COMMUNICABLE DISEASE

 Disease caused by an infectious agent that are transmitted

directly or indirectly to a well person through an agency, vector or
inanimate object CHAIN OF INFECTION

CONTAGIOUS DISEASE
 Disease that is easily transmitted from one person to
another
INFECTIOUS DISEASE
 Disease transmitted by direct inoculation through a break in
the skin

INFECTION
-Entry and multiplication of an infectious agent into the tissue of the
host
INFESTATION INFECTIOUS AGENT
- Lodgement and development of arthropods on the surface of the  Any microorganism capable of producing a disease
body RESERVOIR

ASEPSIS
 Environment or object on which an organism can survive
and multiply
- Absence of disease – producing microorganisms
PORTAL OF EXIT
SEPSIS
- The presence of infection  The venue or way in which the organism leaves the
reservoir
MEDICAL ASEPSIS MODE OF TRANSMISSION
- Practices designed to reduce the number and transfer of  The means by which the infectious agent passes from the
pathogens portal of exit from the reservoir to the susceptible host
- Clean technique PORTAL OF ENTRY
SURGICAL ASEPSIS  Permits the organism to gain entrance into the host
SUSCEPTIBLE HOST
- Practices that render and keep objects and areas free from
microorganisms  A person at risk for infection, whose defense mechanisms
are unable to withstand invasion of pathogens
- Sterile technique
STAGES OF THE INFECTIOUS PROCESS
 CARRIER – an individual who harbors the organism and is  Incubation Period – acquisition of pathogen to the onset of
capable of transmitting it without showing manifestations of the signs and symptoms
disease
 Prodromal Period – patient feels “bad” but not yet
 CASE – a person who is infected and manifesting the signs experiencing actual symptoms of the disease
and symptoms of the disease
 Period of Illness – onset of typical or specific signs and
symptoms of a disease
 SUSPECT – a person whose medical history and signs and  Convalescent Period – signs and symptoms start to abate
symptoms suggest that such person is suffering from that particular and client returns to normal health
disease
 CONTACT – any person who had been in close association MODE OF TRANSMISSION
with an infected person CONTACT TRANSMISSION
 Direct contact – involves immediate and direct transfer
HOST from person-to-person (body surface-to-body surface)
- A person, animal or plant which harbors and provides nourishment  Indirect contact – occurs when a susceptible host is
for a parasite exposed to a contaminated object
RESERVOIR DROPLET TRANSMISSION
- Natural habitat for the growth, multiplication and reproduction of  Occurs when the mucous membrane of the nose, mouth or
microorganism conjunctiva are exposed to secretions of an infected person within a
distance of three feet
ISOLATION VEHICLE TRANSMISSION
- The separation of persons with communicable diseases from other  Transfer of microorganisms by way of vehicles or
persons contaminated items that transmit pathogens
QUARANTINE AIRBORNE TRANSMISSION
- The limitation of the freedom of movement of persons exposed to
communicable diseases
 Occurs when fine particles are suspended in the air for a
long time or when dust particles contain pathogens
VECTOR-BORNE TRANSMISSION
