Tetanus

Definition: Tetanus is an infectious disease caused by Clostridium tetani,

which produces a potent exotoxin with prominent systemic neuromuscular
effects such as generalized spasmodic contractions of the skeletal
musculature.

Mode of transmission:
1. Rugged, Traumatic wounds and burns.
2. The Umbilical stump of the new born, especially if delivered at home
and thus have faulty cord dressings.
3. Babies delivered to mothers without tetanus to void immunization.
4. Unrecognized wound.
5. Dental extraction, circumcision and ear piercing.

Incubation Period:
Adults- 3 days to 3 weeks
New born- 3-30 days

Pathophysiology

RF:

Lack of immunization
Presence of other infected
bacteria
Injured Tissue
Swelling around the injury

Clostridium

Enter through puncture

wounds
Local infection
Extensive
tissue
destruction

Release toxins that are

absorbed by blood streams
lymphatics/ peripheral motor
nerves
Spread into the
CNS
Hyper excitability
of the motor
neurons

Pathognomonic sign:

Lock jaw

Lock jaw
Fever & chills
Stiff neck
Increase BP
Sweating
Increase heart rate
Difficulty swallowing

Asphyxial
convulsion

Toxic
degeneration

Common Nursing Diagnosis:

Altered nutrition: Less than body requirements

Impaired physical mobility
Activity intolerance
Sensory perceptual alteration
High risk for infection/ complication
Hyper excitability
Knowledge deficit

Modalities Treatment:
1. Specific
a. Within 72 hours after a punctured wound, the patient should
receive ATS, TAT, or TIG, especially if the patient does not have
any previous immunization
b. Tetanus toxoid, sec IM, given on standard schedule
c. Pen GN or, to control infection
d. Muscle relaxant to decrease muscle rigidity and spasm
2. Non-specific
a. Oxygen inhalation
b. NGT feeding
c. Tracheostomy
d. Adequate fluid, electrolyte, and caloric intake
e. Good nursing care:
Maintain an adequate airway
Provide cardiac monitoring
Maintain an IV line for medication and emergency care if
necessary
Carry out efficient wound care
Avoid stimulation; warn visitors not to upset or overly
stimulate the patient
Prevent contractures and pressure care
Watch out for urinary retention
Closely monitor vital sign & muscle tone
Provide optimum comfort measures

Prevention and Control:

1. Active immunization with tetanus toxoid for adults and pregnant

women
2. DPLT for babies and children