Question

12)Review the side effects of long term corticosteroids use. What must you educate your patient about this long term use? Discus how to discontinue steroids.

13)Review what is meant by: primary, secondary, third wound intention.

14)Regulation of body temperature primarily occurs in what part of the brain?

15)Antibiotics

• Review the different types of antibiotics, their use, side effect, patient education key points
• Patients should be taught not to discontinue antibiotics prematurely, but rather to complete the entire course of therapy, even if symptoms improve or resolve.
  • Cephalosporins
  • Vancomycin
  • Erythromyecin
  • Sulfonamides
  • Fluoroquinolones

Answer 1

Side effects of long term corticosteroid use

a)oral corticosteroids: cataract( clouding of lense in one or both eye),osteoporosis( thinning bone),high blood sugar which can worsen diabetes, increased risk of infection, severe fatigue, loss of apetite,nausea, muscle weakness, slow wound healing, thin bruising skin

b)inhaled corticosteroids: hoarseness, oral thrush, slow growth rate in children, who use it for asthma.

c) topical corticosteroids:thin skin, red skin lesions and acne

d)injected corticosteroids: loss of colour in the skin( at injection site),intense pain,facial flushing,insomnia,high blood sugar

Educate the patient with long term corticosteroid use regarding:

To ask the doctor about using low dose or to take it evey other day instead of daily.

To wear a medical alert bracelet

To partcipate in activities and eat healthy diet( avoid concentrated sweets eg candy, cakes, pies, cookies)

To take calcium and vitaminD suppliments , it will help to protect the bones.

To get regular check up

Discontinuingthe therapy: Corticosteroids should never stop at sudden, it should do gradully. the reasons is, when taking it for a long term, the adrenal gland may produce less of their natural steroid hormone. To give the adrenal gland time to recover this function, it should be done gradually.

2.Wound intentions

Primary:In this type , the edges of the wound are sutures, or stapled closed and the wound heals quikly with minimal tissue loss, Healing time is usually short.

Secondary:It occurs when the sides of the wounds are not opposed, therefore, healing must occur from the bottom of the wound upward. in this,wound is left open to heal by scar formation, In this type of wound, there is a loss of skin and granulation tissue fills the area left open.Healing is slow , which places the patient in risk of infection.

Tertiary:in this type, intentional delay in closing a wound takes place. on occasion wounds are left open .

3.HYPOTHALAMUS is thepart of brain which regulatesbody temperature, it is also called 'body's thermostat'.

4. a) Cephalosporine:

Uses: it is used to treat bacterial infection such as ear infection, pneumonia,throat infction, kidney infection, meningitis, gonorrhea

Side effects: stomach discomfort, nausea, vominting, diarrhea, rash, itching, oral thrush

Educate the patient , not to take cephalosprin if he is allergic to it. and it is important to finish the entire course prescribed.

b)Vancomycin