 STERILIZATION – the process by which all microorganisms  Transmitted by biologic vectors like rats, snails and
including their spores are destroyed mosquitoes
 DISINFECTION – the process by which pathogens but not
their spores are destroyed from inanimate objects TYPES OF IMMUNIZATION
 CLEANING – the physical removal of visible dirt and debris  ACTIVE – antibodies produced by the body
by washing contaminated surfaces  NATURAL – antibodies are formed in the presence of
active infection in the body; lifelong
CONCURRENT  ARTIFICIAL – antigens are administered to stimulate
- Done immediately after the discharge of infectious materials / antibody production
secretions  PASSIVE – antibodies are produced by another source
TERMINAL  NATURAL – transferred from mother to newborn through
- Applied when the patient is no longer the source of infection placenta or colostrum
 ARTIFICIAL – immune serum (antibody) from an animal or
BACTERICIDAL human is injected to a person
- A chemical that kills microorganisms
BACTERIOSTATIC SEVEN CATEGORIES OF ISOLATION
- An agent that prevents bacterial multiplication but does not kill
 STRICT- prevent highly contagious or virulent infections
microorganisms
 Example: chickenpox, herpes zoster
CD-Bucud 1
 CONTACT – spread primarily by close or direct contact Place the patient in a dorsal recumbent position and then put hands
 Example: scabies, herpes simplex behind the patient’s neck and bend it forward.
If the patient flexes the hips and knees in response to the
 RESPIRATORY – prevent transmission of infectious manipulation, positive for meningitis
distances over short distances through the air KERNIG’S SIGN
 Example: measles, mumps, meningitis Place the patient in a supine position, flex his leg at the hip and knee
 TUBERCULOSIS – indicated for patients with positive then straighten the knee; pain and resistance indicates meningitis
smear or chest x-ray which strongly suggests tuberculosis
 ENTERIC – prevent transmission through direct contact with
feces SIGNS AND SYMPTOMS OF MENINGOCOCCEMIA
 Example: poliomyelitis, typhoid fever
 DRAINAGE – prevent transmission by direct or indirect
contact with purulent materials or discharge
 Ex. Burns
DIC
 UNIVERSAL – prevent transmission of blood and body-fluid URTI: Micro-
borne pathogens Vasculitis:
cough, sore thrombosis
 Example: AIDS, Hepatitis B petechial
throat,
rash in the Purpura
fever,
CENTRAL NERVOUS SYSTEM trunk and
headache, Hypotension
extremities
nausea and
ENCEPHALITIS MENINGITIS MENINGO- vomiting Shock
COCCEMIA
Death
MAIN PROBLEM
- Acute infection of
- Inflammation of - Inflammation of the bloodstream and
the brain the meninges developing vasculitis ENCEPHALITIS MENINGITIS MENINGO-
COCCEMIA
ETIOLOGIC AGENT - Streptococcus
- Arboviruses - Staphylococcus SIGNS AND SYMPTOMS Vasculitis
- Pneumococcus
- Tubercle bacillus Stiff neck Nuchal rigidity Waterhouse-
INCUBATION PERIOD - Neisseria meningitides Photophobia Opisthotonus Friderichsen
5-15 days 1-10 days 3-4 days syndrome
Lethargy Brudzinski’s
MODE OF TRANSMISSION Petechiae with
Bite of infected Convulsions Kernig’s sign the development
mosquito Respiratory droplets
of hemorrhage
INCIDENCE
SIGNS AND SYMPTOMS OF ENCEPHALITIS
5-10 years old < 5 years old 6 months–5
Virus enters neural cells years old

