Leishmaniasis : What Is It ? Natural Treatment, Nursing Management and Advice For Patient

Leishmaniasis : What Is It ? Natural Treatment, Nursing Management and Advice For Patient

Is infection by a species of the genus leishmania. The disease is classified as:

1) Cutaneous leishmaniasis
2) Visceral leishmaniasis (Kala-azar disease)
3) Mucocutaneous leishmaniasis (espundia)

Epidemiology

The disease occurs in large areas of Asia, Latin America, and Africa. It is transmitted by bite of Sand fly and cause a variety of illness is from skin sores to involvement of different internal organs, and as a result it may lead to death.

Cutaneous and mucocutaneous leishmaniasis

Cutaneous leishmaniasis

Caused by protozoan which has three varieties

a) Leishmania ethiopica
b) Leshmania brasiliensis
c) Leshmania mexicana
d) Leshmania aethiopica

But mucocutaneous leishmaniasis is caused by leishmania viannia, agroup of organism called leishviabraziliensis found in central & South America.

a) Reservoir – Animal (rats, wild rodent domestic animals like dog, cat) and infected human

b) Incubation period – from a day to months

c) Clinical picture

The first lesion start with a papule it can grow to nodules or it can be ulcerated and can be covered with crust.

Lesions are small papules that develop in to non-ulcerated dry plaques or large encrusted ulcers with well-demarcated raised and indurate margin.

-The lesion may be single, multiple or diffuse may be self limiting or can be chronic

-If it is mucocutaneous the lesion appears as single or multiple papules. The lesion first is nodular and then becomes ulcerated and wart like that can be painful. Some times the lesion appears as single nodule but later on can be indurate and involve on nasal mucosa and skin and lead to destructions.

-In case of diffuse cutaneous leishmania which is caused by L-Mexican and L. aethiopica, the multiple modules lesion is a non ulcering lesion, and occurs on the entire body

-Involvement of lesion in naso -pharyngeal tissue, is severely disfiguring and often fatal

Mucocutaneous leishmaniasis causes extensive destruction of the soft tissue & cartilage of the nose, oral cavity and lip and extends to the larynx & pharynx.

d) Management and nursing intervention

No effective treatment exists but the following can be use

1. Administer Sodium antimony gluconate IV or IM in a single daily dose 10 mg/kg for adult.

2. For incomplete response and relapse case give 20 mg / kg for 40to 60 days, but electro- cardio -graphic monitoring is important during prolonged use, because the drug will cause cardiac problems

3. As alternative Oral allpurinol 20 to 30 /kg /day in three divided doses is effective

4. Treat secondary infection.

5. For resistance cases,amphotericin 0.5 to 1 mg/kg on alternative days or pentamidine 3 – 4 mg/kg three times/ week for 5 to 25 wks

6. Properly cleaning the wound.

7. Electro cauttry or cryotherapy using liquid nitrogen lesion can be freezed .

NB: Additional Activities expected to be carried out by BSc nurses additionally are: Assessing, Diagnosing, Planning, Prioritizing, Implementing, and evaluation of patients care progress.

Summary of care

A. General nursing assessment for a patient with skin impairment

-Potential for pressure sore due to poor skin care

-Assess individual nutritional status, circulatory status, degree of mobility, whether able to self-care or not able to exercise, and mental alertness are assessed.

-Inspect skin at frequent intervals

-Areas subjected to weight bearing and friction should be given special attention

-Vulnerable areas, sacral region, buttocks, ischal tubersity, spinal processes, scapular areas, occipital areas, ears, elbows, knees and heels should be checked since they are prone to bed sores

-Assess for skin abnormality indicators such as lesion, pruritus, urticaria,.pain, redness, scaling, itching and scratching.

-Check for bacterial infection

-Check for scaring that may lead to stress psychologically.

B. Nursing intervention to maintain skin integrity or to treat skin impairment:

-Encourage cleanliness of the skin regularly
-Apply topical ointment when necessary
-Provide regular skin bathing
-Promote patient ambulation as early as possible if admitted patient
-Have a patient change position frequently
-Teach people to inspect their skin regularly
-Assess the risk factor for skin problems
-Maintain hygiene and cleanliness
-Prevent mechanical, physical and chemical injury to the skin
-Avoid any irritants to the skin
-Ensure adequate nutrition and hydration
-Educate or teach individuals, family and those who give skin care.
-Avoid friction with/on the skin.
-Remove the irritant factor.
-Re-assure the family and patient.

C. Evaluation: After carrying out nursing activities under intervention, try to re-asses the condition of skin whether it is improved or not so that you can redesign your plan of treatment.

Thanks For Vsiting ! Keep Your Healthy !

Leishmaniasis : What Is It ? Natural Treatment, Nursing Management and Advice For Patient 2018-12-26T00:28:00-08:00 Rating: 4.5 Diposkan Oleh: David Maharoni