DEFINITION ETILOGIC AGENT INCUBATION PERIOD MODE OF TRANSMISSION SIGNS AND SYMPTOMS

Filariasis is an infectious tropical Parasites classified short as 4 weeks or Lymphatic filariasis is Lymphatic filariasis infection involves
disease caused by any one of several as long as 8-16 transmitted by different asymptomatic, acute, and chronic
as nematodes
thread-like parasitic round worms. months types of conditions
(roundworms) of the
Lymphatic filariasis, commonly known family Filariodidea. other resources Culex mosquito, widespread Asymptomatic -showing no external signs
as elephantiasis, is a neglected tropical There are 3 types of 6 months and as late across urban and semi-urban of infection while contributing to
disease. as 12 months after areas transmission of the parasite. These
these thread-like infection asymptomatic infections still cause damage
Filariasis is usually a self-limited disease filarial worms: Anopheles, mainly found in to the lymphatic system and the kidneys,
unless reinfection occurs.  rural areas, and alter the body's immune system.
Wuchereria
TYPES bancrofti, which is Aedes, mainly in endemic Acute episodes
responsible for 90% islands in the Pacific. -Fever that last for few days
1.Lymphatic Filariasis of the cases -local inflammation involving skin, lymph
 affects the lymphatic system nodes and lymphatic vessels often
 can result to a more serious Brugia malayi, accompany chronic lymphoedema or
complication such as which causes most of elephantiasis.
enlargement of body parts the remainder of the
 can cause pain and permanent cases Chronic Conditions
disability -lymphoedema (tissue swelling)
Brugia timori, -elephantiasis (skin/tissue thickening) of
2.Subcutaneous Filariasis which also causes limbs
 Affects the subcutaneous area the disease. -hydrocele (scrotal swelling).
of the skin -Involvement of breasts and genital organs

3.Serous Cavity Filariasis

 Affects the abdomen’s serous
cavity
 DIAGNOSTIC PROCEDURES TREATMENT MODALITIES NURSING PREVENTION
MANAGEMENT
1. Circulating filarial antigen (CFA)  Diethylcarbamazine (DEC) -Monitor client’s vital -wear long sleeves and long
-Drug of choice for lymphatic filariasis caused by signs, particularly the pants
This diagnostic examination determines the any of the three nematodes temperature.
presence of W. bancrofti that is released by infected -Potent microfilaricidal agent, but the mode of -Assess skin color and - sleep under a mosquito
mosquitos. It can be performed any time of the day. action is uncertain integrity. Note for net or in air conditioning
-Also kills approximately 50% of adult worms wounds, bleeding or any
-Not distributed for use in the US, but can but can skin changes. -use bug repellent
2. Polymerase chain reaction (PCR)
be obtained through the CDC under an -Assess for any
Investigational New Drug protocol discomfort and pain. -stay indoors or away from
This diagnostic exam detects whether the body is -Has been added to salt in some endemic regions -Provide wound care. mosquito breeding grounds
already infected by Filariasis. This test is not usually -Side effects include fever, headache, anorexia, -Elevate affected body between dusk and dawn
available in the market. nausea, and arthralgias. area to reduce swelling. (they're preferred biting
-Not safe for use during pregnancy -Administer medications time)
3. Blood smears if ordered and discuss
Ivermectin them to the client.
This test can also be helpful in identifying -Single dose can reduce microfilaremia by 90% -Provide support to
roundworms and any infection that takes place in W.bancrofti filariasis perform basic activities.
inside the body. It can be conducted during selected -No significant effect on adult worm viability, so -Encourage range of
times of the day, particularly during at night since results are not sustained without repeated doses motion and simple
roundworms are nocturnal. -May be beneficial in affecting worm fertility exercises of the affected
extremities to stimulate
Albendazole   lymphatic flow.
4. Antifilarial body tests -No direct effect on microfilariae; slow decline over -Recognize client’s self-
a 6-8 week period esteem needs.
This diagnostic exam determines the rise of IgG -14-day courses of treatment show a significant -Provide health teaching
levels and IgG4. Although this test is essential in decrease in microfilariae and information for
determining Filarial entry, it cannot detect presence continuity of care.
of infection and past infections.
Doxycycline
5. Ultrasound and Lymphoscintigraphic techniques -Simultaneously prevents adult worms from
reproducing and produces macrofilaricidal effects
up to 80-90%
These tests distinguish any presence of worm in the
-Clinical improvement in edema
lymphatic system.
-Fewest adverse reactions

