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Disease

Causative Agent

Mode of Transmission
Break in skin integrity (wound)

Incubation

Manifestations

Diagnostics

Medical/objectives Management
Neutralize toxin: - Anti-tetanus serum - Tet anti-toxin - Tet Ig Kill the organism - Antibiotic: Penicillin - Cleanse wound (thin dressing) Control spasm - Muscle relaxant: diazepam, valium, methocarbamol, lioresal (Baclofen), eperisone (Myonal) -

Nursing Care

Prevention

CNS INFECTIONS
Tetanus (Bacterial) Clostridium Tetani Spore Destroyed by O2 Inflammatory Process (RCDTF) Inc. Muscle tone near wound Tachycardia, diaphoresis Low grade fever Spasm: trismus, risussardonicus, opisthotonus, abdominal Clinical observation: LOCK JAW Hx of wound or tooth decay Maintain airway Maintain IV line Decrease stimuli Gentle handling, turn 1x per shift - Minimal handling: cluster care - Protect from injury: padded rails, call light - Provide comfort measures Immunization DPT: 6 wks after birth (3doses, 1mo interval) 0.5cc, IM Expect fever Give warm compress h24 first then cold Tetanus Toxoid: st nd 1 : 2 trim nd 2 : 1mo. rd 3 : 6mos th 4 : 1 yr th 5 : 1 yr Booster: q10 yrs 0.5cc, IM Heaviness at injection site Immunization Proper disposal of nasopharyngeal secretions Do not swallow CMV/TB Cover nose and mouth when sneezing— mask

Meningitis (Bacterial)

Viral: Aseptic Meningitis CMV Fungal Cryptococcus neoformans Immunocomp Bacterial TB nd Streptococcal (2 to respi infection) Staph (skin infection) Meningococcal

Droplet via respiratory tract

2—10 days

- Nasopharyn URTI enters bloodstream vascular sys affectedpathologic vascular changes - Petichae (meningo) - Ecchymosis (meningo) - Abnormal reflexes: kernig’s (leg), brudzinski’s (neck) - Inc ICP

Lumbar Puncture Bacterial: yellowish, turbid, cloudy, inc CHON, WBC, normal sugar Viral: Clear, Increased CHON, WBC, normal sugar C&S, Counter Immuno Electrophoresis (protozoan or viral), blood culture

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Antimicrobal - Neuro fnx Corticosteroid - Adequate nutri (Dexameth, and elimination hydrocort)— - Ensure comfort: NOT Prednisone diversional (Na retention, therapy, noncan’t cross BBB) stimulating env’t, Osmotic elevate HOB 30’, Diuretic: nursing massage Mannitol (Petrissage) Anticonvulsant: Phenytoin (IV/PO), flush before and after, PO—gingival hyperplasia

2gttsPO. chx pox Post vaccine— anti-rabies Toxic: metal poisoning Primary: Vector— mosquito. HA. Body Malaise Lumbar puncture—same as enceph Throat washing/swab— within 1-4days Stool exam/fecalysis—after 5 days - - Analgesic (Narcotic)—Codeine (not causes respi dep) Symptomatic Mech Vent—Iron Lung machine (neg P) .s/sx disappear . NPO 30 mins. nutri and elim - - - - - Polio Myelitis (Viral) Acute Flaccid Paralysis Infantile Paralysis Polio Virus (Legio Debiletans) Type1: Brunhilde— permanent immunity Type2: Lansing Type3: Leon Early (1-4days)— Droplet Late—Fecal-oral Invasive/Abortive Stage . WBC. if .Same as meningitis : Neuro fnx.Symptomatic / supportive . microorganis m Eradicate source of infection Insecticides Repellant Screen doors and windows C-hemically treat mosquito nets (Permethrin sol’n—Soak 1-2days.Hot compress for pain - Viral: permanent immunity but caused by diff. ticks.Convulsions . sore throat . dry 23-days.Encephalitis (Viral) “Brain Fever” Arbovirus Primary: affects brain directly Secondary: previous infection Measles. 3 doses 1 mo interval. HA.Time Virus infects individual . birds .respi: sore throat.Same as Meningitis . fever. clear Counterimmunophoresis EEG—extent of brain damage - Symptomatic . use 3-6mos) L-arvivarous fishes E-nv’t sanitation A-nti mosquito soap N-eem tree/euchaly ptus Immunizatio n (OPV): 6wks after birth.Fever.Behavioral changes (initial symp)— Altered LOC (Lethargy) Lumbar puncture—inc CHON.

