Comhealth Nursing

Nurse Licensure Examination Review Handouts
THE COMMUNITY HEALTH NURSING

AND
COMMUNICABLE DISEASES
Community Health Nursin
COMMUNITY HEALTH NURSING
I ! De"inition o" Terms Community- derived from a latin word comunicas which means a group of
people. a group of people with common characteristics or interests living together within a territory or
geographical boundary place where people under usual conditions are found
Health - is the OLOF (Optimum Level of Functioning
Community Health - part of paramedical and medical intervention!approach which is concerned on the
health of the whole population
Aims# ". health promotion #. disease prevention $. management of factors affecting health
Nursin - both profession % a vocation. &ssisting sic' individuals to become healthy and healthy
individuals achieve optimum wellness
II ! Community Health Nursin
(he utili)ation of the nursing process in the different levels of clientele-individuals* families*
population groups and communities* concerned with the promotion of health* prevention of
disease and disability and rehabilitation.
Goal# (o raise the level of citi)enry by helping communities and families to cope with the discontinuities
in and threats to health in such a way as to ma+imi)e their potential for high-level wellness
MISSION O$ CHN
% Health &romotion ' a(ti)ities relate* to enhan(ement o" health
% Health &rote(tion ' a(ti)ities *esine* to +rote(t the +eo+le
% Health Balan(e ' a(ti)ities *esine* to maintain ,ell -ein
% Disease +re)ention ' a(ti)ities relate to a)oi* (om+li(ation
% So(ial .usti(e ' a(ti)ities relate* to +ra(ti(e e/uity amon (lients
&HILOSO&HY O$ CHN ACCORDING TO DR0 MARGARET SHETLAND
(he philosophy of ,-. is based on the worth and dignity on the worth and dignity of man.
&rin(i+les o" Community Health#
". (he community is the patient in ,-.* the family is the unit of care and there are four levels of clientele/
individual* family* population group (those who share common characteristics* developmental stages and
common e+posure to health problems 0 e.g. children* elderly* and the community.
1
#. 1n ,-.* the client is considered as an &,(123 partner .O( 4&55123 recipient of care
$. ,-. practice is affected by developments in health technology* in particular* changes in society* in
general
6. (he goal of ,-. is achieved through multi-sectoral efforts
7. ,-. is a part of health care system and the larger human services system.
Role o" CH Nurse#
,linician - who is a health care provider* ta'ing care of the sic' people at home or in the 8-9
-ealth &dvocator 0 spea's on behalf of the client
&dvocator 0 act on behalf of the client
5upervisor - who monitors and supervises the performance of midwives
Facilitator - who establishes multi-sectoral lin'ages by referral system
,ollaborator 0 wor'ing with other health team member
COMMON &ROCEDURE IN CHN#
% HOME 1ISIT
% BAG TECHNI2UE
% STERILI3ATION
% S&ECIMEN COLLECTION
! URINE ' sterile -ottle4 mi*stream (olle(tion
! $ECES ! (lean (ontainer4 small amount o" "e(es only
! S&UTUM ! N&O mi*niht 5st (olle(tion early AM then su-mit at the health (enter imme*iately
then 6n* (olle(tion "ollo,in *ay early in the Am then su-mit at the health (enter then
(olle(t the 7r* s+utum4 instru(t +atient to ta8e a *ee+ -reath 9 times then (ouh out
Le)els o" Client in CHN#
". &pplication of .ursing 4rocess to/
50a $amily
50a05 $amily Co+in In*e:
4hysical 1ndependence - ability of the family to move in % out of bed % performed activities of daily living
(herapeutic 1ndependence - ability of the family to comply with the therapeutic regimen (diet* medication
% usage of appliances
:nowledge of -ealth ,ondition- wisdom of the family to understand the disease process
&pplication of ;eneral %4ersonal -ygiene- ability of the family to perform hygiene % maintain
environment conducive for living
3motional ,ompetence 0 ability of the family to ma'e decision maturely % appropriately (facing the
reality of life
Family Living 4attern- the relationship of the family towards each other with love* respect % trust
9tili)ation of ,ommunity 8esources 0 ability of the family to 'now the function % e+istence of resources
within the vicinity
-ealth ,are &ttitude 0 relationship of the family with the health care provider
4hysical 3nvironment 0 ability of the family to maintain environment conducive for living
50a06 $amily Li"e Cy(le
5tage 1 0 <eginning Family (newly wed couples
(&5:/ compliance with the 4= >?7 % acceptance of the new member of the family
5tage 11 0 3arly ,hild <earing Family(@-$@ months old
2
(&5:/ emphasi)e the importance of pregnancy % immuni)ation % learn the concept of parenting
5tage 111 0Family with 4re- school ,hildren ($-?yrs old
(&5:/ learn the concept of responsible parenthood
5tage 12 0 Family with 5chool age ,hildren (?-"#yrs old
(&5:/ 8einforce the concept of responsible parenthood
5tage 2 - Family with (een &gers ("$-#7yrs old
(&5:/ 4arents to learn the concept of let go system and understands the generation gap
5tage 21 0 Launching ,enter ("st child will get married up to the last child
(&5:/ compliance with the 4= >?7 % acceptance of the new member of the family
5tage 211 -Family with Aiddle &dult parents ($?-?@yrs old
(&5:/ provide a healthy environment* adBust with a new lifestyle and adBust with the financial aspect
5tage 2111 0 &ging Family (?"yrs old up to death
(&5:/ learn the concept of death positively
50- ,ommunity
COMMUNITY ASSESSMENT# 5tatus 0 information about morbidity* mortality % life e+pectancy
5tructure 0 information about age* gender and socio economic 4rocess 0 information about how the
community function
TY&ES O$ COMMUNITY ASSESSMENT#
50 COMMUNITY DIAGNOSIS
& process by which the nurse collects data about the community in order to identify factors which may
influence the deaths and illnesses of the population* to formulate a community health nursing diagnosis
and develop and implement community health nursing interventions and strategies.
6 Ty+es#
Com+rehensi)e Community Dianosis &ro-lem!Oriente* Community Dianosis
! aims to obtain general information about
the community
- type of assessment responds to a particular
need
STE&S#
&re+aratory &hase
50 site sele(tion
60 +re+aration o" the (ommunity
70 statement o" the o-;e(ti)es
90 *etermine the *ata to -e (olle(te*
<0 i*enti"y metho*s an* instruments "or *ata (olle(tion
=0 "inali>e sam+lin *esin an* metho*s
?0 ma8e a timeta-le
% Im+lementation &hase
50 *ata utili>ation
60 *ata (olle(tion
70 *ata orani>ation@(ollation
90 *ata +resentation
<0 *ata analysis
% E)aluation &hase
3
60 BIOSTATISTICS
#." =3AO;8&4-C - study of population si)e* composition and spatial distribution as affected by births*
deaths and migration.
Sour(es # ,ensus 0 complete enumeration of the population
6 Aays o" Assinin &eo+le#
". De Jure ! 4eople were assigned to the place where assigned to the place they usually live regardless
of where they are at the time of census. #.De Facto - 4eople were assigned to the place where they are
physically present at are at the time of census regardless* of their usual place of residence.
Com+onents#
". 4opulation si)e
#. 4opulation composition D &ge =istribution D 5e+ 8atio D 4opulation 4yramid D Aedian age - age below
which 7@E of the population fall and above which 7@E of the population fall. (he lower the median age*
the younger the population (high fertility* high death rates. D &ge 0 =ependency 8atio - used as an inde+
of age-induced economic drain on human resources D Other characteristics/ - occupational groups -
economic groups - educational attainment - ethnic group
$. 4opulation =istribution D 9rban-8ural - shows the proportion of people living in urban compared to the
rural areas D ,rowding 1nde+ - indicates the ease by which a communicable disease can be transmitted
from " host to another susceptible host. D 4opulation =ensity - determines congestion of the place
$. 1ITAL STATISTICS
the application of statistical measures to vital events (births* deaths and common illnesses that is
utili)ed to gauge the levels of health* illness and health services of a community.
TY&ES#
&. Fertility 8ate
A0 CRUDE BIRTH RATE
total F of livebirths in a given calendar year G "@@@
estimated population as of Huly " of the same given year
B0 GENERAL $ERTILITY RATE
total F of livebirths in a given calendar year G "@@@
(otal number of reproductive age
<. Aortality 8ate
A0 CRUDE DEATH RATE
Total B o" *eath in a i)en (alen*ar year C 5DDD
Estimate* +o+ulation as o" .uly 5 o" the same (alen*ar year
B0 IN$ANT MORTALITY RATE
Total B o" *eath -elo, 5 yr in a i)en (alen*ar year C 5DDD
C0 MATERNAL MORTALITY RATE
Total B o" *eath amon all maternal (ases in a i)en (alen*ar year C 5DDD
4
C0 Mor-i*ity Rate
A0 &RE1ALENCE RATE
Total B o" ne, E ol* (ases in a i)en (alen*ar year C 5DD
Total B o" +ersons e:amine* at same i)en time
B0 INCIDENCE RATE
Total B o" ne, (ases in a i)en (alen*ar year C 5DD
Estimate* +o+ulation as o" .uly 5 o" the same year
C0 ATTACF RATE
Total B o" +erson ,ho are e:+ose* to the *isease C 5DD
B o" +ersons e:+ose* to the same *isease in same i)en year
III ! E+i*emioloy
the study of distribution of disease or physiologic condition among human population s and the factors
affecting such distribution
the study of the occurrence and distribution of health conditions such as disease* death* deformities or
disabilities on human populations
A0 4atterns of disease occurrence/
E+i*emi( - a situation when there is a high incidence of new cases of a specific disease in e+cess of the
e+pected.
- when the proportion of the susceptibles are high compared to the proportion of the immunes
En*emi( - habitual presence of a disease in a given geographic location accounting for the low number
of both immunes and susceptibles e.g. Malaria is a disease endemic at Palawan.
- the causative factor of the disease is constantly available or present to the area.
S+ora*i( - disease occurs every now and then affecting only a small number of people relative to the
total population
- intermittent
&an*emi( - global occurrence of a disease
5teps in 341=3A1OLO;1,&L 1235(1;&(1O./
". 3stablish fact of presence of epidemic
#. 3stablish time and space relationship of the disease
$. 8elate to characteristics of the group in the community
6. ,orrelate all data obtained
B0 8ole of the .urse
,ase Finding
-ealth (eaching
,ounseling
Follow up visit
I10 Health Situation o" the &hili++ines
5
&hili++ine S(enario#
% In the +ast 6D years some in"e(tious *eenerati)e *iseases are on the rise0
% Many $ili+inos are still li)in in remote an* har* to rea(h areas ,here it is *i""i(ult to *eli)er the
health ser)i(es they nee*
% The s(ar(ity o" *o(torsG nurses an* mi*,i)es a** to the +oor health *eli)ery system to the +oor
1ITAL HEALTH STATISTICS 6DD<
H &RO.ECTED &O&ULATION #
MALE ! 96GI?9G?==
$EMALE ! 96G7=6G59?
BOTH SECES ! I<G67=GJ57
H LI$E EC&ECTANCY
$EMALE ! ?D yrs0 ol*
MALE ! =9 yrs0 Ol*
LEADING CAUSES O$ MORBIDITY
% Most o" the to+ ten lea*in (auses o" mor-i*ity are (ommuni(a-le *isease
% These in(lu*e the *iarrheaG +neumoniaG -ron(hitisG in"luen>aG TBG malaria an* )ari(ella
% Lea*in non CD are heart +ro-lemG H&NG a((i*ents an* malinant neo+lasms
LEADING CAUSES O$ MORTALITY
% The to+ 5D lea*in (auses o" mortality are *ue to non CD
% Diseases o" the heart an* )as(ular system are the 6 most (ommon (auses o" *eaths0
% &neumoniaG &TB an* *iarrheal *iseases (onsistently remain the 5D lea*in (auses o" *eaths0
10 Health Care Deli)ery System the totality of all policies* facilities* eIuipments* products* human
resources and services which address the health needs* problems and concerns of the people. 1t is large*
comple+* multi-level and multi-disciplinary.
HEALTH SECTORS
% GO1ERNMENT SECTORS
De+artment o" Health 1ision# -ealth for all by year #@@@ ands -ealth in the -ands of the 4eople by
#@#@
Mission# 1n partnership with the people* provide eIuity* Iuality and access to health care esp. the
marginali)ed
< Ma;or $un(tions#
". 3nsure eIual access to basic health services
#. 3nsure formulation of national policies for proper division of labor and proper coordination of
operations among the government agency Burisdictions
$. 3nsure a minimum level of implementation nationwide of services regarded as public health goods
6. 4lan and establish arrangements for the public health systems to achieve economies of scale
7. maintain a medium of regulations and standards to protect consumers and guide providers
% NON GO1ERNMENT SECTORS ' +ro)i*es man+o,er in the e:e(ution o" the +roram
% &RI1ATE SECTORS ' +ro)i*es "inan(ial as+e(t in the e:e(ution o" +rorams
&RIMARY STRATEGIES TO ACHIE1E HEALTH GOALS
6
% Su++ort "or health oal
% Assuran(e o" health (are
% In(reasin in)estment "or &HC
% De)elo+ment o" National Stan*ar*
MILESTONE IN HEALTH CARE DELI1RY SYSTEM
% RA 5DI6 ! RHU A(t
% RA 5IJ5 ! Strenthen Health Ser)i(es
% &D <=I ! Restru(turin HCDS
% RA ?5=D ! LGU Co*e
1I ' National Health &lan
.ational -ealth 4lan is a long-term directional plan for healthJ the blueprint defining the countryKs health
0 48O<L3A5* 4OL1,C (-895(5 5(8&(3;135* (-895(5
GOAL # to enable the Filipino population to achieve a level of health which will allow Filipino to lead a
socially and economically-productive life* with longer life e+pectancy* low infant mortality* low maternal
mortality and less disability through measures that will guarantee access of everyone to essential health
care
OB.ECTI1ES# promote eIuity in health status among all segments of society address specific health
problems of the population upgrade the status and transform the -,=5 into a responsive* dynamic and
highly efficient* and effective one in the provision of solutions to changing the health needs of the
population promote active and sustained peopleKs participation in health care
MA.OR HEALTH &LANS TOAARDS KHEALTH IN THE HANDS O$ THE &EO&LE IN THE YEAR
6D6DL
A0 MA.OR HEALTH &LAN
% 67 IN J7
% Health "or more in J9
% Thin8 healthMM Health Lin8
% < in J<
B0 &RIORITY &ROGRAM IN YEAR 6DDD
% &lan <D N&harma(euti(al &lanO
% &lan <DD N &hil Health Insuran(e &lanO
% AomenPs health
% Chil*renPs health
% Healthy Li"estyle
% &re)ention E Control o" In"e(tious Disease
C0 &RIORITY &ROGRAM IN THE YEAR 6DD<
% Litas Buntis Cam+ain
% Ma healthy Li"estlye tayo
% TB Net,or8
7
% Bloo* Donation &roram NRA ??5JO
% DTOMIS
% Litas Ti*as Cam+ain
% Muran Gamot
% Anti To-a((o Sinature Cam+ain
% Do(tors to the Barrios &roram
% $oo* $orti"i(ation &roram
% Sentron Sila Mo)ement
D0 NATIONAL HEALTH E1ENTS $OR 6DD=
.ANUARY
% National Can(er Cons(iousness Aee8 ! N5=!66O
$EBRUARY
% Heart Month
% Dental Health Month
% Res+onsi-le &arenthoo* Cam+ain National Health Insuran(e &roram
MARCH
% AomenQs Health Month
% Ra-ies A,areness Month
% Burn In;ury &re)ention Month
% Res+onsi-le &arenthoo* Cam+ain
% Colon an* Re(tal Can(er A,areness Month
% Aorl* TB Day ! N69O
A&RIL
% Can(er in Chil*ren A,areness Month
% Aorl* Health Day ! N?O
% Briht Chil* Aee8 &hase I !
