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Communicable Dse Reviewer

Communicable Dse Reviewer

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Published by: JanMiguel on Sep 18, 2009
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05/27/2014

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COMMUNICABLE DISEASE NURSINGSUMMER REVIEWCOMMUNICABLE DISEASE
Disease caused by an infectious agent that are transmitted directlyor indirectly to a well person through an agency, vector or inanimateobjectCONTAGIOUS DISEASE
Disease that is easily transmitted from one person to another INFECTIOUS DISEASE
Disease transmitted by direct inoculation through a break in theskinINFECTION-Entry and multiplication of an infectious agent into the tissue of thehostINFESTATION- Lodgement and development of arthropods on the surface of thebodyASEPSIS- Absence of disease – producing microorganismsSEPSIS- The presence of infectionMEDICAL ASEPSIS
-
Practices designed to reduce the number and transfer of pathogens
-
Clean
techniqueSURGICAL ASEPSIS
-
Practices that render and keep objects and areas free frommicroorganisms
-
Sterile
technique
CARRIER – an individual who harbors the organism and is capableof transmitting it without showing manifestations of the disease
CASE – a person who is infected and manifesting the signs andsymptoms of the disease
SUSPECT – a person whose medical history and signs andsymptoms suggest that such person is suffering from that particular disease
CONTACT – any person who had been in close association with aninfected personHOST- A person, animal or plant which harbors and provides nourishmentfor a parasiteRESERVOIR- Natural habitat for the growth, multiplication and reproduction of microorganismISOLATION- The separation of persons with communicable diseases from other personsQUARANTINE- The limitation of the freedom of movement of persons exposed tocommunicable diseases
STERILIZATION – the process by which all microorganismsincluding their spores are destroyed
DISINFECTION – the process by which pathogens but not their spores are destroyed from inanimate objects
CLEANING – the physical removal of visible dirt and debris bywashing contaminated surfacesCONCURRENT- Done immediately after the discharge of infectious materials /secretionsTERMINAL- Applied when the patient is no longer the source of infectionBACTERICIDAL- A chemical that kills microorganismsBACTERIOSTATIC- An agent that prevents bacterial multiplication but does not killmicroorganismsCHAIN OF INFECTIONINFECTIOUS AGENT
Any microorganism capable of producing a diseaseRESERVOIR
Environment or objecton which an organism can survive andmultiplyPORTAL OF EXIT
The venue or way in which the organism leaves the reservoir MODE OF TRANSMISSION
The means by which the infectious agent passes from the portal of exit from the reservoir to the susceptible hostPORTAL OF ENTRY
Permits the organism to gain entrance into the hostSUSCEPTIBLE HOST
A person at risk for infection, whose defense mechanisms areunable to withstand invasion of pathogensSTAGES OF THE INFECTIOUS PROCESS
Incubation Period – acquisition of pathogen to the onset of signsand symptoms
Prodromal Period – patient feels “bad” but not yet experiencingactual symptoms of the disease
Period of Illness – onset of typical or specific signs and symptomsof a disease
Convalescent Period – signs and symptoms start to abate andclient returns to normal healthMODE OF TRANSMISSIONCONTACT TRANSMISSION
Direct contact – involves immediate and direct transfer fromperson-to-person (body surface-to-body surface)
Indirect contact – occurs when a susceptible host is exposed to acontaminated objectDROPLET TRANSMISSION
Occurs when the mucous membrane of the nose, mouth or conjunctiva are exposed to secretions of an infected person within adistance of three feetVEHICLE TRANSMISSION
Transfer of microorganisms by way of vehicles or contaminateditems that transmit pathogensAIRBORNE TRANSMISSION
Occurs when fine particles are suspended in the air for a long timeor when dust particles contain pathogensVECTOR-BORNE TRANSMISSION
Transmitted by biologic vectors like rats, snails and mosquitoesTYPES OF IMMUNIZATION
ACTIVE – antibodies produced by the body
NATURAL – antibodies are formed in the presence of activeinfection in the body; lifelong
ARTIFICIAL – antigens are administered to stimulate antibodyproduction
PASSIVE – antibodies are produced by another source
NATURAL – transferred from mother to newborn through placentaor colostrum
ARTIFICIAL – immune serum (antibody) from an animal or humanis injected to a personSEVEN CATEGORIES OF ISOLATION
STRICT- prevent highly contagious or virulent infections
Example: chickenpox, herpes zoster 
CONTACT – spread primarily by close or direct contact
Example: scabies, herpes simplex
RESPIRATORY – prevent transmission of infectious distancesover short distances through the air 
Example: measles, mumps, meningitis
CD-Bucud 1
 