5ccIM.Efferent nervessalivary gland of animals virus Brain biopsy of animals— negri bodies DFA—direct fluorescent antibody test Observe animal for 10 days 3 factors to consider site of bite (waist up. purified vero cell vaccine (Verorab).Severe muscle pain . N/V. wash with water and soap. Humans . drooling.Siff hamstring . easily bites. anorexia. Can be destroyed by heat 60’c for 35 secs. apply antiseptic sol’n. careful handling stools Inactivated Polio Virus: Salk vaccine. vicious or fierceful look.disposition. walks to and fro. Purified duck embryo (Kyssavac).Flaccid paralysis . stays in a 3mos) corner.Poker Spine— opisthotonus with head retracted .GI: Abd pain.Room away from subutility room . give but do not count.not transmissible without s/sx - - - with diarrhea. 6wks after birth.Provide comfort measures - - - . hyperactive Furious stage: easily agitated. Interval. quiet. 21 years (1withdrawn.2cc/kgbw Human Rabies Ig (HRIg)— . intercostal muscle Animal:3-8 Animals weeks Dumb stage: change in Human:10days.Hoyne sign (head drop) . Diarrhea/Consti Pre-Paralytic Stage CNS involved without paralysis . if immunocom p Avoid MOT— do not put anything in mouth Proper waste disposal Responsible pet owner Keep away from strays Keep animals chained or caged When bitten. 0. overly affectionate.Tri-pod position *Paralytic stage .Dim and quiet env’t . Rabies (Viral) Rhabdo Virus Lyssa La Rage Rhabdo Virus Contact with saliva of rabid animal ..Bulbar type—CN 910 affected .Peripheral nervesCNS--> multiply  will be behind inclusion bodies negri bodies (pathologic bodies formed as microorg multiplies) .Restrain before maniacal behavior . purified chich embryo (Rabipur) IM/ID Passive Immunization: Equine rabies Ig (ERIg)— 0.Supportive/ symptomatic .give vaccine) extent of bite reason for bite Post exposure prophylaxis: Active immunization— anti-rabies vaccine. 3 doses 1 mo.Spinal type—anterior horn cell (motor fnx): extremities. depressed.

