steven johnson syndromemonika 6-6-2011
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MEDICAL
CASE PRESENTATION ON
STEVEN JOHNSON SYNDROM
BY MONICA SWAMIG.N.M.2nd year
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Anatomy of Skin
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Person with Steven Johnson Syndrome
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Definition
Steven Johnson Syndrome is a fatal skin
disorder and the most severe form of
erythematic multiform:- The mortality rate from (SJS) approaches
(30%) .
Antibiotic ant seizure agents but zones
and sulfonamide are the most frequent
medications implicated in (SJS).
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Introduction
SJS disease are mucocutaneous reactions
that constitute a spectrum of reactions, with
SJS being the most severe.
Mortality Rate :- The mortality rate from SJSare trigger by reaction of Medications,
Antibiotics epically Sulfonamides, Ant
seizure agents .Note: - Sulfonamides are the most frequent
medications implicated.
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Clinical Manifestations
SJS is Characterized by conjunctiva burning
or itching.
Coetaneous tenderness, fever, cough, sore-throat,headache,extrememalais and myalgias
(aches& pain).
These signs are followed by a rapid onset
of erytemia involving much of skin surfaceand mucous membrane including the oral
mucosa, and conjunctiva any genitalia
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Incidence Increase in
a. The incidence is increased in older peoplebecause of their use of many medications.
b. People wit (HIV) particularly those with
acquired immunodeficiencysymdrome(AIDS) and other who areimmunocompromised are at the higher riskfor (SJS).
Risk Associated with:- Sulfonamide in (HIV)positive individuals may approach 1 case per1000 odometal 2000.
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Diagnostic Finding
1. Histologic studies of frozen skin cells
from a fresh lession and cytodiagnosis
collection of celluar material from a freshy
denuded area are performed.
2. A genetic Predispostion to erythemia
multiform has been suggested but not
confirmed for all case.
Condiction Effecing :- all ages both genders.
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Nursing Process
1. A careful inspection of skin is made
including its appearance and the extend
of involvements.
2. Pt. vital sign monitor and special attention
is given to the rhythm, and cough.
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Risk Factor In My Patient
Reactions of medicines.
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Clinical Manifestation in my Patitent
Conjunctival Burning.
Cutaneous Tenderness.
Fever.Pain in Hole Body.
Bleeding from lips.
Skin Colour is gone Black.
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PathoPhysiology
It is Unknown.
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Complications
Sepsis and Kerato conjuctivitis are
Complications of (SJS).
Un recognized and untreated sepsis can be life
threatening.
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Progress During Conversation
21.4.011- I took history ofPt. when she was
telling me how she met with this disease her
words was not clear.
22.4.011 I went to pt. room she was feeling
well the words she was saying was some
correct her lips was bleeding.
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Nursing Management
Medical Management
The goals of treatment include control of fluidand electrolyte balance, prevention of sepsis and
prevention of Opthalmic complications.Supporative care is the main treatment.
All nonessential medications are discontinuedimmediately.
If possible pt. is treated in a regional burn centre,because aggressive treatment similar to that forsevere burn is required.
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Nursing Care Plan
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