TUBERCULOSIS – indicated for patients with positive smear or chest x-ray which strongly suggests tuberculosis
ENTERIC – prevent transmission through direct contact with feces
Example: poliomyelitis, typhoid fever 
DRAINAGE – prevent transmission by direct or indirect contact withpurulent materials or discharge
Ex. Burns
UNIVERSAL – prevent transmission of blood and body-fluid bornepathogens
Example: AIDS, Hepatitis B
CENTRAL NERVOUS SYSTEM
MENINGO-COCCEMIAMENINGITISENCEPHALITIS
MAIN PROBLEMETIOLOGIC AGENTINCUBATION PERIODMODE OF TRANSMISSION
-
Inflammation of the brain
-
Inflammation of the meninges-Acute infection othe bloodstream anddeveloping vasculitis
-
Arboviruses
-
Streptococcus
-
Staphylococcus
-
Pneumococcus
-
Tubercle bacillus
-
Neisseriameningitides5-15 days1-10 days3-4 daysBite of infectedmosquitoRespiratory droplets
SIGNS AND SYMPTOMS OF ENCEPHALITIS
Virus enters neural cellsPerivascularcongestionDisruption incellularfunctioningInflammatoryreactionLethargyConvulsionsSeizuresHeadachePhotophobiaVomitingStiff neck FeverSore throat
SIGNS AND SYMPTOMS OF MENINGITIS
THREE SIGNS OF MENINGEAL IRRITATIONOPISTHOTONUSState of severe hyperextension and spasticity in which an individual’shead, neck and spinal column enter into a complete arching positionBRUDZINSKI’S SIGNPlace the patient in a dorsal recumbent position and then put handsbehind the patient’s neck and bend it forward.If the patient flexes the hips and knees in response to themanipulation, positive for meningitisKERNIG’S SIGNPlace the patient in a supine position, flex his leg at the hip and kneethen straighten the knee; pain and resistance indicates meningitis
SIGNS AND SYMPTOMS OF MENINGOCOCCEMIA
URTI:cough, sorethroat,fever,headache,nausea andvomitingVasculitis:petechialrash in thetrunk andextremitiesDICMicro-thrombosisPurpuraHypotensionShock Death
MENINGO-COCCEMIAMENINGITISENCEPHALITIS
SIGNS AND SYMPTOMSINCIDENCE
5-10 years old< 5 years old6 months5years oldStiff neck PhotophobiaLethargyConvulsionsNuchalrigidityOpisthotonusBrudzinski’sKernig’ssignVasculitisWaterhouse-FriderichsensyndromePetechiaewiththe developmentof hemorrhage
DIAGNOSTIC EXAM
Informed consent
Empty bowel and bladder 
Fetal, shrimp or “C” position
Spinal canal, subarachnoid space between L3-L4 or L4- L5
After: bedrest
Flat on bed to prevent spinal headache
MENINGO-COCCEMIAMENINGITISENCEPHALITIS
TREATMENT MODALITIESPREVENTION
1.JapaneseencephalitisVAX1.HiBvaccineDexamethasoneMannitolAnticonvulsantsAntipyreticsCeftriaxonePenicillinChloramphenicolRifampicinCiprofloxacin
MENINGO-COCCEMIAMENINGITISENCEPHALITIS
NURSING MANAGEMENT1. Comfort: quiet,well-ventilatedroom2. Skin care:cleansing bath,change inposition3. Eliminatemosquitobreeding sites:CULEXmosquito1. Respiratoryisolation 24-72hours after onsetof antibiotictherapy2. Room protectedagainst brightlights3. Safety: side-lyingposition andraised side rails1. Side boards2. Close contactsH –ouseI –nfectedpersonkissingS amedaycarecenterS –hare mouthinstruments3. Antibiotics asprophylaxis
CD-Bucud 2
 