pharyngolaryngeal spasm. maniacal behavior—violent Paralytic stage: spasm stops. irritable. sedative hypnotic to dec anxiety. IM.133 cc/kgbw Within 7days Single dose Ventroglutea Multiple bites: Half IM.Stop AMD Fumigation . marked insomnia. joint and bone.Selfprotection . ascending paralysis.000 mm3 Below 150K Symptomatic Fluids to maintain concentration of the blood and intravascular vol (200mL/hr) Coagulants Vit K (aquamephyton) NO protamine sulfate—anti-coag effect Antipyretic—no ASA Vit C—capillary resistance Prevention and control of bleeding: . hydrophobic. normalize behavior of pt.Search and Destroy . antipyretics not effective (RTC may decrease) Pain: HA.Position upright. retrorbital. 24-72hrs 0. numbness and pain at site of bite.gentle nasal care (avoid picking. fever for more than 3 days. half on bites Haloperidol (Haldol): antipsychotic.Cold compress Vomiting of blood Eradicate Mosquito: 4S .000-400. no other signs of DHF Platelet Count CONFIRMATORY N:150.Seek early consultation - - . gum bleed Hematemesis. flulike. photosensitivity. saliva has virus Excitement Stage: Aerophobic. q6h - CIRCULATORY Dengue Hemorrhagic Fever Arbo Virus Onyong-nyong virus Chikungunya virus West nile virus Flavivirus (Philippines) Vector Borne: Mosquito bite Aedes Aegypti Aedes Albopictus Culex fatigan: after biting an infected person. drooling. apprehensive. Rumpel Leede-Test Tourniquet test Capillary rigidity PRESUMPTIVE BP=S+D/2 Inflate 5-children and 10-adults 1sq in. photophobia. Benadryl: anti-histamine. stagnant H2O Without Warning Sx: Like gr1 High grade fever: 3-5 days. restless. use cotton buds with NSS) Nose bleed . abdominal N/V Peticahe/herman’ s sx With Warning Sx: Epistaxis.goes to saliva Invasive stage: itchiness.=20 formation Criteria: 6mos or older. it will be the only one acquiring the disease Day biting Low flying Breeds in clear. lean forward and compress nose .

inc RR and PR (thready.Keep NPO .melena Hematochezia Severe DHF Evidence of circu failure Cold and clammy Cold extremities Prolonged capillary refill (hemoconcentrati on) Altered VS.Ice packs over epi region . weak) Dengue shock syndrome: hypovolemic shock (excessive blood loss from prolonged bleeding) Hematocrit Determination Above 0.Refer to MD Melena .dec BP.Avoid dark colored food .Avoid red meatfor 3 days—occult blood test Provide fluids Increase resistance Supportive .54 (54%) .

Needle prick Night biting Mountainous. convulsions. warm and dry. light loose clothing. multiplies rapidly.P. loss of consciousness. Oval .P.Keep warm: blankets. Province. hot water on soles of feet Hot Stage . Cagayan Valley) Clear flowing water Capable of transferring to blood stream - CNS Respi: Cough.Shivering of body. no need to wait - Antimalarial agents Artemether— first line Chloroquine— mainstay drug Quinine— reserve drug Primaquine Atabrine Fansidar Antimalarial caution with pregnant— abortifacient. 10-15mins Hot Stage. Mt. Malariae Vector Borne: Mosquito Bite (Anopheles Mosquito) BT. delirium. coma) Black water fever—dark urine bec of rapid destruction of RBC Malarial Smear: extracted during fever (parasite in the blood) Quantitative Buffy Coat: rapid test. drop light. Davao. warm drink. forested (Palawan. common in Phil . fluids for dehydration - Eradication of mosquitoes - .Malaria Protoza . vomiting.P. Ham Abd pain. Vivax: common in Phil . confused. 4-6h Wet Stage. Ifugao.P. If with neuro symptoms do not inc.profuse swearing with weakness Chills before fever— rupturing of membranes Severe anemia Cerebral hypoxia (restless. Uremia. fluid intake Wet Stage . Black water fever Stages: Cold Stage.fever. Hematemesis GU: Oliguria. Anuria. Falciparum: most deadly. Melena.Keep comfy. hemoptysis GI: N/V.Lower temp: cold compress. provide fluids. untreated can cause severe anemia to baby No permanent immunity Remission and exacerbation for 3-5 yrs - Cold stage .