% Garantisa*on &am-ata N55!5?O
MAY
% Natural $amily &lannin Month
% Cer)i(al Can(er A,areness Month
% AIDS Can*leliht Memorial Day ! N65O
% Aorl* No To-a((o Day ! N75O
.UNE
% Denue A,areness Month
% No Smo8in Month
% National Fi*ney Month
% &rostate Can(er A,areness Month
.ULY
% Nutrition Month
% National Bloo* Donation Month
% National Disaster Cons(iousness Month
AUGUST
8
% National Lun Month
% National Tu-er(ulosis A,areness Month
% Siht!Sa)in Month
% $amily &lannin Month
% Lun Can(er A,areness Month
SE&TEMBER
% Generi(s A,areness Month
% Li)er Can(er A,areness Month
OCTOBER
% National Chil*renQs Month
% Breast Can(er A,areness Month
% National Ne,-orn S(reenin Aee8 N7!JO
% Briht Chil* Aee8 &hase II Garantisa*on &am-ata N5D!5=O
NO1EMBER
% $ilariasis A,areness Month
% Can(er &ain Manaement A,areness Month
% Tra*itional an* Alternati)e Health Care Month
% Cam+ain on 1iolen(e Aainst Aomen an* Chil*ren
DECEMBER
% $ire(ra(8er In;ury &re)ention Cam+ain#
% KO&LAN IAAS &A&UTOFL
1II ! INTEGRATED MANAGEMENT O$ CHILDHOOD ILLNESSES NIMCIO
INTEGRATED MANAGEMENT O$ CHILDHOOD ILLNESSES NIMCIO
% IMCI is an interate* a++roa(h to (hil* health that "o(uses on the ,ell!-ein o" the ,hole (hil*0
% IMCI stratey is the main inter)ention +ro+ose* to a(hie)e a sini"i(ant re*u(tion in the num-er
o" *eaths "rom (ommuni(a-le *iseases in (hil*ren un*er "i)e
Goal#
% By 6D5DG to re*u(e the in"ant an* un*er "i)e mortality rate at least one thir*G in +ursuit o" the oal
o" re*u(in it -y t,o thir*s -y 6D5<0
AIM#
% to re*u(e *eathG illness an* *isa-ilityG an* to +romote im+ro)e* ro,th an* *e)elo+ment amon
(hil*ren un*er < years o" ae0
% IMCI in(lu*es -oth +re)enti)e an* (urati)e elements that are im+lemente* -y "amilies an*
(ommunities as ,ell as -y health "a(ilities0
IMCI OB.ECTI1ES#
% To re*u(e sini"i(antly lo-al mortality an* mor-i*ity asso(iate* ,ith the ma;or (auses o"
*isease in (hil*ren
% To (ontri-ute to the healthy ro,th E *e)elo+ment o" (hil*ren
IMCI COM&ONENTS O$ STRATEGY#
% Im+ro)in (ase manaement s8ills o" health ,or8ers
9
% Im+ro)in the health systems to *eli)er IMCI
% Im+ro)in "amily an* (ommunity +ra(ti(es
DDFor many sic' children a single diagnosis may not be apparent or appropriate
&resentin (om+laint#
% Couh an*@or "ast -reathin
% Lethary@Un(ons(iousness
% Measles rash
% K1ery si(8L youn in"ant
&ossi-le (ourse@ asso(iate* (on*ition#
% &neumoniaG Se)ere anemiaG &0 "al(i+arum malaria
% Cere-ral malariaG meninitisG se)ere *ehy*ration
% &neumoniaG DiarrheaG Ear in"e(tion
% &neumoniaG MeninitisG Se+sis
$i)e Disease $o(us o" IMCI#
% A(ute Res+iratory In"e(tion
% Diarrhea
% $e)er
% Malaria
% Measles
% Denue $e)er
% Ear In"e(tion
% Malnutrition
THE IMCI CASE MANAGEMENT &ROCESS
% Assess an* (lassi"y
% I*enti"y a++ro+riate treatment
% Treat@re"er
% Counsel
% $ollo,!u+
THE INTEGRATED CASE MANAGEMENT &ROCESS
,hec' for ;eneral =anger 5igns/
% A eneral *aner sin is +resent i"#
! the (hil* is not a-le to *rin8 or -reast"ee*
! the (hil* )omits e)erythin
! the (hil* has ha* (on)ulsions
! the (hil* is lethari( or un(ons(ious
ASSESS MAIN SYM&TOMS
% Couh@DOB
% Diarrhea
% $e)er
% Ear +ro-lems
IMCI COLOR CODING
&INF NURGENT RE$ERRALO
YELLOA NTreatment at
out+atient health "a(ilityO
GREEN NHome
manaementO
O9(4&(13.( -3&L(-
F&,1L1(C L4re-referral
O9(4&(13.( -3&L(-
F&,1L1(C L(reat local
-OA3 ,areta'er is
counseled on/ L-ome
10
treatments L&dvise parents
L8efer child
infection L;ive oral drugs
L&dvise and teach careta'er
Follow-up
treatment!s LFeeding and
fluids LMhen to return
immediately Follow-up
83F388&L F&,1L1(C
L3mergency (riage and
(reatment ( 3(&(
L=iagnosis* (reatment
LAonitoring* follow-up
(reat oral infection
;ive oral drugs
&dvise % teach
careta'er
Follow up
,areta'er is counseled on/
-ome treatments
Feeding % fluids
Mhen to return
immediately
Follow up
ASSESS AND CLASSI$Y COUGH OR DI$$ICULTY O$ BREATHING
- 8espiratory infections can occur in any part of the respiratory tract such as the nose* throat* laryn+*
trachea* air passages or lungs. Assess an* (lassi"y &NEUMONIA
% (ouh or *i""i(ult -reathin
% an in"e(tion o" the luns
% Both -a(teria an* )iruses (an (ause +neumonia
% Chil*ren ,ith -a(terial +neumonia may *ie "rom hy+o:ia Ntoo little o:yenO or se+sis
Nenerali>e* in"e(tionO0
RR A (hil* ,ith (ouh or *i""i(ult -reathin is assesse* "or#
% Ho, lon the (hil* has ha* (ouh or *i""i(ult -reathin
% $ast -reathin ' in(rease in RR
% Chest in*ra,in ' 1isi-le mar8 o" ICS u+on inhalation
% Stri*or in a (alm (hil* ' a*)entitious soun*s hear* e)en ,ithout the ai* o" stethos(o+e0
REMEMBER#
** If the child is 0 months up to 2 months the child has fast breathing if you count 60 breaths per
minute or more
** If the child is 2 months up to 1 year old the child has fast breathing if you count 50 breaths per
minute or more.
** If the child is 12 months up to 5 years the child has fast breathing if you count 0 breaths per
minute or more.
4.39AO.1& 0 (83&(A3.( 5,-3A3
L&ny general danger sign or
L,hest indrawing or L5tridor in
calm child
532383 4.39AO.1& O8
238C 532383 =153&53
L;ive first dose of an
appropriate antobiotic L;ive
2itamin & L(reat the child to
prevent low blood sugar
L8efer urgently to the hospital
L;ive paracetamol for fever N
$O.7o,
L Fast breathing 4.39AO.1&
L;ive an appropriate antibiotic
for 7 days L5oothe the throat
and relieve cough with a safe
remedy L&dvise mother when
to return immediately LFollow
up in # days L;ive
4aracetamol for fever N
$O.7o,
L.o signs of pneumonia or
very severe disease
.O 4.39AO.1& / ,O9;-
O8 ,OL=
L1f coughing more than more
than $@ days* refer for
assessment L5oothe the
throat and relieve the cough
11
with a safe remedy L&dvise
mother when to return
immediately Follow up in 7
days if not improving
Assess an* (lassi"y DIARRHEA
A (hil* ,ith *iarrhea is assesse* "or#
% ho, lon the (hil* has ha* *iarrhea
% -loo* in the stool to *etermine i" the (hil* has *ysentery
% sins o" *ehy*ration0
Classi"y DYSENTERY
% (hil* ,ith *iarrhea an* -loo* in the stool
(wo of the following signs P L
&bnormally sleepy or difficult to
awa'en L 5un'en eyes L .ot able
to drin' or drin'ing poorly 5'in
pinch goes bac' very slowly
532383
=3-C=8&(1O.
L1f child has no other severe
classification/ - ;ive fluid for
severe dehydration ( 4lan , O8
L 1f child has another severe
classification / - 8efer
98;3.(LC to hospital with
mother giving freIuent sips of
O85 on the way - &dvise the
mother to continue breastfeeding
L 1f child is # years or older and
there is cholera in your area* give
antibiotic for cholera
(wo of the following signs / L
8estless* irritable L 5un'en eyes L
=rin's eagerly* thirsty 5'in pinch
goes bac' slowly
5OA3 =3-C=8&(1O.
L;ive fluid and food for some
dehydration ( 4lan < L 1f child
also has a severe classification / -
8efer 98;3.(LC to hospital with
mother giving freIuent sips of
O85 on the way - &dvise mother
when to return immediately L
Follow up in 7 days if not
improving
L.ot enough signs to classify as
some or severe dehydration
.O =3-C=8&(1O.
L-ome ,are L ;ive fluid and food
to treat diarrhea at home ( 4lan
& L&dvise mother when to return
immediately LFollow up in 7 days
if not improving
Ty+es o" Diarrhea
=ehydration present
532383 438515(3.(
=1&88-3&
L(reat dehydration before referral
unless the child has another
severe classification L ;ive
2itamin a L 8efer to hospital
.o dehydration
438515(3.(
=1&88-3&
L&dvise the mother on feeding a
child who has persistent diarrhea
L ;ive 2itamin & L Follow up in 7
days
12
<lood in the stool =C53.(38C
L(reat for 7 days with an oral
antibiotic recommended for
5higella in your area L Follow up
in # days ;ive also referral
treatment
Does the (hil* ha)e "e)erS **Decide ! ! Aalaria 8is' - .o Aalaria 8is' - Aeasles - =engue Malaria
Ris8
L&ny general danger sign or L
5tiff nec'
238C 532383 F3<81L3
=153&53 ! A&L&81&
L;ive first dose of Iuinine
( under medical supervision or
if a hospital is not accessible
within 6hrs L ;ive first dose
of an appropriate antibiotic L
(reat the child to prevent low
blood sugar L ;ive one dose
of paracetamol in health
center for high fever ($O.7o,
or above L 5end a blood
smear with the patient L 8efer
98;3.(LC to hospital
L<lood smear ( Q 1f blood
smear not done/ L .O runny
nose* and L .O measles* and
.O other causes of fever
A&L&81&
L(reat the child with an oral
antimalarial L ;ive one dose
of paracetamol in health
center for high fever ($O.7o,
or above L &dvise mother
when to return immediately L
Follow up in # days if fever
persists L 1f fever is present
everyday for more than R
days* refer for assessment
L<lood smear ( - * or L 8unny
nose* or L Aeasles* or Other
causes of fever
F3238 / A&L&81&
9.L1:3LC
L;ive one dose of
paracetamol in health center
for high fever ($O.7o, or
above L &dvise mother when
to return immediately L Follow
up in # days if fever persists L
1f fever is present everyday
for more than R days* refer for
assessment
No Malaria Ris8
L&ny general danger sign or L
5tiff nec'
1ERY SE1ERE
$EBRILE
DISEASE
L;ive first dose of an appropriate
antibiotic L (reat the child to prevent
low blood sugar L ;ive one dose of
paracetamol in health center for
high fever ($O.7o, or above L
8efer 98;3.(LC to hospital
L.o signs of very severe
febrile disease
F3238 / .O A&L&81& L;ive one dose of paracetamol in
health center for high fever
($O.7o, or above L &dvise mother
when to return immediately L Follow
up in # days if fever persists L 1f
fever is present everyday for more
13
than R days* refer for assessment
Measles
L,louding of cornea or L =eep
or e+tensive mouth ulcers
532383 ,OA4L1,&(3=
A3&5L35
L;ive 2itamin & L ;ive first
dose of an appropriate
antibiotic L 1f clouding of the
cornea or pus draining from
the eye* apply tetracycline
eye ointment L 8efer
98;3.(LC to hospital
L4us draining from the eye or
L Aouth ulcers
A3&5L35 M1(- 3C3 O8
AO9(- ,OA4L1,&(1O.5
L;ive 2itamin & L 1f pus
draining from the eye* apply
tetracycline eye ointment 1f
mouth ulcers* teach the
mother to treat with gentian
violet
LAeasles now or within the
last $ months
MEASLES L;ive 2itamin &
Denue $e)er
L<leeding from nose or gums
or L <leeding in stools or
vomitus or L <lac' stools or
vomitus or L 5'in petechiae or
L ,old clammy e+tremities or L
,apillary refill more than $
seconds or L &bdominal pain
or L 2omiting L (ourniIuet test
( Q
SE1ERE DENGUE
HEMORRHAGIC $E1ER
L1f s'in petechiae or
(ourniIuet test*are the only
positive signs give O85 L 1f
any other signs are positive*
give fluids rapidly as in 4lan ,
L (reat the child to prevent low
blood sugar L =O .O( ;123
&54181. L 8efer all children
9rgently to hospital
.o signs of severe dengue
hemorrhagic fever
F3238/ =3.;93
-3AO88-&;1, 9.L1:3LC
L=O .O( ;123 &54181. L
;ive one dose of paracetamol
in health center for high fever
($O.7o, or above L Follow up
in # days if fever persists or
child shows signs of bleeding
L &dvise mother when to
return immediately
Does the (hil* ha)e an ear +ro-lemS
L(ender swelling behind the
ear
A&5(O1=1(15
L;ive first dose of appropriate
antibiotic L ;ive paracetamol
for pain L 8efer 98;3.(LC
L4us seen draining from the
ear and discharge is reported
for less than "6 days or L 3ar
pain
&,9(3 3&8 1.F3,(1O.
L;ive antibiotic for 7 days L
;ive paracetamol for pain L
=ry the ear by wic'ing L
Follow up in 7 days
L4us seen draining from the
ear and discharge is reported
for less than "6 days
,-8O.1, 3&8 1.F3,(1O.
L=ry the ear by wic'ing L
Follow up in 7 days
L.o ear pain and no pus seen
draining from the ear
.O 3&8 1.F3,(1O. L.o additional treatment
Che(8 "or Malnutrition an* Anemia
Gi)e an A++ro+riate Anti-ioti(# A0 $or &neumoniaG A(ute ear in"e(tion or 1ery Se)ere *isease
14
COTRIMOCA3OLE
<1= FO8 7 =&C5
AMOCYCILLIN
<1= FO8 7 =&C5
Ae or Aeiht A*ult ta-let Syru+ Ta-let Syru+
# months up to "#
months ( 6 - S > 'g
" ! # 7 ml " ! # 7 ml
"# months up to 7
years ( "@ 0 ">'g
" R.7 ml " "@ ml
B0 $or Dysentery
COTRIMOCA3OLE <1= FO8 7 =&C5 AMOCYCILLIN <1= FO8 7 =&C5
AGE OR AEIGHT TABLET SYRU& SYRU& 6<DMG@<ML
# 0 6 months ( 6 -
S ?'g
T 7 ml ".#7 ml ( U tsp
6 0 "# months ( ? -
S "@ 'g
T 7 ml #.7 ml ( T tsp
" 0 7 years old
( "@ 0 "> 'g
" R.7 ml ( " tsp
C0 $or Cholera
TETRACYCLINE V1=
FO8 $ =&C5
COTRIMOCA3OLE <1= FO8 $ =&C5
AGE OR AEIGHT Ca+sule 6<Dm Ta-let Syru+
# 0 6 months ( 6 - S ?'g T " ! # 7ml
6 0 "# months ( ? - S "@ 'g U " ! # 7 ml
" 0 7 years old ( "@ 0 "> 'g " " R.7ml
Gi)e an Oral Antimalarial
,-OLO8OV91.3
;ive for $ days
4rimaIuine ;ive
single dose in
health center for
4. Falciparum
4rimaIuine ;ive
daily for "6 days for
4. 2iva+
5ulfado+ine Q
4yrimethamine ;ive
single dose
&;3 (&<L3( ( "7@A; (&<L3( ( "7A; (&<L3( ( "7A; (&<L3( ( "7A;
=&C" =&C# =&C$
#months 0
7months
T T T T
7 months 0 "#
months
T T T 5@6
"#months 0 $
years old
" " T U T V
$ years old - 7
years old
" T " T " $!6 "!# "
GI1E 1ITAMIN A
&;3 21(&A1. & ,&459L35 #@@*@@@ 19
? months 0 "# months "!!# ( "@@*@@@ 19 red capsules
"# months 0 7 years old " ( #@@*@@@ 19 blue capsules
GI1E IRON
&;3 or M31;-(
1ron!Folate (ablet Fe5o6 #@@mg Q
#7@mcg Folate (?@mg elemental iron
1ron 5yrup Fe5o6 "7@ mg!7ml
( ?mg elemental iron per ml
#months-6months ( 6 - S?'g #.7 ml
6months 0 "#months ( ? - S"@'g 6 ml
"#months 0 $ years ( "@ - S"6'g "!# 7 ml
$years 0 7 years ( "6 0 ">'g "!# R.7 ml
15
GI1E &ARACETAMOL $OR HIGH $E1ER N 7I0<oC OR MORE O OR EAR &AIN
&;3 O8 M31;-(
(&<L3(
( 7@@A;
5C894 ( "#@A; ! 7AL
# months 0 $ years ( 6 - S"6'g U 7 ml
$ years up to 7 years ( "6 0 "> 'g "!# "@ ml
GI1E MEBENDA3OLE ;ive 7@@mg Aebenda)ole as a single dose in health center if / N hoo'worm !
whipworm are a problem in children in your area* and N the child is # years of age or older* and N the
child has not had a dose in the previous ? months
1III ! DOH &ROGRAMS DENTAL HEALTH &ROGRAM
H To im+ro)e the /uality o" li"e o" the +eo+le throuh the attainment o" the hihest +ossi-le oral
health0
H O-;e(ti)e# To +re)ent an* (ontrol *ental *iseases an* (on*itions li8e *ental (aries an*
+erio*ontal *iseases thus re*u(in their +re)alen(e0
OSTEO&OROSIS &ROGRAM
H It is (hara(teri>e* -y a *e(rease in -one mass an* *ensity that +roresses ,ithout a sym+tom
or +ain until a "ra(ture o((urs enerally in the hi+G s+ine or ,rist0
H O-;e(ti)es#
H To in(rease a,areness on the +re)ention an* (ontrol o" osteo+orosis as a (hroni( *e-ilitatin
(on*ition4
H To in(rease a,areness -y +hysi(ians an* other health +ro"essionals on the s(reeninG treatment
an* reha-ilitation o" osteo+orosis4
H To em+o,er +eo+le ,ith 8no,le*e an* s8ills to a*o+t healthy li"estyle in +re)entin the
o((urren(e o" osteo+orosis0
HEALTH EDUCATION E CO
% A((e+te* a(ti)ity at all le)els o" +u-li( health use* as a means o" im+ro)in the health o" the
+eo+le throuh te(hni/ues ,hi(h may in"luen(e +eo+les thouht moti)ationG ;u*ment an*
a(tion0
Three as+e(ts o" health e*u(ation# 1nformation ,ommunication 3ducation Se/uen(e o" ste+s in
health e*u(ation# ,reating awareness ,reating motivation =ecision ma'ing action
RE&RODUCTI1E HEALTH
50 $amily &lannin
60 MCH E Nutrition
70 &re)ention @ treatment o" Re+ro*u(ti)e Tra(t In"e(tion E STD
90 &re)ention o" a-ortion E its (om+li(ation
<0 E*u(ation E (ounselin on se:uality E se:ual health
=0 A*oles(ent se:ual re+ro*u(ti)e health
?0 1iolen(e aainst ,omen
I0 MenPs re+ro*u(ti)e health N Male se:ual *isor*er O
J0 Breast CA E other yne +ro-lem
5D0 &re)ention @ treatment o" in"ertility
OLDER &ERSONS HEALTH SER1ICES
16
% &arti(i+ation in the (ele-ration o" Healthy National El*erly Aee8 N O(t 5!?O
! Le(ture on healthy li"estyle "or the el*erly
% &ro)ision o" *rus "or the el*erlyN 6DW *is(ountO
GUIDELINES $OR GOOD NUTRITION
% Nutritional Gui*elines are +rimary re(ommen*ations to +romote oo* health throuh +ro+er
nutrition0
ACTI1ITIES#
50Malnutrition Reha-ilitation &roram
H Tarete* $oo* Tas8 $or(e Assistan(e &roram NT$A&O
H Nutrition Reha-ilitation Aar*
H A8-ayan sa Falusuan sa Fa-ataan NASF &ro;e(tO
60Mi(ronutrient Su++lementation &roram
% K67 in XJ7L
% $orti"ie* 1itamin Ri(e
% KHealth "or More in XJ9L
% K"u#an ng $abataan% &ag'asa ng "ayanL
% National $o(us# National Mi(ronutrient Day or KAra# ng Sang(ap &inoyL
&ROTEIN ENERGY MALNUTRITION ". Aarasmus 0 loo's li'e an old worried man - less subcutaneous
fats #. :washior'or - a moon face child - with flag sign (hair changes 21(&A1. & =3F1,13.,C
3arly symptoms/ Geropthalmia (.igtblindess
<itotKs spot (silvery foamy spot located W lateral sclera
,orneal Gerosis (eye lesion
,onBunctival Gerosis(scar in the eyes
:eratomalacia ( whitish to grayish sclera
<L1.=.355
RES&IRATORY IN$ECTION CONTROL
H &ro)ision o" me*i(ines
H Consultati)e meetins ,ith CARI (oor*inators
H Monitorin o" health "a(ilities on the im+lementation o" the +roram
ALTERNATI1E MEDICINE
% RA I967
% 67 IN J7
A0 The 5D Her-al Me*i(ineNLUBBY SANTAO
Her-al Me*i(ine USES
17
Laun*i N 1ite: Neun*oO SHARED
S8in *iseases Hea*a(heG
AsthmaG"e)erG(ouhE(ol*s
Rheumatism E(>ema Dysentery
Ulasiman Bato N&e+eronia
&ellu(i*aO RA
Lo,ers uri( a(i* Rheumatism
Arthritis
Ba,an N Allium Sati)umO HAT Hea*a(he an* Toota(he
Baya-as N &si*ium Gua;a)aO Anti se+ti(G Anti!*iarrheal
Yer-a Buena NMentha Cor*i"oliaO
S&ITMAND
S,ollen umsG &ainG Inse(t -itesG
Tootha(heG Menstrual E as +ainG
Arthritis E rheumatismG Nausea E
)omitin E Diarrhea
Sam-on NBlumea Balsami"eraO
ADA
Anti ! e*emaG Diureti(sG Anti uro!
