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Communicable and Infectious Disease Nursing-New

Communicable and Infectious Disease Nursing-New

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Communicable and Infectious Disease Nursing

Communicable Disease= caused by a pathogenic microorganism from an infected person to a non-infected person through direct contact, a break in the skin integrity or any other means. Infectious Disease= characterized by the presence of microorganisms in the body which cannot be transmitted through ordinary means. Contagious Disease= a disease that can easily be transmitted. Common Causes of Infectious or Communicable Diseases 1. Bacterial invasion 2. Viruses 3. Fungal infection 4. Protozoan infection 5. Algae 6. Parasitic or Helminthic Usual Modes of Transmission of Infectious Diseases 1. Direct contact- may be transmitted from person to person, sexual intercourse or through blood 2. Respiratory droplets 3. Aerosol 4. Food and water-borne 5. Zoonotic- transmission from animals to man 6. Vertical- congenital syndromes and other perinatal infections The Epidemiologic Triad 1. Host- a man or other organism that harbors the infection. The host may be classified as a suspect, patient, carrier or contact. 2. Agent- an organism that causes the infection 3. Environment- a medium conducive to the growth and development of the microorganisms and may be said as either symbiotic, commensalism or parasitic. General Aspects of Care to Communicable Disease Patients 1. Preventive aspect- happens when a person is not yet infected with the disease but the occurrence is likely and must be stopped. This can be carried out through performance of health education classes, immunization, environmental sanitation and proper ways of food handling and storage. 2. Control aspect- happens when a disease is already present but the spread is to be limited to the present infection rate. This can be done through isolation, disinfection, disinfestations and fumigation practices. 3. Isolation Precautions- instituted to isolate the infection and not the patient; also instituted to protect other people from contracting the disease the patient may be carrying and also to protect an immunocompromised patient from any other pathogenic organism that may bring about an infection.

Diseases Affecting the Central Nervous System Meningitis


alteration in the level of consciousness. Gram staining and culture and sensitivity studies for CSF may also be done to determine the right drug to be used. Patients with advanced meningeal irritation may present with positive Kernig’s and Brudzinski’s signs c. odontogenic causes and sinusitis) c. Hematogenous spread: from the respiratory tract b. b. d. Fungal causes are related to cryptococcal infection. vomiting. fungal or parasitic infection. projectile vomiting (2-3 feet). widened pulse pressure. It may also be viral as in the case of HIV patients. CSF return that is cloudy and reveals low glucose levels is suspected for bacterial infection. CT Scans. Cancer. The etiology may be bacterial as in the case of Neisseria meningitides infection. diuretics to relieve intracranial pressure and other anti-microbial agents to treat a disease caused by other etiologies. Fever. Risk Factors a. Encephalitis An infectious disease characterized by the inflammation of the brain matter itself. e. Patients with untreated infection may progress to coma which can eventually cause death. Signs of increased intracranial pressure for children: increased head circumference (if the child is below 18 months old). Lumbar Puncture. c. viral or other etiologic agent. seizures. MRI and EEG are also done to determine exact involvement of the CNS in the disease process. while a clear CSF return is subjected to CIE (counter-immuno electrophoresis) to determine viral or other infection. Diagnostic Examinations a. malaise. poor feeding. dexamethasone is also given to reduce inflammation. irritability. Penetrating head trauma d.reveals CSF that may be infected with bacterial. decreased respiratory rate. nausea.An inflammatory disease involving the meninges and other surrounding structures of the brain and is usually brought upon by arboviruses (arthropod-borne viruses). The disease may be brought about by the invasion of arboviruses. Previous neurosurgical procedures or shunting e. alcoholism and other immunodeficient states Manifestations a. The disease has four primary classifications: 2 . neck stiffness (Nuchal rigidity). restlessness b. Signs of increased intracranial pressure in older children and adults: headache. Medical Management a. or those infected with the West Nile Strain of the Dengue Virus. and Haemophilus influenza B bacilli. and other alterations in the vital signs. Patients are usually given penicillin and a third generation cephalosphorin as treatment for bacterial infection. Patients are also given anti-convulsants to decrease seizure activity. while other causes include previous syphilis and Tuberculosis infection. confusion. bacterial. b. Streptococcus pneumoniae. Parameningeal focus (from conditions such as otitis media.

