NCLEX and CGFNS - MEDICAL SURGICAL NURSING: August 2008

Paronychia is a suppurative inflammation of the nail fold surrounding the nail plate; may be due to bacteria or fungi, most commonly staphylococci and streptococci. It most commonly occurs in middle-aged women and in the client with diabetes mellitus.

Person who has paronychia will have painful, redness and swelling around the nailbed, and soreness at nailbed. There may be pus-filled blisters, especially with a bacterial infection. Because of paronychia, the nail may look detached, abnormally shaped, or have an unusual color.

There are three types of paronychia :

Bacterial paronychia that is caused by bacteria.
Candidal paronychia that is caused by a specific type of yeast.
Fungal paronychia that is caused by a fungus other than Candida.

Nursing Intervention for paronychia:

Monitor temperature
Monitor for infection around the nails
Monitor for cellulitis in the affected area
Soaking the nail in hot water 2 or 3 times a day helps reduce inflammation and pain
Incision and drainage of infected area if prescribed
Antibiotic and fungicidal ointments as prescribed

Kaposi’s Sarcoma is a multifocal malignant neoplasm that occur primarily in individuals with a compromised immune system such as AIDS. It is clinically manifested by cutaneous lesions consisting of reddish-purple to dark-blue macules, plaques, or nodules, that seen most commonly in men over 60 years of age.

Kaposi’s sarcoma may first appear on the feet or ankles, thighs, arms, hands, or face. Organ involvement includes the lymph nodes, airways or lungs, or any part of the gastrointestinal tract from the mouth to anus. So person has Kaposi’s Sarcoma may also has bleeding from gastrointestinal lesions, shortness of breath from lesion in the lung, and bloody sputum from lesions in the lung. Refer to images (end of this article)

Treatment of Kaposi’s sarcoma will depend on the extent and location of the lesions, person’s symptoms, and degree of immunosuppression. Radiation therapy, cryotherapy or chemotherapy also may be used for lesions in certain areas.