lithiasis
A8a+ul8o $unal in"e(tionG s8in *iseases
Nio Nioan N2uis/ualis In*i(aO Anti!helminthi(
Tsaan Gu-at NCarmona
RetusaOSAD
Stoma(ha(he E Diarrhea
Am+alaya NMomor*i(a CharantiaO DM
MATERNAL! CHILD CARE
I ! Maternal Care
A0 $AMILY &LANNING
I0 S+a(in @ Arti"i(ial Metho*
A0 Hormonal
B0 Me(hani(al E Barrier
C0 Bioloi(
D0 Natural
II0 &ermanent Nsuri(al@irre)ersi-leO
A0 Tu-al Liation
B0 1ase(tomy
III0 Beha)ioral Metho*
B0 BREAST$EEDING
II ! CHILD CARE
A0 UNDER $I1E CARE &ROGRAM
% A +a(8ae o" (hil* health!relate* ser)i(es "o(use* to the D!<J months ol* (hil*ren to assure
their ,ellness an* sur)i)al
Gro,th Monitorin Chart NGMCO
% A stan*ar* tool use* in health (enters to re(or* )ital in"ormation relate* to (hil* ro,th an*
*e)elo+mentG to assess sins o" malnutrition0
B0 EC&ANDED &ROGRAM ON IMMUNI3ATION
% LEGAL BASIS
% &D BJJ= ' Com+ulsory -asi(
% && B59? ' National Immuni>ation Day
% && B??7 ' Fno(8 out &olio Days
% && B 5D=9 ' +olio era*i(ation (am+ain
18
% && B9 ! Litas Ti*as month
MENTAL HEALTH a state of well-being where a person can reali)e his or her own abilities* to cope with
the normal stresses of life and wor' productively
Com+onents o" Mental Health &roram 5tress Aanagement and ,risis 1ntervention =rugs and
&lcohol &buse 8ehabilitation (reatment and 8ehabilitation of Aentally-1ll 4atients 5pecial 4roBect for
2ulnerable ;roups
SENTRONG SIGLA MO1EMENT AIM# to promote availability of Iuality health services
9 +illars# Vuality assurance ;rants % technical assistance -ealth promotion &ward
COMMUNITY ORGANI3ING &ARTICI&ATORY ACTION RESEARCH
Community Orani>in
% a (ontinuous an* sustaine* +ro(ess o"
% EDUCATING THE &EO&LEG
% CRITICAL AAARENESS
% MOBILI3ING
&arti(i+atory A(tion Resear(h
% A (om-ination o" e*u(ationG resear(h an* a(tion0
% The +ur+ose is the EM&OAERMENT o" +eo+le
9 &hases#
% &re entry
% Entry
% Orani>ational Buil*in
% Sustenan(e an* Strenthenin
La,s A""e(tin CHN Im+lementation#
RA I?9J - ,lean &ir &ct (#@@@
RA =96< 0 =angerous =rug &ct/ sale* administration and distribution of prohibited drugs is punishable by
law
RA J5?7 ' 4hilippine .ursing act of #@@#
RA 67I6 0 4hilippines Aedical &ct/ define the practice of medicine in the 4hilippines
RA 5DI6 0 8ural -ealth &ct/ employment of more physicians* nurses* midwives who will live in the rural
areas to help raise the health condition.
RA 7<?7 ! 8eporting of ,ommunicable =isease
RA ==?< ' ;eneric &ct/ promotes* reIuires and ensures the production of an adeIuate supply*
distribution* use of drugs identified by their generic names.
RA =7=<
RA =?<I
RA 9?D7 &dvocates -ome (reatment for all Leprae 4atient
RA ?7D< 0 Aagna ,arta for 4ublic -ealth Mor'ers (approved by 4res. ,ora)on ,. &Iuino/ aims to
promote and improve the social and economic well being of health wor'ers* their living and conditions.
RA ?5=D 0 Local ;overnment ,ode/ responsibility for the delivery of basic services of the national
government
IC ! CHRONIC COMMUNICABLE DISEASES
19
I ! TUBERCULOSIS (< is a highly infectious chronic disease that usually affects the lungs.
Causati)e Aent# Aycobacterium (uberculosis
S@S# cough afternoon fever weight loss night sweat blood stain sputum
&re)alen(e@In(i*en(e# ran's si+th in the leading causes of morbidity (with ""6*##" cases in the
4hilippines si+th leading cause of mortality (with #O7@R cases in the 4hilippines.
Nursin an* Me*i(al Manaement 2entilation systems 9ltraviolet lighting 2accines* such as the
bacillus ,almette ;uerin (<,; vaccine drug therapy
&re)entin Tu-er(ulosis <,; vaccination &deIuate rest <alanced diet Fresh air &deIuate
e+ercise ;ood personal -ygiene
DOTS NDire(t O-ser)e* Treatment Short CourseO
Reimen Ty+e o" TB &atient
Reimen I #8143 ! 681
.ew pulmonary smear (Q cases .ew
seriously ill pulmonary smear (- cases w!
e+tensive lung lesions .ew severely ill e+tra-
pulmo (<
Reimen II #81435! "8143 ! 7813
.ew pulmonary smear (Q case .ew
seriously ill pulmonary smear (- cases w!
e+tensive lung lesions .ew severely ill e+tra-
pulmo (<
Reimen III #814 ! 681
.ew smear(- but with minimal pulmonary (<
on radiography as confirmed by a medical
officer .ew e+tra-pulmo (< (not serious
II ! LE&ROSY 5ometimes 'nown as HansenQs *isease
is an infectious disease caused by * an aerobic* acid fast* rod-shaped mycobacterium
;erhard &rmauer -ansen - discovered the microbes
-istorically* leprosy was an incurable and disfiguring disease
(oday* leprosy is easily curable by multi-drug antibiotic therapy
Sins E Sym+toms
Early staeNCLUM&O
Change in s'in color
Loss in sensation
Ulcers that do not heal
Muscle wea'ness
&ainful nerves
Late StaeNGMISCO
Gynocomastia
Madarosis(loss of eyebrows
Inability to close eyelids (Lagopthalmos
Sin'ing nosebridge
Clawing!contractures of fingers % nose
&re)alen(e Rate Aetro Aanila* the prevalence rate ranged from @.6@ 0 $.@" per one thousand
population.
MANAGEMENT# =apsone* Lamprene clofa)imine and rifampin Aulti-=rug-(herapy (A=( si+
month course of tablets for the milder form of leprosy and two years for the more severe form
C ! 1e(tor Borne Communi(a-le Disease
20
I ' LE&TOS&IROSIS an infectious disease that affects humans and animals* is considered the most
common )oonosis in the world
Causati)e Aent# Leptospira interrogans
S@S# -high fever -severe headache -chills -muscle aches -vomiting -may include Baundice (yellow s'in and
eyes -red eyes -abdominal pain -diarrhea
TREATMENT# 43( - N &enicillins * Erythromycin* Tetracycline
II ! MALARIA Aalaria (from Aedieval 1talian/ mala aria - Xbad airXJ formerly called ague or marsh fever
is an infectious disease that is widespread in many tropical and subtropical regions.
Causati)e Aent# &nopheles female mosIuito
Sins E Sym+toms# Chills to convulsion Hepatomegaly Anemia Sweats profusely Elevated temperature
Treatment# ,hemoprophyla+is 0 chloroIuine ta'en at wee'ly interval* starting from "-# wee's before
entering the endemic area.
&re)enti)e Measures# NCLEANO
Chemically treated mosIuito nets
Larvae eating fish
Environmental clean up
Anti mosIuito soap!lotion
Neem trees!eucalyptus tree
III ! $ILIARIASIS name for a group of tropical diseases caused by various thread-li'e parasitic round
worms (nematodes and their larvae
larvae transmit the disease to humans through a mosIuito bite
can progress to include gross enlargement of the limbs and genitalia in a condition called elephantiasis
S@S#
Asym+tomati( Stae
,haracteri)ed by the presence of microfilariae in the peripheral blood
.o clinical signs and symptoms of the disease
5ome remain asymptomatic for years and in some instances for life
A(ute Stae
Lymphadenitis (inflammation of lymph nodes
Lymphangitis (inflammation of lymph vessels
1n some cases the male genitalia is affected leading to orchitis (redness* painful and tender scrotum
Chroni( Stae
-ydrocoele (swelling of the scrotum
Lyphedema (temporary swelling of the upper and lower e+tremities
3lephantiasis (enlargement and thic'ening of the s'in of the lower and ! or upper e+tremities* scrotum*
breast
MANAGEMENT# =iethylcarbama)ine 1vermectin* &lbenda)olethe
.o treatment can reverse elephantiasis
1I ' SCHISTOSOMIASIS parasitic disease caused by a larvae
Causati)e Aent# 5chistosoma intercalatum* 5chistosoma Baponicum* 5chistosoma mansoni
Sins E Sym+toms# NBALLI&SO
Bulging abdomen
21
Abdominal pain
Loose bowel movement
Low grade fever
Inflammation of liver % spleen
&allor
Sei)ure
Treatment# =iethylcarbama)epine citrate (=3, or -etra)an (drug of choice
1II ' DENGUE DENGUE is a mosIuito-borne infection which in recent years has become a maBor
international public health concern..
1t is found in tropical and sub-tropical regions around the world* predominantly in urban and semi-urban
areas.
S@S# N1LINOS&ARDO
1omiting
Low platelet
Increase 4latelet count
Nausea
Onset of fever
Severe headache
&ain of the muscle and Boint
Abdominal pain
Rashes
Diarhhea
)*+A),+-)!
(he mainstay of treatment is supportive therapy.
- intravenous fluids
- & platelet transfusion
- .o aspirin
22
Communi(a-le Disease
Mo*ule on Communi(a-le Diseases
,ommunity -ealth .ursing is faced with problems regarding communicable diseases. 1t is
important therefore that the nurse poses basic 'nowledge on how to deal with related problems
and more so prevent its occurrence* since this is li'e wise the focus of community health
nursing.
1.(8O=9,(1O.
(his module focuses on the basic communicable diseases affecting the patterns of mortality and
morbidity in the 4hilippine community. 1t will give you the basic information regarding the
description* etiology* mode of transmission* incubation period* signs and symptoms* diagnostic
procedures and management of these diseases. &s an added bonus each topic is carefully
selected to prepare you both in the practical application in the community setting and the board
e+am most especially. =ue to this you are advised to be familiari)ed with the following phrases/
O. (-3 <O&8= refers to common Iuestion that comes out in the board e+am.
,L1.1,&L FO,95 refers to the important reminders that are crucial in the actual practice.
;8O94 &L38( refers to age group variation that also demand different approaches. & post test
is prepared for your satisfaction so that you will be able to measure your 'nowledge. 1t is
recommended that you supplement your studies with te+t boo's which focus on the said topic.
(his is Bust a guide and although careful review has been made the author waive any
responsibility that may negatively occur due to application of the concepts learned here in.
O<H3,(123 ;3.38&L (o study the different communicable diseases affecting man and the
family as a component of the community
543,1F1, <y the end of the module in R days you should be able toJ
". 9nderstand the basic concepts of ,=
#. Familiari)e with the basic control and method of prevention to the said diseases.
$. be able to apply to practice the concepts learned by effectively giving health education all
these is e+pected to be attained by you none the less* by passing at least ?7E of the final
assessment Iuestions.
Ahat is in"e(tionS 1nfection is the successful entry and multiplication of micro-organism in the
human body. 9sually their entrance results in the appearance of the disease. <ut it doesnKt
always follow the same. 5ome organism may enter the body but no obvious illness is apparent.
Ahat are the ty+es o" in"e(tionS (here are two types of infection it could be nosocomial or
opportunistic. Nosocomial 0 refers to hospital acIuired infection with sets in within the premises
of the hospital during confinement. 8emember an infection is considered nosocomial if it sets in
23
after R# hours upon admission. Aost of the time the responsible organism are hospital
pathogens such as pseudomonas* 'lebsiella etc. Opportunistic 0 refers to the type infection
acIuired due to the failure of the immune defenses. 9sually this is caused by the normal
microflora.
Ahat are (ommuni(a-le *iseases an* (ontaious *iseasesS Communicable diseases are
any disease that are caused by microorganism and can be transferred from one body to another*
hence it is communicable. Contagious diseases are any communicable infection that are easily
transmissible. O. (-3 <O&8=Y :eep in mind that every contagious disease is communicable
and all communicable diseases are infection but never the other way around.
Ahat is +athoeni(ityS 1t is the over all ability of the organism to cause pathogenic changes in
the body. Mhich is further described by the following terms/
Mode o action 0 manner by which organism damages the host. 3+ample clostridium tetani
releases to+in while plasmodium falciparum 'ills the 8<,.
!irulence 0 it is the over all strength of the microorganism
Dose 0 the number of the organism reIuired to cause infection for e+ample as little as 6 tubercle
bacilli inhaled is sufficient to cause (uberculosis among high ris' patient. "n#asi#eness 0 the
ability of the organism to penetrate an intact barrier
$o%igenicit& 0 the ability of the organism to produce to+ins
'peciicit& 0 is the ability of the organism to attach on specific cellular surface receptors. !iabilit&
0 the ability to sustain life outside the body of the host
(ntigenicit& 0 the ability of the organism to stimulate and or resist antibody response
THE 7 LE1ELS O$ &RE1ENTION
&RIMARY 0 focuses on health promotion and disease prevention
Promoti#e 0 there is no ris' of having the disease. &ctivity is directed in promoting healthy
lifestyle* proper nutrition* adeIuate e+ercise and environmental sanitation.
Pre#enti#e 0 ris' of having the disease is already e+isting and activity is directed in avoiding the
ris' ergo the disease it self. 3+ample are 341* 4ap smear* <53 and 5(3.
SECONDARY 0 focuses on the ,urative aspect of care.
Curati#e 0 effort is directed for early treatment. Aove is also underta'en to avoid possible
complications
TERTIARY 0 focuses on the rehabilitative aspect
)ehabilitati#e 0 effort of helping the patient adBust with the limitations and disability brought
about by the previous disease.
ELEMENTS O$ DISEASE CAUSATION 8efers to the relationship of the (gent
(microorganism* *ost (-uman and the En#ironment (reservoir. 1f balance between the three is
present disease is absent but if one of the three gain advantage over the other it may
compromise one element and cause disease.
STAGES O$ IN$ECTION
a 3+posure 0 the stage of contact with the infectious agent
24
b 1ncubation or latent 0 the organism successfully entered the body. .o apparent illness is
present. (he organism is still multiplying so as to manifest an actual illness.
c 4rodromal 0 the manifestation of vague signs and symptoms start to appear. 3+ample fever*
cough* pain etc.
d &cute disease 0 an acute disruption in the physiologic mechanism. =isease due to the
infecting organism is already present.
e ,onvalescence 0 the stage of resolution. (he body is able to maintain homeostasis. (he
infectious organism is under control
f 8elapse 0 a stage of reactivation of a previous infection which may be due to re-e+posure or
waning immunity.
CHAIN O$ IN$ECTION (he series of events that ta'es place in order for infection to occur.
(he following subtopics describe each component of the chain.