Antibodies to poliovirus can be diagnostic. Louis Encephalitis. Primary. Treatment is also similar. Spinal polio is the most common form of paralytic poliomyelitis.a. Poliomyelitis Poliomyelitis. Poliomyelitis is highly contagious and spreads easily by human-to-human contact. which denotes inflammation. meaning "grey". The extent of spinal paralysis depends on the region of the cord affected. The focus of modern treatment has been on providing relief of symptoms. moderate 3 . Post Vaccine Encephalitis.inflammation of the brain that is caused by metal poisoning. but transmission is possible as long as the virus remains in the saliva or feces. The term derives from the Greek poliós (πολιός). reveals an increased number of white blood cells (primarily lymphocytes) and a mildly elevated protein level. one arm. Any limb or combination of limbs may be affected —one leg. but may also be caused by the bite of an infected mosquito 4. causing infection and inflammation 1. which is collected by a lumbar puncture ("spinal tap"). a mode especially visible in areas with good sanitation and hygiene. St. specifically lead d. which are responsible for movement of the muscles. with a maximum range of 3 to 35 days. It is occasionally transmitted via the oral-oral route. which may be cervical. 2. or lumbar. analgesics for pain. by ingesting contaminated food or water. is usually 6 to 20 days. Paralysis is often more severe proximally (where the limb joins the body) than distally (the fingertips and toes).a milder form of the previous classification and usually affects adults. Japanese Encephalitis. Polio is most infectious between 7–10 days before and 7–10 days after the appearance of symptoms. or both legs and both arms. There is no cure for polio. referring to the "spinal cord". The time between first exposure and first symptoms. or the ventral (front) gray matter section in the spinal column. primarily via the fecal-oral route. [4] Analysis of the patient's cerebrospinal fluid (CSF). myelós (µυελός). known as the incubation period. Toxic encephalitis.believed to be brought about by an organism that enters the olfactory tract.commonly an adverse reaction to rabies vaccine The manifestations of the disease is similar to that of meningitis but with more pronounced changes in mentation and levels of consciousness of the patient.an infection brought about by a previous infection that has spread into the brain like meningitis c.the virus attacks the brain directly. The virus may affect muscles on both sides of the body. speeding recovery and preventing complications.a potentially severe form that is spread by the bite of an infected Culex triteaniorhynchus mosquito b. The disease is transmitted primarily via the fecal-oral route. limbs and the intercostal muscles. and the suffix -itis. it results from viral invasion of the motor neurons of the anterior horn cells. Eastern Equine. 3. Supportive measures include antibiotics to prevent infections in weakened muscles. Secondary encephalitis. Western Equine. including those of the trunk. thoracic. often called polio or infantile paralysis. and are generally detected in the blood of infected patients early in the course of infection.considered a serious epidemic disease of the horses and principally affects children under five years of age and is brought about by a bite from the Aedes solisitans mosquito. A laboratory diagnosis is usually made based on recovery of poliovirus from a stool sample or a swab of the pharynx. but more often the paralysis is asymmetrical. is an acute viral infectious disease spread from person to person.

Diagnosis of the disease is based on the patient’s symptoms and based on the behavior of the animal that has bit the patient. owing to a theoretical risk of increased spasms. Manifestations of the disease is divided into three phases. The causative agent is Rhabdovirus. or lockjaw. occuring only in low-form mammals such as felines and canines and is transmitted only to man through the contaminated saliva. Penicillin was once used to treat tetanus. insomnia and flu-like symptoms. sweating. which can cause infection anywhere from 3 weeks to years from the time of its inoculation into the site of the bite.paralysis sets in and the patient becomes quiet and unconscious. spasms of the cardiac and respiratory muscles lead to eventual coma and death.patient experiences sore throat. numbness on the site of the bite. Spasms continue for 3–4 weeks. restlessness. behavior similar to that or a rabid animal. orthopedic surgery. b. and the facial spasms called rhisus sardonicus. Infection generally occurs through wound contamination and often involves a cut or deep puncture wound. corrective shoes and. and rigidity of pectoral and calf muscles. elevated blood pressure. is an acute viral infection communicated to man by the saliva of an infected animal. there is associated loss of bowel and urinary control. There are no blood tests that can be used to diagnose tetanus. Prodromal phase. The first sign is trismus. The wound must be cleaned. a. The disease is zoonotic. Passive immunization with human anti-tetanospasmin immunoglobulin or tetanus immune globulin is crucial. Dead and infected tissue should be removed by surgical debridement. a neurotoxin produced by the Gram-positive. and episodic rapid heart rate. vicious look on the face.[56] Treatment of polio often requires long-term rehabilitation. All tetanus victims should be vaccinated against the disease or offered a booster shot. Other symptoms include elevated temperature. A brain biopsy of the animal may also be done 10-14 days after the bite incident to detect the presence of Negri bodies. muscle spasms develop in the jaw (thus the name "lockjaw") and elsewhere in the body. and apprehension. irritability. Excitement or Maniacal. slight photosensitivity. The diagnosis is based on the presentation of tetanus symptoms and does not depend upon isolation of the bacteria. a neurotrophic organism. then normal human immunoglobulin may be given instead. Paralytic Stage. The primary symptoms are caused by tetanospasmin. also called lockjaw. The generalized form usually presents with a descending pattern.exercise and a nutritious diet. representing about 80% of cases. including physical therapy. Profuse drooling of saliva c. its use is recommended if metronidazole is not available. obligate anaerobic bacterium Clostridium tetani. Tetanus Tetanus. Generalized tetanus is the most common type of tetanus. difficulty in swallowing. braces. 4 . Animals which yield negative results for the Negri bodies are then subjected to a fluorescent antibody test to confirm rabies infection. and complete recovery may take months. is a medical condition characterized by a prolonged contraction of skeletal muscle fibers. If specific anti-tetanospasmin immunoglobulin is not available. aerophobia. As the infection progresses. However.the patient presents with hydrophobia. Spasms may occur frequently and last for several minutes with the body shaped into a characteristic form called opisthotonos. the pathologic lesions found in the brain of at least 70% of all rabid animals. followed by stiffness of the neck. but is no longer the treatment of choice. Rabies Also known as Lyssa and Le Rage. Administration of the antibiotic metronidazole decreases the number of bacteria but has no effect on the bacterial toxin. in some cases.

