Week 7: Nursing Care

Nursing Considerations-Nursing Diagnoses

*Acute pain *Fatigue *Impaired skin integrity *Risk for infection

Nursing Considerations-Expected Outcomes

*Express feelings of comfort and relief from pain *Report increased levels of energy
*Maintain warm, dry, and intact skin with healed or improved lesions or wounds
*Remain free from signs and symptoms of secondary infections.

Nursing Considerations-Nursing Interventions

*Notify the local health department immediately if you suspect monkeypox in a patient.
*Institute a combination of standard, contact, and droplet precautions in all health care settings. *Maintain airborne precautions until monkeypox is confirmed and smallpox is ruled out. 

*Continue contact precautions until lesions are crusted.

Nursing Considerations-Associated Nursing Procedures

*Contact precautions *Immunization guidelines *Oral drug administration *Reportable diseases
*Temperature assessment

Patient Teaching-General

*Disorder, diagnosis, and treatment, including information that the infection is usually self-limiting and resolves in 2 to 4 weeks
*Need to wear a mask over his nose and mouth and to cover exposed lesions with a sheet or gown when he's in contact with others
*Proper hand-washing practices *Comfort measures *Care of lesions, including the use of contact precautions until lesions are crusted
*Measures to reduce the risk of infection such as importing of exotic animals as pets.

 Providing supportive care

Care for a patient with monkeypox is supportive. Place him in a negative-pressure room (preferably) or a private room and initiate contact, droplet, and airborne precautions. Use a face shield or goggles if splashing or spraying of body fluids might occur. Strictly follow infection control protocols for hand hygiene and disinfection or disposal of equipment.

If a patient with monkeypox is recovering at home, he should be isolated in his home; he should stay in a private room and minimize contact with others if he has respiratory symptoms or lesions that aren't easily covered. 

 Teach his caregivers to follow strict hand hygiene and other infection control measures, including the use of personal protective equipment as appropriate. To prevent infection hazards from fomites, provide this advice to patients and their families:

* Don't shake bedding, towels, or clothing, which may release airborne droplets.

* Launder bedding and clothing with warm water in the washing machine and dryer. Bleach may be added, but isn't required.

* Don't share dishes or eating utensils with the patient. Clean the patient's dishes and utensils as usual in a dishwasher or by hand with soap and warm water.

* Clean and disinfect contaminated surfaces with a standard household disinfectant.

* Place soiled dressings and disposable medical equipment in a plastic bag and place it in another container for disposal with the household trash.