The Power of Fever: A Healing Response in the Body

This assignment discusses the case of Mary who develops a wound infection due to Staphylococcus aureus bacteria. The endogenous source of contamination is her own normal microbiota on the skin, which can remain in deep crevices and sweat glands. The exogenous source is the hospital setting where she received a tetanus booster, with cross-infection from patients or healthcare workers being a common route. Augmentin antibiotic was prescribed due to the high likelihood of MRSA resistance. Staphylococcus aureus infection can be treated effectively with Augmentin, which is a combination of amoxicillin and clavulanic acid.

1Running head: NURSING
Nursing
Name of student:
Name of university:
Author note:

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Q1.
1. Tetanus is caused by the bacteria Clostridium tetani. This is a serious concern as Mary
might develop tetanus due to infection with the bacteria when coming in contact with
manure, leading to severe medical complications. Tetanus also called as lockjaw, is the
condition in which muscle spasms are severe. The spasms initiate in the jaws and
successively progresses to the other parts of the body. The most adverse impact is bone
fracture; other complications include a headache, fever increased heart rate and trouble in
swallowing. Recovery takes months, depending on the patient, and research indicates that
around 10% of the individuals infected with this disease die.
2. The guidelines in The Australian Immunisation Handbook state that administration of
tetanus booster. The rationale for giving Mary the tetanus booster is to reduce the chances of
the infection. A booster vaccine is to be given to any individual who has suffered a puncture
wound and is uncertain of his last vaccination. In the present case, Mary had suffered a deep
4 cm cut to her right calf. The booster would help in the formation of tetanus antibodies
within the patient’s body within a short span of time (immunise.health.gov.au, 2017).
Q2.
1. The three wound observations for Mary were wound edges to be red and hot to touch;
swelling in surrounding tissues, odorous and purulent discharge. These three observations are
signs and not symptoms of the condition. According to (Marieb & Hoehn, 2016), a symptom
is the subjective evidence of any disease. In contrast, a sign is the objective evidence of any
disease. Thus, a symptom is the set of occurrences experienced by the individual who has
been effected by the disease; a sign is the set of occurrences that can be detected easily by
other individuals in addition to the person who has developed the disease. In the present case,
the three observations could be detected by individuals other than Mary.

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2. Tissue injury due to the deep cut suffered by Mary has led to the red and hot wound edges
as a result of the inflammatory response. The initial stimulation due to tissue injury is
responsible for the release of inflammatory chemicals. Inflammation is triggered due to injury
in the body, and the role is to prevent the spreading of damaging agents to the tissues that are
in the surrounding. The common inflammatory chemicals are histamine, complement, kinins
and prostaglandins. The chemicals promote vasodilation of the arterioles and promote the
formation of exudates. The triggering of inflammation consequently leads to dilation of
arterioles. This process leads to increased blood flow to the area of injury. The process is
termed as local hyperaemia. The subsequent results are increased heat in the area and redness.
3. Swelling in the are of the wound is another result of the inflammatory response triggered
by the body. Release of cells like kinins and prostaglandins lead to increased capillary
permeability. As a result of this, the capillaries leak fluid, and the fluid that is highly rich in
protein gets filled up in the tissue spaces. The ultimate result is the swelling of the tissues.
4. Inflammatory chemicals such as histamine and kinin increase the permeability of the local
capillaries. Exudates that contains antibodies and clotting factors are swept from the blood.
This is the cause of exudates formation, commonly the odorous and purulent discharge
(Marieb & Hoehn, 2016).
Q3.
1. Inflammation occurring in the wound area is the localised response that the body develops
to the infection. However, the response of the body to the way microorganisms invade the
body is at times more severe and widespread. Fever is the abnormally high body temperature
that is the systematic response of the body against the microorganisms that have invaded
Mary’s body through the wound site. When macrophages and leukocytes get exposed to any
incoming foreign body entering the patient’s body, chemicals known as pyrogens are