O. (-3 <O&8=Y 8emember infection will never occur unless the si+ chain are completed.
a ,ausative agent 0 refers to the microorganism such as fungi* proto)oa* parasite* viruses*
bacteria etc.
b 8eservoir 0 the medium or body which the microorganism thrive and survive.
c 4ortal of 3ntry 0 opening in the body where in the microorganism could use as passageway to
reach the internal physiological structures. For e+ample mouth* nose* wound etc.
d 4ortal of e+it 0 any opening to which the organism uses to e+it from the body. 3+ample are
anus* nose* vagina* penis* etc.
e Aode of transmission 0 the method on how the organism travels from one infected host to
another.
i. =irect 0 reIuires physical contact from the point source of infection. 5uch as 'issing and
unprotected se+ual intercourse.
ii. 1ndirect 0 transmitted through fomites and other non living organism. ,ontaminated surgical
instruments.
iii. 2ector borne 0 relies greatly on the presence of the secondary host to cause infection. e.g.
mosIuitos* flies and rats
iv. =roplet 0 organism travels through droplet nuclei that comes out during coughing* snee)ing
etc.
v. &irborne 0 the organism can uniIuely suspend in the air and carried on air current and the li'e
method.
f 5usceptible host 0 any person whose immune defenses are wea' or those who are healthy
but do not posses adeIuate specific immunity
O. (-3 <O&8=Y 8emember that the mode of transmission is the chain that is easiest to brea'Y
THE DE$ENSE MECHANISM O$ THE BODY (he defensive mode is divided into three*
namely/
i. "st line of defense
ii. #nd line of defense
iii. $rd line of defense
+st ,"NE OF DEFEN'E .on specific defense mechanism this is the first to come in contact with
25
harmful organism. 3.g. s'in* saliva*. (ears* stomach acids* urine etc. -ND ,"NE OF DEFEN'E
.on specific phagocytic response. 3.g. phagocytosis by neutrophils.
.)D ,"NE OF DEFEN'E 5pecific immune response dependent upon the presence of specific
anti bodies. 3.g. immunity against chic'enpo+
IMMUNITY &bility of the body to effectively mount an immune response to prevent infection. it is
usually dependent on the presence of antibodies.
a. .atural active 0 contact with infectious organism and the immunity that follows after that.
b. .atural passive 0 immunity received from the mother through the placenta
c. &rtificial active 0 immunity gained after the administration of vaccines
d. &rtificial passive 0 immunity gained after receiving immune serum or immune globulin.
E&IDEMIOLOGY 8efers to study of the pattern and distribution of diseases among the identified
population.
a. 3ndemic 0 the disease is always present in a community the rise and fall remains steadily
predictable.
b. 3pidemic 0 there is a sharp increase in the number of disease as it affects the population over
a period of time and specific locality.
c. 4andemic 0 nations are affected by a disease. 1t is commonly referred to as international
epidemic.
d. 5poradic 0 patches in appearance. (he disease does not manifest it self as a dominant entity.
Aost often the disease affects only a small portion of the community.
e. Out brea' 0 the disease has affected the population but the number of the people afflicted is
above the endemic proportion but lower than epidemic levels. &n outbrea' is an indicator of
impending epidemic.
GENERAL MEASURES TO CONTROL COMMUNICABLE DISEASES
*and washing / the most basic of infection control practices. 1t is the use of soap and water to
remove contaminant from our hands.
Disinection 0 the use of chemicals li'e alcohol or other physical means to destroy disease
causing organism outside the body.
a. (erminal disinfection 0 disinfecting the surroundings of the patient
b. ,oncurrent disinfection 0 disinfection of substances and materials discharged from the body.
'terili0ation / all forms of microbial life are eliminated.
"solation / the act of separating an infected patient to prevent cross infection. (he following are
the types of isolation precaution.
i. First (ier 0 5tandard precaution J applied to all patient regardless of their clinical diagnosis. 1t is
desired that the application of this tie will protect the nurse and the patient from body fluids
including blood as well as wounds or any brea' in the s'in and mucous membrane. 9se of
gloves.
ii. 5econd (ier 0 (ransmission based precaution refers to any patient who reIuire more stringent
control that necessitates deeper method than those identified above. (hese includes contact*
airborne and droplet precaution.
26
a. ,ontact precaution 0 to protect against direct and indirect transmission. Aas' and gown are
added.
b. &irborne precaution 0 the use of air filters to prevent infection due to organism suspended in
the air.
c. =roplet precaution 0 maintaining a distance of $ feet from the point source of infection to
avoid droplet nuclei. (he use of high particulate mas' and goggles are added.
1uarantine / the act of limiting the movement and freedom of travel of any patient who have
been e+posed from an infectious organism. (he length of time is dependent to the ma+imum
incubation period of the suspected disease. 'ur#eillance - monitoring of patients* high ris'
groups or families to predict* identify and control infection.
CHEMICAL DISIN$ECTANTS THAT ARE COMMONLY USED
Germicide 0 also 'nown as disinfectant this can 'ill disease causing organism.
2actericidal 0 refers to its ability to 'ill bacteria only.
2acteriostatic 0 the ability of a chemical agent to halt bacterial reproduction
(ntiseptic / chemicals that can 'ill or control the growth of microorganism. (his are usually
applied on the s'in to prevent wound infection. 5oaps and detergents 0 effective against
bacteria found in clothes.
Phenols 3,&sol4 0 effective against gram negative bacteria.
(lcohol 0 ideally isopropyl alcohol in R@E solution. 3ffective in 'illing broad range of microbes.
Chlorine 0 one of the most effective water disinfectants "odine 0 eIually effective with chlorine in
antimicrobial activity. (his is also used in s'in disinfection (<etadine -ydrogen 4ero+ide 0
wound cleanser and disinfectant for surgical devices.
COMMUNICABLE DISEASES -+.*/0/1I2A0 S3S)+,
TETANUS ALSO FNOAN AS LOCF .AA
Des(ri+tion# An a(ute in"e(tion asso(iate* ,ith +ain"ul mus(ular s+asm
Etioloy# Cause* -y Clostri*ium tetani ,hi(h are "oun* on soils an* human "e(es
Mo*e o"
transmission#
Contamination o" ,oun*
In(u-ation +erio*# < ' 5D *ays
Sins an* sym+toms
$e)erG lo(8 ;a,G the most im+ortant sin is trismus an* risus sar*oni(us0
Ahile larynos+asm is the most li"e threatenin (on*ition0
Dianosti(
+ro(e*ure
None0 History o" ,oun* an* +ossi-le (ontamination are usually enouh
to arouse sus+i(ion an* ta8e ne(essary manaement0
Manaement
Aash ,oun*G a++ly ,oun* antise+ti(0 Assess "or history o"
immuni>ation Gi)e tetanus to:oi* "or neati)e history o" immuni>ation
A*minister Antito:in a"ter neati)e s8in test &eni(illin is the *ru o"
(hoi(e &re+are "or intu-ation0 NGT "ee*in may -e(ome ne(essary0
A)oi* o)er stimulation to +re)ent +ain"ul mus(le (ontra(tion0 Dia>e+am
is the *ru o" (hoi(e "or mus(le s+asm
27
MENINGITIS
Des(ri+tion# An a(ute in"lammation o" the menines
Etioloy#
Cause* -y Nesseria meniniti*es this is usually a normal inha-itant o"
the naso+haryn:0
Mo*e o"
transmission#
Dro+let in"e(tion
In(u-ation +erio*# 6 ' 5D *ays
&atho+hysioloy#
The oranism enters the -loo*stream a"ter in)a*in the res+iratory
tissues0 Rea(hes the s+inal (or* an* o" (ourse the menines0 It
stimulates (hemota:is that lea*s to leu8o(yte in"iltration o" the
menines0 As a result in"lammation "ollo,s0 This -uil* u+ +ressureG +us
an* (om+resses sensiti)e ner)ous tissuesG that may *e(rease the le)el
o" (ons(iousness an* in more se)ere (ases +us (oul* im+e*e -loo*
"lo, an* -rain in"ar(t my ensue0
Sins an* sym+toms
The most sini"i(ant "in*in in*i(atin menineal irritation# -ru*>ins8i
an* 8ernis sin0 Other sin o-ser)a-le are hea*a(heG o+isthotonusG
"e)er an* +ete(hiae
Dianosti(
+ro(e*ure
Lum-ar +un(ture NCS$ analysisO
Manaement
Institute *ro+let +re(aution Ri"am+i(in or Ci+ro"lo:a(in "or +ro+hyla:is
Am+i(illin is the *ru o" (hoi(e Ce"tria:one "or systemi( an* CNS
in"e(tion i)en in (om-ination ,ith Am+i(illin to (om-at resistant
oranism0 Mass +ro+hyla:is is not nee*e* +ro)i*e* that all (hil*ren in
*ay (are (enters ,ho ha)e -een e:+ose* are e:em+te* hen(e they nee*
+ro+hyla:isG this also in(lu*es all other (hil*ren ,ho are (lose to the
in"e(te* +atient su(h as ,hen they share eatin utensils0 Nurses an*
Do(tors are not at ris8 o" ha)in the *isease e:(e+t ,hen (lose (onta(t
o((urre* li8e in mouth to mouth resus(itation0
ENCE&HALITIS
Des(ri+tion# In"lammation o" the tissues o" the Brain
Etioloy#
Mos/uito -orne ' .a+anese en(e+hG Aest Nile en(e+h et( 1iral -orne '
Com+li(ation o" (hi(8en +o: or measles Ame-i( ' A(anthamoe-a
hystolyti(a
Mo*e o"
transmission#
Mos/uito -orne ' -ite o" the in"e(te* mos/uito 1iral ' may -e *ro+let or
air-orne Ame-i( ' a((i*ental entry in the naso ! +haryn: *ue to
s,immin in in"este* ,aters0
In(u-ation +erio*# Mos/uito -orne ' )arie* 1iral ' < ' 5< *ays Ame-i( ' 7 ' ? *ays
28
&atho+hysioloy#
The in"e(tious oranism rear*less o" the ty+e +enetrate the -rain an*
(auses in"lammation o" the -rain tissues it sel"0 the in"lammatory
res+onse (om+resses the -rain stru(ture ,hi(h e:+lains the ra+i*
*eterioration o" the LOC0 En(e+halitis is more se)ere than meninitis0
Sins an* sym+toms
Mar8e* *e(rease in LOC0 Bru*>ins8i an* 8ernis may also -e +resent i"
menineal irritation result0 The most sini"i(ant thouh is the
a++earan(e o" *e(orti(ate an* *e(ere-ate rii*ity0
Dianosti(
+ro(e*ure
Lum-ar Ta+ NCS$ analysisO EEG
Manaement
&rimarily su++orti)e0 The -o*y (an neutrali>e the oranism thru the
+resen(e o" anti-o*y0 Ame-i( en(e+halitis may -ene"it "rom
metroni*a>ole0 Anti in"lammatory may -e i)en Mannitol (oul* *e(rease
IC&
&OLIOMYELITIS
Des(ri+tion# An a(ute +aralyti( in"e(tion that *estroys the a""e(te* ner)es0
Etioloy# Cause* -y +olio )irus 5 NBrunhil*eOG 6 NLansinOG 7 NLeonO
Mo*e o"
transmission#
$e(al ' oral route0 &arti(ularly ram+ant amon those in the s/uatters
area ,ho ha)e no a((ess to sanitary toilet "a(ilities
In(u-ation +erio*# ? ' 59 *ays
&atho+hysioloy#
The )irus enters the oral (a)ity an* re+ro*u(es in the intestines ,hi(h
later +enetrate the intestinal ,all (ausin )iremia an* rea(hin the motor
ner)es an* the s+inal (or*0 The )irus re+ro*u(es insi*e the ner)e an* as
they are release*G the in"e(te* (ell *ieG hen(e +aralysis results0
Sins an* sym+toms
&o8ers sinG Haynes sinG tonsillitisG a-*ominal +ain an* "la((i*
+aralysis
Dianosti(
+ro(e*ure
Stool e:amG +an*ys testG EMG
Manaement
&re)ention O&1 No anti )iral thera+y0 Toilet hyiene must -e rein"or(e*
Aat(h out "or res+iratory +aralysis Assist in reha-ilitation N+hysi(al
thera+y an* (om"ort measures O&1 is +re"erre* o)er I&1 -e(ause the
latter (an only +ro)i*e
RABIES
Des(ri+tion# Another a(ute )iral in"e(tion ,hi(h ha)e a >oonoti( oriin
Etioloy#
&rimarily (arrie* -y mammals s+e(ially lan* an* aerial mammals0 In the
&hili++ines Dos an* Cats are amon the most im+ortant reser)oir0 The
(ausati)e oranism is Rha-*o 1irus
Mo*e o"
transmission#
Bite o" in"e(te* animal0 S(rat(h ,oun* "rom (ats (an also (ause
in"e(tion sin(e (ats usually li(8 their +a,s0
In(u-ation +erio*# 5D *ays "or man 59 *ays "or animals
&atho+hysioloy# The )irus re+li(ates at siht o" in"e(tion ,hi(h later +ro(ee*s to in"e(t
29
the near-y a:ons an* then rea(hes the ner)e it sel"0 $rom that +oint
on,ar*s the )irus tra)els alon the ner)e +ath,ay to rea(h the -rain0 In
the -rain the )irus insihts in"lammatory rea(tion that i)e rise to the
a++earan(e o" en(e+halitis li8e sym+toms later the oranism *es(en*s
"rom the -rain an* e:it to a""e(t other ner)es in he -o*y0 The a""e(tation
o" trieminal ner)e (auses throat s+asms ,hi(h i)es rise to its (lassi(
"in*in Khy*ro+ho-iaL
Sins an* sym+toms
Hy*ro+ho-iaG aero+ho-iaG larynealG &haryneal s+asm e:(essi)e
sali)ation0
Dianosti(
+ro(e*ure
$luores(ent anti-o*y StaininG Neri -o*ies "oun* in -rain -io+sy o" the
in"e(te* animal
Manaement
Human Di+loi* Cell 1a((ineG Ra-ies Immunolo-ulinG Ra-ies Anti serum0
tetanus anti serum is also i)en i" ,ith neati)e or ina*e/uate
immuni>ation history Aash ,oun* ,ith soa+ an* ,aterG may a++ly
,oun* antise+ti( On(e sin an* sym+toms are +resent +assi)e
immuni>ation is alrea*y useless0 Su++orti)e thera+y (omes ne:t0 &rote(t
"rom lare an* sunlihtG +rote(t "rom ,ater an* air (urrent0 Co)er I1
-ottle an* tu-in ,ith (ar-on +a+er or any other else that (an e""e(ti)ely
hi*e the i) "lui*s0 Se(ure (onsent an* restrain the +atient0 O-ser)e*
(onta(t an* *ro+let +re(aution0
LE&ROSY
Des(ri+tion#
A (hroni( in"e(tion that usually a""e(ts the +eri+heral ner)es an* lea*s
to +aresthesias
Etioloy#
A +ossi-le >oonoti( in"e(tion ,hi(h is rarely (ulture* in la-oratory -ut
seen to -e ro,in "reely amon arma*illo0 Causati)e oranism is
My(o-a(terium le+rae
Mo*e o"
transmission#
Dro+let in"e(tion is the most im+ortant transmission0 S8in (onta(t may
(ause in"e(tion only i" there is an o+en lesion ,ith +rolone* (onta(t0
In(u-ation +erio*# = months to I years
&atho+hysioloy#
The oranism enters the -o*y )ia *ro+let in"e(tion0 It is ineste* -y
ma(ro+haes -ut (anPt -e 8ille*G as this (ir(ulatin ma(ro+hae rea(hes
