COMPLICATIONS of SJS

• Ophthalmologic
• Gastroenterologic
• Genitourinary
• Pulmonary
• Cutaneous
MEDICAL MANAGEMENT
 1 Step:
st

STOP INTAKE OF
OFFENDING
AGENT
(if Drug-Related)
 Approach:
BURN
MANAGEMENT
• Airway and Hemodynamic Stability
• Fluid Resuscitation (using
Parkland formula)
• Wound/Burn Care
• Pain Control
Treatment is primarily
SUPPORTIVE
AND
SYMPTOMATIC
 PHARMACOLOGIC MGT.

• Cyclophosphamide
• Plasmapheresis
• Hemodialysis
• Corticosteroids
• Immunoglobulin
• Mouthwashes for oral cavity
sores
• Eyedrops for eye infection
• Analgesic medications for pain
NURSING MANAGEMENT
 NURSING DIAGNOSES
• Impaired tissue integrity related to
epithelial shedding
• Deficient fluid volume and electrolyte
losses related to loss of fluids from
denuded mucosa
• Risk for imbalanced body temperature
related to heat loss secondary to
epidermal denudation
 NURSING DIAGNOSES
• Potential Complications: Sepsis and
Keratoconjunctivitis
• Acute Pain related to denuded skin, oral
lesions, and possible infection
• Body Image Disturbance related to
changes in physical appearance and
threat of death
Nursing Interventions
 Impaired tissue integrity
• Apply topical agents to prevent infection
and hasten healing
• Apply warm compresses gently at
denuded areas
• Encourage body and oral hygiene
• Monitor for: rupture of bullae, new lesions,
seepage from lesions
• Inspect oral cavity for blistering and
erosive lesions
 Impaired tissue integrity
• Inspect for itching, burning, and drying of
the eyes
• Regularly check on patient’s ability to
swallow fluids
• Monitor vital signs (pay close attention to
presence and character of fever; RR,
depth, rhythm, and presence of cough and
respiratory secretions)
• Assess pain and fatigue levels regularly
 Fluid and Electrolyte Losses
• Monitor V/S, I/O, and sensorium for signs
of hypovolemia
• Periodically check on laboratory values
(blood chemistry, U/A, CBC)
• Weigh patient if possible
• Administer IVFs as prescribed
• Increase OFI as tolerated
• Provide Oral and Eye care to prevent inury
due to dryness
• Monitor for signs of dehydration
 Imbalanced Body Temperature
• Conserve body heat (may use blankets,
covered clothing, heat lamps)
• Work rapidly and efficiently when skin is
exposed
• Monitor V/S with temperature
 Potential Complications
• Maintain strict asepsis during routine skin
care measures
• Administer medications as prescribed
• Provide optic, oral, and skin care as
indicated
• Monitor for signs of development of
complications
 Acute Pain
• Administer analgesics as prescribed
• Provide thorough explanations and speak
in a calm manner before and after
treatments to allay anxiety
• Implement measures that promote rest
and sleep
• Perform non-pharmacologic measures of
pain relief
• Put on position of comfort; TTSq2h
 Body Image Disturbance
• Establish trusting relationship
• Visit frequently and acknowledge the
patient as someone who is worthwhile
• Provide assistance with self-care needs
while promoting independence/individual
abilities
• Acknowledge and accept feelings of
dependency, grief, etc.
 Body Image Disturbance
• Encourage verbalizations
• Provide accurate information as
desired/requested
• Offer positive reinforcement for efforts
made