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Biblio, Nrsg and Medical Mgt

Biblio, Nrsg and Medical Mgt

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Published by: hsiria on Jun 03, 2009
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A Case Study Amoebiasis
Nursing Diagnosis Handbook: A Guide to Planning Care7
Edition by Betty J. Ackley and Gail B. Ladwig
Nurse’s Pocket Guide Diagnosis, Prioritize Interventionsand Rationales 10
Edition by Manilyn E. Doengens,M.F. Moorhouse, A.C. Murr
Handbook of Common Communicable and InfectionsDisease by Dionesia Monagar-Navales RN, MA Ed.
Nursing Diagnosis Reference Manual 6
Edition bySheila Sparks Ralph, RN, DNSC, Faan and Cynthia M. Taylor, RN, MS.
PPD’S Nursing Drug Guide 2007 Edition by Malan Press
Nursing 2008 Drug Handbook 28
Edition by LippincottWilliams and Wilkins
 The American Medical Dictionary and Health Manual byRobert E. Rothenberg
A Case Study Amoebiasis
E. histolytica
infections occur in both the intestine and in tissue of theintestine and/or liver. As a result two different sorts of drugs areneeded to rid the body of the infection, one for each location.Metronidazole, or a related drug such as Tinidazole,Secnidazoleor Ornidazole, is used to destroy amebae that have invaded tissue. Theseare rapidly absorbed into the bloodstream and transported to the siteof infection. Because they are rapidly absorbed there is almost noneremaining in the intestine. Since most of the amebae remain in theintestine when tissue invasion occurs, it is important to get rid of thosealso or the patient will be at risk of developing another case of invasivedisease. Several drugs are available for treating intestinal infections,the most effective of which has been shown to beParomomycin(alsoknown as Humatin);Diloxanide Furoate(also known as Furamide) isused in the US andIodoquinol(also known as Yodoxin) is used incertain other countries. Both tissue and lumenal drugs must be used totreat infections, with Metronidazole usually being given first, followedby Paromomycin or Diloxanide.
E. dispar 
does not require treatment,but many laboratories (even in the developed world) do not have thefacilities to distinguish this from
E. histolytica
.For amebic dysentery a multi-prong approach must be used, startingwith one of:
Metronidazole500-750mg three times a day for 5-10 days
 Tinidazole2g once a day for 3 days is an alternative tometronidazoleIn addition to the above, one of the following luminal amebicidesshould be prescribed as an adjunctive treatment, either concurrently orsequentially, to destroy
in the colon:
Paromomycin500mg three times a day for 10 days
Diloxanide furoate500mg three times a day for 10 days
Iodoquinol650mg three times a day for 20 daysFor amebic liver abscess:
Metronidazole 400mg three times a day for 10 days
 Tinidazole 2g once a day for 6 days is an alternative tometronidazole
Diloxanide furoate 500mg three times a day for 10 days (or oneof the other lumenal amebicides above) must always be givenafterwardsDoses for children are calculated by body weight and a pharmacistshould be consulted for help.
1.Observe isolation and enteric precaution2.Provide health education and instruct patient to:A.Boil water for drinking or use purified waterB.Avoid washing food from open drum or pailC.Cover leftover foodD.Wash hands after defecation or before eating and;E.Avoid ground vegetables ( lettuce, carrots, and the like )
A Case Study Amoebiasis
 TurbidSL. HAZYTurbid (cloudy) urinemay be caused byeither normal orabnormal processes.Observe properhygiene and limitintake of starchyand highlysugared foods
1.0301.010 -1.030High specific gravity(above 1.035) occursin patients who are inshockor who sufferfromnephroticsyndrome, dehydration, acuteglomerulonephritis,congestiveheartfailure,or liver failure.Increase oral fluidintake to avoiddehydration
 TraceThere is indication oprotein in the urineIncrease oral fluidintake to keep theright amount of fluid circulatingthroughout yourbody
10-15 / HPF 10-15 /HPFEvidence of inflammation with orwithout infection of thelower GI tractAvoid highlyseasoned foodsthat can irritatethe GI tract
ModerateModerateIndicative of wrongspecimen collectionPractice idealmethod incollectingspecimen
ModerateModerateIf present- GUTinfection/contamination of external genitaliaFrequently cleanthe perianal area

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