Prevention is the major focus of nursing interventions. blood tinged or frothy sputum. Treatment includes administration of antibiotics or other anti-infective agents to the patient and treating the underlying cause. Nasal. fever. Nursing management includes maintenance of the patient in respiratory isolation until the first two weeks of treatment. fever. chest discomforts. chest x-ray films. which is transmitted through droplet. productive cough and dyspnea.the presence of irritating nasal discharges characterized by serosanginous foul. nonproductive cough. The infection may also occur in other areas of the body such as the bones. necrosis and calcification. arterial blood gas studies and bronchoscopic examinations. malaise. productive or purulent coughing. wheezing. gastrointestinal tract and urinary tract. cyanosis and confusion. people who suffer from aspiration. headache. conjunctiva. Usual manifestations of the disease include low grade afternoon. Direct and indirect contacts. tachypnea. Medical management of patients in the Philippines follow the DOTS program of the Department of Health. The patient may also be asked to undergo chest x-rays and tuberculin testing (for those in areas where TB is not endemic). Pneumonia may present with both typical and atypical symptoms. chest and back pains. tetanus toxoid injections on the site of the bite and thorough washing of the wound. b. The patient should also be taught proper disposal of nasopharyngeal secretions and the importance of avoiding the modes of transmission of the disease. The disease has three main types: a. Diseases Affecting the Respiratory Tract Pneumonia Pneumonia is the infection of the lung parenchyma.dyspnea. which is geared towards eradication of the disease in the country. Vaccines (BCG) are also helpful for infants. Diagnosis to confirm the presence of the disease is through AFB staining using the patient’s sputum as sample. encouragement of smoking cessation. genitals and respiratory system. musty odor secretions and present with pseudomembrane 5 .Medical management of the patient includes provision of both passive and active rabies vaccine to the person bitten by the infected animal. It is brought about by several factors such as impairment in lung defenses as in people who are smoking cigarettes. Atypical. tachycardia.insidious onset of fever. a. weight loss. administration of the medication through the entire treatment regimen. Diphtheria Diphtheria is an acute bacterial disease that infects the person’s mucus membranes. increasing fluid and nutritional intake and activity modifications. The infection is brought about by the inoculation of Mycobacterium tuberculosis into the respiratory tract. Tuberculosis Tuberculosis is a chronic sub-acute or acute respiratory disease commonly affecting the lungs characterized by the formation of tubercles in the tissues which tends to undergo casseation. Diagnostic examinations include sputum cultures. Three consecutive positive readings of the AFB test will automatically mean a positive diagnosis for PTB. The patient may also be given mucolytics and oxygen inhalation therapy in cases of severe pneumonia. It is an infection brought about by the Corynebacterium diphtheria and is transmitted through droplet. body malaise. Typical. Nursing management is focused towards provision of patient comfort and support both the patient and his family. rales. Decreased tactile fremitus. Some patients may present with blood tinged sputum or even cough out blood. anorexia. inhaling toxic substances. those with mechanical obstruction and are intubated and immunocompromised.

