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Nursing Care of Patients with Bacterial Diseases acquired through Trauma of Inoculation Communicable Diseases

 Extremities: stiff and extended

Forms of Tetanus Localized  Signs of onset are spasms and increased muscle tone around the wound

TETANUS
 Lock jaw  An acute exotoxin mediated infection characterized by neuromuscular manifestations. CA: clostridium tetani (soil, dust) MOT: through traumatic breaks in the skin ◦ Contamination of unhealed umbilical stump.

Systemic or Generalized  Marked muscular tonicity

 Hyperactive deep tendon reflexes  Painful involuntary muscle contraction

 lockjaw or trismus  risus sardonicus  Boardlike abdominal rigidity  Opisthotonus  Intermittent tonic convulsions

IP: 7-14 days  Clostridium tetani  Anaerobic, spore-forming, gram positive (+) rod  With round terminal spores giving it a “drum-stick” appearance Clinical Manifestations  Onset: insidious with muscular spasms and cramp-like pain around the site of inoculation  Irritability and restlessness with progressively increasing stiffness of the voluntary muscles  Jaw: trismus or lockjaw opisthotonus

Neonatal tetanus is always generalized.  Difficulty in sucking between 310 days after birth.  inability to suck (jaw becomes too stiff), with excessive crying  irritability and nuchial rigidity  May end with flaccidity, anorexia, exhaustion, and finally death

 Neck & back:  Face:  Trunk: abdomen

risus sardonicus rigid, board-like Diagnostics

Penicillin-G  Diazepam Prevention  DPT vaccine  Hyperimmune globulin plus toxoid. Primarily a clinical diagnosis (history and physical exam)  Organism is rarely isolated. malariae: Quartan malaria P.  Serologic tests not useful. cephalosphorins  MALARIA  Plasmodium species  Vector-borne infectious disease caused by protozoan parasites that invade the RBC. falciparum: Malignant tertian malaria P. ovale: reticulocytes P. falciparum: every 36-48 hours   Plasmodium has 4 important species that affect humans:  Plasmodium Vivax MOT: Bite of female Anopheles mosquito. vivax and P. .   Infected RBCs   P. ovale: Ovale tertian malaria  Antibiotics . falciparum: erythrocytes of all ages  Prophylactic antibiotics ◦ penicillin.  Plasmodium Falciparum ◦ most severe and life threatening  Plasmodium Oval  Plasmodium Malariae Management  Hyperimmune human globulin ◦ to neutralize toxin  Plasmodium diseases    P. malariae: senescent erythrocytes P. ovale: every 48 hours P. vivax and P. malariae: every 72 hours P.  Debride wound. vivax: Benign tertian malaria P.  Female Anopheles mosquito ◦ Vector and definitive host ◦ Cyclic paroxysm of fever:  P.

Vivax and Ovale . Signs and symptoms  Chills.◦ mature sporozoites are injected into the victim. liver spleen enlargement. lasts for about 2-4 hrs. ◦ areas with a high risk of chloroquine resistance. EPIDEMIOLOGY: Occurs primarily in the tropical areas of Asia. usually takes 2 months or shorter.ranging from chills to extreme shaking.14 days  P. lasts from 2-3 hrs. high fever.high fever up to >41°C.  Protection from bites. Falciparum . jaundice. ◦ ◦  Chloroquine resistant cases. and Latin America INCUBATION PERIOD:  P. Prevention Chemoprophylaxis  Chloroquine .30 days  Infection from blood transfusion depends on the number of parasites. Wet stage characterized by profuse sweating. poor prognosis  Blood transfusion  Contaminated needles and syringes.12 days ◦ Diagnostics  P. Hot stage . ◦ ◦ cerebral malaria Black water fever – severe destruction of RBCs – dark-colored urine.pre-exposure prophylaxis  Primaquine to prevent relapses. Signs and symptoms occurs when RBC’s rupture Complications:  Control mosquitoes ◦ insecticides . lasts from 3-4 hrs. sweating. headache. acute renal failure. Africa. Malariae .`  Thick and thin blood smears are the most reliable test for malaria  Thick smear ◦ ◦ detect the presence of malarial parasites determine parasite density  Thin smear ◦ Identify the species of plasmodium. myalgia Has 3 stages: ◦ Cold stage .

direct contact ◦ Droplet infection LEPROSY  Hansen’s Disease  A chronic disease of the skin and peripheral nerves.  Incubation period averages several years. Characteristics:  Hypopigmented or reddish skin lesions  Definite loss of sensation  Damage to the peripheral nerves  Positive skin smear  Optimal growth at less than body temperature (30°C)  Grows preferentially in the skin and superficial nerves. Clofazimine. . ◦ ◦  Lepromatous leprosy multiple nodular skin lesions occur Leonine facies  Lepromatous Management  Multi-drug therapy: *Multibacillary leprosy = clients with (+) smear at any site combination of Rifampicin.  Onset of the disease is gradual.  Humans are the natural hosts. Signs and symptoms  Tuberculoid leprosy ◦ ◦ ◦ hypopigmented macular skin lesions thickened superficial nerves significant anesthesia of the skin lesions occur.◦ draining water from breeding areas.  Cannot be cultured in vitro. MOT: Prolonged contact.  Lepromatous form is more contagious than the Tuberculoid form. Dapsone *Paucibacillary leporsy = clients w/ (-) smears at all sites combination of Rifampicin & Dapsone *Rifampicin – urine may be slightly reddish in color for a few hours Has 2 distinct forms: ◦ ◦ Tuberculoid leprosy Lepromatous leprosy CA: Mycobacterium Leprae HABITAT: Human skin and nerves.

◦ Occasionally through ingestion of contaminated food and droplet inhalation. LEPTOSPIROSIS  AKA Weil’s disease  Acute systemic zoonotic infection.4th to 10th days during acute illness Urine .like illness.10th day MANAGEMENT Amoxicillin and Ampicillin . Conjunctivitis Diarrhea and abdominal pain Jaundice and hemorrhagic rash.1st week CSF . influenza. CA: Leptospira interogans Diagnostics  Isolation of Leptospira in body fluid ◦ ◦ ◦ Blood . MOT: Direct contact w/ urine or tissue of infected animals.  Characterized by extensive vasculitis.  Health education. Signs and symptoms  First Phase ◦ ◦ ◦ ◦ 4.most important drug for leprosy Source of infection: Water or soil contaminated w/ infected urine or tissues from infected animals.-.  No vaccine is available.  Adequate nutrition.7 days: non specific symptoms. IP: 7 -12 days ◦ Range of 2-20 days  Completion of treatment & cure: *Paucibacillary leprosy – six doses of MDT w/n 9 months – considered as cured *Multibacillary leprosy – 24 doses of MDT w/n 36 months – considered cured Prevention  Isolation of all lepromatous patients  Chemoprophylaxis with Dapsone for exposed children and close family contacts.  Second Phase ◦ ◦ Kidney or liver failure meningitis for 3 weeks or more. jaundice. and renal dysfunction.  Good personal hygiene.

/Day TID. IV Amoxicillin 500 mg. Adult ◦ ◦  Pedia ◦ ◦ Prevention  Proper disposal of infected urine Amoxicillin 30-50 mg/Kg./Kg.IV  Use Gloves  Avoid wading in flood waters  Control of rodents  Chemoprophylaxis for high risk people ./Day QID.QID. QID. PO Ampicillin 500-750 MG. PO Ampicillin 100 mg.