the s8in the -a(teria +enetrate the ner)es0 Later *ue to immune
re(onition ABC atta(8s the in"e(te* (ell ,hi(h results to the
*estru(tion o" the a""e(te* (ell hen(e the a++earan(e o" +aresthesias
an* (onsum+tion o" the in)ol)e* e:tremity -e(omes a++arent *ue to
immune res+onse it sel"0
Sins an* sym+toms
&ainless ,oun*G +aresthesiasG ul(er that *oes not healG leonine
a++earan(eG ma*erosis0 Ner)e in)ol)ement ,ith a(i* "ast -a(illi is the
+athonomi( sin o" le+rosy
Dianosti(
+ro(e*ure
S(ra+e* in(ision metho*0
Manaement Institute (on(urrent *isin"e(tion s+e(ially o" nasal *is(hare0 &re)ention
30
is a(hie)e* -y BCG immuni>ation Ri"am+inG Da+sone an* lam+reme are
e""e(ti)e treatment aainst this in"e(tion
2I*2.0A)/*3 S3S)+,
DENGUE HEMORRHAGIC SHOCF
SYNDROME
Des(ri+tion# An a(ute arthro+o* -orne in"e(tion ,hi(h (auses massi)e -lee*in0
Etioloy#
Causati)e oranism is Denue )irus 5G 6G 7 an* 9 the +rimary )e(tor
is Ae*es ey+ti other ,ise 8no,n as tier mos/uito -e(ause o" the
-la(8 stri+es +resent at the *orsal les o" the inse(t0 The mos/uito
+re"ers to thri)e on (lean stanant ,ater0
Mo*e o"
transmission#
Bite o" the in"e(te* )e(tor mos/uito
In(u-ation
+erio*#
= ' ? *ays
&atho+hysioloy#
The )irus is (arrie* -y the in"e(te* mos/uito an* trans"erre*
throuh -ites in the )i(tim0 On(e the +ro-os(is +ier(e* the
(a+illaries it also lea)es the )iral oranism0 The )irus mi:es in the
-loo*stream sur)i)e an* re+ro*u(e (ausin )iremia ,hi(h e:+lains
the a++earan(e o" enerali>e* "lushin0 The )irus ,ill then
su((ess"ully enters the -one marro, an* arrest the maturation o"
mea8aryo(yte0 Sin(e the +re(ursor o" +latelets (an not ta8e "ull
(ourse it ,ill result to massi)e *ro+ in the +atientPs +latelet (ount
,hi(h sini"i(antly raises the ris8 "or hemorrhae0
Sins an*
sym+toms
&ete(hiaeG -lee*inG e+ita:isG HermanPs sin an* "e)er
Dianosti(
+ro(e*ure
Tourni/uet testG +latelet (ount0
Manaement
Aat(h out "or -lee*in0 Minimi>e in;e(tions an* other +arenteral
+ro(e*ures i" +ossi-le0 A++ly +ressure "or 5D minutes on in;e(tion
site0 A)oi* as+irin use a(etamino+hen +ro)i*e TSB as an a*;un(t to
anti +yreti(s0 Monitor +latelet (losely0 &re+are "or +latelet
(on(entrate or "resh ,hole -loo* as the nee* may (all "or it0 Hy*rate
,ith &NSS &re)enti)e measure "o(uses on 9 o (lo(8 ha-it Use DEET
as an e""e(ti)e mos/uito re+ellant Use mos/uito nets
MALARIA
Des(ri+tion#
Another ty+e o" mos/uito -orne in"e(tion most (ommon in the
tro+i(s
Etioloy#
The (ausati)e oranisms are &lasmo*ium 1i)a:G $al(i+arumG O)aleG
an* Malariae0 The +rimary )e(tors are ano+heles mos/uitoes0
31
Mo*e o"
transmission#
Bite o" the in"e(te* mos/uito
In(u-ation
+erio*#
$or $al(i+arum 56 *aysG "or 1i)a: an* O)ale 59 *ays an* "or
Malariae 7D *ays
&atho+hysioloy#
$rom the -ite o" the in"e(te* mos/uito the oranism enters the -o*y
)ia -loo*stream an* imme*iately +ro(ee* to the li)er in the "orm o"
s+oro>oites0 Insi*e the he+ato(ytes re+ro*u(tion (ontinues until the
host -urst releasin the +arasite in the "orm tro+ho>oites that enters
the RBCG insi*e it the oranism *i)i*es an* "orm s(hi>ont0 This ,ill
later +ro*u(e mero>oites that enters RBC the +ro(ess (auses *ro+
in the num-er o" (ir(ulatin RBC lea*in to anemia an* (a(he:ia0
Sins an*
sym+toms
A (y(le o" hot stae Nhih "e)erO "ollo,e* -y *ia+horeti( stae
Ns,eatinO an* then (ol* stae N(hillinO0 The (y(le re+eats lea*in
to malarial (a(he:ia
Dianosti(
+ro(e*ure
Malarial smear or +eri+heral -loo* smear
Manaement
Chloro/uine is the *ru o" (hoi(e0 &rima/uine must -e i)en to
+re)ent rela+se0 &re)ent -y usin mos/uito re+ellant an* mos/uito
net Chloro/uine is the *ru o" (hoi(e "or +ro+hyla:is0
$ILIRIASIS
Des(ri+tion# A (hroni( lym+hati( *isor*er that is relate* to ele+hantiasis
Etioloy# Causati)e oranism is Au(hereria -an(ro"ti +rimary )e(tor Cule: s++0
Mo*e o"
transmission#
Bite o" the in"e(te* mos/uito
In(u-ation +erio*# = ' 56 months
&atho+hysioloy#
The oranism enters the -o*y a"ter the )e(torsP -iteG it then matures an*
mirate on the lym+hati( )essels -ut it usually a""e(ts those in the lo,er
e:tremity0 The +roto>oal +arasite (ro,*s an* *estroy the "ilterin a-ility
o" the lym+h no*es ,hi(h then lea*s to the a((umulation o" lym+h or
-o*y "lui*s (ausin e*ema an* at ,orst (ases ross *e"ormity hen(e it
(oul* lea* to ele+hantiasis0
Sins an* sym+toms
Re(urrent lo, ra*e "e)erG lym+hanitisG no(turnal asthma an* in ,orst
(ases ele+hantiasis
Dianosti(
+ro(e*ure
Mi(ros(o+i( e:amination o" +eri+heral -loo*0
Manaement
Use o" mos/uito re+ellant an* nets Hetra>an is e""e(ti)e aainst $iliriasis
a*)erse rea(tion thouh are seen in a num-er o" +atientsG i" su(h may -e
+resent may use I)erme(tin
*+S&I*A)/*3 S3S)+,
32
DI&HTHERIA
Des(ri+tion#
An a(ute in"e(tion o" the u++er res+iratory system ,hose (om+li(ation
may in(lu*e the lo,er res+iratory tra(t0
Etioloy# The oranismG Coryne-a(terium *i+htheriae is u-i/uitous0
Mo*e o"
transmission#
Dro+let in"e(tion is the means o" s+rea*
In(u-ation +erio*# 5 ' ? *ays
&atho+hysioloy#
The oranism in"e(ts the oral (a)ity ,hi(h later *ue to its a-ility o"
releasin to:ins (auses the *eath o" the in)ol)e* tissues0 This i)es rise
to the a++earan(e o" +su*omem-arne ,hi(h may -e *islo*e an* -lo(8
the air,ay0 As to:ins are se(rete* the heartG 8i*ney an* the ner)es
a-sor- itG this to:ins halt +rotein synthesis o" the in"e(te* (ell ,hi(h
later on (auses its *eath0
Sins an* sym+toms
&athonomoni( Sin is +seu*o mem-rane0 Tonsillitis may also -e
+resent0 $e)er an* malaise0 I" (om+li(ation arises +aralysisG en*o(ar*itis
an* 8i*ney "ailure may -e seen0
Dianosti(
+ro(e*ure
Throat s,a-
Manaement
Gather s+e(imen "or (ulture &re+are "or e+ine+hrine an* +ossi-le
intu-ation Be rea*y "or antito:in thera+y a"ter (he(8in "or allery
A*minister +eni(illin or erythromy(in
&ERTUSIS
Des(ri+tion#
A ,i*es+rea* oranism that threaten any one ,ho ha)e no immunity
aainst it0
Etioloy# Causati)e oranism is Bor*etella +ertussis
Mo*e o"
transmission#
Dro+let in"e(tion
In(u-ation +erio*# ? ' 65 *ays
&atho+hysioloy# The oranism enters the u++er res+iratory tra(t atta(hes to the
res+iratory e+ithelium an* (auses an in(rease* +ro*u(tion o" (y(li(
amino +hos+hate that essentially lea*s to hy+era(ti)ity o" the mu(ous
se(retin (ells0 Thi(8 tena(ious se(retions -lo(8s the air,ay0 The
oranism also halts the mu(o(iliary es(alator lea)in (ouhin re"le:
the last e""e(ti)e +rote(ti)e me(hanism o" e:+ellin s+utum0 Due to its
relati)e tena(iousness the -o*y e:+erien(es *i""i(ulty in (ouhin out
33
+hlem thus ,e o-ser)e +atient to mani"est )iolent (ouh0
Sins an* sym+toms
&athonomoni( o" this in"e(tion is )iolent (ouh ,@out inter)enin
inhalation "ollo,e* -y an ins+iratory ,hoo+0 1omitin may -e +resentG
In(rease* in IC& an* IO& are also seen0 Hernia is also a hih ris8
in(i*ent0
Dianosti(
+ro(e*ure
Throat s,a-
Manaement
&eni(illinG Erythromy(in 4 Mu(olyti( may -e or*ere*0 Ne-uli>ation may
also -e in*i(ate*4 &ro)i*e small "ee*ins A++ly a-*ominal -in*er 4
A)oi* *ust an* *ra"ts
TUBERCULOSIS
Des(ri+tion# A (hroni( lun in"e(tion that lea*s to (onsum+tion o" al)eolar tissues
Etioloy# Causati)e oranism is a(i* "ast -a(illus my(o-a(terium tu-er(ulosis0
Mo*e o"
transmission#
Dro+let in"e(tion as ,ell as air-orne
In(u-ation +erio*# 6 ' 9 ,ee8s
&atho+hysioloy#
The -a(illi is inhale* an* ta8en in the al)eoli ,here ma(ro+hae ,ill
inest -ut "ail to 8ill the oranism0 As these ma(ro+haes mirate to
near-y lym+h no*es it ,ill *ie an* lea)e the (a+sulate* -a(teria
un*ieste*0 On(e the -o*yPs immune system *ro++e*G the -a(teria ,ill
-e a(ti)ate* an* stimulate immune res+onse ,hi(h li8e,ise *amae the
al)eolar tissues lea*in to (asseation ne(rosis an* (oul* e)entually
(onsume the entire luns i" the +ro(ess is re+eate* "re/uently
Sins an* sym+tomsA"ternoon "e)erG niht s,eatsG (ouh "or 6 ,ee8sG anore:ia ,eiht loss0
Dianosti(
+ro(e*ure
S+utum mi(ros(o+yG CCRG Mantou: test
Manaement
Institute DOTS Gi)e as or*ere*4 &yra>inami*eG I>onia>i*G Ri"am+i(inG
Etham-utol an* Stre+tomy(in0 Che(8 "or sensiti)ity to any o" the *ru
mentione* &ro)i*e B= i" re(ei)in I>onia>i* Aat(h out "or )isual +ro-lem
i" re(ei)in Etham-utol Etham-utol is (ontra in*i(ate* "or (hil*ren ,ho
(ant )er-ali>e )isual +ro-lems yet0
&NEUMONIA
Des(ri+tion# an a(ute usually -a(terial in nature
Etioloy#
the most (ommon (ausati)e oranism is str+to(o((us +neumoniae
u-i/uitousG orainsm an* may -e trans"erre* amon +o+ulation that has
+oor )entilation an* im+aire* res+iratory (illiary "un(tion0 (ertain
*isease li8e measles may +romote the *e)elo+ment o" +neumonia
Mo*e o"
transmission#
Dro+let in"e(tion
In(u-ation +erio*# 69 to ?6 hrs usually 9I hrs
34
&atho+hysioloy#
the oranism enters the res+iratory tra(t an* i" the (illiary me(hanism
"ails to +re)ent its "urther entry the oranism then in"e(ts the lo,er
res+iratory (enters ,here it stimulate an in"lammatory rea(tion0 this
res+onse lea*s to miration o" ABC in +arti(ular ,ith neutro+hil hen(e
leu8o(yte in"iltration is seen in (hest :!rays as (onsoli*ation0 the -uil*
u+ +uss in(reases the al)eolar +resure (ausin in atele(tasis on(e
(olla+se* al)eoli (ant +arti(i+ate in as e:(hane anymore lea*in to
im+aire* DOB0
Sins an* sym+toms
Rusty (olore* s+utum is the +athonomoni( sin this is (ause* -y ABC
in"iltratesG RBC an* s+utum0 DOBG in(rease* RRG (ouhin an* in late
(ases letharyG (yanosis an* *eath0
Dianosti(
+ro(e*ure
s+utum e:am
Manaement
Co Trimo:a>ole an* entamy(in are the *ru o" (hoi(e0 althouh Co!tri
is use* more ,i*ely than entamy(in -e(ause o" its oral +re+aration
,hi(h are allo,e* to -e a*ministere* -y mi*,i)es "or +atient in "ar "lun
areas0 instru(t the mothers to (ontinue the a*ministration o" anti-ioti(
"or < straiht *ays TSB i" in (ase "e)er may arise &romote +ro+er room
)entilation a)oi* (ro,*in as mu(h as +ossi-le Use &neumo(o((al
)a((ine as in*i(ate*
COLDS NCORY3AO
Des(ri+tion# The (ausati)e aent (omes "rom a*eno)irus an* rhino )irus0
Mo*e o"
transmission#
Dro+let in"e(tionG *ire(t (onta(t0
In(u-ation +erio*# 5 ' 7 *ays
&atho+hysioloy#
As the )irus enters the res+iratory tra(tG it atta(hes itsel" to the mu(ous
mem-rane an* (auses lo(al irritation an* in"lammation0 In res+onseG the
mu(ous mem-rane releases mu(ous to "lush out the )irus0 Sin(e there is
an in(rease* in the +ro*u(tion o" the mu(ous it usually "lo,s -a(8 an*
(auses rhino rhea an* -e(ause o" the naso!la(rymal *u(tG in(rease*
mu(ous +ro*u(tion im+e*es the *rainae o" tears thus ,atery eyes is
+resent0 Com+li(ations# Chil*ren ' otitis me*ia an* -ron(ho+neumonia
A*ult ' sinusitis
Sins an* sym+toms
General malaise
$e)erG (hills
Snee>inG *ry an* s(rat(hy throat
Teary eyesG hea*a(he
Continues ,ater *is(hare "rom nares
Manaement
a0 &ro)i*e a*e/uate rest an* slee+ -0 In(rease "lui* inta8e (0 &ro)i*e
a*e/uate an* nutritious *iet *0 En(ourae )itamins s+e(ially )itamin C
35
IN$LUEN3A NLA GRI&&E O$ $LUO
Des(ri+tion#
A hihly (ontaious *isease (hara(teri>e* -y su**en onset o" a(hes
an* +ains0
Etioloy# In"luen>a )irus AG BG C
Mo*e o"
transmission#
Dro+let in"e(tionG (onta(t ,ith naso+haryneal se(retions
In(u-ation +erio*# 69 ' 9I hrs0
&atho+hysioloy#
U+on entry in the u++er res+iratory tra(tG it is *e+osite* in the same site
an* +enetrates the mu(osal (ells0 Causin lysis an* *estru(tion o" the
(iliate* e+ithelium the )irus releases neurami*ase that *e(reases the
)is(osity o" the mu(osa0 $a(ilitatin the s+rea* o" the in"e(te* e:u*ates
to the lo,er res+iratory tra(tG this (auses intestinal in"lammationG an*
ne(rosis o" the al)eolar an* -ron(hiolar e+ithelium0 ThusG the al)eoli are
"ille* ,ith e:u*ates (ontainin ABCG RBC an* hyaline (artilae0 This
+la(es the +atient to in(rease* +ossi-ility o" a(/uirin -a(terial
+neumonia usually (ause* -y S0 Aureus0
Sins an* sym+toms
Res+iratory ' most (ommon
"e)er
anore:ia
(hills
mus(le +ain an* a(hes
(ory>a
sore throat
-itter taste
or-ital +ain
Intestinal
)omitin
se)ere a-*ominal +ain
"e)er
o-stinate (onsti+ation
se)ere *iarrhea
Ner)ous
hea*a(he
Manaement
a0 +ro)i*e a*e/uate rest an* )entilation -0 te+i* s+one -ath to re*u(e
the tem+erature (0 monitor the )ital sins *0 +ro)i*e a*e/uate nutrition e0
assist the +atient in (onser)in strenth ,hen she is )ery ,ea8 "0 *ru
o" (hoi(e# % anti-ioti(s % sul"onami*es
I-)+1.,+-)A*3 S3S)+,
SCARLET $E1ER NSCARLATINAO
Des(ri+tion# Is an a(uteG "e-rileG (ontaious (on*ition (hara(teri>e* -y su**en onset
usually ,ith )omitin an* -y +un(tuate erythematous s8in eru+tion
"ollo,e* -y (hara(teristi( e:"oliation o" the s8in *urin (on)ales(en(eG
36
ra+i* +ulse an* sore throat0
Etioloy# Grou+ A hemolyti( stre+to(o((us rou+
Mo*e o"
transmission#
Dire(t (onta(tG *ro+let in"e(tion an* in*ire(t (onta(t
In(u-ation +erio*# 5 ' ? *ays
&atho+hysioloy#
The -a(terium releases erythroeni( to:insG ,hi(h (auses sensiti)ity
rea(tion in the -o*y0 The to:in (an (ause to:i( in;ury to the small
(a+illaries o" )as(ular e+ithelium "oun* in the -o*y0 The s8in is the site
,here the mani"estations are most )isi-le ,here one ,ill o-ser)e*
stra,-erry li8e tonueG rashesG et(0 Com+li(ations# % sinusitis % ne+hritis %
otitis me*ia % myo(ar*itis@en*o(ar*itis % mastoi*itis
Sins an* sym+toms
I0 &ro*omal stae
"e)er
ta(hy(ar*ia
sore throat
)omitin
hea*a(he
a-*ominal +ain
-o*y malaise
II0 Eru+ti)e stae
rashes# a++ears at the en* o" 69 hours on the (hest s+rea*
