A Case Study Amoebiasis

BIBLIOGRAPHY

• Nursing Diagnosis Handbook: A Guide to Planning Care

7th Edition by Betty J. Ackley and Gail B. Ladwig

• Nurse’s Pocket Guide Diagnosis, Prioritize Interventions

and Rationales 10th Edition by Manilyn E. Doengens,
M.F. Moorhouse, A.C. Murr

• Handbook of Common Communicable and Infections

Disease by Dionesia Monagar-Navales RN, MA Ed.

• Nursing Diagnosis Reference Manual 6th Edition by

Sheila 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 28th Edition by Lippincott

Williams and Wilkins

• www.wikipedia.com

• http://health.msn.com

• http://www.answers.com

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• www.cancerbackup.org.uk

• The American Medical Dictionary and Health Manual by

Robert E. Rothenberg

• http://www.udel.edu/medtech/mclane/UAreview.html
• http://kidney.niddk.nih.gov/kudiseases/pubs/proteinuria
• http://www.intelihealth.com
• http://www.astrologyzine.com/health/yeast-
infections.shtml
 A Case Study Amoebiasis
MEDICAL MANAGEMENT

E. histolytica infections occur in both the intestine and in tissue of the

intestine and/or liver. As a result two different sorts of drugs are
needed to rid the body of the infection, one for each location.
Metronidazole, or a related drug such as Tinidazole, Secnidazole or
Ornidazole, is used to destroy amebae that have invaded tissue. These
are rapidly absorbed into the bloodstream and transported to the site
of infection. Because they are rapidly absorbed there is almost none
remaining in the intestine. Since most of the amebae remain in the
intestine when tissue invasion occurs, it is important to get rid of those
also or the patient will be at risk of developing another case of invasive
disease. Several drugs are available for treating intestinal infections,
the most effective of which has been shown to be Paromomycin (also
known as Humatin); Diloxanide Furoate (also known as Furamide) is
used in the US and Iodoquinol (also known as Yodoxin) is used in
certain other countries. Both tissue and lumenal drugs must be used to
treat infections, with Metronidazole usually being given first, followed
by Paromomycin or Diloxanide. E. dispar does not require treatment,
but many laboratories (even in the developed world) do not have the
facilities to distinguish this from E. histolytica.
For amebic dysentery a multi-prong approach must be used, starting
with one of:
• Metronidazole 500-750mg three times a day for 5-10 days
• Tinidazole 2g once a day for 3 days is an alternative to
metronidazole
In addition to the above, one of the following luminal amebicides
should be prescribed as an adjunctive treatment, either concurrently or
sequentially, to destroy E. histolytica in the colon:
• Paromomycin 500mg three times a day for 10 days
• Diloxanide furoate 500mg three times a day for 10 days
• Iodoquinol 650mg three times a day for 20 days
For amebic liver abscess:
• Metronidazole 400mg three times a day for 10 days
• Tinidazole 2g once a day for 6 days is an alternative to
metronidazole
• Diloxanide furoate 500mg three times a day for 10 days (or one
of the other lumenal amebicides above) must always be given
afterwards
Doses for children are calculated by body weight and a pharmacist
should be consulted for help.

NURSING MANAGEMENT

1. Observe isolation and enteric precaution

2. Provide health education and instruct patient to:
A. Boil water for drinking or use purified water
B. Avoid washing food from open drum or pail
C. Cover leftover food
D. Wash hands after defecation or before eating and;
E. Avoid ground vegetables ( lettuce, carrots, and the like )
 A Case Study Amoebiasis
LABORATORY RESULTS

URINE

PHYSICAL NORMA INTERPRETATION NSG.

L CONSIDERATIO
VALUES NS
TRANSPAREN Turbid SL. HAZY Turbid (cloudy) urine Observe proper
CY: may be caused by hygiene and limit
either normal or intake of starchy
abnormal processes. and highly
sugared foods
SPECIFIC 1.030 1.010 - High specific gravity Increase oral fluid
GRAVITY : 1.030 (above 1.035) occurs intake to avoid
in patients who are in dehydration
shock or who suffer
from nephrotic
syndrome,
dehydration, acute
glomerulonephritis,
congestive heart
failure, or liver failure.
CHEMICAL
ALBUMIN : Trace There is indication of Increase oral fluid
protein in the urine intake to keep the
right amount of
fluid circulating
throughout your
body
MICROSCOPI
C
PUS : 10-15 / HPF 10-15 / Evidence of Avoid highly
HPF inflammation with or seasoned foods
without infection of the that can irritate
lower GI tract the GI tract
SQUAMOS: Moderate Moderate Indicative of wrong Practice ideal
specimen collection method in
collecting
specimen
BACTERIA : Moderate Moderate If present- GUT Frequently clean
infection/contaminatio the perianal area
n of external genitalia
 A Case Study Amoebiasis
FECES

RESUL NORMA INTERPRETAT NSG.

T L ION CONSIDERATIO
VALUES NS
CONSISTENC Water ĉ soft, GI Provide
Y: mucus and disturbances, rehydration
well- diarrhea therapy
formed
BACTERIA : Plenty Intestinal Administer
Infection antibacterial
drugs as ordered
YEAST CELLS: Few Infection Avoid consuming
foods that
support yeast
growth, such as
sugar (sucrose),
vinegar,
fermented or
pickled foods.
E. 0-1 / 0 HPF Acute Gastro Increase oral
HISTOLYTICA HPF Enteritis, fluid intake and
Amoebiasis emphasize strict
CYSTS:
proper hygiene