TETANUSRABIES
POLIOMYELITIS
MAIN PROBLEM
ETIOLOGIC AGENT
Acute infection of the CNS –musclespasm, paresis andparalysisAcute viral diseaseof the CNS –bysaliva of infectedanimalsAcute infectiousdisease with systemicneuromusculareffectsLegiodebilitansRhabdovirusBullet-shapedAffinity to CNSKilled by sunlight,UV light, formalinResistant toantibioticsClostridium tetaniAnaerobicGram positiveDrumstick appearance
TETANUSRABIES
POLIOMYELITIS
INCUBATION PERIODMODE OF TRANSMISSION
7-21 days2-8 weeksAdult: 3 days-3weeks
Distance of bite tobrain
-Direct contact withinfected feces
Bite of an infectedanimalDirect inoculationthrough a brokenskin
Extensiveness of thebiteResistance of thehost
Neonate: 3-30 days
-Direct contact withrespiratory secretions-Indirect with soiledlinens and articles
TETANUSRABIES
POLIOMYELITIS
SIGNS AND SYMPTOMS
1.Abortive type1.Prodromal/invasionphaseRisussardonicus3. Paralytic type2. Pre-paralyticor meningetictype3. Terminal /paralytic type2. Excitement /neurologicalphaseOpistothonusTrismusConvulsionsHeadacheIrritabilityLaryngealspasm
POLIOABORTIVE TYPE
Does not invade the CNS
Headache
Sore throat
Recovery within 72 hours and the disease passes by unnoticed
PRE-PARALYTIC OR MENINGETIC TYPE
Slight involvement of the CNS
Pain and spasm of muscles
Transient paresis
(+) Pandy’s test (increased protein in the CSF)
PARALYTIC TYPE
CNS involvement
Flaccid paralysis
Asymmetric
Affects lower extremities
Urine retention and constipation
(+) HOYNE’S SIGN (when in supine position, head will fall backwhen shoulders are elevated)
RABIESPRODROMAL/INVASION PHASE
Fever 
Anorexia
Sore throat
Pain and tingling at the site of bite
Difficulty swallowing
EXCITEMENT OR NEUROLOGICAL PHASE
Hydrophobia (laryngospasm)
Aerophobia (bronchospasm)
Delirium
Maniacal behavior 
Drooling
TERMINAL OR PARALYTIC PHASE
Patient becomes unconscious
Loss of urine and bowel control
Progressive paralysis
Death
TETANUSRABIES
POLIOMYELITIS
COMPLICATIONISOLATION PRECAUTIONDIAGNOSTIC PROCEDURESParalysisof respiratory musclesRESPIRATORYFAILURE
DEATH1.Stool culture
1.Throat washings1.Blood exam
Enteric isolationRespiratoryisolation2. CSF culture
2. Flourescentrabiesantibody (FRA)3. Negribodies
TETANUSRABIES
POLIOMYELITIS
TREATMENT MODALITIES
1.Analgesics1.Localtreatment of wound
1.Tetanus immuneglobulin (TIG)
2. Morphine3. Moist heatapplication4. Bed rest5. Rehabilitation2. ActiveimmunizationLyssavacImovaxAntirabiesvax2. Passiveimmunization
2. Tetanus antitoxin(TAT)3. Penicillin G4. Tetracycline5. Diazepam6. Phenobarbital7. Tracheostomy8. NGT feeding
TETANUSRABIES
POLIOMYELITIS
NURSING MANAGEMENT
1.Enteric isolation1.Isolation1.Adequate airway2. Proper disposalof secretions3. Moist hot packs4. Firm /nonsaggingbed5. Suitable bodyalignment6. Comfort andsafety2. Optimumcomfort3. Restfulenvironment4. Emotionalsupport5. Concurrentand terminaldisinfection2. Quiet, semi-dark environment3. Avoid suddenstimuli and light
CD-Bucud 3

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