UNIT I

MANAGEMENT FOR CLIENTS WITH INFECTIOUS DISEASES

Lesson 1 Overview

This unit gives you an idea of how a disease-caused by the growth of pathogenic microbes in the body
becomes infectious. It may or may not be contagious. In modern science has controlled, eradicated, or
decreased the incidence of many infectious diseases. However, increases in other infections, such as
those caused by antibiotic-resistant organisms and emerging infectious diseases, are of great and
growing concern. Examples of these contagious diseases are presented in this unit.

It is vital to understand infectious causes and the treatment of transmissible, acute, and joint infections.
The nurse plays an essential role in infection control and prevention. Educating patients may decrease
their risk of becoming infected or may reduce the after effect or condition and injury of infection. Using
appropriate barrier precautions, observing prudent hand hygiene, and ensuring aseptic care of
intravenous (IV) catheters and other invasive equipment also assists in reducing infection (Smeltzer, S.,
Bare, B., Hinkle J., & Cheever, K.,2010).

Learning Objectives

At the end of the unit, I am able to:

1. define and understand the chain of infection and its stages of the infectious process;

2. differentiate between colonization, infection, and disease;

3. determine whether an infection exists in a health care facility or geographic area;

4. describe the reasons why microorganisms that because infectious diseases are so difficult to control;

5. describe the role of a nurse to a communicable disease;

6. enumerate the factors affecting the entrance of an organism into the body;

7. identify the different infection control measures; and

8. describe the types of precautions and the patients requiring the precautions.

Lesson
Proper_______________________________________________________________________________
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Terminologies that will help you understand the discussion of the lessons proper in this unit.

Colonization describes microorganisms present without host inference or interaction (e.g.,

Streptococcus Aureus lives on the skin- “colonized”).

Infection indicates host interaction with the organism (e.g., bacteria enter a wound, causes local
inflammation).
Infectious Disease is the infected host, displays a decline in wellness due to the infection (e.g., 10 of
people infected with TB have a clinically significant disease).

Contagious is a condition that is easily transmitted from one person to another.

Infectious is not transmitted by ordinary contact. Require direct injection through a broken skin.

Infection is the entry and multiplication of an infectious agent into the tissue of the host.

Infestation is a lodgment and development of arthropods on the surface of the body.

Asepsis is an absence of disease–producing microorganisms.

Sepsis is the presence of infection.

Medical Asepsis (Clean technique) is a practices designed to reduce the number and transfer of
pathogens.

Surgical Asepsis (Sterile technique) is a practices that render and keep objects and areas free from
microorganisms.

Carrier pertains to the individual who harbors the organism is capable of transmitting it without showing
manifestations of the disease.

Case is a person who harbors the body is capable of carrying it is manifesting the signs and symptoms of
the disease.

The Suspect is an individual whose medical history and signs and symptoms suggest that such a person
is suffering from that particular disease.

Contact is a person who had been in close association with an infected person.

Isolation it is the separation of persons with communicable diseases from other persons.

Quarantine is the limitation of the freedom of movement of persons exposed to communicable

diseases.

Sterilization is the process by which all microorganisms including their spores is destroyed

Concurrent disinfection that will be done immediately after the discharge of infectious
materials/secretions

Terminal disinfection is applied when the patient is no longer the source of infection.

Bactericidal is a chemical that kills microorganisms.

Bacteriostatic is an agent that prevents bacterial multiplication but does not kill microorganisms.

Disinfection is the destruction of a pathogenic organism outside the body by physical or chemical means
directly applied.

Concurrent Disinfection is done immediately after the discharge of infectious materials/ secretions from
the infected individual, a method that the patient is still the source of infection.
Terminal Disinfection is applied when the patient is no longer the source of infection.

Habitat is a place where an organism is usually found/lives.

Pathogen is a bacterium, virus, or other microorganisms that can cause disease.

Six components in the infectious disease process, known as the chain of infection (Lareza, 2010).

1. Causative agent-any microorganism capable of producing disease.

2. A reservoir of infection-the environment and objects on which an organism can survive and multiply.

3. Portal of exit- the path or way in which the body leaves the reservoir. Usually, this is where the
organism grows.

4. Mode of transmission-the means by which the infectious agent passes from the portal of exit from the
reservoir to the susceptible host –the most natural link to break the chain of infection.

