POLIOMYELITIS

Main Problem: paralysis, inability to walk

⮚ Common below 10 years old
⮚ Also called infantile paralysis cause by Legio Debilitans
1. Brunhilde
2. Lansing
3. leon
Mode of transmission: fecal-oral
Incubation Period: 7-14 days average (3-21 days), period of communicability, 7-16
days before & few days after onset of signs and symptoms
Clinical Manifestation:
It is characterized by febrile episodes with varying degrees or muscle weakness or
occasionally a progressive Flaccid Paralysis
Minor Polio
⮚ Inapparent/subclinical
⮚ Abortive: recover within 72 hours, flulike, backache, vomiting
Major Polio
⮚ Paralytic: asymmetrical weakness, paresthesia, urinary retention, constipation
⮚ Bulbar: brainstem affected
⮚ Spinal: anterior horn cells of the spine affected
⮚ Non paralytic: slight involvement of the CNS, poker’s spine or stiffness and
rigidity of the spine, spasms of hamstring muscles, with paresis
⮚ Both paralytic & non-paralytic
Tripod position: extend his arms behind him for support when upright
Hoyne’s sign: head falls back when he is in supine position with the shoulder
elevated
Meningeal Irritation
⮚ (+) Kernig’s and Brudzinski’s signs
Diagnostic test: throat swab, stool exam, lumbar puncture
Nursing diagnosis: impaired physical mobility
Intervention:
⮚ Supportive
⮚ No morphine
⮚ Moist heat application for spasms
⮚ Airway: tracheostomy
⮚ Footboard to prevent foot drop
⮚ Increase fluids
⮚ Enteric and strict isolation/precaution

RABIES
Main Problem: also called Hydrophobia lyssa caused by Rhabdovirus (neutropic virus
from the genus Lyssa viruses) causing paralysis and eventually death
Mode of transmission: animal bite, through scratch or break in the skin
Incubation Period: 10-14 days, the nearer the bite, the shorter the incubation period
Clinical Manifestation:
Rabid dog: withdrawn, dumb, paralytic, Furious stage: bites without provocation
Manifestations in man
Prodromal
⮚ Headache
⮚ Malaise
⮚ Anorexia
⮚ Sore throat
⮚ Salivation
⮚ Diaphoresis
⮚ Tingling sensation
⮚ Numbness at the site of bite
⮚ Low grade fever
Excitement/Maniacal
⮚ Hydrophobia
⮚ Aerophobia
⮚ Increase anxiety
⮚ Cranial affectation
Paralytic stage
⮚ Die of paralysis or respiratory arrest
Diagnostic test: brain tissue (dog); fluorescent rabies antibody staining
Nursing diagnosis: alteration in comfort, pain
Intervention:
⮚ Wash with soap and running water
⮚ Antirabies immunization
Administration of RIG (Rabies Immunoglobulin) 20 IU/kg for human RIG40
IU/kg for Equine RIG
Vaccine shouldn’t be injected into the gluteal region Rabivac, Verorab,
Imovax, Rabies vero, Rabipur
⮚ Sedatives: haloperidol and benadryl
⮚ Restraint patient, cover IV line

SCABIES
Main Problem: locally known as “Galis” caused by Sarcoptes/Acarus Scabiei, itcmite
from dogs
Mode of transmission: acquired thru infected dog
Clinical Manifestation: itch mite thrives in warm moist folds of the body burrowing
itself and its eggs in linear formation which caused infection and itchiness of the area
No lab exam needed
Nursing diagnosis: impaired skin integrity
Intervention:
⮚ Eurax ointment (Crotamiton)
⮚ Hydrogen peroxide (wound)
⮚ Kwell lotion (Gamma Benzene Hexachloride/Permethrin)
Neurotoxic contraindicated in young children and pregnant women
⮚ Meticulous skin care, use Hydrogen peroxide, sundry blankets and linens