DIAGNOSTIC EXAM
Disruption in Perivascular Inflammatory  Informed consent
cellular congestion reaction  Empty bowel and bladder
 Fetal, shrimp or “C” position
functioning
 Spinal canal, subarachnoid space between L3-L4 or L4- L5
 After: bedrest
Lethargy Headache Fever  Flat on bed to prevent spinal headache
Convulsions Photophobia Sore throat ENCEPHALITIS MENINGITIS MENINGO-
Seizures Vomiting COCCEMIA
Stiff neck TREATMENT MODALITIES

Dexamethasone Ceftriaxone

Mannitol Penicillin
SIGNS AND SYMPTOMS OF MENINGITIS Anticonvulsants Chloramphenicol
Antipyretics

PREVENTION

1. Japanese 1. HiB vaccine Rifampicin

encephalitis
Ciprofloxacin
VAX

THREE SIGNS OF MENINGEAL IRRITATION

OPISTHOTONUS
State of severe hyperextension and spasticity in which an individual’s
head, neck and spinal column enter into a complete arching position
BRUDZINSKI’S SIGN

CD-Bucud 2
 ENCEPHALITIS MENINGITIS MENINGO-  Recovery within 72 hours and the disease passes by
COCCEMIA unnoticed
NURSING MANAGEMENT PRE-PARALYTIC OR MENINGETIC TYPE
1. Side boards  Slight involvement of the CNS
1. Comfort: quiet, 1. Respiratory 2. Close contacts  Pain and spasm of muscles
well-ventilated isolation 24-72  Transient paresis
room hours after onset H – ouse  (+) Pandy’s test (increased protein in the CSF)
of antibiotic I – nfected person PARALYTIC TYPE
2. Skin care:
therapy kissing  CNS involvement
cleansing bath,
change in 2. Room protected S – ame daycare  Flaccid paralysis
position against bright center  Asymmetric
lights  Affects lower extremities
3. Eliminate S – hare mouth
 Urine retention and constipation
mosquito instruments
3. Safety: side-lying  (+) HOYNE’S SIGN (when in supine position, head will fall
breeding sites:
position and 3. Antibiotics as back when shoulders are elevated)
CULEX
raised side rails prophylaxis
mosquito

POLIOMYELITIS RABIES TETANUS

RABIES
MAIN PROBLEM PRODROMAL/INVASION PHASE
Acute infection of Acute viral disease Acute infectious  Fever
the CNS – muscle of the CNS – by disease with systemic  Anorexia
spasm, paresis and saliva of infected neuromuscular  Sore throat
paralysis animals effects  Pain and tingling at the site of bite
 Difficulty swallowing
ETIOLOGIC AGENT Rhabdovirus Clostridium tetani EXCITEMENT OR NEUROLOGICAL PHASE
Legio debilitans Bullet-shaped  Hydrophobia (laryngospasm)
Anaerobic
 Aerophobia (bronchospasm)
Affinity to CNS Gram positive  Delirium
Killed by sunlight, Drumstick  Maniacal behavior
UV light, formalin appearance  Drooling
TERMINAL OR PARALYTIC PHASE
Resistant to
 Patient becomes unconscious
antibiotics
 Loss of urine and bowel control
POLIOMYELITIS RABIES TETANUS  Progressive paralysis
 Death
INCUBATION PERIOD
2-8 weeks POLIOMYELITIS RABIES TETANUS
7-21 days Distance of bite to Adult: 3 days-3
brain weeks
COMPLICATION
Extensiveness of the Neonate: 3-30 days
Paralysis of RESPIRATORY
bite DEATH
respiratory muscles FAILURE
Resistance of the
host
MODE OF TRANSMISSION DIAGNOSTIC PROCEDURES
1. Throat washings 1. Blood exam
- Direct contact with 1. Stool culture
infected feces 2. Flourescent rabies
Bite of an infected Direct inoculation antibody (FRA)
- Direct contact with 2. CSF culture
respiratory secretions
animal through a broken
skin 3. Negri bodies
- Indirect with soiled
linens and articles ISOLATION PRECAUTION

Enteric isolation Respiratory

POLIOMYELITIS RABIES TETANUS
isolation

SIGNS AND SYMPTOMS R – isus sardonicus POLIOMYELITIS RABIES TETANUS

1. Abortive type 1. Prodromal / O – pistothonus
invasion TREATMENT MODALITIES 1. Tetanus immune
2. Pre-paralytic phase globulin (TIG)
T – rismus 1. Analgesics 1. Local
or meningetic
type treatment of 2. Tetanus antitoxin
2. Excitement / C – onvulsions 2. Morphine (TAT)
wound
neurological 3. Moist heat
3. Paralytic type H – eadache 3. Penicillin G
phase 2. Active
application
immunization 4. Tetracycline
3. Terminal / I – rritability 4. Bed rest
Lyssavac 5. Diazepam
paralytic type
L – aryngeal 5. Rehabilitation 6. Phenobarbital
spasm Imovax
7. Tracheostomy
Antirabies vax
8. NGT feeding
POLIO 2. Passive
ABORTIVE TYPE immunization
 Does not invade the CNS
 Headache
 Sore throat