teaching about proper disposal of nasopharyngeal secretions and avoiding the mode of transmission of the disease. shaking of the body (chills) b. The disease can manifest in for different serologic types commonly known as the Onyong-nyong. instructing the patient not to touch or scrape the pseudomembrane and other comfort measures. In instances wherein the patient experiences respiratory arrest. The most common causative agent is the Plasmodium falciparum. brought about by the Plasmodium parasite. petechiae and intermittent fever b. the patient experiences dyspnea. Penicillin. If the disease is confirmed. melena.b.manifestations of Grade I plus spontaneous bleeding (hematemesis. blood transfusions in cases of massive blood loss and addressing any other problems that may arise in conjunction with the disease. Grade III (Hypovolemia). West Nile and Flavivirus. Grade IV (Dengue Shock Syndrome). abdominal pains and vomiting 6 . the King of Tropical Diseases. Chikunggunya. Hot Stage. Cold Stage.chilling sensation. sterna retractions.hradaches. dry metallic or barking cough and pseudomembrane formation in the larynx which leads to airway obstruction. The treatment is usually supportive and symptomatic. is an acute febrile disease caused by the infection with one of the serotypes of the dengue virus which is transmitted by the mosquito Aedes Aegypti. a. Laryngeal.manifestations of Grade III plus shock Diagnostic tests done to confirm the presence of the disease includes tourniquet test. Grade II (Dengue Hemorrhagic Fever).affects the larynx and airway passages. a tracheostomy may be performed. including administration of paracetamol for fever. provision of oxygen therapy to alleviate difficulty of breathing. Malaria Also called Ague.the patient usually experiences flu-like symptoms.fever may rise up to 41 degrees Centigrade (lasting from 4 to 6 hours). carried by the female Anopheles mosquito. Diseases Affecting the Cardiovascular System Dengue Fever Also called Breakbone Fever. Prevention of the disease includes having at risk population vaccinated. the patient is usually treated with antidiphtheria serum. gum bleeding and epistaxis) c.the patient feels difficulty swallowing and membranes turn grayish-white.manifestations of Grade II plus beginning symptoms of circulatory failure (cold and clammy skin) d. The disease has four different stages. is an infectious disease characterized by indefinite chills and fever. It also the most life-threatening strain since this is known to multiply rapidly and cause massive destruction of the red blood cells of an individual. and oxygen therapy. platelet counts and hematocrit and hemoglobin determination. The disease progress in three distinct stages: a. provision of adequate fluid and nutritional intake and oral hygiene. a positive Herman’s sign. Dengue fever is not always hemorrhagic. ` Nursing care for patients with diphtheria includes maintenance of patients on bed rest. IV replacement of lost fluids. c. the patient also exhibits a bull neck appearance. hematochezia. Nursing management focuses on provision of comfort and ensuring patient safety because of his risk for uncontrolled bleeding episode should platelet counts fall below the normal. Diagnosis is confirmed through nose and throat cultures to detect the presence of the causative agent. Grade I (Dengue Fever Syndrome). Pharyngeal or Facial.

Diseases Affecting the Integumentary System Leprosy Hansen’s disease or Hansenosis is a chronic systemic infection characterized by progressive cutaneous lesions. chronic skin ulcers. with the treatment period lasting from 6 to nine months b. The most common type of the disease are: a. non-healing skin ulcers (sometimes mistaken for diabetic wound).administered to patients with borderline and lepromatous type of leprosy.non-infectious type and is usually benign. Presents with a gradual thickening of the skin with the development of a granulomatous condition. The disease is transmitted through skin contact. nasal obstruction and nose bleeding. Signs and symptoms of the disease include pain and redness around the eyes. promotion of range of motion exercises to reduce the risks of development of contractures and preventing disease transmission. Bleeding episodes should also be watched out for and signs such as melena.possesses some of the characteristics of the first two subtypes. droplet and fomites and is caused by the etiologic agent Mycobacterium leprae. 7 . Treatment includes administration of anti-malarial agents such as Chloroquine. Tuberculoid. The etiologic agent is an acid fast bacilli which belongs to the same classification as the TB bacilli. Sulfadoxine and Primaquine to patients infected with the disease. sinking of the bridge of the nose (painless and natural amputation. drooping of the eyelids (lagupthalmos). Transfusion of erythrocytes and oxygen inhalation therapy may also be prescribed for patients who have suffered from Black Water fever brought about by the falciparum strain. muscle weakness and paralysis of the affected extremity. Dapsone and Lamprene. The treatment has two types: a. subsiding fever Diagnosis of the disease includes obtaining blood samples for Malarial Smears. irreversible). provision of adequate skin care. contractures and other symptoms.c. Diagnostic tests include skin smear test and skin lesion biopsy to determine the presence of Mycobacterium leprae on the skin. Diaphoretic Stage. appears mostly on the face. more clearly defined. Multibacillary. causes damage to the respiratory tract. The skin lesions are diffused and poorly defined. falling off of the eyebrows (madarosis). Nursing management includes stressing out the patient’s adherence to the treatment plan to decrease the risk of the development of drug resistant strains. with a lot of pathogenic organism present on skin. The drugs usually part of this treatment plan are Rifampicin. the eyes. hematochezia or decreasing levels of consciousness need to be reported.the most infectious type. Patient comfort is given priority as well as adequate nutritional and fluid intake. color changes in the skin. b. Borderline. Medical management is geared towards eradicating the etiologic agent on the skin of the patient. Paucibacillary. Usual incubation periods last from 5 months to 8 years. as well as on the nerves and skin.excessive sweating. leonine face. c. and testes. The samples are best taken at the height of the fever because the more malarial parasites are seen on film during this stage. Nursing management varies depending on the stage of the disease progression and is therefore supportive and symptomatic.given for patients with tuberculoid type of leprosy and includes administration of Rifampicin and Dapsone. The treatment course ranges from 24 months to 30 months. Quinine. Lepromatous. the patient has a few Mycobacterium leprae on skin. feeling of weakness.