neglected nodolous. lessen period of communicability 2 approaches Pauci: 6-9mos.loss of brows and lashes Saddle nose deformitysinking of bridge of nose.lion Contractures—claw fingers and toes Chronic skin ulcers Gynecomastia Active. rifampicin 1x a mo. In respi tract 5.INTEGUMENTARY Leprosy Hansen’s disease Hansenosis Mycobacterium Lebrae Prolonged Intimate Skin contact—bacteria in skin lesion Droplet—conc. many with resistance Multiple Drug Therapy: prevent resistance. anhydrosis (absent sweating) (+) skin smear mycobacterium leprae 2 types based on lesions Paucibacillary—Good Prog 1-5 skin patches or nodules Non-infectious type Tuberculoid. dapsone and lamprene 1x a day (hyperpigment skin) Pscyh aspect Skin care— prevent skin infection Provide physical exercise— strengthen muscle and prevent contracture Provide adequate drug info Immunization BCG Avoid MOT - - .can’t close eyelids Madarosis. hasten recovery. lepromatous Skin smear test Skin lesion biosy Lepromin test—pauci or multi Wassermann reaction test—blood exam Pregnancy—wait for delivery before tx Dapsone: single drug. rifampicin 1x a month. dapsone 1x a day Multi: 1218months.5months— 8yrs Cardinal Sx: Peripheral nerve enlargement Loss of sensation on affected part—loss of hair. absorption of small bones Natural amputation Leonine face. Benign Mild manifestations Multibacillary Lepromatous type Infectious >5 lesions Severe manifestations Changes of recovery but with complications Early sign: skin changes Color change—does not disappear with tx Skin lesions that won’t heal Late Signs Lagopthalmus.

leprosy lesions on face .

petechial on soft palate Eruptive Rash formation. mild rash after 3-4days MMR—at 1215mos. starts behind earsface necktrunkextremities) rd 3 day of illness 2-3days whole body coeAHvered with rashes Post-eruptive Rashes start to disappear from ears Fine barry desquamination (brown first. discrete. rashes peel not skin). 0..5ccIMm may have fever.give immunization at 6mos but revaccinate at 15mos Proper disposal of nasopharyngeal secretions Clinical observation Same as measles - Same as Measles - Same as Measles . maculopapular—pinkish.5ccSQ. Colds Forscheimer’s spots: enanthem. Road to recovery Pre-eruptive Absent fever 1-2days Cough. within inner cheek Eruptive Maculo-papular rash (reddish. 0. conjunctivitis Photosensitivity Koplik’s spots (hallmark)— fine red spots with bluish gray spots at center. cephalocaudal. fine red spots. finer and smaller than measles Cephalocaudal—face first 24hrs—completely covered Enlargement of lymph nodes—differentiating Clinical observation Symptomatic Mx - - Symptomatic/supportive Prevent acquiring secondary infection Prevent patient’s exposure to draft— pulmonary complication Keep warm and dry - Permanent immunity Immunization: AMV—at 9 mos. Coryza (colds).Measles Rubeoloa Paranyxovirus (Rubeola Virus) Airborne Communicable: 4 days before appearance of rash 5 days after appearance of rash German Measles Rubella Psydoparamyxo virus (Toga/Rubella Virus) Direct (Droplet) Stages Pre-eruptive High fever 3-4days Cough. blotch. can be given to adults (no pregnancy for 3mos) Epidemic.

posterior auricular.Chicken Pox Varicella Varicella-zoster virus Airborne (nasopharyngeal secretions. scalp) Unifocular appearance— one at a time. falls off (peels off) Vesiculo-papular rash Painful-persists for 2 mos after recovery Unilateral distribution— follows nerve pathway Appears in cluster Clinical observation Symptomatic Anti-viral agents (acyclovirZovirax) Antipuritic agentsantihistamin. may have feverm may have rash 3-4days afterm below 13 single dose. pustule Take a bath daily (tepid) Might develop boilscarbuncle cellulitisgangrene Rupture scar (Pock Marks) Generalized distribution— first on the covered part of body (trunk. body malaise. sub-occipital. never fuses Post-eruptive Crusts (dry). muscle pain 1-2days Eruptive Vesiculo-pustular rashes Macule. papule. vesicle. above 13 2 doses with 1mo interval Same as measles Clinical observation - Symptomatic May be given analgesics - Symptomatic - Temporary immunity .5ccSQ. calamine lotion - - Skin care Increase body resistance—adequate rest and nutrition - - - Communicable until all have dried Immunization (Viravax): at 1218mos. secretions of rashes) Herpes Zoster Shingles Zona Varicella-zoster virus Direct (Droplet) Acute posterior ganglionitis: posterior nerve roots affected Dormant chx pox Inactive chx pox Can’t have factor. posterior cervical Post-eruptive rd Rash disappears—3 day of illness Enlarged lymph nodes gradually subside Pre-eruptive Presence or absence of low grade fever HA. 0.