CD-Bucud 3
 POLIOMYELITIS RABIES TETANUS BIRD FLU SARS
COMPLICATIONS
NURSING MANAGEMENT Severe viral pneumonia Severe viral
1. Enteric isolation 1. Adequate airway pneumonia
1. Isolation Acute respiratory distress
syndrome
2. Proper disposal 2. Optimum 2. Quiet, semi-dark
of secretions comfort environment Hypoxemia
Fluid accumulation in
3. Moist hot packs 3. Restful 3. Avoid sudden alveolar sacs
4. Firm / environment stimuli and light Respiratory failure
nonsagging bed 4. Emotional Severe breathing difficulties
5. Suitable body support
alignment 5. Concurrent Multiple organ failure
6. Comfort and and terminal
safety disinfection
DEATH
POLIOMYELITIS RABIES TETANUS BIRD FLU SARS
TREATMENT MODALITIES
PREVENTION 1. Aseptic
1. If the dog is
1. Amantadine/Rimantadine 1. No definitive treatment
Salk vaccine healthy handling of for SARS
umbilical cord - Generic flu drugs
2. If the dog dies or
- Inactivated shows signs - H5N1 developed resistance 2. Antiviral drugs
polio vaccine suggestive of 2. Tetanus toxoid (normally used to treat
rabies immunization 2. Oseltamivir (TAMIFLU) AIDS)
- Intramuscular Zanamavir (RELENZA)
3. If dog is not 3. Antibiotic - RIBAVIRIN
Sabin vaccine available for prophylaxis - Primary treatment
observation - Within 2 days at onset of 3. Corticosteroids
- Oral polio - Penicillin symptoms
vaccine 4. Have domestic
dog 3 months to - Erythromycin - 150 mg BID x 2 days
- Per orem 1 year old
immunized - Tetracycline

BIRD FLU SARS

RESPIRATORY SYSTEM PREVENTION

1.Culling – killing of 1.Quarantine

BIRD FLU SARS sick or exposed
MAIN PROBLEM birds 2. Isolation
Flu infection in birds that A new type of atypical pneumonia
affects humans that infects the lungs 2. Banning of 3. WHO alert
importation of on SARS
ETIOLOGIC AGENT
birds (Executive
Avian influenza virus, H5N1 Corona virus
order # 280)
(March 12,
2003)
INCUBATION PERIOD 3. Cook chicken
3-5 days 2-8 days thoroughly
MODE OF TRANSMISSION
NURSING MANAGEMENT
Inhalation of feces and Respiratory droplets BIRD FLU
discharge of an infected bird WHAT TO DO WITH A PERSON SUSPECTED TO HAVE BIRD
FLU
• Isolation
BIRD FLU SARS • Face mask on the patient
SIGNS AND SYMPTOMS • Caregiver: use a face mask and eye goggles/glasses
• Distance of 1 meter from the patient
Body weakness or muscle • Transport the patient to a DOH referral hospital
pain
REFERRAL HOSPITALS
Cough
• National Referral Center – Research Institute for Tropical
Difficulty breathing Medicine (RITM) (Alabang, Muntinlupa)