German Measles A mild viral illness characterized by feverish episodes with rashes and joint aches.Chickenpox and Herpes Zoster Qualities Chickenpox Defining Characteristics An acute and highly contagious disease of viral etiology characterized by vesicular eruptions on the skin and mucus membranes with mild systemic symptoms. calamine lotion for itchiness. oral care. transmitted through droplet Fever for 1-2 days. Paramyxiviridae Variable. Koplik’s spots Nose and throat swabs. colds and mild cough. headache. rashes starting from the trunk. excessive lacrimation. lymphadenopathy. malaise. transient polyarthralgia and polyarthritis. blood examinations Symptomatic and supportive. vesicles Diagnostic Tests Presence of the virus on the lesions Medical Management Usually supportive and symptomatic. bactericidal and oxidative) Avoiding infection. averaging 7-12 days. transmitted through droplet nuclei High grade fever for three to four days. transmitted Mode of Transmission through droplet and direct contact Signs and Symptoms Low grade fever. anti-virals and analgesics Proper skin care. prevention of superimposed infection on lesions. conjunctivitis. Pseudoparamyxoviridae 14 to 21 days. transmitted through direct contact with an infected person Vesiculo-pustular rashes unilaterally distributed along a nerve pathway History and viral isolation from the lesions Acyclovir and Potassium Permanganate (three effects: astringent. Causative Agent Varicella zoster Incubation period and 10 to 21 days. Forscheimer’s spots Usually none. prevention of mouth sores. mild cough and colds. provision of psychological support Measles and German Measles Qualities Defining Characteristics Causative Agent Incubation period and Mode of Transmission Signs and Symptoms Diagnostic Tests Medical Management Nursing Care Measles An acute and contagious exanthematous disease that usually affects children which are susceptible to upper respiratory tract infections. muscle pains. body malaise. adequate fluid and nutritional intake Herpes Zoster An acute viral infection of the sensory nerve occurring in partially immune individuals to a previous infection or exposure to Chickenpox Herpes zoster 13 to 17 days. Acyclovir is the drug of choice Nursing Care Comfort measures. macula-papular rashes appearing from the head to the feet. the disease lasts approximately 3days Symptomatic Supportive 8 .

stool and urine examinations. abdominal pain. Dysentery-like symptoms. and decreased pulse rate. Treatment includes administration of metronidazole. milk. preventing perianal skin from breakdown and prevention of the transmission of the disease to non-infected persons. nausea and vomiting. a bacterial infection transmitted by contaminated water. The focus of nursing management is restoration of fluid and electrolyte balance. patients may present with melena or hematochezia. Reservoir of the agent is usually infected persons and is transmitted through the fecal-oral route. persistence of fever and sometimes abdominal tenderness d. ladder-like fever.gradual relief from the signs and symptoms of the disease. The drug of choice is Chloramphenicol. The causative agent is the bacteria Salmonella typhosa which is transmitted through the fecal-oral route. Patients sometimes present with Typhoid psychosis. dull headache. cramping. Clinical features if the disease includes. The disease is most prevalent in areas of poor sanitation such as crowded living environements and near sewerage systems. Ciprofloxacin and Ceftriaxone. the confirmatory test. Weight loss c.the bacteria continuously multiplies in this stage. It is an infection that primarily affects the lymphoid tissues of the small intestines (Peyer’s patches). Shigellosis Also known as Bloody flux or Shigal. b. is an infectious disease brought about by the ingestion of a gram negative organism that invades the lumen of the intestines and causes 9 . maintaining patient safety especially in the stage of altered mental functioning and prevention of bleeding. low-grade fever with profuse diarrhea b. but are not limited to Ampicillin.presence of fever. but is not limited to: a. correction of fluid and electrolyte imbalances caused by diarrhea and treating any co-existing disease if present. Pyrexia.abdominal pain. Defervescence. Other drugs given to the patient may include. splenomegaly. diarrhea (which sometimes alternate with constipation). Other tests that may be performed for the patient includes blood cultures. ulcerations in the linings of the intestinal wall. Nursing management is focused on maintenance of enteric precautions on infected patients. c. Lysis or Convalescent. Diagnosis is usually confirmed through the performance of Typhidot. Amoebiasis Amoebiasis is an infectious disease brought about by the invasion of the pathologic agent Entamoeba histolytica. colitis.adequate rest and nutrition Diseases Affecting the Gastro-Intestinal Tract Typhoid Fever The disease is also known as Enteric Fever. shellfish. which is best administered via the IV route. vomiting. an alteration in mental functioning brought about by the disease process. Prodromal Stage. or other food stuff. food preparation and handling and the practice of handwashing. Manifestations a. Preventive measures focus on teaching proper waste disposal. ensuring an adequate fluid and nutritional intake.also called as Fastigial Stage. Cotrimoxazole. characterized by the presence of Rose Spots in the abdomen. Anorexia The patient’s stool is usually tested for the presence of cysts and trophozoites before the diagnosis is confirmed. Widal Test. vigilant monitoring of the patient’s vital signs.

