b. The guidelines in The Australian Immunisation Handbook (Dept.
Discuss the reasons Mary was given the tetanus boost according to the 2017 Australian Immunisation Handbook (Dept.
The physiological basis for the three wound observations
Each of the three wounds has an observation that indicates, and provides a reason, whether it is a sign, or a symptom.
Discuss the physiological basis for the first observation.
Discuss the physiological basis for the second observation.
d. Discuss the physiological foundation of the third observation.
The benefits and development of fever.
What is Mary fever?
Discuss two benefits of fever.
Sources of contamination and transmission modes
Name an endogenous source for contamination. Discuss the transmission mode from the source to the host.
Identify one source of contamination exogenously and describe the transmission mode from that source to the host.
Describe the additional benefits Augmentin offers, and make reference to the roles of the main ingredients.
Clostridium Tetani is a bacterium which can infect wounds that are exposed to soil or dirt. It is an endospore-forming rod-shaped bacterium and can cause tetanus.
Mary had an open wound from gardening and could have been exposed to soil and the bacterium C. tetani.
Tetanus is caused by two neurotoxins, tetanolysin and tetanospasmin, which are both released by the bacteria.
Mary should be 50 years old and receive the booster vaccine against tetanus, especially if she hasn’t had a vaccine in 10 years.
In some cases, even a booster given before the injury can not prevent tetanus.
An early tetanus booster can help Mary increase her immunity to toxins from tetanus. This will make her more capable of fighting Clostridium difficile infections if necessary.
The wound site releases several biochemicals to try to restore homeostasis.
The wound edges are red and hot due to an acute inflammatory response.
The injury site is irritated by chemicals such as histamines, prostaglandins, and some kinins.
These compounds, along with some cytokinins, increase blood flow to the injury site. The edges appear reddish due to their combined effects.
The role of nitric oxide in vasodilation is played by the capillaries around the cut for increased blood flow.
Prostaglandins E1 and E2 increase vascular permeability so neutrophils can escape from the capillaries to the surrounding tissue. They also relax the smooth musclesof the blood vessels.
The cells begin to meetbolize faster when the temperature rises at the site of injury (Craft 2015).
c. Evidence of swelling around the injury.
This is also called edema. It’s caused by the fluid leaking from the blood vessels.
This fluid clogs the tissues, and is accompanied by pain.
Pain reduces movement, and patients can recover faster from injuries due to a lack of movement (Marieb Hoehn 2014).
d. Mary becomes febrile if there is a purulent or odorous discharge from her wound.
This is an indication that there is an infection. The healthcare staff sent a wound sample to test for the pathogen. Armstrong, Duerden, Armstrong 2001.
The immune system reacts to an infection by producing more exudate, which results in swelling and pain.
To treat an infection caused by a pathogen, an oral antibiotic can be administered to the patient (Craft 2015).
Fever is an important part the immune system.
Fever can be defined as a core temperature measured rectally that is equal or greater than 380C.
Mary was infected by an infectious bacteria. Endotoxins from this bacteria caused Mary to release interleukin-1 and interleukin-6, the pyrogenic cytokines.
These in turn trigger the release of prostaglandin E2, cortotrophin releasing factors, and endothelin I.
The pyrogens are able to activate a fever by activating the pre-optic region of the anterior hypothalamus.
As the body starts to produce heat and conserve it, the temperature begins to rise (Craft 2015).
Fever can be beneficial as it can stop the multiplication and growth of pathogenic bacteria.
Fever reduces the amount of copper, iron, and zinc needed for bacteria replication. It also slows down the rate at which pathogens multiply.
Phagocytosis is also more rapid and leads to faster elimination of pathogens (Marieb Hoehn 2014).
Transmission is possible by contact with contaminated hands. This is the main source of most endogenously transmitted diseases.
The bacterium can be transferred to the injured area, such as a cut. Once it has found more nutrition in the moist environment, it quickly becomes a pathogen that slows down healing.
To treat infected wounds, antibiotics may be required (Demidova, Hamblin, Herman 2012).
Hands of healthcare workers or surfaces such as showerheads or door handles contaminated with Staphylococcus Aureus could be an exogenous source.
Mary’s wound was infected with soil bacteria, but it is not known if soil bacteria can cause wound infections.
S. aureus infections are typically endogenous and occur when the wound is not properly cleaned by healthcare personnel (Lee 2016).
Mary’s wound swab report revealed that she had an S. aureus infection.
According to the report, Amoxycillin was also sensitive to the culture.
However, several strains are resistant to beta-lactam antibiotics. Augmentin is an effective antibiotic against these resistant S Aureus (Bullock Manias 2017, 2017).
b. Augmentin is a mixture of Clavulenic acid and Amoxycillin.
Amoxycillin acts by blocking the formation of peptidoglycan cells walls in bacteria.
The beta lactam antibiotics became ineffective against bacteria due to antibiotic resistance.
Bacteria has the ability to produce beta lactamase enzyme, which causes the beta lactam-ring to be broken down. This means that even with the antibiotic, multiplication could continue unabated.
Because clavulenic acids could block beta lactamase enzyme activity, and because beta lactam could again disrupt peptidoglycan cells wall formation, the antibiotic was made more effective by adding clavulenic to amoxycillin.
Augmentin can thus be used to treat S. aureus infections (Bullock Manias 2017, 2017).
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