00:01
Okay. Now, I know that's probably
going to be so you'll see some
pictures that might be hard to look at,
but as you're looking at the picture,
I want you to think about
what are the signs of infection
that every nurse should be watching for?
Now, we're likely showing some
ones that should have been
caught a little earlier, so we
want you to catch
the signs of infection when you
see something like fever.
00:23
Now, fever is not always a bad thing.
It kind of helps us defeat those cells.
00:27
That's a sign that your patient has a healthy
immune system and they can respond.
00:33
People who are immunocompromised can't
necessarily fight back with this fever.
00:38
The other thing you want to look for
is chills. If someone has fever
and chills, like they're so warm and
they just feel it, they feel really cold,
that's what chills are.
00:46
If they're sweating, that's a sign
of a really advancing infection.
00:50
When you look at the wound, you'll
notice redness in the wound.
00:54
Now, a little bit of redness is a good
thing, right, because that tells us,
"Hey, your immune system is kicking in,
and it's really working well." So, a
little bit of redness is okay,
but as that advances, that becomes
sign for alarm.
01:06
If there's pain and swelling
at the site, wow,
things are starting to get really bad.
01:11
And if the patient tells you they
just feel all-over tired,
these are all signs, as we put them together,
are telling us that our patient
is at risk for infection.
01:21
Now we've got a few more to talk about
because this is when the infections
become really severe,
a patient might experience weight loss.
01:27
Yeah, and not the kind you want, right?
This isn't the kind of weight loss
that's going to make you look
better on the beach.
01:33
This is because their body is just becoming
overwhelmed with the infection.
01:37
Now, lab work that we can look at
is a white blood cell count.
01:41
So we would expect if the patient
is experiencing infection
and their immune system is responding,
we would expect their white blood
cell count to be elevated.
01:51
Now, pus is one of the more graphic,
nastier parts of infection,
but that is definitely a sign
that the wound has become infected.
In fact, sometimes,
we can't even really treat the
wound effectively
until we incise it and drain all that
pus out so we can distribute
that antibiotic and get it to
the point of infection.
02:13
Now, also keep in mind, the signs
and symptoms can
really vary widely based on
where the infection is.
02:20
If it's right on the outside of my
skin, that's going to be
easier for you to see the
signs and symptoms.
02:25
But I can also have infections deep
and internal in my body,
and I'm not going to necessarily see
the external signs so easily.
02:34
Another thing I want you to keep in
mind, we've kind of touched on it,
but older people, our geriatric
population, or someone
whose immune system isn't working very well --
an immunocompromised patient --
might not show you the signs of infection.
02:47
Okay, let me give you an example.
02:49
Let's say we have an elderly client
who's in the nursing home.
02:53
All of a sudden, they start acting really
weird, kind of crazy and disoriented,
and not like they normally would.
I've seen patients come to
be admitted to the hospital because they
thought maybe they'd had a stroke.
03:06
Do you know what they really had?
They had a urinary tract infection.
03:10
That's what made them act so crazy.
03:13
They didn't show fever. They didn't show
a white cell count that went up,
but we know that the geriatric population,
when they have a UTI, can have
these kind of unusual
neurological changes.
03:23
So when we did a urine sample,
we found out that's what it was,
started the patient on an antibiotic,
and things resolved and they
went right back to normal.
03:32
So, older people may not show you
the normal signs of infection,
but they will show you crazy.
03:39
So always consider,
if you have a geriatric client and
things have changed like that,
why are they acting that way?
Might have been their blood sugar,
but this patient wasn't diabetic.
03:49
Might have been an infection, you
start thinking about UTI,
very common in the elderly population.
03:54
So don't ever assume that an old
person is just confused.
03:59
Always ask yourself, "Why are they
confused?" And remember,
geriatric clients or immunocompromised
clients
will not show you the signs of
infection of younger
or people who have very strong
immune systems.
04:13
Okay, now, that is a killer picture, isn't it?
And this is a great question.
04:18
These antibiotics sound amazing,
but how do they know how to attack bacteria,
but not human cells?
So pause the video for just a
moment and see if
you can remember back from your
microbiology courses,
why antibiotics can attack bacteria,
but not human cells.
04:40
Well, here's the answer to your question.
04:42
Antibiotics don't kill human cells
because bacteria cells are different
than human cells.
04:49
So, this is a really cool concept
in antibiotics.
04:52
It's called selective toxicity, and we'll
talk about that in just a minute.
04:56
But I want you to really look at
these graphics first.
04:59
Look at the difference between
the human cell
and the bacterial cell.
05:05
Okay? Their walls are different.
05:07
So we can use some different mechanisms
of action to kill bacteria
that leave the human cells alone.
05:14
It would be amazing if we could get
chemotherapy to do the same thing
because if you look at selective toxicity --
there's a lot of words there, but
essentially, it tells us
that selective toxicity
is the ability of the drug to injure
the target cell or organism,
and while not messing with the human cell.
05:35
So, let me try that one more time for you.
05:38
If something is selectively toxic,
that means it will only kill the bacteria
and not the human cell.
05:45
See, when I talked about chemotherapy,
chemotherapy, the cytotoxic cells
of chemotherapy --
the cytotoxic activity is where it will
kill all cells that have a high
growth fraction;
the cancer cells and the human cells.
06:01
So chemotherapy can be very difficult
to receive as a patient.
06:05
But antibiotics have selective toxicity,
meaning, they selectively kill bacteria
and leave the human cells alone.