ra*ually u+,ar* an* *o,n,ar*
enanthem# ma(ular eru+tion on the har* +alate
+astiaPs line# *ue to the rou+in o" ma(ules "oun* aroun* the
"ol*s o" the s8in +arti(ularly on the el-o,
tiny su-(uti(ular )esi(les# "oun* in the (uti(les o" the nails
stra,-erry tonue# tonue -e(omes re* at the e*es an* enlare*
+a+illae sho,
ras+-erry tonue# (ir(umoral +allor
III0 Des/uamation NI ' 5D *aysO % s8in -eins to +eel % she**in o" the hair
an* nails
Dianosti(
+ro(e*ure
S(ult>!Charlton rash e:tin(tion or -lan(hin test ' "or sensiti)ity
to s(arlet "e)er antito:in
Di(8 test ' *etermines ,hether or not a +erson is naturally
immune to s(arlatine
nasal s,a-
La-oratory#
+ositi)e throat (ulture "or stre+
ele)ate* ASO titer
,hite an* *i""erentiate* (ount hih as <DGDDD in(reae in
eosino+hils
Manaement
50 isolation ' me*i(al ase+ti( te(hni/ue
60 -e* rest
70 8ee+ the +atient ,arm at all times an* a)oi* *ra"ts
37
90 a++ly i(e (a+@+a(8s "or hih "e)er
<0 i)e TSB "or hih tem+erature
=0 in(rease oral "lui* inta8e
?0 ta8e )ital sins / 7 ' 9 hrs
I0 *aily -ath shoul* -e i)en# so*ium -i(ar-onate or star(h is
use* in e:(essi)e it(hin an* oil ru- a"ter -ath is use"ul
J0 use o" mouth,ashes an* arles "or oo* oral hyiene
5D0 +re)ent e:oriations -y ,i+in nasal *is(hares ,ith so"t
tissues an* a++li(ation o" (ol* (reams
550 en(ourae *aily elimination
560 *iet shoul* -e o" hih (alorie "oo*s an* "ruit ;ui(esG mil8
(ream an* sou+s
Me*i(al manaement# a0 antito:ins -0 (on)ales(ent serum (0 samma
lo-in ' a*ministere* IM *0 sul"onami*es e0 anti-ioti(s ' +eni(illin N"or
(leanin the throat o" stre+to(o((usO
LE&ROSY NHANSENPS DISEASEG
HANSENOSISG LE&RAEG LEONTHIASISO
Des(ri+tion#
A (hroni( in"e(tious *isease (hara(teri>e* -y the a++earan(e o"
mo*ules in the s8in or mu(ous mem-ranes or -y (hanes in the ner)es
lea*in to anesthesiaG +aralysis or other (hanes
Etioloy#
My(o-a(terium le+rae Na(i* "ast -a(illusOG s+ora*i(@en*emi( (asesG
o((urs in tro+i(al an* semitro+i(al (ountries throuhout the ,orl*0 It
(an -e (ontra(te* in (hil*hoo* Nmani"este* at ae 5< an* *ianose* -y
the ae o" 6D yearsO0 &ronosis# Y the loner the time o" a(ti)e *iseaseG
se)ere lesionsG the more ra+i*ly they ha)e a*)an(e* ,ithout a-ility to
+ro*u(e the le+romin rea(tion ' the +oorer the +ronosis Y (ase un*er
65 years ol* ' hih rela+se rate
Mo*e o"
transmission#
&rolone* intimate s8in to s8in (onta(tG nasal se(retions
In(u-ation +erio*# &rolone*G un*etermine* an* )aries "rom one to many years
&atho+hysioloy#
The -a(teriumG ,hi(h is an a(i*!"ast -a(illusG atta(8s the s8in tissues
an* +eri+heral ner)eG ,hi(h (auses s8in lesionsG anesthesiaG in"e(tion
an* *e"ormities
Sins an* sym+tomsAssessment#
50 Tu-er(uloi* ty+e ' sho,s hih resistan(e to HansenPs -a(illi0
Clini(al mani"estations are mainly in the s8in an* ner)es an*
usually are use* or non!in"e(tious0
60 Le+romatous ty+e ' minimal resistan(e to the multi+li(ationG
e:isten(e o" the -a(illusG (onstant +resen(e o" lare num-ers in
the lesions an* "orm lo-i N(hara(teristi( mani"estations in the
s8in an* mu(us mem-ranesO an* +eri+heral ner)es0
70 O+en or in"e(tious (ases
90 In*erterminate ty+e ' (lini(al mani"estations are lo(ate* (hie"ly in
38
s8in an* ner)es4 lesions are "lat ma(ules0
<0 Bor*erline
Clini(al Mani"estations# 50 Early stae % loss o" sensation % +aralysis o"
e:tremities % a-sen(e o" s,eatin Nanhy*rosisO % nasal o-stru(tion % loss
o" hair Neye-ro,sO % eye re*ness % (hane in the s8in (olor % ul(ers that
*oes not heal % mus(le ,ea8ness 60 Late sym+toms % (ontra(tures %
leonine a++earan(e N*ue to no*ular an* thi(8ene* s8in o" the "orehea*
an* "a(eO % ma*arosis N"allin o" eye-ro,sO % syne(omastia % sin8in o"
-ri*e o" nose 70 Car*inal sins % +resen(e o" HansenPs -a(illi % +resen(e
o" lo(ali>e* areas o" anesrhesia % +eri+heral ner)e enlarement
Dianosti(
+ro(e*ure
50 Le+romin rea(tion ' a +ositi)e test *e)elo+s a no*ule at the site o"
ino(ulation N"irst an* thir* ,ee8O
60 Aassermann rea(tion
Manaement
&lannin an* im+lementation
50 &re)ention
o se+arate in"ants "rom le+romatous +arents at -irth
o sereate an* treat o+en (ases o" le+rosy
o re/uire +u-li( health su+er)ision an* (ontrol o" (ases o"
HansenPs *isease
60 Me*i(al manaement
50 Multi+le *ru thera+y % +au(i-a(illary treatment ' si: months or until
neati)e N!O results o((ur % re"am+i(in ' on(e a month % *a+sone ! on(e a
*ay 60 Multi-a(illary treatment ' "or 6 (onse(uti)e years or until neati)e
N!O "or le+rosy test % ri"am+i(in on(e a month % lam+rene on(e a *ay %
*a+sone on(e a *ay
70 "ullG ,holesome enerous *iet
90 al(ohol or TSB may -e use* "or hih "e)er
<0 +atient shoul* ha)e a *aily (leansin -ath an* (hane o" (lothin
=0 oo* oral hyiene
?0 normal elimination shoul* -e maintaine*
h0 meti(ulous s8in (are "or ul(ers
MEASLES NRUBEOLAG MORBILLIG ? ' DAY
MEASLESO
Des(ri+tion#
An e:tremely (ontaious e:anthematous *isease o" a(ute onset ,hi(h
most o"ten a""e(ts (hil*ren an* the (hie" sym+toms o" ,hi(h are
re"era-le to the u++er res+iratory +assaes0
Etioloy# The (ausati)e aent is the +aramy:o )irus
Mo*e o"
transmission#
Nasal throat se(retionsG *ro+let in"e(tionG in*ire(t (onta(t ,ith arti(les
In(u-ation +erio*# I ' 6D *ays
&atho+hysioloy# As the )irus enters the -o*y it imme*iately multi+lies in the res+iratory
e+iyhelium0 It *isseminate -y ,ay o" the lym+hati( system (ausin
39
hy+er+lasia o" the in"e(te* lym+hoi* tissue0 As a result there is a +rimary
)iremia ,hi(h in"e(ts the leu8o(yte an* in)ol)es the ,hole
reti(uloen*othelial system0 As the in"e(te* (ells *ie it ne(rose an*
release more )iruses to in"e(t other leu8o(ytes lea*in to se(on*ary
)iremiaG ,hi(h also (auses e*ema o" u++er res+iratory tra(t +ro*u(in
its sym+toms an* it may +re*is+ose to +neumonia0 Com+li(ations# %
otitis me*ia % -ron(ho+nuemonia % se)ere -ron(hitis &ronosis# % *eath
rate is hihest in the "irst t,o years o" li"e N6DWO % a"ter 9 years '
un(ommon % o)er all mortality ' less than
Sins an* sym+toms
Assessment#
50 Staes
50 in(u-ation +erio* Na)erae o" 5D *aysO
60 &re!eru+ti)e stae or stae o" in)asion N7!= *aysO % "rom the
a++earan(e o" the "irst sins an* sym+toms to the earliest e)i*en(e o"
the eru+tion0 % "e)erG se)ere (ol* % "re/uent snee>in % +ro"use nasal
*is(hare % eyes are re* an* s,ollen ,ith mu(o+urulent *is(hare Nli*s
sti(8 toetherO % StimsonPs sin N+u""iness o" lo,er eyeli*s ,ith *e"inite
line o" (onestion on the (on;un(ti)aeO % re*ness o" -oth ear*rums %
)omitinG *ro,siness % har*G *ry (ouh % Fo+li8Ps s+ot Na++ears on
se(on* *ayO# small -rihtG re* ma(ules or +a+ules ,ith a tiny or -luish!
,hite s+e(8s on the (enter an* (an -e "oun* on the -u((al (a)ity %
ma(u+a+ular rashes Nseen late in 9th *ayO# a++ears "irst on the (hee8s or
at the hairline % true measles rash# slihtly ele)ate* sensation to tou(hG
a++ears "irst on the "a(e an* s+rea*s *o,n,ar* o)er ne(8G (hest trun8G
lim-s an* a++earin last on the ,rist an* -a(8 o" the han*
70 Eru+ti)e stae % (hara(teri>e* -y a eneral intensi"i(ation o" all lo(al
(onstitutional sym+toms o" the +re!eru+ti)e stae ,ith the a++earan(e
o" -ron(hitis an* loose -o,els % irrita-ility an* restlessness % re* an*
s,ollen throat % enlarement o" (er)i(al lan*s % "e)er su-si*es 90
Des/uamation stae % "ollo,s a"ter the rash "a*es % "ollo,s the or*er o"
*istri-ution seen in the "ormation o" eru+tion
Dianosti(
+ro(e*ure
No s+e(i"i( *ianosti( e:am e:(e+t only "or the +resen(e o" leu(o+enia0
Manaement a0 +re)ention % e*u(ation o" +arents rear*in the *isease % +assi)e
immuni>ation o" in"ants an* (hil*ren Nammalo-ulinO % a(ti)e
immuni>ation N5st year o" li"eO
-0 manaement % *rus Z anti-ioti(s Z sul"o*ia>ine % isolation %
meti(ulous s8in (are ' ,arm al(ohol ru- to +re)ent +ressure sores %
oo* oral an* nasal hyiene % in(rease oral "lui* inta8e % +ro+er (are o"
the eyes ' eye s(reen to a)oi* *ire(t liht4 ,ear *ar8 lasses % ears
shoul* -e (leane* a"ter -ath i" there is *is(hares ' +atient shoul* lie
the a""e(te* ear *o,n or to,ar*s the -e* %
40
i)e am+le o" "lui*s *urin "e-rile stae
GERMAN MEASLES NRUBELLAG ROTHEING
ROSEOLAG 7!DAY MEASLESO
Des(ri+tion#
An a(ute in"e(tious *isease (hara(teri>e* -y mil* (onstitutional
sym+tomsG rose (olore* ma(ular eru+tion ,hi(h may resem-les measles
an* enlarement an* ten*erness
Etioloy#
Cause* -y my:o)irus0 O((urs mostly in s+rin an* seen mostly in
(hil*ren o)er < years o" ae
Mo*e o"
transmission#
Dire(t (onta(t
In(u-ation +erio*#
59 ' 65 *ays &erio* o" (ommuni(a-ility ' ? *ays -e"ore to < *ays a"ter
the rash a++ears
&atho+hysioloy#
As the )irus ains entran(e to the naso+haryn:G it imme*iately in)a*es
the nearest lym+h lan* (ausin lym+ha*eno+athy0 Later onG the )irus
enters the -loo* stream that stimulates the immune res+onseG ,hi(h is
the (ause o" rashes "oun* in the -o*y o" in"e(te* in*i)i*ual0 I" rashes
has a++eare* it means that )iremia has su-si*e*0 Sin(e the *isease is
enerally mil* an* serious (om+li(ation has ha -een )ery rareG ,hat
shoul* -e ,at(he* out rather are its (onenital e""e(ts -e(ause it (an
(ross the +la(ental -arrierG ,hi(h may 8ill the "etus or (ause (onenital
ru-ella syn*rome0 Com+li(ations# % otitis me*ia % en(e+halitis % transient
al-uminuria % arthritis % (onenital *e"e(ts "or -a-ies ,hoPs mother ,ere
e:+ose* in early +renan(y &ronosis# )ery "a)ora-le
Sins an* sym+toms
% "e)erG (ouh % loss o" a++etite % enlarement o" lym+h no*es % s,eatin %
leu(o+enia % )omitin Nin some (asesO % hea*a(heG mil* sore throat %
*es/uamation "ollo,s the rash % enanthem o" u)ula ,ith tiny re* s+ots %
rash N(ar*inal sym+tomO a((om+anie* ,ith (er)i(al a*enitis# -eins on
the "a(e in(lu*in the area aroun* the mouth4 o)alG +aleG rose!re*
+a+ules a-out the si>e o" a +inhea*4 (o)ers the -o*y ,ithin 69 hours
an* one -y the en* o" the 9th *ay
Manaement
&lannin an* im+lementation
a0 &re)ention# )a((ination % amma lo-ulin ' i)en to +renant ,omen
,ith neati)e history an* ,ho ha)e -een e:+ose* in the "irst trimester o"
+renan(y % in(lu*e in MMR i)en at 5<months to the -a-y
-0 manaement % isolation ' N(atarrhal stae ' to +re)ent in"e(tion to
othersO % -e* rest "or "irst "e, *ays % meti(ulous s8in (are es+e(ially a"ter
the rash "a*es % oo* oral an* nasal hyiene Nuse o" +etroleum ;elly i"
li+s -e(ome *ryO % no s+e(ial *iet is ne(essaryG in(rease oral "lui* inta8e
41
1ARICELLA NCHICFEN &OCO
Des(ri+tion#
A )ery (ontaious a(ute *isease usually o((urrin in small (hil*renG
(hara(teri>e* -y the a++earan(e o" )esi(les "re/uently +re(e*e* -y
+a+ulesG o((asionally "ollo,e* -y +ostules -ut en*in in (rustin
Etioloy# 1ari(ella >oster )irus Nair-orneO
Mo*e o"
transmission#
Dro+let in"e(tionG *ire(t (onta(t
In(u-ation +erio*# 6 !7 ,ee8s
&atho+hysioloy#
The )irus ain entran(e )ia the u++er res+iratory tra(t it (rosses the
mu(ous mem-rane an* (ause systemi( in"e(tion "ollo,e* -y
a++earan(e o" numerous ma(u+a+ular rash0 The rash are "lui* "ille* that
(ontain +olymor+honu(lear leu8o(ytes0 &erio* o" (ommuni(a-ility#
hihly (ontaious "rom 6 *ays +rior to rash to = *ays a"ter rash eru+t0
$ull -lo,n (ase im+orts +ermanent immunity0 Com+li(ations# %
+neumonia % ne+hritis % en(e+halitis % im+etio % +ittin or s(arrin o" the
s8in
Sins an* sym+toms
% sliht "e)er# "irst to a++ear % -o*y malaiseG mus(le +ain % eru+tion
Nma(ulo+a+ularO then +roresses to )esi(le N7!9 *aysO4 -eins on trun8
an* s+rea*s to e:tremities an* "a(e Ne)en on the s(al+G throat an*
mu(us mem-ranesO % intense +ruritus % )esi(les en*e* as a ranular
s(a- % irrita-ility
Manaement
50 Drus % +eni(illin ' (an -e use* ,hen the (rusts are se)ere or in"e(te*
to +re)ent s(arrin or se(on*ary in)asion % al8alini>in aent to +re)ent
ne+hritis an* to sto+ )omitin % a(y(lo)irG immunosin ' anti)iral %
hy*ro(ortisone lotion 5W "or it(hin
60 isolation in a room -y itsel"
70 +ro)i*e a ,ell )entilate*G ,arm room to the +atient
90 ,arm -ath shoul* -e i)en *aily to relie)e it(hin4 use a (alamine
lotion
<0 a)oi* in;urin the lesions -y usin so"t a-sor-ent to,el an* the
+atient shoul* -e +atte* *ry instea* o" ru--e* *ry =0 maintain oo* oral
hyieneG i" lesions are "oun* in the mouth or nasal +assaesG antise+ti(
+re+ may -e use* ?0 *iet shoul* -e reular
HER&ES 3OSTER NSHINGLESO
Des(ri+tion#
A(ute )iral in"e(tion o" the +eri+heral ner)ous system *ue to rea(ti)ation
o" )ari(ella >oster )irus0 The )irus (auses an in"lammatory rea(tion in
isolate* s+inal an* (ranial sensory anlia an* the +osterior ray matter
o" the s+inal (or*0 Contaious to anyone ,ho has not ha* )ari(ella or
,ho immunosu+resse*0
Sins an* sym+toms
% neurali( +ain % malaise % -urnin % "e)er % (luster o" s8in )esi(les alon
(ourse o" +eri+heral sensory ner)es Nunilateral an* "oun* in trun8G
thora: or "a(eO4 a++ears 7!9 *ays
42
Manaement
50 *rus
o analesi(s
o (orti(osteroi*s
o a(eti( a(i* (om+resses or ,hite +etrolatum
o anti!)iral Na(y(lo)irO
60 isolate (lient
70 a++ly *ryin lotion
90 a*minister me*i(ations as or*ere*
<0 instru(t (lient to +re)enti)e measures
SCABIES
Des(ri+tion#
An in"e(tion o" the s8in +ro*u(e* -y -urro,in a(tion o" a +arasite mite
resultin in irritation an* the "ormation o" )esi(les or +ostules0
Etioloy#
It(hmiteG sar(o+tes s(a-eiG o((urs in in*i)i*ual li)in in area o" +o)erty
,here (leanliness is la(8in0
Mo*e o"
transmission#
Dire(t (onta(t ,ith in"e(te* +ersonsG in*ire(t (onta(t throuh soile* -e*
linensG (lothin an* others0
In(u-ation +erio*# !