without chx pox .

apply abd binders) No permanent immunity but second attacks are rare - - Proper disposal of nasopharyngeal secretions Cover mouth and nose when coughing . loss of voice (temporary) .Hoarseness. bottle feeding should have small hold. dysphagia .Coughing (barking. found on nasal septum. postural drainage Provide adequate nutria Provide comfort measures - - - Immunization Proper disposal of nasopharyngeal secretions Covering of the nose and mouth when sneezing or coughing Never kiss  - - Nasal swab— during cararrhal stage Nasopharyngeal culture— confirmatory test. pharyngeal . anterior aspect of neck. agar plate. withhold feeding.Bull-neck appearance— neck edema. steam). foul smell . turn to side q2 to prevent pooling D: suction. tiredness and listlessness Paroxysmal/spasmodic 5-10 successive force of coughing that ends in a prolonged inspiratory phase or a whoop—too much pressure exerted Congested face Congested tongue (purple) - - Nose and throat swab—confirms Schick test— determine immunity and susceptibility Moloney test— hypersensitivity to diphtheria toxin - - Anti-deptheria serum—neutralize toxin Antibioticpenicillin—kill microorganism - - - CBR (prevents myocarditis) Maintain patent air way I: upright position. neb. uvula. inhalation therapy (O2. Encourage DBCE. nocturnal coughing. characteristic sign.Sore throat. epigastric pain Catarrhal stage Highly communicable Lasts 1 wk Colds. chesty physiotherapy. bordet-gengou test.(+)pseudomembrane— grayish white appearance.RESPIRATORY Diptheria Corynebacterium dipheriae (Klebsloeffler baccilus) Direct (Droplet) - Pertusis Whooping cough Chin cough Bordatella Pertussis Hemophilus pertussis Direct (Droplet)-<6yrs of age 7—10 days Irritating nasal discharge— serosanguinous. croupy) . Hypotension. fever. chest pain. Inc fluids. cough plate - Antibiotic Antibodies— pertussis Ig F&E replacement Codeine with mild sedation— antitussive effect - - - Provide adequate rest to dec O2 demand Adequate nutrition with SAP (once coughing.Myocarditis:marked facial pallor. soft-palate. very irregular PR. tonsils. inflammation of cervical lymph node .

- Pneumonia Virus: CMV. weight loss. orange secretions Isoniazid: hepatotoxic. Right deltoid. fatigability.05cc abscessformation on site of . anorexia. DBCE. lung consolidations. after 3 th DB. CAP (strep pneumoniae) HAP: Staph aureus. Aspiration Pneumo Mycobacterium Tuberculosis hominis—from humans Direct (Droplet) Teary red eyes with eyeball protusion Distended face and neck veins Involuntary micturition and defacation Abdominal hernia Chokes on mucus (vomiting) Convalescent No longer communicable Signs and symptoms start to subside Cardinal Sx: Feverm shaking chills/rigor. cough on 4 . productive cough Sputum production rusty colored (CAP). splint chest wall. 5-10mL. apply chest binders. opportunistic microorganism Protozoa: Pneumocystis carnil pneumonia. provide adequate nutrition (SFF. Creamy yellow (Staph). Clear (None) Chest pain/pleuritic pain: friction between pleural layers. turn to affected side Fast breathing. Currant Jelly (Klebsiella). 0. patchy infiltrates) Sputum exam (first thing in the morning. chest and back Tuberculin test Screening only (+) if with TB exposure Consistently (+)- - - Rifampicin: hepatotoxic. high cal). avoid - Provide adequate rest: do activities gradually. chest indrawing (subcoastal retraction). body malaise. put tongue behind lower teeth) - Antibiotic Inhalation therapy Expectorants Atitusives - Maintain patent airway Provide adequate rest Provide nutrition Provide comfort - Immunization Proper disposal of secretions Tuberculosis Koch’s infection Airborne 1 wk— 2mos - Asymptomatic Low grade feverm night sweats. OM Bacteria: Most common. drug - Immunization (BCG)—ID.breathe through nose and release through pursed lips. wheezes - - Chest x-ray (definitive. Greenish (Pseudomonas). stridor. Gram (-) (pseudomonas) Noxious substances: Lipid pneumonia (oilbased lubricants).

