Republic of the Philippines Founded 1907 RA 9299

NEGROS ORIENTAL STATE UNIVERSITY

Dumaguete, Bais, Guihulngan, Mabinay, Pamplona, Siaton and Bayawan-Sta. Catalina
COLLEGE OF NURSING, PHARMACY AND ALLIED HEALTH SCIENCES

MEDICAL MANAGEMENT

Diagnostic Procedure
o Tetanus is suspected upon a bite or punctured wound; diagnosis is made through clinical findings and history since C. Tetani exhibits such exquisite sensitivity to
oxygen or difficult to grow from clinical specimen.

Pharmacologic Intervention
o Sedation, antitoxin, muscle relaxants, antibiotics
o Some of the anti-tetanus medication may include Decavac, Tetanux toxoid (adsorbed or fluid), Pediarix, Infanrix, Tripedia, Adacel, Tetanus immunoglobulin
(human)/HTIG.

Medical Intervention
o Mechanical ventilator (respirator)
o Three principles apply:
1. Prevent further toxin release
2. Neutralize toxin present in the body outside CNS
3. Minimize the effects of the toxin already in the CNS
 Republic of the Philippines Founded 1907 RA 9299

NEGROS ORIENTAL STATE UNIVERSITY

Dumaguete, Bais, Guihulngan, Mabinay, Pamplona, Siaton and Bayawan-Sta. Catalina
COLLEGE OF NURSING, PHARMACY AND ALLIED HEALTH SCIENCES

NURSING MANAGEMENT

 Ensure intensive nursing care.

 Provide complete bed rest to the patient.
 Keep patient in dim lighted, quiet, and well ventilated room, as spasms can be precipitated by bright light, noise or even touch.
 Minimize external stimuli.
 Handle the patient carefully while sedated and as little as possible; change position every 3 to 4 hours to avoid bedsores.
 Teach family the danger signs and instruct them to call the nurse for the slightest respiratory symptom (cough, difficulty breathing, apnea, excessive secretions, cyanosis,
etc.)
 Prompt suctioning and oxygen administration is essential.
 Fluid and electrolyte balance should be maintained; establish IV access for hydration, IV injections.
 Provide hydration and nutrition feeds divided over 24 hours.
 Gentle suction of secretions (mouth, oropharynx).
 Due to spasm and increased muscle activity, patients are exhausted and need extra calories, so provide high calorie and protein diet to patient.
 Insert a nasogastric tube for hydration, feeding and administration of oral medications.
 General hygiene including bath, oral care, and elimination should be maintained.
 Care of wound such as removal of necrosed tissue, cleaning with hydrogen peroxide and treatment with antibiotic ointment is done.
 Monitor vital signs regularly.