&atho+hysioloy#
Both "emale an* male +arasites li)e on the s8in0 A "emale +arasite
-urro,s into the su+er"i(ial s8in to *e+osit es0 &ruritus o((urs an*
s(rat(hin o" s8in may +ro*u(e se(on*ary in"e(tion0 S(attere* "olli(ular0
Eru+tion (ontains immature mites0 In"lammation may +ro*u(e +ostules
an* (rust0 Es is hat(he* in 9 *ays0 Lar)ae un*ero a series o" matts
-e"ore -e(omin a*ult0 Li"e (y(le is (om+lete in 5!6 ,ee8s0
Sins an* sym+toms
% intense it(hin es+e(ially at niht % sites ' -et,een "iners or "le:or
sur"a(es o" ,rists an* +almsG aroun* ni++lesG um-ili(usG in a:illary "ol*sG
near roin or luteal "ol*sG +enisG s(rotum0
Dianosti(
+ro(e*ure
&resen(e on s8in o" "emale miteG o)a an* "e(es u+on s8in s(ra++in0
Manaement
50 Ta8e a ,arm soa+y sho,er -ath or -ath to remo)e s(alin *e-ris
"rom (rusts0
60 A++ly +res(ri-e* s(a-i(i*e su(h as#
o lin*ane lotion N8,ellO 5W
o (rotamiton NEura:O (ream or lotion
o =!5DW +re(i+itate o" sul"ur in +etrolatum
70 en(ourae to (hane (lothin "re/uently
RINGAORM NTRICHO&HYTOSISO
Des(ri+tion#
A rou+ o" *iseases (ause* -y a num-er o" )eeta-le "uni an* a""e(tin
)arious +ortion o" the -o*y in *i""erent ,ays Ns8inG hairG nailsO
Etioloy# TINEA &EDIS NAthletePs "ootO ' a su+er"i(ial "unal in"e(tion *ue to
tri(ho+hyton Ru-rumG mentaro+hytesG or e+i*ermo+hyton "lo((osum
,hi(h may mani"est itsel" as an a(uteG in"lammatoryG )esi(ular +ro(ess
43
or as (hroni( rash in)ol)in the soles o" the "eet an* the inter!*iital ,e-
s+a(es0 +arti(ularly (ommon in summerG (ontra(te* s,immin area an*
lo(8er rooms0 TINEA COR&ORIS or TINEA CIRCINATA ' rin,orm o" the
-o*y0 TINEA CRURIS N.o(8 it(hO ' su+er"i(ial "unal in"e(tion o" the
roin ,hi(h may e:ten* to the inner thih an* -utto(8s areas an*
(ommonly asso(iate* ,ith tinea +e*is0 TINEA CA&ITIS Nrin,orm o" the
s(al+O ' (ause* -y mi(ros+orum (anisG tri(ho+hyton tonsurans0 % usually
s+rea* throuh (hil* to (hil* (onta(tG use o" to,elsG (om-sG -rushes an*
hats % 8itten an* +u++ies may -e the sour(e o" the in"e(tion % +rimarily
seen in (hil*ren -e"ore +u-erty %
Sins an* sym+toms
TINEA &EDIS % s(aly "issures -et,een toesG )esi(les on si*es o" "eet %
+ruritus % -urnin an* erethema % lym+hanitis an* (ellulites may o((ur
TINEA COR&ORIS or TINEA CIRCINATA % intense it(hin % a++earan(e#
-eins as s(alin erythematous lesions a*)an(in to rins o" )esi(les
,ith (entral (learin an* a++ears on e:+ose* areas o" -o*y0 TINEA
CRURIS % *ull re* -ro,n eru+tion o" the u++er thihs an* e:ten*s to
"orm (ir(ular +la/ues ,ith ele)ate* s(aly or )esi(ular -or*ers0 % it(hin %
seen most in ;oersG o-ese in*i)i*uals an* those ,earin tiht
un*er(oatin0 TINEA CA&ITIS % re**ene*G o)al or roun* areas o" alo+e(ia
% +resen(e o" 8erion# an a(ute in"lammation that +ro*u(es e*emaG
+ostules an* ranulomatous s,ellin
Dianosti(
+ro(e*ure
TINEA &EDIS % *ire(t e:amination o" s(ra+ins Ns8inG nailsG hairO %
isolation o" the oranisms in (ulture TINEA CA&ITIS % ,oo*Ps lam+ %
mi(ros(o+i( e)aluation
Manaement TINEA &EDIS
50 &re)ention# instru(t (lient to 8ee+ "eet *ry su(h as -y usin
tal(um +o,*er0
60 Manaement#
o Drus# to+i(al aentG (lotrima>oleG mi(ona>oleG tolna"tate
o Systemi( anti!"unal thera+y# riseo"ul)inG 8eto(ona>ole
o Ele)ate "eet "or )esi(ular ty+e o +ain in"e(tion0
TINEA COR&ORIS or TINEA CIRCINATA
50 &re)ention# in"e(te* +et is a (ommon sour(e an* shoul* -e
ins+e(te* an* treate* -y a )eterinarian0
60 Manaement
o see treatment "or tinea +e*is
o ,ear (lean (otton (lothin ne:t to s8in
o use (lean to,el *aily
o *ry all areas an* s8in "ol*s thorouhly
o use sel" monitorin "or sins o" re!in"e(tion a"ter a (ourse o"
thera+y0
TINEA CRURIS
50 &re)ention# a)oi* nylon un*er(lothinG tiht!"ittin un*er,ear an*
+rolone* ,earin o" ,et -athin suit0
60 Manaement#
o Drus ' to+i(al thera+y Nmi(ona>ole (reamO4 riseo"ul)in
44
NoralO
o a)oi* e:(essi)e ,ashin or s(ru--in4 ,ear (otton
un*er,ear0
TINEA CA&ITIS ' same ,ith other "unal in"e(tion
1AS)*/I-)+S)I-A0 DIS/*D+*S
TY&HOID $E1ER NENTERIC $E1ERO
Des(ri+tion#
A eneral in"e(tion (hara(teri>e* -y the hy+er+lasia o" the lym+hoi*
tissuesG es+e(ially enlarement an* ul(erations o" the &eyerPs +at(hes
an* enlarement o" the s+leenG -y +are(hymatous (hanes in )arious
orans an* li-eration o" an en*oto:in in the -loo*0
Etioloy#
Salmonella ty+hosaG +re)alent in tem+erate (limatesG hih in(i*en(e in
"allG an* mostly a""e(te* are the males an* in youth an* in"ant0
Mo*e o"
transmission#
In"e(te* urine an* "e(es an* inta8e o" (ontaminate* "oo* an* ,ater
&atho+hysioloy#
The oranism enters the -o*y )ia the GI tra(t an* in)a*es the ,alls o"
the GI tra(t lea*in to -a(teremia that lo(ali>es in mesenteri( lym+h
no*esG in the masses o" lym+hati( tissueG in the mu(us mem-rane o" the
intestinal ,all N&eyerPs +at(hesO an* in smallG solitary lym+h "olli(les in
the ileum an* (olon thus ul(eration o" the intestines may result0
Com+li(ation# % +er"oration o" the intestine ' "rom erosion o" one o" the
ul(ers % intestinal hemorrhae ' "rom erosion o" -loo* )essels % rela+se %
throm-o+hle-itis % urinary in"e(tion % meninitis
Sins an* sym+toms
50 Gra*ual onset
o se)ere hea*a(heG malaiseG mus(le +ainsG non!+ro*u(ti)e
(ouh
o (hills an* "e)erG tem+erature rises slo,ly
o +ulse is "ull an* slo,
o s8in eru+tion ' irreularly s+a(e* small rose s+ots on the
a-*omenG (hest an* -a(84 "a*es 7!9 *ays
o s+lenomeally
60 Se(on* ,ee8
% "e)er remains (onsistently hih % a-*ominal *istention an* ten*ernessG
(onsti+ation or *iarrhea % *elirium in se)ere in"e(tion % (oma!)iil loo84
+u+ils *ilate an* +atient a++ears to stare ,ithout seein % sultus ten*ium
't,it(hin o" the ten*on sets
70 Thir* ,ee8
% ra*ual *e(line in "e)er an* sym+toms su-si*es
Dianosti(
+ro(e*ure
% ,hite -loo* (ell (ounts % -loo* or -one marro, (ulture % +ositi)e urine
an* stool (ultures in later stae % -loo* serum alutination ' N[O at the
en* o" s(on* ,ee8
Manaement
50 &re)ention# *e(ontamination o" ,ater sour(esG mil8
+asteuri>ationG in*i)i*ual )a((ination o" hih ris8 +ersonsG (ontrol
(arriers0
45
60 Drus
o (hloram+heni(ol
o am+i(illin
o sul"ametho:a>ole
o trimetho+rim
o "ura>oli*one
70 intra)enous in"usion ' to treat *ehy*ration an* *iarrhea
90 Nursin (are
o i)e su++orti)e (are
o +osition the +atient to +re)ent as+iration
o use o" enteri( +re(autions
o TSB "or hih "e)er
o en(ourae hih "lui* inta8e
o monitor "or (om+li(ations
<0 intestinal *e(om+ression +ro(e*ureG I1 "lui*s an* suri(al
inter)ention ' "or +er"oration
=0 ,ithhol* "oo*G -loo* trans"usions an* -o,el rese(tion ' "or
intestinal hemorrhae
LE&TOS&IROSIS NAEILPS DISEASEG CANICOLA
$E1ERG HEMMORHAGIC .AUNDICEG
ICTEROHEMORRHAGIC S&IROCHETOSISG
SAINEHERDPS DISEASEG MUD $E1ERO
Des(ri+tion#
Aorl*,i*e in its *istri-ution an* es+e(ially in areas ,here sanitation is
+oorest4 (ommon in .a+an0 Usually those ,ho are a""e(te* are the se,er
,or8ersG miners an* s,immers in +ollute* ,ater0
Etioloy# Le+tos+ira i(terohaemorrhaiae (arrie* -y ,il* rat
In(u-ation +erio*# < ' = *ays
Sins an* sym+toms
su**en onset ,ith (hillsG )omitin an* hea*a(he -y se)ere "e)er
an* +ains in the e:tremities
intense it(hin o" the (on;un(ti)ae
se)ere ;aun*i(e ,ith hemorrhae in the s8in an* mu(us
mem-ranes
hematemesisG hematuria an* he+atomealy "or se)ere (ases
(on)ales(en(e o((urs in the thir* ,ee8 unless there is a
(om+li(ation
Dianosti(
+ro(e*ure
&ositi)e alutination test
Manaement
&re)ention ' era*i(ation o" rats an* en)ironmental sanitation Drus '
antiserum or (on)ales(ent serum4 +eni(illin Nursin (are ' su++orti)e
an* sym+tomati(
46
DYSENTERY
Etioloy#
BACILLARY DYSENTERY NshiellosisG -loo*y "lu:O ' (ause* -y shiella
*yseteriae an* shiella +ara*ysenteriae (omin "rom -o,el *is(hares
o" in"e(te* +ersons an* (arriers0 1IOLENT DYSENTERY NCholeraO '
(ause* -y )i-rio (holeraG )i-rio (omma Noa,a an* ina-aO "rom in"e(te*
"e(es or )omitus0
Mo*e o"
transmission#
BACILLARY DYSENTERY ' eatin o" (ontaminate* "oo*sG han* to mouth
trans"er o" (ontaminate* materialG "liesG o-;e(ts soile* ,ith *is(hares o"
in"e(te* +ersonG (ontaminate* ,ater0 1IOLENT DYSENTERY ' *ire(t or
in*ire(t "e(al (ontamination o" ,ater or "oo* su++lies -y soile* han*sG
utensils or me(hani(al (arriers su(h as "lies0
In(u-ation +erio*#
BACILLARY DYSENTERY ' 5!? *ays Na)erae o" 9 *aysO % +erio* o"
(ommuni(a-ility ' *urin a(ute +hase an* until N!O stool e:am 1IOLENT
DYSENTERY ' "rom a "e, hours to "i)e *ays Na)erae 7 *aysO % +erio* o"
(ommuni(a-ility ' until the in"e(tious oranism is a-sent "rom the -o,el
*is(hares N?!59 *aysO %
Sins an* sym+toms
BACILLARY DYSENTERY % (hills % "e)er % nausea an* )omitin %
tenesmus % se)ere "iarrhea a((om+anie* -y -loo* an* mu(us %
alternatin e+iso*es o" *iarrhea an* (onsti+ation N(hroni(O 1IOLENT
DYSENTERY
50 Onset
o a(ute (oli(8y +ain in the a-*omen
o mil* *iarrhea Nyello,ishO
o mar8e* mental *e+ression
o hea*a(heG )omitin
o "e)erG may or may not -e +resent
60 Colla+se stae ' a"ter 5 or 6 *ays
% +ro"use ,atery stools Nrayish ,hite or ri(e ,aterO % thirst %
se)ere@)iolent (ram+s in the les an* "eet % thi(8ly "urre* tonue %
sun8en eye-alls % ash!ray (olore* s8in
70 Rea(tion stae ' a"ter 7 *ays
% in(rease* (onsisten(y o" stools % s8in -e(omes ,arm an* (yanosis
*isa++ear % +eri+heral (ir(ulation im+ro)es % urine "ormation in(reases
Dianosti(
+ro(e*ure
BACILLARY DYSENTERY
stool e:am
seroloi( test
1IOLENT DYSENTERY
N[O stool e:am@)omitus
Manaement BACILLARY DYSENTERY
50 Metho*s o" (ontrol an* +re)ention
o re(onition o" *isease an* re+ortin
o (on(urrent *isin"e(tion "rom -o,el *is(hares
o in)estiation o" sour(e o" in"e(tion N"oo*G ,ater an* mil8
su++liesG eneral sanitation an* sear(h "or (arriersO
47
o +re)ention o" "ly-ree*inG s(reenin
o sanitary *is+osal o" human e:(reta
o +rote(tion an* +uri"i(ation o" +u-li( ,ater su++lies an*
+re)ention o" su-se/uent (ontamination
60 Drus
% 8aolin % -ismuth an* +areori( N(om-ination o" sul"onami*eO %
(hloram+heni(ol
70 Nursin (are
% isolation -y me*i(al ase+ti( te(hni/ue % *aily (leansin -ath % in(rease
oral "lui*s in a(ute stae % TSB "or "e)er % re(or* an* the (hara(ter o"
stools +asse*G amount an* "re/uen(y o" )omitin 1IOLENT DYSENTERY
50 &re)ention
% immuni>ation % s(reen the si(8room "rom "lies % +rote(t the "oo*
su++lies "or (ontamination -0 Drus ' tetra(y(line (0 Re+la(ement o"
"lui*s an* ele(trolytes *0 Isolation e0 &atient shoul* -e s+are* all
unne(essary e""orts *urin the a(ute stae "0 Butto(8s shoul* -e 8e+t
(lean ,ith ,arm ,ater an* soa+ an* ru--e* *ry 0 antise+ti( mouth,ash
in (ase o" )omitin h0 "lui*s is i)en as soon as they (an -e tolerate*
MUM&S NIN$ECTIOUS OR E&IDEMIC &AROTITISO
Des(ri+tion#
An a(ute (ontaious *isease the (hara(teristi( "eature o" ,hi(h is the
s,ellin o" one or -oth o" the +aroti* lan*s usually o((urrin in
e+i*emi( "orm0
Etioloy#
$iltera-le )irusG mem-er o" my:o)irus "amilyG in"e(te* oral an* nasal
se(retions is the sour(e o" in"e(tion Com+li(ation# or(hitis or
e+i*i*ym+!or(hitis &ronosis# "a)ora-le in most (ases o" mum+sG
(om+lete re(o)ery or*inarily ta8es +la(e e)en (om+li(ations ta8e +la(e0
Mo*e o"
transmission#
Dire(t (onta(t ,ith a +erson ,ho has the *isease or -y (onta(t ,ith
arti(les ,hi(h is (ontaminate*0
In(u-ation +erio*#
59 ' 65 *ays
+erio* o" (ommuni(a-ility# -e"ore the lan*s is s,ollen to the time
+resent o" lo(ali>e* s,ellin
Sins an* sym+toms
+ain in the +aroti* reion
hea*a(he
eara(he
"e)er
*i""i(ulty to o+en the mouth ,i*e
eneral malaise
sore throat
Dianosti(
+ro(e*ure
mo*erate leu8o(ytosis
(om+lement "i:ation test
s8in test "or sus(e+ti-ility to mum+s
48
Manaement
a0 &re)ention# immuni>ation NMMR i)en at 5< monthsO -0 Drus ' as+irin
"or "e)erG (ortisone (0 isolation *0 a-solute -e* rest to +re)ent
(om+li(ations Nat least 9 *aysO e0 *aily -ath shoul* -e i)en "0 so"t -lan*
*iet "or sore ;a, 0 a*)ise male to ,ear ,ell "ittin su++ort to relie)e the
+ull o" ra)ity on the testes an* -loo* )essels h0 TSB "or "e)er i0 i(e
+a(8@(ollar a++li(ation
&ARASITISM
Des(ri+tion#
Etioloy#
% &INAORM NEntero+iasisO ' o:yuris )ermi(ularisG o((urs "rom "omitesG
autoin"e(tionG "e(al (ontaminationG a""e(ts one in "amily an* in)aria-ly
in"e(ts entire "amily0 % GIANT INTESTINAL ROUNDAORMS NAs(ariasisO '
as(aris lum-ri(oi*esG "rom s+utum an* o)a in soil0 % THREADAORM '
stronyloi*es ster(oralisG "rom "e(al soil (ontamination % AHI&AORM
Ntri(huriasisO ' "rom "e(al soil (ontamination % HOOFAORM
Nan(ylostomiasisO ' "rom lar)ae in "e(al soil (ontamination % TA&EAORM
NtaeniasisO Ty+es#
hymenole+is nana ' "rom "e(al (ontamination
taenia sainata N-ee"O ' "rom insu""i(iently (oo8e* meat
taenia solium N+or8O ' (ontaminate* meat
*i+hyllo-othrium latun ' +oorly (oo8e* in"este* "ish
Mo*e o"
transmission#
&INAORM ' mouth GIANT INTESTINAL ROUNDAORMS ' mouth
THREADAORM ' enter usually throuh the s8in or "eet AHI&AORM '
mouth HOOFAORM ' throuh s8in o" the "eet TA&EAORM ! mouth
Sins an* sym+toms
&INAORM
eosino+hiliaG it(hin aroun* the anusG (on)ulsions in (hil*ren0
GIANT INTESTINAL ROUNDAORMS
(hest +ainG (ouh a"ter t,o monthsG malnutritionG in*iestionG
*iarrheaG (oli(8y a-*ominal +ain0
THREADAORM
intermittent *iarrhea
AHI&AORM ' nausea an* )omitinG *iarrheaG anemiaG stunte* ro,th4
may (ause +rola+se o" re(tum in (hil*ren an* o((asionally a++en*i(itis0
HOOFAORM ' anemiaG *iarrheaG stunte* ro,thG -ron(hial sym+tomsG
o-stru(tion o" the -iliary an* +an(reati( *u(t0
Dianosti(
+ro(e*ure
&INAORM ' a*ults an* o)a in stool GIANT INTESTINAL ROUNDAORMS
' a*ults an* o)a in stool THREADAORM ' lar)ae AHI&AORM ' o)a in
stool HOOFAORM ' o)a in stool TA&EAORM ' o)a an* sements o" the
,orm in the stool
Manaement THREADAORM ' &re)ention# ,ear shoes an* use sanitary toilets
use o" sanitary toilets
+ro)i*e hyiene e*u(ation o" the "amily
*is+ose o" the in"e(te* stools (are"ully
meti(ulous (leansin o" s8in es+e(ially anal reionG han*s an*
nails
49
*rus ' antihelminthi( *rusG +i+era>ine (itrateG +yrantel +amoateG
me-en*a>ole
HE&ATITIS
Des(ri+tion#
Ai*es+rea* in"lammation o" the li)er tissue ,ith li)er (ell *amae *ue to
he+ati( (ell *eeneration an* ne(rosis4 +roli"eration an* enlarement o"
the Fu""er (ells an* in"lammation o" the +eri+ortal areas thus may (ause
interru+tion o" -ile "lo,0
Etioloy#
TY&E A Nin"e(tious he+atitisO ' o((urs in (ro,*e* li)in (on*itions4 ,ith
+oor +ersonal hyiene or "rom (ontaminate* "oo*G mil8G ,ater or
shell"ish0 Common o((urren(e *urin "all an* ,inter months usually
a""e(tin (hil*ren an* youn a*ults0 TY&E B Nserum he+atitisG SH )irusG
)iral he+atitisG trans"usion he+atitisG homoloous serum ;aun*i(eO TY&E
C Nnon!AG non!B he+atitisO
Mo*e o"
transmission#
TY&E A ' "e(al@oral route TY&E B ' -loo* an* -o*y "lui*s Nsali)aG semenG
)ainal se(retionsOG o"ten "rom (ontaminate* nee*les amon I1 *ru
a-usersG intimate@se:ual (onta(t0 TY&E C ' -y +arenteral routeG throuh
-loo* an* -loo* +ro*u(tsG nee*les an* syrines
In(u-ation +erio*#
TY&E A ' 5<!9< *ays
+erio* o" (ommuni(a-ility ' 7 ,ee8s +rior an* one ,ee8 a"ter
*e)elo+in ;aun*i(e
TY&E B ' <D!5ID *ays TY&E C ' ?!<D *ays
&atho+hysioloy# !