blood Fluke. Boiling water before drinking or use for cooking in endemic areas Viral Hepatitis Viral hepatitis is an acute inflammation of the liver marked by liver-cell destruction. these are: a. Abdominal pain c. boydii or sonnei). necrosis. Vomiting and diarrhea d. There are three major types of organism which causes the infection. Eradication of breeding and resting sites of the snail c.the disease which manifests itself as severe watery diarrhea. Schistosoma mansoni. and infects the intestinal tract of the individual. is a slowly progressive disease caused by blood flukes of the class trematoda and is common among farmers in the southern part of the country. Schistosoma japonica. The most common causative agent is the Shigella (flexneri. Schistosomiasis Alson known as Bilharziasis. Signs and symptoms of the disease includes: a. Protect the skin integrity to avoid creating a portal of entry of the organism e. Swimmer’s fever.common in other tropical countries like Africa and South America c. Itchiness at the site of entry of the microorganism Tests that determine the presence of flukes in the patient’s body includes stool examinations. The usual signs and symptoms include the presence of fever (although some patients do not experience fever). and this includes: a.affects mostly the urinary tract and is common in Middle Eastern countries The sources of infection are infected man and animals and the disease is transmitted through inoculation in broken skin or ingestion of water contaminated with the eggs of the fluke. Prevention of infection is the primary thrust of the nurse. In most patients hepatic cells eventually regenerate with little or no residual damage. The disease is confirmed through the performance of stool examinations and rectal swabbing to determine presence of shigella. 10 . Checking at risk individuals (stool exam) b. Emaciation f. blood tests (COPT and ELISA) and rectal biopsy Treatment includes administration of anti-Schistosomal agents (Fuadin and Praziquantel) and supportive management for any symptoms present on the patient. patient teaching about prevention of infection and prevention of complications. The source of infection are the parasitic worm Schistosoma japonicum. Abdominal distention e. Jaundice g. b.the most common or endemic in the Philippines. Nursing management includes encouraging an increased fluid intake. and Katayama Fever. Medical management focuses on the eradication of the causative agent through the administration of anti-microbial agents and oral dehydration of the patient. and autolysis. found in the snails called Oncomelania quadrasi. Snail fever. vomiting. abdominal pain and diarrhea which is accompanied by straining (tenesmus). Advising farmers to wear proper foot protection d. Schistosoma haematobium. providing adequate nutrition. Low grade fever b. which is transmitted through fecal-oral route.