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released. The pyrogens function on the thermostat of the body. As the action is on the neuron
cluster present in the hypothalamus, the temperature of the body rises above the normal level.
2. Fever is the adaptive response of the body that has distinct benefits for the individual.
Firstly, fever causes the spleen and the liver to sequester zinc and iron. This makes the spleen
and liver less available for supporting the growth of bacteria. In addition, fever is responsible
for increasing the tissue cell’s metabolic rate. As a result, the repair process becomes faster
within the body (Craft & Gordon, 2015).
Q4.
1.The endogenous source of contamination for Staphylococcus aureus is normal microbiota
of the skin on Mary. Endogenous infections occur when the pathogen is already present in the
host itself. The resident microbiota of the individual's skin remains in deep crevices of the
skin layers and sweat glands. The mentioned organism is one of the common organisms
present in human skin. The organism prefers to remain in a moist environment within the
skin. Nasal carriers of the organism are known to transfer the organism from the nose to the
open wound in the body. In the present case, this is the possibility of Mary developing
infection at the wound site. When such a passage occurs, the area around the wound is
perceived to be a suitable site for causing infection.
2. The exogenous source of contamination for Staphylococcus aureus is the hospital setting
where Mary had received the tetanus booster. Exogenous infections are acquired that are
termed as healthcare associated infections (HAI). The other name for such form of infection
is a nosocomial infection. Exogenous infections occur when organisms from the surroundings
of external environment infect the individual. Cross infection from patients within a clinical
setting is common. In healthcaresettings, people spread such infections as others are
contaminated with the organism. The route of transmission is person to person contact. It is

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likely that Mary had come in contact with an individual in the clinical setting who had the
particular infection. Unrelenting nasal carriage of .S aureus is strongly associated with an
increased risk for development of nosocomial infections such as bacteraemia and wound site
infections. This is more prominent in case of patients who are immunocompromised.
Insufficient health hygiene of care workers is a prime cause of such infections. The bacterium
is able to survive in hospitals under normal conditions. Regular mode of transmission is
hands of the workers who are contaminated from the already infected patient, before passing
off to another individual (Lee & Bishop, 2016).
Q5.
1. Given that the colonizing organism was Staphylococcus aureus, Augmentin was an
appropriate prescription. There are high chances that the strain of Staphylococcus aureus is
resistant to the antibiotic methicilin (MRSA). Augmentin is the penicillin antibiotic that
contains a combination of clavulanate potassium and amoxicillin, and empirical evidence
indicates that it is highly effective against infection with Staphylococcus aureus, particularly
MRSA.
2. Augmentin is an effective antibacterial drug since it is the combination of amoxicillin and
clavulanic acid. Due to this combination of ingredients, the drug is effective against different
infections such as urinary tract infection, sinusitis, ear infection, pneumonia and bronchitis. It
is a beta-lactamase inhibitor which is highly indicated in the treatment of infections as it is
effective against susceptible isolates of different bacteria. Augmentin does not have a
particular benefit over amoxicillin alone. The combination with clavulanic acid is more
powerful. This drug is the first line choice of drug for these infections if the symptoms are
more precisely vomiting and fever (Bullock & Manias, 2017).

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References
Bullock, S., & Manias, E. (2017). Fundamentals of pharmacology (8th ed.). Frenchs Forest,
Australia: Pearson Australia.
Craft, J., & Gordon, C. (Eds.). (2015). Understanding pathophysiology (2nd Australian and
New Zealand ed.). Chatswood, Australia: Elsevier. Available Online
Department of Health. (2017). 4.19 Tetanus. Retrieved from
http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/
Handbook10home~handbook10part4~handbook10-4-19
Lee, G., & Bishop, P. (Eds.). (2016). Microbiology and infection control for health
professionals (6th ed.). Melbourne, Victoria: Pearson Australia.
Marieb, E.N., & Hoehn, K. (2016). Human anatomy & physiology (10th global ed.). Harlow,
United Kingdom: Pearson Education.