case – prevention is so much more important when working with the elderly. Washing hands and avoiding highly congested areas where the chance of acquiring an infection is higher are the caregiver’s greatest opportunity for defense.

Virginia Garberding R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance

www.pleasegettoknowme.com

Posted on August 24, 2010 - by Nurse Virginia

TAKE CARE OF SKIN PROBLEMS FOR THE ELDER THE WAY THE NURSING HOME DOES

Taking care of skin problems the way the nursing home does means being proactive, and documenting all abnormal skin areas. When the elder has a bruise or abrasion, write down where it is, what size it is and how it looks. Something like – dark purple bruise the size of a quarter above the right elbow.

This kind of tracking protects the family or caregiver from false accusations of poor care. This also protects the family if the elder has to go to the hospital or a nursing home. When there is a controversy over skin problems acquired during transport or in a nursing facility your record keeping will prove invaluable.

Nursing facilities do a skin assessment every time the elder has a shower or bath.  Every skin tear, wound, bruise or abrasion is documented at that time. If the elder has a bruise that is healing, writing – the bruise above the right elbow is now the size of a nickel and light brown shows, that it is in fact the same bruise healing.

Prevent Infections by being Pro-Active

When the elder has their toe nails cut – immediately applying a small amount of a Triple-Antibiotic Ointment to the area can prevent an infection. Always having some form of Antibiotic Ointment on hand, whether it is a Polysporin product or a natural product can prevent infection.

The natural product I like is Tea Tree Oil, which is an antiseptic product that can be used in the same way as the ointment but is applied with a cotton swab, since it is in an oil form. Any time there is a reddened area in the skin there is potential for a nasty infection. Something as simple as a reddened belly button area, (navel to some) because it is covered and could be moist and warm is the perfect scenario for an infection gone wild. Applying a small amount of an ointment or antiseptic oil at the first sign of redness could clear it up the same day.

Virginia Garberding, R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance

www.pleasegetoknowme.com

Posted on June 1, 2010 - by Nurse Virginia

GOOD SKIN CARE FOR ELDERLY- BEST WAY TO PREVENT CELLULITES

Bob ran into a bush while on his riding mower and a large branch hit him in the shin. His skin wasn’t broken, and he said later he had hardly felt it and” just kept going.”  Problem was Bob is 67, had a knee replacement in that leg and experiences decreased circulation in his lower extremities due to heart disease.

At first, it was a lump that just appeared on his shin the size of a small egg. The next day, it was painful and because of his knee replacement his wife insisted he go to the doctor.

Now, three days later and on an oral antibiotic, his leg is twice the size of the other and hot to the touch. His knee area is bright red and the leg is various shades of red and blue down to his ankle. Bob now has to go on a second antibiotic and if not successful, it will mean IV antibiotics in the hospital.

Signs and symptom of cellulites: (inflammation of the cells)

• Skin warm or hot to the touch
• Redness
• Pain
• Swelling
• Possible fever

Cellulites can occur anywhere on your body from your face to your toes. However there are certain areas much more susceptible. Lower legs are the most likely, especially for anyone with compromised circulation. Any break in the skin is an opportunity for bacteria to enter and start an infection. Be it insect bite, wound, ulcer, dermatitis, athlete’s foot or any opening in the skin that is an opportunity for infection.

Sometimes you don’t find an opening in the skin at all, as in the case of Bob. Just the trauma to the tissue was all he needed with his history of bad circulation to start a cellulites.

Skin is always the first line of defense against infection and keeping the skin in the best of condition requires diligence.  In 1859 a young chemist noticed that the men working on an oil rig in Pennsylvania were using a by product of the oil on their skin. It was a thick substance that formed a water barrier on their hands and aided in healing cuts. The young man took some of this substance and studied it, then named it Vaseline. Vaseline products continue to be one of the best ways to maintain soft skin. Keeping a jar of this old remedy in your medicine cabinet, might not be a bad idea, I do.

Virginia Garberding, R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance

www.pleasegettoknowme.com