DEFINITION ETILOGIC AGENT INCUBATION MODE OF SIGNS AND SYMPTOMS


Schistosomiasis caused by blood flukes
(trematode worms) of the
, also known as
bilharzia, is a disease genus Schistosoma. 
caused by parasitic
worms.  S. haematobium causes
urinary tract disease; the
The infectious form of other Schistosoma species
the parasite, known as cause intestinal disease.
cercariae, emerge from
Geographic distribution
the snail into the
water. You can become differs by species:
infected when your
skin comes in contact -S. haematobium: Widely
with contaminated distributed over the African
freshwater continent with smaller foci in
the Middle East, Turkey, and
India
-S. mansoni: Widespread in
Africa, foci in Middle East, and
the only species in the
Western Hemisphere in parts
of South America and some
Caribbean islands
-S. japonicum: Asia, mainly in
China, the Philippines,
Thailand, and Indonesia
-S. mekongi: Southeast Asia
-S. intercalatum: Central and
West Africa
DIAGNOSTIC PROCEDURES
PERIOD TRANSMISSION
4-6 WEEKS Early stage - Initial penetration of skin by cercariae results in
People become
hypersensitivity and transient pruritic., papular skin rash (swimmer's
infected when larval itch).
forms of the parasite
Intermediate stage 
– released by -After penetration, the organism enters the bloodstream and migrates
freshwater snails – through the lungs. 
- fever, malaise, cough, rash, abdominal pain, diarrhea, nausea,
penetrate the skin lymphadenopathy, and eosinophilia (Katayama fever). 
during contact with - a mucoid bloody diarrhea accompanied by tender hepatomegaly occurs. 
infested water.
Chronic schistosomiasis - retained eggs induce the formation of
eosinophilic granulomas, fibrosis and scarring, probably  mediated by
Transmission occurs cytokines and involves T helper lymphocytes.
when people
suffering from Bladder:
schistosomiasis -The bladder becomes inflamed and fibrotic
contaminate -Symptoms and signs include dysuria, urgency, terminal microscopic and
gross hematuria, secondary urinary tract infections, and nonspecific pelvic
freshwater sources
pain.
with their excreta -Chronic urinary carriage and bacteremia with salmonella can occur
containing parasite .
eggs, which hatch in Bowel. S. mansoni and japonicum produce congestion and ulceration of
water. the bowel wall.
-Long-term involvement of the colon produces abdominal pain and
bloody diarrhea.  
-Recurrent Salmonella bacteremia is related to parasitization of the
schistosome gut by Salmonella.
Liver
Portal hypertension can develop and cause hepatosplenomegaly, ascites,
and esophageal varices.
Swimmer's itch (cercarial dermatitis) is caused by the larvae of other
avian and mammalian schistosome species that penetrate human skin but
do not complete the life cycle and do not cause chronic fibrotic disease. 
-Manifestations include mild to moderate pruritus at the penetration site a
few hours after exposure, followed in 5 to 14 days by an intermittent
pruritic, sometimes papular, eruption. 
-In previously sensitized persons, more intense papular eruptions may
occur for 7 to 10 days after exposure.
TREATMENT MODALITIES NURSING MANAGEMENT/PREVENTION
-Infection with S mansoni and other species (except S - Avoid swimming or wading in freshwater when
haematobium) is determined by microscopic  Praziquantel you are in countries in which schistosomiasis
examination of concentrated stool specimens to detect Single-day oral treatment with praziquantel (20 mg/kg occurs. 
characteristic eggs.  - Drink safe water. Although schistosomiasis is not
twice a day for S. haematobium, S. mansoni, and S.
transmitted by swallowing contaminated water, if
o In light infections, several specimens may have intercalatum; 20 mg/kg 3 times a day for S. your mouth or lips come in contact with water
to be examined before eggs are found japonicum and S. mekongi) containing the parasites, you could become
o A biopsy of the rectal mucosa may be -Praziquantel is effective against adult schistosomes, infected. 
necessary.  but not developing schistosomula, which are present - Water used for bathing should be brought to a
o The fresh tissue obtained should be early in infection. rolling boil for 1 minute to kill any cercariae, and
compressed between 2 glass slides and then cooled before bathing to avoid scalding. 
- For asymptomatic travelers who have had exposure
examined under low power (unstained) for - Vigorous towel drying after an accidental, very
in potentially contaminated fresh water, treatment is brief water exposure may help to prevent
eggs. 
delayed for 6 to 8 weeks after the last exposure. parasites from penetrating the skin. 
-Schistosoma haematobium is diagnosed by - Adverse effects of praziquantel are generally mild - Chemicals used to eliminate snails in freshwater
examining filtered urine for eggs.  and include abdominal pain, diarrhea, headache, and sources may harm other species of animals in the
water 
dizziness. 
o Egg excretion often peaks between noon and 3 -Corticosteroids are often used to reduce the symptoms -The sanitary disposal of urine and feces reduces
PM the likelihood of infection.
of this reaction. 
-Mass community-based or school-based
-Biopsy of the bladder mucosa may be necessary.  treatment with praziquantel, education
There is no specific therapy for dermatitis or Katayama
programs, and molluscicides to reduce snail
syndrome. 
-Serologic tests may be particularly helpful for populations are used to control schistosomiasis
-Swimmer's itch is a self-limited disease that requires
detecting light infections or before eggs appear in the in endemic areas.
only symptomatic treatment of the urticarial rash
stool or urine.