Give B6 (Pyrodoxine) Pyrazinamide: hyperurecemia. small spots like petichate. children-9mos. dyspnea may have developed sensitivity to microorganism Purified protein derivative (PPD) After 48-72h (+) >10mm if with HIV >5mm (+) Mantoux test Tine test/multipuncture test Vollmer and Pirquet (skin scratch/patch) X-ray . alkalinize urine Ethambutol: optic neuritis. koch’s phenomenon) Prophylaxis (INH). Flies. vomiting. trunk.6 months. color blindness Streptomycin: nephrotoxic. face (child) . hand washing.Rose spots—character sign. proper prep.Ladder-like fever .Bovis. ototoxic compliance - injection (longer than 3 mos— indolent abscess. productive cough. far advanced TB Blood exam—confirms Blood culture—first wk of infection Widal test Presence of antigen left by microorganism Antigen Osomatic antigen H. hemoptysis (erosion of lung capillaries. Food. sx of dehydration (<48h. monitor liver enzymes.Minimal.flagellar antigenpreviously exposed to TF or had immunization Typhidot Presence of antibodies - - - alcohol. spicy and irritating food. immunocom12months GASTROINTESTINAL Typhoid Enteric Fever Salmonella typhosa Fecal-oral 5F’s Feces.Splenomegaly Intestinal perforation peritonitis - chloramphenicol— antibiotic F&E replacement - Maintain F&E.TB of birds— pet owners. moderately advanced. vomiting-SFF. peripheral neuritis. Fingers. diarrhea. abd pain. Children on NPO initially to rest GI Give clear liquid to gen liquids to soft and full Provide comfort measures - Gives temporary immunity Immunization Avoid sources: proper disposal of excreta. don’t put anything in mouth - - - .Extent of disease .Fever. Fomites While on Blood stream . I&O.TB of cattles—from contaminated milk Avis. wt loss) Provide adequate nutrition: avoid fatty. sx of visual disturbance. constipation Peyer’s patches (target) . no CPT). eradicate flies. storage and handling of food. dull HA. mycobacterium Avium Complex pain.

- - IgM— presently infected igG— recovering .