5. Portal of entry- the venue where the organism gain entrance into the responsive host. The infective
microbes use the same avenues when they exit from the reservoir.

6. Susceptible host- the human body have many defenses against the entry and multiplication of
organism. When the cases are reasonable, no infection will take place. However, in a weakened host,
the microbes will launch an infectious disease.

The following are the stages of the infectious process that will be mentioned in the succeeding lessons.

1.Incubation Period is the acquisition of a pathogen to the onset of signs and symptoms;

2.Prodromal Period is the period in which the patient feels “bad” but not yet experiencing actual
symptoms of the disease;

3.Period of Illness is the onset of typical or specific signs and symptoms of a disease; and

4.Convalescent Period is the time in which signs and symptoms start to decrease, and the client returns
to normal health.

The discussion on the following sub-topics was taken from Lareza, 2010.

The production of microorganisms can injure the patient by either:

1. Competing with the host metabolism;

2. Cellular damage produced by the microorganisms; and

3. Intracellular multiplication of microorganisms.

Such damage could be localized (such as infected pressure ulcer) or maybe systemic such as septicemia.

The severity of infection varies on the following criteria, and these are:

1. the ability of the organism to cause disease;

2. the number of invading organisms;

3. the resistance of the host; and

4. other factors like; lifestyle, medications or immunosuppressive

drugs.

The following are taken into consideration to determine whether an infection exists in a health care
facility or geographic area.

1. Sporadic Diseases- these are diseases that occur occasionally and irregularly with no specific pattern.
Example: Tetanus

2. Epidemic Diseases- are diseases that occur higher than the expected number in a particular area over
a specific time. Case: An increasing number of diarrheal conditions in an evacuation area.

3. Pandemic- is an epidemic that affects several countries or continents. Example: COVID-19, HIV/AIDS,
and SARS

4. Endemic Disease- are those that are present in a population or community at times. They usually
involve few people during a specific time. Example: Schistosomiasis is rampant in Samar and Leyte

Microorganisms are challenging to control that cause infectious diseases due to the reasons below;

1. some bacteria develop resistance to antibiotics;

2. some organisms, especially those that cause influenza, have so many different strains that a single
vaccine cannot protect against them all;

3. most viruses resist antiviral drugs;

4. new infectious agents occasionally arise such as HIV and Corona Viruses;

5. some microbes localize in areas of the body that make treatment difficult, especially those that invade
the bones, the brain, and the spinal cord;

6. opportunistic organisms can cause infection in immune-compromised patients;

7. some people have not received immunization;

8. an increase in air travel can spread the virulent organism to a densely populated area in just a short
period;
9. the use of biological warfare and bioterrorism with bodies such as Anthrax, Plaque, is an increasing
threat to health and safety throughout the world; and

10.the abusive use of immunosuppressive drugs and invasive procedures increases the risk of infection
for many people, especially the young population.

THE NURSE AND COMMUNICABLE DISEASE

The primary function of a professional nurse in the nursing care of patients with infectious diseases.
However, her responsibilities extend beyond the immediate supervision of the patient. She must be
equipped with knowledge of the following:

1. the nurse of the specific microorganism and its capacity for survival both within and outside the body;

2. the method of destruction is most useful for the particular organism;

3. the route of entry and escapes from the body of the entity that invades the host;

4. the incubation period and communicability of a particular disease;

5. how specific drugs alter the clinical signs and the infectious course of the disease;

6. most modern methods and concepts of prevention of contagious illnesses;

7. control measures and isolation techniques; and

8. identify and carry out all levels of prevention.

The three levels of preventive care- primary, secondary, and tertiary care- are detailed below:

1. Primary Prevention is applied to clients who are physically and emotionally healthy, this precedes a
disease or dysfunction, and this level of prevention is considered real prevention because the problem
has not yet occurred.

2. Secondary Prevention is focused on those experiencing health problems and illness of an individual,
protecting those who are at risk for developing complications or worsening conditions and geared
toward early diagnosis and treatment.