Episodes of sore throat • Luzon – San Lazaro Hospital (Quiricada St., Sta. Cruz,
Manila)
Fever • Visayas – Vicente Sotto Memorial Medical Hospital
(Cebu City)
High fever >38’Celsius • Mindanao – Davao Medical Center (Bajada, Davao City)
SARS
Chills SUSPECT CASE
1. A person presenting after 1 November 2002 with a history of:
 High fever >38 0C AND
 Cough or breathing difficulty AND
CD-Bucud 4
 • Suffocation, cyanosis or death
 One or more of the following exposures during the 10 days
WOUND OR CUTANEOUS DIPHTHERIA
prior to the onset of symptoms:
• Yellow spots or sores in the skin
 Close contact, with a person who is a suspect or
probable case of SARS PERTUSSIS
CATARRHAL STAGE
 History of travel, to an area with recent local
transmission of SARS • Lasts for 1 to 2 weeks
 Residing in an area with recent local transmission of • Most communicable stage
SARS • Begins with respiratory infection, sneezing, cough and
2. A person with an unexplained acute respiratory illness resulting fever
in death after 1 November 2002, but on whom no autopsy has been
performed :
• Cough becomes more frequent at night
AND PAROXYSMAL STAGE
• Lasts for 4 to 6 weeks
 One or more of the following exposures during the 10 days
prior to the onset of symptoms: • Aura: sneezing, tickling, itching of throat
 Close contact, with a person who is a suspect or • Cough, explosive outburst ending in “whoop”
probable case of SARS • Mucus is thick, ends in vomiting
 History of travel, to an area with recent local • Becomes cyanotic
transmission of SARS
•With profuse sweating, involuntary urination and
 Residing in an area with recent local transmission of exhaustion
SARS CONVALESCENT STAGE
PROBABLE CASE • End of 4th-6th week
1. A suspect case with radiographic evidence of infiltrates • Decrease in paroxysms
consistent with pneumonia or respiratory distress syndrome on Chest
x-ray.
DIPHTHERIA PERTUSSIS
DIAGNOSTIC PROCEDURES
2. A suspect case of SARS that is positive for SARS coronavirus by
one or more assays.
 SCHICK’S TESTS  CBC– increase in
- Susceptibility and immunity to lymphocytes
diphtheria
3. A suspect case with autopsy findings consistent with the
pathology of SARS without an identifiable cause. -ID of dilute diphtheria toxin (0.1
cc)
(+) local circumscribed area of
DIPHTHERIA PERTUSSIS redness, 1-3 cm
MALONEY’S TEST
MAIN PROBLEM
Acute bacterial disease -Determines hypersensitivity to
Repeated attacks of spasmodic diphtheria anti-toxin
characterized by the elaboration coughing
of an exotoxin -ID of 0.1 cc fluid toxoid
ETIOLOGIC AGENT -(+) area of erythema in 24 hours
Corynebacterium diphtheriae or Bordetella pertussis
Klebs-Loeffler bacillus
DIPHTHERIA PERTUSSIS
INCUBATION PERIOD

7-14 days COMPLICATIONS Convulsions (brain

2-5 days
Toxins in the bloodstream
MODE OF TRANSMISSION damage from
1. Respiratory droplets asphyxia)
Myocarditis Peripheral Broncho-
2. Direct contact with respiratory secretions (epigastric paralysis pneumonia Otitis media
or chest (tingling, (fever,
3. Indirect contact with articles pain) numbness, cough) (invading
paresis)
DIPHTHERIA PERTUSSIS organisms)
SIGNS AND SYMPTOMS Heart Respirat Bronchopneumonia
Decreased
failure in ory
arrest
(most dangerous
Types: Stages: respiratory
rate complication)
1. Nasal 1. Catarrhal DEATH
2. Tonsilopharyngeal
2. Paroxysmal
3. Laryngeal DIPHTHERIA PERTUSSIS
3. Convalescent
4. Wound or TREATMENT MODALITIES
cutaneous 1. Diphtheria anti-toxin 1. Erythromycin – drug of
- Requires skin testing choice
- Early administration 2. Ampicillin – if resistant
NASAL DIPHTHERIA aimed at neutralizing the to erythromycin
• Bloody discharge from the nose toxin present in the 3. Betamethasone
• Excoriated nares and upper lip circulation before it is (corticosteroid) –
TONSILOPHARYNGEAL DIPHTHERIA absorbed by the tissues decrease severity and
• Low grade fever 2. Antibiotic therapy length of paroxysms
• Sore throat
• Bull-neck appearance - Penicillin G 4. Albuterol
(bronchodilator)
•
Pseudomembrane- Group of pale yellow membrane over - Erythromycin
tonsils and at the back of the throat as an inflammatory
response to a powerful necrotizing toxins
LARYNGEAL DIPHTHERIA
• Hoarseness
• Croupy cough
• Aphonia
• Membrane lining thickens à airway obstruction

