Fournier's gangrene is a rare disease with a significant mortality rate. The potentially fatal disease stems from both aerobic and anaerobic bacteria and primarily occurs in men. The majority of Fournier's gangrene cases are idiopathic or derived from perineal and genital skin infections. Comorbid risk factors include diabetes mellitus, alcohol misuse, and immunosuppression (Benjelloun et al., 2013). The infection initially presents as a cellulitis in the perineum or perianal area. As Fournier's gangrene progresses, the infected tissue becomes swollen, significantly painful, and necrotic. The progression of infection can lead to systemic symptoms, sepsis, and death. Early intervention is a key component in the treatment plan for Fournier's gangrene. The primary intervention is surgical debridement of the necrotic tissue. If an abscess is present, incision and drainage are indicated. In addition to surgical debridement, the administration of broad-spectrum antibiotics and hemodynamic stabilization are required (Cottrill, 2013). Complications after treatment include chronic pain, sexual dysfunction, decreased sensation of the penile skin, and scarring (Benjelloun et al., 2013).
Measles, mumps, and rubella have impacted millions of American lives over the last 100 years. During the last century, researchers have identified viral diseases, developed a combination vaccine, and have continued ongoing research when outbreaks have occurred. Despite the high incidence of vaccinated individuals, these highly communicable diseases continue to flourish within clusters of outbreaks throughout the United States. Emergency medicine providers play a key role in early recognition and diagnosis of the disease. The proper management and reporting reflect the emphasis on prevention of widespread outbreaks.
The purpose of the article was to understand that the variations in common surgical procedures, physical, laboratory, and radiographic examinations that are typical in the postoperative patient can help direct treatment options. Nurse practitioners in outpatient settings need to quickly identify and treat postoperative complications. This article discusses three postoperative patients who presented to the emergency department. Data sources included personal health records and review of literature. Various factors that decrease hospital readmission rates include proper discharge education regarding signs and symptoms of infection, importance of medication compliance, and appropriate follow-up care. In addition, the outpatient nurse practitioners' knowledge of the surgical patient and common postoperative ailments will aid in more effective treatment and communication between the nurse practitioner and the surgeon if necessary. Nurse practitioners who have a better understanding of potential postoperative complications will be better equipped to care for this patient population when encountered in a nonsurgical, outpatient setting.
Patient anxiety related to prostate cancer surgery may lead to reduced patient satisfaction. Repeated reinforcement of pre-operative education to reduce anxiety greatly impacts provider time. Improved knowledge retention of what to expect postoperatively may reduce patient anxiety. This quality improvement project demonstrated that a take-home educational video supports patient knowledge retention, reduces patient anxiety, increases patient satisfaction, and saves postoperative provider time.
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