3. Tertiary Prevention occurs when a disability is permanent or irreversible; nursing management is

directed toward preventing complications, deterioration, and permanent disability.

Nursing a patient with Communicable Diseases involves the following:

1. self-protection;

2. preventing the spread of the infectious agent through medical asepsis and concurrent disinfection;

3. physical care of the patient;

4. emotional support of the patient; and

5. the spiritual aspect of care.

Factors affecting the entrance of organisms into the body, like:

1. Age, sex, genetic, constitution of the host

2. Nutritional status, fitness, environmental factors

3. General condition, physical, emotional, mental state

4. Absence of or abnormal immunoglobulin

5. Presence of underlying diseases (DM, Lymphoma, Leukemia, Neoplasm or Uremia)

6. Patients treated with certain antimicrobials, corticosteroids, irradiation, or immunosuppressive drugs.

INFECTION CONTROL MEASURES

To prevent contact with blood, a Universal Precaution shall be observed and other potentially infectious
materials. Universal Precautions means that all patients shall be assumed to be contagious with HIV/
AIDS and other blood-borne pathogens (Lareza, 2010).

According to Lareza,2010 to control infection, the following measures requires that:

1. Employees shall wash their hands immediately after hand contact with blood and other infectious
materials and the removal of personal protective equipment;

2. All PPE’s shall be removed immediately upon leaving the work area or as soon as possible if overtly
contaminated and place in an appropriately designated area or container for storage, washing,
decontamination or disposal;

3. Used needles and sharps shall not be sheared, bent, broken, recapped, or re-sheathed by hand used
needles. Not be removed used needles from disposable syringes;

4. Eating, drinking, smoking, applying cosmetics or lip balm are prohibited in work areas where there is
potential for occupational exposure;

5. Food drinks shall not be stored in refrigerators, freezers, or cabinets where blood or other potentially
infectious materials are stored or in other areas of possible contamination;

6. Procedures that involve blood or potentially infectious materials shall be all performed to minimize
splashing these substances; and

7. Mouth pipetting or suctioning is prohibited.

Summary of types of precautions and patients requiring the precautions are the following:

1. Standard Precautions. Use Standard Precautions for the care of all patients.

2. Airborne Precautions. Aside from Standard Precautions, use Airborne Precautions for patients known
or suspected to have serious illnesses transmitted by airborne droplet nuclei. Example: Measles, TB

3. Droplet Precautions. In addition to Standard Precautions, use Droplet Precautions for patients known
or suspected to have serious illnesses transmitted by large-particle droplets. Example: Haemophilus
Influenza

4. Contact Precautions. In addition to Standard Precautions; use Contact Precautions for patients with
known or suspected severe diseases easily transmitted by direct patient contact or by contact with items
in the patient’s environment. Example: GI, Respiratory, skin, or wound infections

Preventive aspects of care for clients with Communicable Disease concerns the following:

1. Health Education. Educate the family and the client about:

1.1. Availability and importance of prophylactic immunization

1.2. How infectious illness is spread and methods in avoiding the spread

1.3. The importance of seeking medical advice in any sign of health problem

1.4. Influence of environmental cleanliness and personal hygiene

1.5. Steps of preventing contamination of food and water supply

2. Immunization. It is the introduction of specific protective antibodies in a susceptible person or animal

or the production of cellular immunity in such person or animal.

Pathogenesis encompasses the entire host-pathogen interaction and requires an understanding of the
pathogen and pathogen-associated factors that contribute to the disease process as well as host
responses that can be protective, or contribute to disease pathology of infectious diseases:

1. The way of entering the pathogen into the body

2. Attachment of pathogen to some tissues within the body

3. Multiplication of the pathogen

4. Invasion/Spread of the Pathogen

5. Evasion of host defenses

6. Damage to host tissues

Antibiotics-used to treat bacterial infections. In can be ineffective in treating illnesses caused by viruses.
Also, antibiotics treat specific bacteria. Overuse or misuse of antibiotics can lead to drug-resistant
bacteria. It needs to be taken correctly and for the duration of the prescription. If antibiotics are stopped
early, the bacteria may develop a resistance to the antibiotics, and the infection may occur (Lareza,
2010).