and outbreaks are common in areas of overcrowding and poor sanitation. Type C accounts for about 20% of all viral hepatitis as well as most cases that follow transfusion 4. All forms of viral hepatitis are caused by hepatitis viruses A.There are five major forms of viral hepatitis which are currently recognized. C. possibly with liver and lymph node enlargement Signs and symptoms in icteric phase (lasts 1 to 2 weeks): • Mild weight loss • Dark urine and clay-colored stools • Yellow sclera and skin • Continued hepatomegaly with tenderness Signs and symptoms in the convalescent phase (lasts 2 to 12 weeks or longer): • Continued fatigue • Flatulence. arthralgia. 3. and serum globulin levels are high Liver biopsy and scan show patchy necrosis Treatment includes: The patient should rest in the early stages of the illness and combat anorexia by eating small meals high in calories and protein. B. Type B. photophobia. Chronic hepatitis B with liver inflammation is treated with interferon alfa-2b for 16 weeks. hepatitis cases in the US. Monitoring of blood counts is essential during treatment. Serum transaminase levels (ALT and AST) are elevated Serum alkaline phosphatase levels are elevated Serum and urine bilirubin levels are elevated (with jaundice) Serum albumin levels are low. Lamivudine is another therapy for hepatitis B to decrease the viral load of hepatitis B • • • • • • • • • • • • 11 . and headache • Loss of appetite. Viral load is measured by quantitative polymerase chain reaction assay and is useful in determining need for treatment and monitoring therapy. myalgia. Vaccinations are available and are now required for health care workers and school children in many states. D. abdominal pain or tenderness. Large meals are usually better tolerated in the morning. 2. accounts for 5% to 10% of posttransfusion. and indigestion Diagnostic tests include: The presence of hepatitis B surface antigens and hepatitis B antibodies confirms a diagnosis of type B hepatitis Detection of an antibody to type A hepatitis confirms past or present infection with type A hepatitis Detection of an antibody to type C confirms a diagnosis of type C hepatitis. such as IV drug users and hemophiliacs 5. or E. The incidence is also increasing among homosexuals and in people with human immunodeficiency virus (HIV) infection. Type D is confined to people frequently exposed to blood and blood products. and vomiting • Altered sense of taste and smell • Fever. Signs and symptoms in the preicteric phase: • Fatigue. nausea. PT is prolonged (more than 3 seconds longer than normal indicates sever liver damage). Type E was formerly grouped with Type C under the name non-A. malaise. also increasing among HIV-positive people. Type A is transmitted almost exclusively by the fecal-oral route. non-B hepatitis. each caused by a different virus: 1. Day-care centers and other institutional settings are common sources of outbreaks.

Inform visitors about isolation precautions Give patient plenty of fluids. Headache c. Use of mosquito nets when sleeping b. The patient needs instruction on self-injection and adverse effects Laboratory tests-including CBC with differential. Adherence to the treatment regimen d. dehydration. malaise. Antiemetics may be given 30 minutes before meals to relieve nausea and prevent vomiting. Fever d. albendazole or diethycarbamazine. and keep accurate intake and output records Observe the patient’s stool for color. Eradication of breeding and/or resting sites of mosquitoes c. thyroid studies. and amount Watch for signs of hepatic coma. frequency. Encourage the anorexic patient to drink fruit juices. and GI disturbance Patients need to be proactive in their treatment to properly monitor and succeed in taking their medication. Swelling e. flulike syndrome. Areas of abscess Diagnostic exams include blood tests. vascular problems. Ask the patient to name the persons he came in contact with recently. Brugia timori. legs or scrotum f. pneumonia. or surgery to remove the enlarged tissue and drain the lymph nodes. Evaluate the patient • • • • • • • Filariasis Also known as Elephantiasis. Chills b. Brugia malayi. consistency.• • • • • • • Therapy for hepatitis C includes interferon or a combined interferon and ribavirin therapy. a parasitic disease caused by an African eye worm transmitted through person to person by mosquito bites. the patient needs IV infusions In severe hepatitis. Practicing proper environmental sanitation Sexually Transmitted Disease 12 . Medical management includes the administration of Ivermectin. Redness and pain in the arms. It is caused by three types of worms: Wuchereria bancrofti. corticosteroids may give the patient a sense of well-being and may stimulate the appetite while decreasing itching and inflammation. fatigue. Circulating Filarial Antigen (CFA) . Nursing care is supportive and management focuses on the prevention of the disease rather than its treatment a. and pressure ulcers Report all cases of hepatitis to health officials. liver function tests. Record weight daily. If vomiting persists. Symptoms may vary depending on the type of parasitic worm but usual symptoms in all cases include. but are not limited to the following: a. Nursing care includes: Observe enteric and blood and body fluid precautions for all types of hepatitis. and hepatitis quantitative studies-help determine the effectiveness if therapy and prevent complications during treatment. and taking the patient’s history. Caution patients against becoming pregnant during the course of therapy or in the 6 months immediately following treatment Adverse effect of medications include depression.