CD-Bucud 5
 DIPHTHERIA
NURSING MANAGEMENT
1. Isolation: 14 days (until
2-3 cultures, 24 hours
apart)
2. Bedrest for 2 weeks
3. Care for nose and
throat (gentle swabbing)
4. Ice collar (decrease pain
of sore throat)
5. Diet (soft food, small
frequent feedings)
PERTUSSIS AMOEBIASIS SHIGELLOSIS
MAIN PROBLEM
1. Isolation: 4-6 weeks from
onset of illness Acute infection of the lining
Protozoal infection of the large
of the small intestine
intestine
2. Supportive measures
(bedrest, avoid ETIOLOGIC AGENT
excitement, dust, smoke
and warm baths) Entamoeba histolytica Shigella group
3. Safety (during - Prevalent in areas with ill 1. Shigella flesneri – most
paroxysms, patient sanitation common in the Philippines
should not be left alone) -Acquired by swallowing 2. Shigella connei
4. Suctioning (kept at 3. Shigella boydii
- Trophozoites: vegetative form
bedside for emergency
use) - Cyst: infective stage 4. Shigella dysenterae – most
infectious type

MUMPS AMOEBIASIS SHIGELLOSIS

MAIN PROBLEM
An acute contagious disease, with swelling of one or both of the SIGNS AND SYMPTOMS
parotid glands
ETIOLOGIC AGENT 1. Acute amoebic dysentery
Filterable virus of paramyxovirus group
Fever
- Diarrhea alternated with
INCUBATION PERIOD
12-26 days
constipation Abdominal pain
MODE OF TRANSMISSION - Tenesmus
Respiratory droplets - Bloody mucoid stools Diarrhea and
PERIOD OF COMMUNICABILITY
6 days before and 9 days after onset of parotid swelling 2. Chronic amoebic tenesmus
SIGNS AND SYMPTOMS dysentery
- Enlarged liver Bloody mucoid
PRODROMAL PHASE
F-ever (low grade) - Large sloughs of intestinal stool
H-eadache tissues accompanied by
M-alaise hemorrhage

PAROTITIS
F-ace pain
AMOEBIASIS SHIGELLOSIS
E-arache DIAGNOSTIC TESTS
S-welling of the parotid glands
1. Stool exam
COMPLICATIONS 2. Blood exam
• Orchitis – the most notorious complication of mumps
3. Sigmoidoscopy
• Oophoritis – manifested by pain and tenderness of the
abdomen TREATMENT MODALITIES
• CNS involvement – manifested by headache, stiff neck,
delirium, double vision 1. Metronidazole – drug 1. Cotrimoxazole – drug
• Deafness as a result of mumps
of choice of choice
NURSING MANAGEMENT
1. Prevent complications 2. Tetracycline
− Scrotum supported by suspensory 3. Chloramphenicol
− Use of sedatives to relieve pain
− Treatment: oral dose of 300-400 mg cortisone followed by
100 mg every 6 hours AMOEBIASIS SHIGELLOSIS
− Nick in the membrane
2. Diet NURSING MANAGEMENT
- Soft or liquid diet
- Sour foods or fruit juices are disliked
1. Enteric isolation
3. Respiratory isolation 2. Boil water for
4. Comfort: ice collar or cold applications over the parotid glands may
relieve pain drinking
5. Fever: aspirin, tepid sponge bath 3. Handwashing
6. Concurrent disinfection: all materials contaminated by these
secretions should be cleansed by boiling 4. Sexual activity
7. Terminal disinfection: room should be aired for six to eight hours
5. Avoid eating
uncooked leafy
GASTROINTESTINAL TRACT vegetables

CD-Bucud 6
 CHOLERA TYPHOID FEVER CHICKENPOX HERPES ZOSTER
MAIN PROBLEM
MAIN PROBLEM
Acute bacterial disease of the An infection affecting the
A highly contagious disease An acute viral infection of
GIT characterized by profuse Peyer’s patches of the small
characterized by vesicular the sensory nerve
secretory diarrhea intestines
eruptions on the skin and
ETIOLOGIC AGENT mucous membranes
Vibrio cholerae Salmonella typhi ETIOLOGIC AGENT
Varicella zoster virus
INCUBATION PERIOD INCUBATION PERIOD

1 to 3 days 1 to 3 weeks 10-21 days 13-17 days

MODE OF TRANSMISSION MODE OF TRANSMISSION
1. Droplet method
1. Fecal-oral transmission 2. Direct contact
2. 5 F’s 3. Indirect contact