-Swimmer's itch can be difficult to differentiate from
other causes of dermatitis. A skin biopsy may
demonstrate larvae, but their absence does not
exclude the diagnosis.
-Metrifonate may be used for S. hematobium and
oxamniquine for S. mansoni as alternative drugs
-No satisfactory alternative drug for S japonicum is
available. 

DEFINITION MODE OF TRANSMISSION SIGNS AND SYMPTOMS

Leptospirosis is a bacterial disease that -It can pass from animals Mild leptospirosis
affects humans and animals. to humans when an  a fever and chills
unhealed break in the skin  coughing
-Several species of the Leptospira genus of bacteria comes in contact with  diarrhea, vomiting, or both
cause leptospirosis. It can progress to conditions water or soil where animal  headache
such as Weil’s disease or meningitis, which can be urine is present.  muscle pain, particularly lower back and calves
fatal.  a rash
-It can also enter through  red and irritated eyes
-Leptospirosis is more common in tropical areas, your nose, mouth, or  jaundice
where the World Health Organization genitals.
(WHO) estimate that it affects 10 or more people in Severe leptospirosis
-The condition does not
every 100,000 each year. usually pass from one person
-Symptoms depend on which vital organs are involved. It can lead to kidney or liver
to another.
failure, respiratory distress, and meningitis. 
-People traveling to tropical areas have a greater -fatigue
risk of exposure. -irregular, often fast, heartbeat
-muscle pains
Etiologic Agent: bacteria of the genus Leptospira -nausea
-nosebleeds
Incubation Period: 5-14 days with a range of 2-30 -pain in the chest
days jaundice, seen in a yellowing of the whites of the eyes, tongue, and skin

DIAGNOSTIC PROCEDURES TREATMENT MODALITIES NURSING MANAGEMENT PREVENTION

• Antibodies for leptospirosis develop between 3-10 days after For patients with mild symptoms: -Avoid contaminated water.
symptom onset, thus any serologic test must be interpreted doxycycline is the drug of choice (100 - Keep away from infected animals,
accordingly – negative serologic test results from samples They will receive antibiotics
collected in the first week of illness do not rule out disease, and
mg orally, twice daily), if not intravenously. especially wild rats. Rats and other
serologic testing should be repeated on a convalescent sample contraindicated. rodents are the main carriers of the
collected 7-14 days after the first bacteria. 
Other options include: Depending on which organs - Be aware of your surroundings,
• In the acute phase of illness, leptospires are present in the -azithromycin (500 mg orally, once leptospirosis affects, the especially when you travel. In
blood (septicemia) for approximately the first 4–6 days of illness.
daily) individual may need a countries with poor sanitation,
Leptospires may be shed intermittently in the urine after ventilator to help them
approximately the first week of illness onset. Due to the -ampicillin (500-750 mg orally, every 6 leptospirosis is more common and
transience of leptospires in body fluids, a negative PCR test does hours) breathe. may be hard to avoid.
not rule out leptospisosis. -amoxicillin (500 mg orally, every 6 - Use disinfectant. Bleach, Lysol, acid
hours). If it affects the kidneys, solutions, and iodine are deadly to the
• It is best to submit as many specimen types as possible.
Recommended specimens based on collection timing: » Acute
dialysis may be necessary. bacteria. 
illness (first week): whole blood and serum » Convalescent For patients with severe disease: -controlling pests, especially
illness (after first week): serum +/- urine - IV penicillin is the drug of choice (1.5 Intravenous fluids can provide rodents
MU IV, every 6 hours) hydration and essential -washing hands with soap and water
Supportive Diagnostic Tests - ceftriaxone (1 g IV, every 24 hours) can after handling animals and animal
• IgM-based commercial assays, such as » ELISA IgM » nutrients.
be equally effective. products
ImmunoDOT » Lateral flow tests
• IgM assays are screening tests and results should be confirmed -avoiding touching dead animals
using one of the confirmatory methods below. with bare hands
-cleaning all wounds as soon as
Confirmatory Diagnostic Tests possible and covering them with
1. Microscopic agglutination test (MAT) — confirmatory
waterproof dressings
serologic testing
» Acute and convalescent serum samples collected 7–14 days
apart is ideal.
» If only one serum sample can be sent for testing, a sample
collected after the first 7–10 days of illness is preferred.
2. Polymerase chain reaction (PCR) –Whole blood collected in
the first week of illness (in the first 4 days is ideal)
» Urine (collected at least 1 week after symptom onset is ideal)
» Cerebrospinal fluid from a patient with signs of meningitis