cough. AIDS is caused by infection with HIV. such as ritonavir. a retrovirus present in body fluids. such as zidovudine (AZT). these drugs are designed to inhibit HIV viral replication. Sexually transmitted disease (STD) is the most common infections present. depending on patient’s disease stage and condition Offer support in coping with the social impact and discouraging prognosis of AIDS Evaluate the patient. protozoans. fungi. such as blood and semen. and (3) with a history of STD. noting its pattern Assess for tender. didanosine. and saquinavir • Nucleoside reverse transcriptase inhibitors. Although no cure exists for AIDS. lamivudine. (2) with multiple sexual partners. which may include bacteria. signs and symptoms can be managed with treatment. and diarrhea Encourage daily oral rinsing with normal saline or bicarbonate solution Follow standard precautions as directed by your facility. such as nevirapine and delaviridine Used in various combinations. • • • • • • • STDs Nursing responsibilities include: Monitor the patient for fever. Enzyme-linked immunosorbent assay and a confirmatory Western blot assay detect HIV antibodies to diagnose HIV infection. Primary therapy for HIV infection includes three different types of antiretroviral drugs: • Protease inhibitors. Modes of HIV transmission include: • Sexual contact. such as skin breakdown. or ectoparasites. Patient high at risk include those (1) under age 25. an infected person may have no signs or symptoms-or may have a flulike illness and then remain asymptomatic for years. 13 . viruses.HIV/AIDS Acquired immunodeficiency syndrome (AIDS) is marked by progressive weakening of cell-mediated immunity. leads to infection. AIDS increases susceptibility to opportunistic infections and unusual cancers. nelfinavir. swollen lymph nodes. Levels of circulating HIV are measured regularly to assess the risk of disease progression and the patient’s response to therapy. and stavudine • Nonnucleoside reverse transcriptase inhibitors. especially associated with trauma to the rectal or vaginal mucosa • Transfusion of contaminated blood or blood products • Use of contaminated needles • Placental transmission from an infected mother to a fetus through cervical or blood contact at delivery • Breast milk from an infected mother Risk factors for AIDS include: • Multiple sexual contacts with homosexual or bisexual men • Heterosexual contact with someone who has AIDS or is at risk for it • Present or past abuse of IV drugs • Transfusion of blood or blood products After initial exposure. and check laboratory values regularly Watch for signs and symptoms of infection. Transmission of the causative organism. and Chlamydia is the most common STD. The Centers for Disease Control and Prevention defines AIDS as a CD4+ cell count below 200 cells/µl or when a patient has an opportunistic infection in the setting of HIV infection. sore throat. zalcitabine. indinavir.

follow up in 7 to 10 days. and skin or mucous membrane lesions. in males. proctitis. urethritis. Treatment is based on the specific causative organism. Name and Possible signs and Treatment Special Organism symptoms considerations Chlamydia >purulent discharge Doxycycline or >all sexual contacts Chlamydia >Males: burning on azithromycin must be treated trachomatis urination and >potential symptoms of complications in epididymitis females are pelvic >Females: usually inflammatory disease asymptomatic (PID). patient history. topical relieve pain genital area. recurrent vaginitis. pharyngitis. The diagnosis of a specific STD is made by physical examination. epididymitis. and laboratory tests to determine the causative organism. vaginal or penile discharge. in males. epididymitis. and prostatitis. and abstain from sexual activity until treatment is completed. mild analgesics may 2 >multiple vesicles on acyclovir. urethritis. prostatitis. epididymitis. lower abdominal pain. anesthetic ointment >patient should buttocks or thighs avoid sexual activity >painful dysuria during the prodromal >fever stage and during >headache outbreaks until all >malaise lesions have dried up >many patients have recurrences every 2 to 3 months. Genital herpes >Females: purulent Famciclovir. and spontaneous abortion. >patient should take medication as prescribed. infertility. >warm baths and Herpes simplex type vaginal discharge valacyclovir.Signs and symptoms of STDs are vaginitis. and sterility >patient should take 14 . sterility and ectopic pregnancy. local hyperesthesias may occur 24 hours before outbreak of lesions Gonorrhea >purulent discharge Ceftriaxone plus >all sexual contacts Neisseria >dysuria azithromycin or must be treated gonorrhoeae >urinary frequency doxycycline >potential complications in females are PID.

and abstain from sexual activity until treatment is completed >all sexual contacts must be treated >complications in females include recurrent infections and salpingitis >patient should take medication as prescribed. secondary. >all sexual conrtacts must be treated >patient should take medication as prescribed. cryosurgery Syphilis Treponema pallidum Trichomoniasis Trichomonas vaginalis >chancre on genitalia. and abstain from sexual activity until treatment is completed 15 . usually asymptomatic >Females: frothy vaginal discharge with erythema and pruritus. or tertiary. follow up in 7 to 10 days. follow up in 7 to 10 days. mouth. and rapid plasma regain test >Males: urethritis or penile lesions. lips.Human papilomavirus (HPV) >pink-gray soft lesions. singularly or in clusters Podophyllin 10% to 25% to lesions. fluorescent treponemal antibodies test. and abstain from sexual activity until treatment is completed >patient should receive frequent Papanicolaou tests >HPV has an 80% chance of recurrence >HPV is the most common cause of cervical cancer >syphilis may be characterized as primary. may be asymptomatic penicillin metronidazole medication as prescribed. follow up in 7 to 10 days. or rectum >fever >lymphadenopathy >positive results for Venereal Disease Research Laboratories test.

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