Sins an* sym+toms
a0 &re!i(teri( stae % anore:ia % nausea an* )omitin % "atiue %
(onsti+ation or *iarrhea % ,eiht loss % riht u++er /ua*rant *is(om"ort %
he+atomealy % s+leenomealy % lym+ha*eno+athy -0 I(teri( stae %
"atiue % ,eiht loss % liht (olore* stools % *ar8 urine % ;aun*i(e % +ruritus
% (ontinue* he+atomealy ,ith ten*erness (0 &ost!i(teri( stae % "atiue
-ut in(rease* sense o" ,ell -ein % he+atomealy# ra*ually *e(reasin
Dianosti(
+ro(e*ure
a0 All 7 ty+es % SG&TG SGOTG al8aline +hos+ataseG -iliru-inG ER ' all
in(rease* in +re!i(teri( % leu8o(ytesG lym+ho(ytesG neutro+hils ' all
*e(rease* % +rolone* &T -0 HE&A A# He+a A NHA1O in stool -e"ore onset
% Anti!HA1 NIGO ' a++ears soon a"ter onset o" ;aun*i(eG +ea8s in 5!6
months an* +ersist in*e"initely % Anti!HA NIMO ' +ositi)e in a(ute
in"e(tion lasts 9!= ,ee8s (0 HE&A B % H-sAG Nsur"a(e antienO ' +ositi)eG
*e)elo+s 9!56 ,ee8s a"ter in"e(tion % Anti!H-sA ' neati)e in IDW (ases
% Anti!HBC asso(iate* ,ith in"e(ti)ityG *e)elo+s 6!5= ,ee8s a"ter
in"e(tion % ABeAG ' asso(iate* ,ith ine""e(ti)ely an* *isa++ears -e"ore
;aun*i(e % Anti!H-e ' +resent in (arriersG re+resents lo, ine""e(ti)ity
Manaement a0 &re)ention I0 Ty+e A % oo* han* ,ashin % oo* +ersonal hyiene %
(ontrol an* s(reenin o" "oo* han*lers % +assi)e immuni>ation ' ISGG to
e:+ose* in*i)i*uals an* +ro+hyla:is "or tra)elers to *e)elo+in
(ountries II0 Ty+e B % s(reen -loo* *onors HB7A % use *is+osa-le
nee*les an* syrines % reistration o" all (arriers % +assi)e immuni>ation
' ISG % a(ti)e immuni>ation ' he+ata)a: B )a((ine an* "ormalin treate*
50
he+atitis B )a((ine i)en in 7 *oses -0 Nursin manaement % +romote
a*e/uate nutrition ' small "re/uent meals o" hih CHOG mo*erate to hih
CHONG hih )itaminG hih (alori( *ietG a)oi* )ery hot or (ol* "oo*s0 %
ensure rest an* rela:ation % monitor@reli)e +ruritus ' (oolG moist
(om+ressesG emollient lotion % a*minister (orti(osteroi* as or*ere* %
isolation +ro(e*ures as re/uire* % +ro)i*e (lient tea(hin an* *is(hare
+lannin ,ith rear*s to# Z im+ortan(e o" a)oi*in al(ohol Z im+ortan(e
o" not *onatin -loo* Z re(onition@re+ortin o" sins o" ina*e/uate
(on)ales(en(e Z a)oi*an(e o" +ersons ,ith 8no,n in"e(tions % Drus '
li)er +rote(tor NessentialeG ;e(to"erG inter"eron *ruO
$OOD &OISONING
Des(ri+tion#
A astroenteritis o"ten +ro*u(e* -y the +resen(e o" a *isease oranism
or its to:ins0
Etioloy#
SALMONELLA GASTROENTERITIS ' salmonella ty+himuriumG
salmonella +araty+hi AG BG an* C4 salmonella ne,+ort
STA&HYLOCOCCUS GASTROENTERITIS ' (oaulase ' +ositi)eG ram
+ositi)e# ro,s ra+i*ly on "oo* (ontainin (ar-ohy*rates Re(o)ery#
,ithin 69 ' 7= hours BOTILISM ' (lostri*ium -otulinum
In(u-ation +erio*#
SALMONELLA GASTROENTERITIS ' = to 9I hours a"ter the inestion o"
(ontaminate* "oo* STA&HYLOCOCCUS GASTROENTERITIS ' 6 to =
hours a"ter inestion BOTILISM ' 69 hours a"ter the inestion
Sins an* sym+toms
SALMONELLA GASTROENTERITIS
hea*a(he
nausea an* )omitin
*iarrhea Nstools are usually "lui* an* (ontain mu(us4 -loo*y i" in
se)ere in"e(tionO
STA&HYLOCOCCUS GASTROENTERITIS
su**en a-*ominal +ain
e:(essi)e +ers+iration
)omitin
*iarrhea
+allor ,ea8ness
BOTILISM
+eri+heral ner)ous system
Z )omitin Z ata:ia Z (onsti+ation Z o(ular +aralysis Z a+honia Z other
neu"romas(ular sins
+aralysis o" the res+iratory system ,hi(h may lea* to *eath
Dianosti(
+ro(e*ure
SALMONELLA GASTROENTERITIS ' history o" illness a"ter inestion o"
(ertain "oo*s
Manaement SALMONELLA GASTROENTERITIS@STA&HYLOCOCCUS
GASTROENTERITIS
re+la(ement o" "lui*s an* salts
se*ati)es an* anti(holineri( to re*u(e hy+ermo-ility o" the
intestine
51
oo* oral hyiene
a++li(ation o" heat to a-*omen to relie)e (ram+s
BOTILISM
+re)ention
Z reulation o" (ommer(ial +ro(essin o" (anne* "oo*s Z e*u(ation o"
house,i)es (on(ernin +ro+er +ro(essin o" home (anne* "oo*s Z
(anne* "oo*s shoul* -e -oile* "irst to *estroy the to:ins Z +oly)alent
antito:ins N-otulinum antito:inO
+atient ,ith -otulinum shoul* -e +la(e* on /uiet room an*
a)oi*an(e o" unne(essary a(ti)ity
sym+tomati(
intu-ation "or "ee*in
tra(heostomy ' in res+iratory "ailure
o:yen -y I&&B
S+4.A003 )*A-S,I))+D DIS+AS+
GONORRHEA NSTRAING CLA&G .ACFG
MORNING DRO&G G0C0 GLEETO
Des(ri+tion#
An in"e(tious *iseaseG ,hi(h (auses in"lammation o" the mu(ous
mem-ranes o" the enitourinary tra(t0 Com+li(ations# MALE ' -ilateral
e+i*i*ymitisG sterility $EMALE ' +el)i( in"lammatory *iseaseG sterility
NEABORN ' o+thalmia neonatorum ' mother to (hil*
Etioloy# Neisseria onorrhea
Mo*e o"
transmission#
Se:ual (onta(t
In(u-ation +erio*# 6 ' < *ays
Sins an* sym+tomsMALE
-urnin sensation in the urethra u+on urination
+assae o" +urulent Nyello,ishO *is(hare
+el)i( +ain
"e)er
52
+ain"ul urination
$EMALE
-urnin sensation u+on urination
+resen(e or a-sen(e o" )ainal *is(hare
+el)i( +ain
a-*ominal *istention
nausea an* )omitin
urinary "re/uen(y
Dianosti(
+ro(e*ure
(ulture an* sensiti)ity
"emale# +a+ smear or (er)i(al smear4 male# urethral smear
-loo* e:am ' 1DRL
Manaement
e*u(ate men an* ,omen to re(oni>e sins o" onorrhea an* to
see8 imme*iate treatment
monitor urinary an* )o,el elimination
im+ortant to treat se:ual +artnerG as (lient may -e(ome re!in"e(te*
ma8e arranements "or "ollo,!u+ (ulture 6 ,ee8s a"ter thera+y is
initiate*
Drus ' +eni(illin# *ru o" (hoi(e
Z tetra(y(lines Z (e"tria:one so*ium Nro(e+hinO Z amo:i(illin
NaumentinO
SY&HILIS NLEUSG &OCG BAD BLOOD DISEASEO
Des(ri+tion#
A (ontaious *isease that lea*s to many stru(tural an* (utaneous
lesions Com+li(ations# a0 still -irth -0 (hil* -orn ,ith sy+hilis % +la(enta
is -ier than the -a-y % +ersistent )esi(ular eru+tions an* nasal
*is(hares % ol* man "eature % mu(us +at(hes on mouth an* anus (0
(hil* -orn ,ith late sy+hilis Nsins an* sym+toms a"ter 6 yearsO %
hut(hinsonPs teeth % *ea"ness % sa**le nose % hih +alate
Etioloy# Tre+onema +alli*um
Mo*e o"
transmission#
Se:ual (onta(t
In(u-ation +erio*# 7 ' = ,ee8s
Sins an* sym+tomsa0 &rimary sy+hilis
(han(re on enitaliaG mouth or anus
serous *rainae "rom (han(re
enlare lym+h no*es
may-e +ain"ul or +ainless
hihly in"e(tious
-0 Se(on*ary sy+hilis
s8in rash on +alms an* soles o" "eet
53
re**ish (o++er ' (olore* lesions on +alms o" han*s an* soles o"
"eet
(on*ylomas# lesions@sores that "use* toether
erosions o" oral mu(us mem-ranes
alo+e(ia
enlare* lym+h no*es
"e)erG hea*a(heG sore throat an* eneral malaise
(0 Tertiary sy+hilis
umma ' the (hara(teristi( lesions
(ar*io)as(ular (hanes
ata:ia
stro8eG -lin*ness
Dianosti(
+ro(e*ure
a0 +ositi)e test "or sy+hilis % )enereal *isease resear(h la-oratory N1DRLO
% ra+i* +lasma reain (ir(le (ar* test NCR&R!CTO % automate reain test
NARTO % "luores(ent tre+onemal anti-o*y a-sor+tion test N$TA!ABSO %
,essermann test % 8han +re(i+itation test % 8lineG hinton an* ma>>in tests
-0 *ar8"iel* e:amination (0 (ulture an* sensiti)ity *0
Manaement
stri(t +ersonal hyiene is an a-solute re/uirement
assist in (ase "in*in
instru(t (lient to a)oi* se:ual (onta(t until (learan(e is i)en -y
+hysi(ian
en(ourae monoamous relationshi+
e:+lain nee* to (om+lete (ourse o" anti-ioti( thera+y
Drus ' +eni(illinG tetra(y(lins@8ithramy(in
AC2UIRED IMMUNE DE$ICIENCY
SYNDROME NAIDSO
Des(ri+tion#
An a(/uire* immune *e"i(ien(y (hara(teri>e* -y a *e"e(t in natural
immunity
Etioloy#
Retro)irusG human immuno*e"i(ien(y )irus NHI1!5 an* HI1!6O +re)iously
re"erre* to as human T!lym+hotro+i( )irus ty+e III NHTL1!IIIO
Mo*e o"
transmission#
Bloo* trans"usionG se:ual (onta(tG (ontaminate* nee*lesG +erinatal
transmission
In(u-ation +erio*# = months to J years
&atho+hysioloy#
Sins an* sym+toms
anore:ia
"atiue
*ys+nea
niht s,eats
"e)er
54
*iarrhea
enlare* lym+h no*es
HI1 en(e+halo+athy# memory lossG la(8 o" (oor*inationG +artial
+aralysisG mental *eterioration
HI1 ,astin syn*romeG ema(iation
+ositi)e test "or HI1 anti-o*y
+ositi)e test "or +resen(e o" HI1 itsel"
o++ortunisti( in"e(tion# neumo(ysti( (ariniiG (ystomealo)irusG
8a+osiPs sar(oma
Dianosti(
+ro(e*ure
ELISA test Nen>yme!lin8e* immunosor-ent assayO ' a s(reenin
test
,estern -lot ' a (on"irmatory test
Manaement
+ro)i*e "re/uent rest +erio*s
+ro)i*e s8in (are
+ro)i*e hih!(alorieG hih +rotein *iet to +re)ent ,eiht loss
+ro)i*e oo* oral hyiene
+ro)i*e o:yen an* maintain +ulmonary "un(tion
+ro)i*e measures to re*u(e +ain
+rote(t the (lient "rom se(on*ary in"e(tion4 (are"ully assess "or
early sins
en(ourae )er-ali>ation o" "eelins
tea(h (lient the im+ortan(e o"#
Z in"ormin se:ual (onta(ts o" *ianosis Z not sharin nee*le ,ith
other in*i)i*uals Z (ontinuin me*i(al su+er)ision
CHLAMYDIAL IN$ECTION
Des(ri+tion#
A se:ually transmitte* *isease that is hihly (ontaious (ause* -y
(hlamy*ial oranism
Etioloy# Chlamy*ia tra(homatis
Mo*e o"
transmission#
6 !7 ,ee8s "or males
In(u-ation +erio*# Se:ual inter(ourse
&atho+hysioloy# !
Sins an* sym+toms
+ruritus in )aina
-urnin sensation in )aina
+ain"ul inter(ourse
+ruritus o" urethral meatus in men
-urnin sensation *urin urination
Dianosti(
+ro(e*ure
Culture o" as+irate* material "rom )ainalG anal or +enile *is(hares
Manaement
*o:y(y(line or a>ithromy(in Nre(ommen*e* "or +renant ,omanO
55
uni)ersal +re(aution shoul* -e +ra(ti(e*
TRICHOMONIASIS
Des(ri+tion#
Another ty+e o" se:ually transmitte* *isease that may also -e
transmitte* -y other means su(h as han*lin o" in"e(te* "omites0 It is
(ause* -y a +roto>oan +arasites0
Etioloy# Tri(homonas )ainalis
Mo*e o"
transmission#
Se:ual inter(ourseG (onta(t ,ith ,et to,els an* ,ash (lothes in"e(te*
-y the oranism
In(u-ation +erio*# 9 ' 6D *aysG usually ? *ays
Sins an* sym+toms
)ainal *is(hare
-urnin an* +ruritus o" )aina
re*ness o" the introitus
usually asym+tomati( in men
Dianosti(
+ro(e*ure
(ulture o" o-taine* s+e(imen
Manaement
metroni*a>ole
sit> -ath may relie)e sym+tom
a(i* *ou(hes
tetra(y(lines may -e i)en on male ,ho are also in"e(te*
"I/)+**/*IS, A-D &A-D+,I2S Z
In the re(ent (ourse o" international (on"li(tsG ,hi(h has lea* to ,arG has use* ,ea+on
that are /uite *i""erent "rom the (on)entional ones use* -e"ore0 The me*i(al s(ien(e is
-ein use* not to +rolon li"e -ut to (ause imme*iate *eath -y in"e(tion o" )arious
-ioloi(al oranisms0 The "ollo,in i)es an insiht o" these *anerous -ioloi(al
terrorism lea*in to +an*emi(s0
SMALL &OC
Des(ri+tion#
$or a-out t,o *e(a*es the AHO has *e(lare* that the ,orl* is alrea*y
Ksmall +o: "reeL0 Althouh eliminate* in the ,orl* o)erG the s+e(imen is
still 8e+t in t,o la-oratory "a(ility in the Unite* States0
Etioloy# 1ariola )irus NDNA )irusO
Mo*e o"
transmission#
Dire(t (onta(t or -y *ro+let "rom +erson to +erson
In(u-ation +erio*# 56 *ays
Sins an* sym+toms
hih "e)er
malaise
56
hea*a(he
-a(8 a(he
ma(ulo+a+ular rash in the "a(eG mouth an* +haryn: Nthe +atients
are (ontaious a"ter the a++earan(e o" the rashO
Manaement
enerally su++orti)e (are
-e"ore ren*erin (are transmission +re(aution shoul* -e
s+e(i"i(ally in*i(ate*
auto(la)in o" soile* linens is nee*e*
isolation is ne(essary until no loner (ontaious
ANTHRAC
Des(ri+tion#
Also 8no,n as ,hoolsorters *iseaseG the (a+sulate* "orm o" this
oranism is "oun* in soil ,orl*,i*e0 The oranism nee*s to ta8e a-out
IGDDD to <DGDDD to +ut a +erson at ris8 o" (ontra(tin the *isease0
Etioloy# Ba(illus anthra(is
Mo*e o"
transmission#
inhalation o" s+ores
inestion o" s+ores
entran(e throuh s8in lesions
In(u-ation +erio*# $or inhalation anthra: =D *aysG "or (utaneous anthra: 5!= *ays
Sins an* sym+toms
a0 Inhalation anthra: % (ouh % hea*a(he % "e)er % )omitin % (hills %
,ea8ness % *ys+nea % syn(o+e
-0 Cutaneous anthra: % nausea an* )omitin % a-*ominal +ain %
hemato(he:ia % as(ites % massi)e *iarrhea
Manaement
a0 stan*ar* +re(aution is alrea*y su""i(ient to (ontrol the s+rea* o" the
in"e(tion
-0 (i+ro"lo:a(in@*o:y(y(line is +res(ri-e* "or mass e:+osure@(asualty
,ith in"e(tin oranism (0 im+ortant +harma(oloi( inter)entions are
+eni(illinG erythromy(inG (hloram+eni(ol an* entamy(in
SE1ERE ACUTE RES&IRATORY SYNDROME NSARSO
Des(ri+tion#
Latest amon all the rest o" +an*emi(s ,hi(h has its oriin "rom China
an* has s+rea* to USAG Cana*aG &hili++ines an* other South East Asian
Country
Etioloy# Corona )irus
Mo*e o"
transmission#
Air-orne
In(u-ation +erio*# ? ' 5D *ays
Sins an* sym+toms
"e)er
(ouh
ra+i* res+iratory (om+romise
*ys+nea
atele(tasis
57
Manaement
su++orti)e treatment
+ro)i*e )entilatory assistan(e
use NJ< mas8 to a)oi* in"e(tion
58

Comhealth Nursing

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Comhealth Nursing

Uploaded by

Copyright:

Available Formats

Nurse Licensure Examination Review Handouts

THE COMMUNITY HEALTH NURSING

You might also like