Stevens-Johnson Syndrome is a potentially deadly skin disease that usually results from a drug reaction. Another form of the disease is called Toxic Epidermal Necrolysis, and again this usually results from a drug-related reaction. Both forms of the disease can be deadly as well as very painful and distressing. In most cases, these disorders are caused by a reaction to a drug, and one drug that has come under fire lately is the cox-2 inhibitor Bextra, which is already linked to these disorders.
Symptoms
Other symptoms that may occur with this disease:
1. Imbalanced Nutrition Less Than Body Requirements
related to difficulty swallowing
Expected Outcomes: Demonstrate stable weight / weight gain
Intervention:
1. Assess food habits are preferred / not preferred.
Rational: give the patient / significant others a sense of control, increasing participation in treatment and may improve revenue
2. Serve in warm food.
Rationale: increased appetite
3. Give portions to eat little but often.
Rational: helps prevent gastric distension / discomfort
4. Collaboration with a dietitian.
Rational: calories, protein and vitamins to meet the increased metabolic demands, maintain weight and promote tissue regeneration.
2. Impaired skin integrity
related to inflammatory dermal and epidermal
Expected Outcomes: Shows the skin and skin tissue intact.
Intervention:
1. Use a thin clothing and soft loom.
Rational: reduce irritation and pressure from the suture line of clothes, leave the incision open to air increases the healing process and reduce the risk of infection.
2. Observation of skin turgor circulation daily notes and sensory as well as other changes that occur.
Rational: determining a baseline by which changes in status can be compared and appropriate intervention
3. Keep loom is used.
Rationale: to prevent infection.
3. Activity Intolerance
related to physical weakness
Expected Outcomes: Clients reported increased activity tolerance
Intervention:
1. Assist clients in meeting their daily activities with the limitations of the client.
Rational: the energy expended is more optimal.
2. Assess the individual response to the activity.
Rational: determine the level of the individual's ability to fulfill their daily activities.
3. Involve the family in fulfilling client's activities.
Rationale: The client has the support of family psychology.
4. Explain the importance of energy restriction.
Rational: vital energy to help the body's metabolic processes
4. Acute Pain
related to inflammation of the skin
Expected Outcomes: Reported reduced pain, Facial expressions / body posture relaxed
Intervention:
1. Assess complaints of pain, note the location and intensity.
Rational: pain is almost always present in some degree of severity of tissue involvement
2. Monitor vital signs.
Rational: IV method is often used in early to maximize the effects of the drug.
3. Provide basic comfort measures ex: massage at an area hospital.
Rational: increase relaxation, reduce muscle tension and general fatigue
4. Give analgesics as indicated.
Rational: to relieve pain.
Symptoms
- Fever
- General ill feeling
- Itching of the skin
- Joint aches
- Multiple skin lesions: Start quickly and may return, May spread, May appear as a nodule, papule, or macule and may look like hives, Central sore surrounded by pale red rings, also called a "target", "iris", or "bulls-eye", May have vesicles and blisters of various sizes (bullae), Located on the upper body, legs, arms, palms, hands, or feet, May involve the face or lips, Usually even on both sides (symmetrical)
Other symptoms that may occur with this disease:
- Bloodshot eyes
- Dry eyes
- Eye burning, itching, and discharge
- Eye pain
- Mouth sores
- Vision problems
1. Imbalanced Nutrition Less Than Body Requirements
related to difficulty swallowing
Expected Outcomes: Demonstrate stable weight / weight gain
Intervention:
1. Assess food habits are preferred / not preferred.
Rational: give the patient / significant others a sense of control, increasing participation in treatment and may improve revenue
2. Serve in warm food.
Rationale: increased appetite
3. Give portions to eat little but often.
Rational: helps prevent gastric distension / discomfort
4. Collaboration with a dietitian.
Rational: calories, protein and vitamins to meet the increased metabolic demands, maintain weight and promote tissue regeneration.
2. Impaired skin integrity
related to inflammatory dermal and epidermal
Expected Outcomes: Shows the skin and skin tissue intact.
Intervention:
1. Use a thin clothing and soft loom.
Rational: reduce irritation and pressure from the suture line of clothes, leave the incision open to air increases the healing process and reduce the risk of infection.
2. Observation of skin turgor circulation daily notes and sensory as well as other changes that occur.
Rational: determining a baseline by which changes in status can be compared and appropriate intervention
3. Keep loom is used.
Rationale: to prevent infection.
3. Activity Intolerance
related to physical weakness
Expected Outcomes: Clients reported increased activity tolerance
Intervention:
1. Assist clients in meeting their daily activities with the limitations of the client.
Rational: the energy expended is more optimal.
2. Assess the individual response to the activity.
Rational: determine the level of the individual's ability to fulfill their daily activities.
3. Involve the family in fulfilling client's activities.
Rationale: The client has the support of family psychology.
4. Explain the importance of energy restriction.
Rational: vital energy to help the body's metabolic processes
4. Acute Pain
related to inflammation of the skin
Expected Outcomes: Reported reduced pain, Facial expressions / body posture relaxed
Intervention:
1. Assess complaints of pain, note the location and intensity.
Rational: pain is almost always present in some degree of severity of tissue involvement
2. Monitor vital signs.
Rational: IV method is often used in early to maximize the effects of the drug.
3. Provide basic comfort measures ex: massage at an area hospital.
Rational: increase relaxation, reduce muscle tension and general fatigue
4. Give analgesics as indicated.
Rational: to relieve pain.
