MRSANursing Care Plans Diagnosis and Interventions
MRSA NCLEX Review and Nursing Care Plans
Methicillin-resistant Staphylococcus aureus MRSA is a type of infection caused by S. aureus bacteria and is known to show resistance to many antibiotic therapies that can usually treat ordinary staph infections.
Many MRSA cases involve people who have previously been admitted to the hospital, dialysis centers, or nursing homes. However, some MRSA cases are community-acquired in crowded places.
MRSA is mainly diagnosed with an MRSA swab test that determines whether the person is positive or negative to it. The treatment for MRSA is focused on the elimination of the pathogen while the infected person is isolated in the healthcare facility.
Signs and Symptoms of MRSA
- Swollen and painful red bumps on the skin- can contain pus or serous fluids
- Warm and/or inflamed skin
- Fever (may or may not be present)
Some patients who are MRSA positive may not present with any signs or symptoms.
Causes and Risk Factors of MRSA
MRSA emerged from many years of utilizing antibiotic unnecessarily, particularly when they were prescribed for viral infections such as flu and colds while they actually should not have been treated with such antibiotic therapy.
Bacteria evolve fast and develop resistance against the antibiotics. The risk factors of getting infected with MRSA include hospitalization, undergoing a surgical procedure or any invasive medical treatment, playing contact sports such as wrestling, use of intravenous drugs, and living in crowded places or long-term healthcare facility.
Complications of MRSA
Staphylococcus aureus bacteria can burrow deep into the skin, reaching an infection the bones, joints, lungs, heart valves, and the bloodstream.
Bronchiectasis, or the dilatation of the lung airways, can be a serious complication of MRSA infection. Antibiotic resistance makes the treatment for patient with MRSA and its complications difficult, as this enables the pathogen to spread to other parts of the body.
Diagnosis of MRSA
MRSA infection is diagnosed by collecting a nasal and groin swabs and sending the to the lab to grow for up to 48 hours, in a dish that contains nutrients that encourage the growth of the staph bacteria.
Treatment of MRSA
- Decolonization. If MRSA is found on the skin, the patient is given an antibacterial wash every day for a period of 5 days. There is an antibacterial cream called mupirocin (Bactroban) that will be applied in the nostrils 3 times a day for a period of 5 days. He/she is then re-swabbed to check if the MRSA bacteria have been eradicated.
- Isolation. The patient should be isolated in a room while receiving medical treatment in a hospital facility. The clothes, towels, and beddings need to be changed every day, and should be placed in a separate laundry bag and washed at a high temperature.
- Antibiotic therapy. Tetracycline or clindamycin can be used as antibiotic therapy for MRSA infections. It is important to note that rifampicin and fusidic acid should be used in combination and not as single treatments when treating MRSA, as using one of these on its own can result to an increased rate of antibiotic resistance. Glycopeptides like vancomycin can be used for severe MRSA infections of the skin and soft tissues.
- Incision and drainage. The infected wound or lesion may contain pus that can be needle-aspirated or drained from the skin or soft tissue.
Prevention of MRSA
- Proper hand hygiene and single use PPEs such as gloves and apron are needed to prevent the spread of hospital-acquired MRSA.
- Contact precaution can help reduce the risk of spreading MRSA from the infected or colonized patient to other patients and staff in the ward or unit.
- Open wounds should be covered by dry, sterile bandage or dressing to reduce the risk of infection.
Nursing Diagnosis for MRSA
MRSA Nursing Care Plan 1
Nursing Diagnosis: Infection related to MRSA as evidenced by positive MRSA bacterial swab culture result, temperature of 38.5 degrees Celsius, and increased white blood cell count
Desired Outcome: The patient will be able to avoid the development of an infection.
|MRSA Nursing Interventions||Rationales|
|Assess vital signs and monitor the signs of infection.||To establish baseline observations and check the progress of the infection as the patient receives medical treatment.|
|Administer the prescribed antibiotic for MRSA. The antibiotic choice is based on the result of the swab culture and sensitivity test.||To treat the underlying infection. Tetracycline or clindamycin can be used as antibiotic therapy for MRSA infections. Glycopeptides like vancomycin can be used for severe MRSA infections of the skin and soft tissues.|
|Place the patient in contact isolation. Explain to the patient the reason behind the need to isolate until the MRSA culture returns a negative result. Teach the patient to perform proper hand hygiene.||To reduce the risk of spreading the MRSA infection.|
|Perform MRSA decolonization as prescribed.||To eliminate the MRSA on the skin, the patient is given an antibacterial wash every day for a period of 5 days. There is an antibacterial cream called mupirocin (Bactroban) that will be applied in the nostrils 3 times a day for a period of 5 days.|
|Obtain a new swab sample for MRSA culture once the antibiotic therapy has been completed.||To confirm that the infection has been completely treated, or if there is a need to continue the same antibiotic therapy or shift to a different treatment.|
MRSA Nursing Care Plan 2
Nursing Diagnosis: Hyperthermia related to MRSA infection as evidenced by temperature of 38.5 degrees Celsius, rapid and shallow breathing, flushed skin, profuse sweating, and weak pulse.
Desired Outcome: Within 4 hours of nursing interventions, the patient will have a stabilized temperature within the normal range.
|MRSA Nursing Interventions||Rationales|
|Assess the patient’s vital signs at least every hour. Increase the intervals between vital signs taking as the patient’s vital signs become stable.||To assist in creating an accurate diagnosis and monitor effectiveness of medical treatment, particularly the antibiotics and fever-reducing drugs (e.g. Paracetamol) administered.|
|Remove excessive clothing, blankets and linens. Adjust the room temperature.||To regulate the temperature of the environment and make it more comfortable for the patient.|
|Administer the prescribed antibiotic and anti-pyretic medications.||Use the antibiotic to treat bacterial infection, which is the underlying cause of the patient’s hyperthermia. Use the fever-reducing medication to stimulate the hypothalamus and normalize the body temperature.|
|Offer a tepid sponge bath.||To facilitate the body in cooling down and to provide comfort.|
|Elevate the head of the bed.||Head elevation helps improve the expansion of the lungs, enabling the patient to breathe more effectively.|
More MRSA Nursing Diagnosis
Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon
Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon
Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon
Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon
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