NCP FOR FILARIASIS

 ASSESSMENT DIAGNOSIS OUTCOME PLANNING INTERVENTION EVALUATION
IDENTIFICATION
Subjective Data: Impaired physical Patient will be able to At the end of 8 hours -Present a safe environment: bed rails up The goal was met.
“Hindi ko kayang mobility related to performs physical of nursing R: These measures promote a safe, secure Patient was able to
ilakad ang mga paa tissue thickening activity independently intervention patient environment and may reduce risk for falls. demonstrates the use
ko” as verbalized by of the lower limbs or within limits of will be able to of adaptive devices to
the patient disease. demonstrates the -Execute passive or active assistive ROM increase mobility and
use of adaptive exercises to all extremities. demonstrates
Objective Data: devices to increase R: Exercise enhances increased venous measures to increase
-Inability to move mobility and return, prevents stiffness, and maintains mobility
purposefully within demonstrates muscle strength and stamina
physical environment, measures to increase
including bed mobility -Exercise enhances increased venous return,
mobility, and prevents stiffness, and maintains muscle
ambulation strength and stamina
R: These devices can compensate for
-Inability to perform impaired function and enhance level of
action as instructed activity. 

-Limited ROM -Show the use of mobility devices, such as the

following: trapeze, crutches, or walkers.
-Reluctance to R: These devices can compensate for
attempt movement impaired function and enhance level of
activity.

- Provide the patient of rest periods in between

activities. Consider energy-saving techniques.
R: Rest periods are essential to conserve
energy. The patient must learn and accept
his/her limitations.

-Give positive reinforcement during activity

R: boost the patient’s chances of recovering
and to increase his or her self-esteem.

NCP FOR LEPTOSPIROSIS

 ASSESSMENT DIAGNOSIS OUTCOME PLANNING INTERVENTION EVALUATION
IDENTIFICATION
Subjective Data: Hyperthermia Patient will be At the end of 8 INDEPENDENT: The goal was met. The
“parang inaapoy related to able to maintains hours of nursing - Adjust and monitor environmental factors like room patient was able to
sa init yung bacteria of the body temperature intervention the temperature maintain normal body
pakiramdam ko” genus Leptospir between normal patient will be R: Room temperature may be accustomed to near temperature from 38.8 C
normal body temperature
as verbalized by a range of 36.5-37.5 able to maintain from 37.5C
the patient C. normal body
-Eliminate excess clothing and covers
temperature. R:Exposing skin to room air decreases warmth and
increases evaporative cooling.

-Perform Tepid Sponge Bath

Objective Data: R: Reduce heat loss by evaporation
-warm to touch
-flushed skin -Encourage ample fluid intake by mouth
-dry mucous R:If the patient is dehydrated or diaphoretic, fluid loss
membrane contributes to fever.
-malaise or
-Provide high caloric diet or as indicated by the physician
weakness
R:Appropriate diet is necessary to meet the metabolic
-increased heart demand of the patient.
and respiratory
rate -Raise the side rails at all times
-Vital Sign: R:This is to ensure patient’s safety even without the
presence of seizure activity.
BP:110/90mmHg
PR: 110 bpm DEPENDENT:
RR: 26cpm - Start intravenous normal saline solutions or as indicated.
T:38.8 C R: Intravenous normal saline solution replenishes fluid
losses during shivering chills.