CHOLERA TYPHOID FEVER CHICKENPOX HERPES ZOSTER

SIGNS AND SYMPTOMS
Fever (ladder-like) PERIOD OF COMMUNICABILITY

Rice-water stool One day before eruption

Rose spots One day before eruption
of 1st lesion and five days
Abdominal cramps of 1st rash and five to six
Diarrhea after appearance of last
days after the last crust
Vomiting crop
TYPHOID STATE
SIGNS AND SYMPTOMS
Intravascular Sordes
PRODROMAL
Dehydration
Subsultus Tendinum PERIOD
Shock - Fever (low-grade)
Coma vigil
- Headache
Carphologia
- Malaise

CHOLERA TYPHOID FEVER CHICKENPOX HERPES ZOSTER

TREATMENT MODALITIES • Rashes
SIGNS AND SYMPTOMS
1.Chloramphenicol –
1.Lactated Ringer’s -Unilateral, band-like
drug of choice • Rashes : Centrifugal distribution
solution distribution -Dermatomal
2. Ampicillin/
2. Oral rehydration Amoxicillin – for •Rash stages: macule - Erythematous base
therapy typhoid carriers papule vesicle - Vesicular, pustular or
3. Antibiotic therapy pustule crust crusting
3. Cotrimoxazole – for •Regional
- Tetracycline – drug severe cases with lymphadenopathy
• Pruritus
of choice relapses •Pruritus
- Cotrimoxazole •Pain – stabbing or
burning
- Chloramphenicol
CHOLERA TYPHOID FEVER CHICKENPOX HERPES ZOSTER
NURSING MANAGEMENT
COMPLICATIONS
RAMSAY-HUNT
1. Maintain and restore the fluid SYNDROME - Involvement of
SCARRING – most common
and electrolyte balance the facial nerve in herpes zoster
complication; associated with
with facial paralysis, hearing
staphylococcal or streptococcal
2. Enteric isolation loss, loss of taste in half of the
infections from scratching
tongue
3. Sanitary disposal of excreta NECROTIZING FASCIITIS –
GASSERIAN
most severe complication
GANGLIONITIS –
4. Adequate provision of safe Involvement of the optic nerve
REYE SYNDROME –
drinking water abnormal accumulation of fat in resulting to corneal anesthesia
the liver plus increase of
ENCEPHALITIS – acute
5. Good personal hygiene pressure in the brain resulting to
inflammatory condition of the
coma, therefore leading to
brain
DEATH

INTEGUMENTARY SYSTEM

CD-Bucud 7
 - Soft palate to mucus membrane
CHICKENPOX HERPES ZOSTER
MEASLES GERMAN MEASLES
TREATMENT MODALITIES

1. Antihistamines – 4. Corticosteroids – anti- SIGNS AND SYMPTOMS ERUPTIVE STAGE

symptomatic relief of itching inflammatory and decreased 2. ERUPTIVE STAGE 1. Rash
pain Rashes
Ex. Diphenhydramine - pinkish, maculopapular
Ex. Prednisone - Elevated papules
(Benadryl) - Begins on the face
- Begin on the face and behind
the ears - Spread to trunk or limbs
2. Analgesics and antipyretics - Spread to trunk and
extremities - No pigmentation or
Ex. Acetaminophen desquamation
Color: Dark red – purplish hue
– yellow brown 2. Posterior auricular and
3. Antiviral agents – for patient to
3. Stage of Convalescence suboccipital
experience less pain and faster lymphadenopathy
resolution of lesions when used within - Desquamation
48 hours of rash onset - Rashes fade from the face
downwards
Ex. Acyclovir (Zovirax)

