N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide • Inquire about exposure: animals in home and exposure to non-domestic animals • Review laboratory data o Test for rabies antibodies using the rapid fluorescent focus inhibition test (RFFIT) • Ask if animals in the home have been vaccinated for rabies Nursing diagnosis for rabies: • Risk for altered mental status related to central nervous system breakdown, secondary to rabies virus infection • Risk for ineffective breathing pattern related to central nervous system breakdown • Risk for skin infection related to animal bite • Knowledge deficit regarding rabies, immunization of domestic animals, treatment, and risks of transmission Nursing interventions for rabies: • Monitor for changes in mental status and level of consciousness • Monitor respiratory status and central nervous system/cranial nerve function • Administer rabies vaccination as soon as possible, per MD order: o Rabies immune globulin: Given as soon as possible after exposure o Rabies vaccine: Four doses are given over a 14-day period, spaced at day three, day seven and day fourteen after the first injection; rabies injections are given in the arm and are almost painless o Tetanus-diphtheria booster: Another disease that can be transmitted via animal saliva • Wash bite wounds as soon as possible; flush with plenty of water • Give needed and supportive care for those experiencing symptoms of rabies infection; patient may require ICU admission for respiratory (ventilator) care • Use personal protective equipment (PPE) • Isolation and droplet precautions • Teach patient wound care measures and signs and symptoms of infection in wounds • Give antibiotics as ordered by MD for prophylaxis • Teach about rabies infection: stay away from non-domestic animals, vaccinate all domestic pets, and report any suspicious animals to animal control Expected outcomes for rabies: • Demonstrates appropriate level of consciousness and alert mental status • Demonstrates effective breathing pattern and adequate ventilation • Demonstrates proper wound healing without signs of infection • Verbalizes understanding of rabies, including symptoms of infected animals and vaccination ©2017 Achieve Test Prep Page 73 of 204

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