-Give antipyretic medications as prescribed.

R: Antipyretic medications lower body temperature by
blocking the synthesis of prostaglandins that act in
the hypothalamus.

NCP FOR SCHISTOPSOMIASIS

 ASSESSMENT DIAGNOSIS OUTCOME PLANNING INTERVENTION EVALUATION
IDENTIFICATION
Subjective Data: Diarrhea related to Patient will be able to Short Term Goal: INDEPENDENT: The goal was met. Patient
“pang apat na araw enteric infection- state relief from At the end of 8 -Weigh patient daily and note decreased was able to explain the
na akong ganito, parasitic. cramping and less or hours of nursing weight. treatment and rationale of
tatlo hangat apat na no diarrhea. intervention the R: An accurate daily weight is an the intervention and reports
beses akong dumumi patient will be important indicator of fluid balance in no diarrhea
sa isang araw”as able explains the body.
verbalized by the cause of diarrhea
patient. and rationale for - Provide the following dietary alterations
treatment. reach in bulking agents such as rice, apples,
cheese, cereal, and grains
Objective Data: Long Term Goal: R: Bulking agents and dietary fibers
- Frequency of stools At the end of 1-2 absorb fluid from the stool and help
(more than 3/day) days of nursing thicken the stool
-Hyperactive bowel intervention the
sounds or sensations patient will be -Avoidance of stimulants (e.g., caffeine,
-Loose or liquid able to reports carbonated beverages)
stools less diarrhea R: Stimulants may increase
-Vital Sign: within 36 hours. gastrointestinal motility and worsen
BP:110/80mmHg diarrhea.
PR: 86 bpm
RR: 20cpm - Encourage fluids 1.5 to 2 L/24 hours
T:37.1 C R: Increased fluid intake replaces fluid
lost in the liquid stool.

DEPENDENT:
-Give antidiarrheal drugs as ordered
R: Most antidiarrheal drugs suppress
gastrointestinal motility, thus allowing
for more fluid absorption
 Modifiable Factor Non Modifiable Factor
-farmer -tropical countries
-exposure to contaminated -gender (men)
water

Cercariae penetrate human skin within a few minutes

after exposure

Penetrate the skin, they lose their forked tail an

d transform into schistosomula

Which travel through the bloodstream to the liver,

where they mature into adults

The adults then migrate to their ultimate home in the intestinal veins or
the venous plexus of the genitourinary tract.

Adult schistosoma worms live and copulate within venules

of the mesentery or bladder

eggs penetrate the intestinal or bladder mucosa and

are passed in stool or urine

Signs and Symptoms

fever, malaise, cough, rash, abdominal pain,
diarrhea, nausea, lymphadenopathy,
hypersensitivity , transient pruritic, papular skin rash
gross hematuria, secondary urinary tract infections, and
nonspecific pelvic pain.

SCHISTOSOMIASIS
Modifiable Factor Non Modifiable Factor
-poor environmental sanitation -tropical countries
- polluted water -gender (men)
-open drainage canal
-occupation-dependent exposure
to mosquitoes 

Microfilaria enter the lymphatic vessels of mammary gland and

develop into adult worms, disrupting lymphatic drainage

Intact adult worms produce minimal tissue reaction but can cause
obstruction leading to lymphedema

Degenerating / dying worms provoke an inflammatory reaction forming a

mass with eosinophilic and granulomatous inflammation

Some of the inflammation is in response to antigens of the endosymbiotic

bacteria Wolbachia, which the filarial worms contain

lymphangitis and fibrosis may result

Chronic inflammation leads to nonpitting edema,
hyperpigmentation and hyperkeratosis and
chronic lymphoedema or elephantiasis.
limbs and hydrocele (scrotal swelling).
Involvement of breasts and genital organs

FILARIASIS

Modifiable Factor Non Modifiable Factor

- associated with freshwater -tropical regions
or animal exposure -Gender (Male)
-Work related (Sewage workers, farmers,
veterinarians, or hunters)
- leisure activities (kayaking, tramping, and
other outdoor sports)

gains entry via open wound

penetrate the mucosal lining of the skin

multiplies in blood and nearby tissue

produce endotoxin

attached to endothelial cells

spread to any part of the body particularly

affectsthe liver and kidney

Signs and Symptoms

Hypovolemia, from dehydration
fever , chills and muscle pain
diarrhea, vomiting, headache
pain in the chest,
jaundice and fatigue

LEPTOSPIROSIS