after 30— stool cyst) - Antibiotic Tetracycline - Symptomatic/ supportive Monitor UOconsistency.Leptospirosis Leptospira (Spirochete) Skin penetration Need not wounded Enters pores 2day— 1mo (56days ) - - Flulike: fever. blood streakes if severe Endotoxin affects intestines Rice watery stools one after another Releases vibrio substance stimulate peristalsisdiarrhea Microorganism will not destroy intestinal wall. pus in blood Leptospira agglutination test (LAT) Leptospira Antigenantibody test (LAAT) Microscopic Agglutination Test (MAT) Stool exam submitted fresh (trophozites for 30mins only. env’t sanitation DYSENTRY Bacillary Shigellosis Bloddy Flux Violent Cholera Eltor Shigella Dysenteriae Flexneri Boydii Sonnei Vibrio cholera Comma shaped Ogawa Inaba Eltor Fecal-oral - - Antibiotic (Cotrimoxazole) ORT Antibiotic (tetracycline) IVT - Same with Typhoid - Same with Typhoid Fecal oral - - Same with Typhoid - Same with Typhoid - - Amebic Amebiasis Inactive (Cyst) Active (Trophozoites) Fecal oral - Stool exam submitted fresh (trophozites for 30mins only. only stimulate Rapid dehydration Washer woman’s hands (dry and wrinkled. amt - Eradicate rates: poison. poor skin turgor) Walten Bed (hole and pale underneath) Stool with fishy odor Mucopurulent blood streaked stool Trophozoites dissolves intestinal tieeues mucus. muscle tenderness and pain (calf muscles) Jaundice with hemorrhage Orange eyes and skin Anuria Uremia kidney failure Mucoid stool. HA. after 30— stool cyst) - Anti-amebic (metronidazole) ORT Chloroquine (antiprotozoan) - Same with typhoid - Same with typhoid . after 30— stool cyst) Stool exam submitted fresh (trophozites for 30mins only. Vomiting. frequency.

if BW is <2kg. Jetipar (kids) Carriers and Chronic Hep B (antiviral): Larnivodine table OD x 1yr Immune stimulant: interferon 2-3x a week for 3 mos - Provide adequate rest dec.Lactic dehydrogenase— liver damage Serum AntigenAntibody Test— Hepa A: HAgAB (-)Anti-HBS= infected (+) both carrier - - - Symptomatic Hepatic protector: phospholipids. infectedmoderate.5ccIM. loss and malaise— liver unable to convert glucose to glycogen Anorexia. vertical—child birth. vitamins and mineralsallows to relax but not tx. silimarin.Alanine aminotransferase-#1 indicator of CHON AST. tumor or bile stones obstructing biliary tree GGT. extra dose th on 10 wk Avoid MOT .Infectious hepatitis Alcoholism Drug intoxication Chemical intoxication (arsenic) Microorganism. any hard candy CHON. st nd 1 at birth. blood and other fluids Parenteral 6wks6mos 5-12 wks Parenteral 3-13 wks - Hepatitis E Hepatitis G Virus Fecal-oral Parenteral 3-6wks Unknown Pre-icteric Before Jaundice Arises Fever RUQ pain Wt. meds. 3 at 3th 14 week. 2 at th rd 2-6 wk. at birth 3 doses 0. metab— - - - liver relax Nutrition: Low Fat (not enough bile).Aspartate aminotransferase —inc upon onset of jaundice ALP.low No permanent immunity Immunization: (-) antigen and antibody. liver is directly affectedcommunicable Hepatitis A Virus (RNA) - - - - Fecal-oral 2wks6mos - B Serum Hepatitis Hepatitis B Virus (DNA) - C Post transfusio n hepatitis D Dormant HepB Cannot have D without B E G Hepatitis D Virus/Delta virus Parenteral. viral hepatitis. complications. essentiale.HEPATITIS A .modify based on condition. n/v—liver can’t deaminase Anemia—decreased lifespan of RBC (<120d) Icteric Jaundice: inability of the liver to remove normal amt of bilirubin goes to sweat bile salts on skin pruritus Tea-colored urine Excess bilirubin thrown out by kidney into urine Acholic stool—clay color Pre-icteric symptoms but less degree Post-icteric Jaundice disappers s/sx subside inc energy 3-4mos liver regeneration Avoid alcohol and OTC Liver enzyme test Determine extent of liver damage ALT. Hi CHO (spare protein metab to prevent Ammonia formationhepati c enceph) Butterball diet— prevent protein breakdown.Gamma Glutamyl Transferase—toxic hepa: alcohol. chemical LDG. oral to oral (6-8gal of saliva). sexual contact. recovering high.Alkaline phosphate—inc with obstructive hepa.

meds for 1 yr .

SEXUALLY TRANSMITTED - - INFECTIONS - - .