CHICKENPOX HERPES ZOSTER

MEASLES GERMAN MEASLES
NURSING MANAGEMENT
COMPLICATIONS 1. Encephalitis
Strict isolation
2. Congenital rubella syndrome
Prevent secondary infection (cut Pneumonia - Spontaneous abortion
fingernails short, wear mittens) - Intrauterine growth retardation
Otitis media (IUGR)
Eliminate itching: calamine - Thrombocytopenia purpura
lotions, warm baths, baking soda
paste
Severe diarrhea (leading “blueberry muffin skin”
- Cleft lip, cleft palate, club foot
to dehydration)
- Heart defects (PDA, VSD)
Encourage not going to school:
usually 7 days Encephalitis - Eye defects (Cataract,
glaucoma)
Disinfection of clothes and linen - Ear defects (Deafness)
with nasopharyngeal discharges - Neurologic (microcephaly,
by sunlight or boiling mental retardation, behavioral
disturbances

MEASLES GERMAN MEASLES MEASLES GERMAN MEASLES

TREATMENT MODALITIES
MAIN PROBLEM

A contagious exanthematous A benign communicable 1.Vitamin A – helps 1.Aspirin – help reduce

disease with chief symptoms to exanthematous disease caused prevent eye damage inflammation and
the upper respiratory tract by rubella virus and blindness fever
ETIOLOGIC AGENT 2. Antipyretics – for
Filterable virus of Rubella virus fever
paramyxoviridae
3. Penicillin – given
INCUBATION PERIOD only when secondary
10-12 days 14-21 days infection sets in
MODE OF TRANSMISSION
1. Droplet method
2. Direct contact with respiratory discharges
3. Indirect with soiled linens and articles

MEASLES GERMAN MEASLES MEASLES GERMAN MEASLES

PERIOD OF COMMUNICABILITY
4 days before and 5 days after
the appearance of rashes
NURSING MANAGEMENT
1. Darkened room to relieve photophobia
One week before and four days
after the appearance of rashes 2. Diet: should be liquid but nourishing

SIGNS AND SYMPTOMS 3. Warm saline solution for eyes to relieve

eye irritation
PRE-ERUPTIVE STAGE PRE-ERUPTIVE STAGE
4. For fever: tepid sponge bath and anti-
Cough Fever pyretics
Coryza Headache 5. Skin care: during eruptive stage, soap is
omitted; bicarbonate of soda in water or
Conjunctivitis Malaise lotion to relieve itchiness
Fever (high-grade) Coryza 6. Prevent spread of infection: respiratory
Photophobia Conjunctivitis isolation

KOPLIK’S SPOT (Rubeola)

- Bluish white spots surrounded by a red halo SCABIES
- Appear on the buccal mucosa opposite the premolar teeth MAIN PROBLEM
FORCHEIMER’S SPOTS (Rubella) Infestation of the skin produced by the burrowing action of a parasite
- small, red lesions mite resulting in skin irritation and formation of vesicles and pustules
ETIOLOGIC AGENT
Sarcoptes scabiei
CD-Bucud 8
INCUBATION PERIOD
Within 24 hours
AIDS SYPHILIS
MODE OF TRANSMISSION
Direct contact SIGNS AND SYMPTOMS
Indirect contact
OPPORTUNISTIC INFECTIONS

Sarcoptes scabiei 1. Pneumocystis carinni

1. Yellowish white in color pneumonia
2. Barely seen by the unaided eye
3. Female parasite burrows beneath the epidermis to lay eggs 2. Oral candidiasis
4. Males are smaller and reside on the surface of the skin 3. Toxoplasmosis
SIGNS AND SYMPTOMS
4. Acute/chronic diarrhea
• Thin, pencil-mark lines on the skin
5. Pulmonary tuberculosis
• Itching, especially at night
• Rashes and abrasions on the skin MALIGNANCIES
PRIMARY LESIONS 1. Kaposi’s sarcoma
NODULAR LESIONS
2. Non-Hodgkin’s lymphoma
SECONDARY LESIONS
TREATMENT MODALITIES
• SCABICIDE : Eurax ointment (Crotamiton) AIDS SYPHILIS
• PEDICULICIDE : Kwell lotion (Gamma Benzene
Hexachloride) – contraindicated in young children and SIGNS AND SYMPTOMS 1. PRIMARY SYPHILIS
pregnant women
• Topical steroids - CHANCRE: small, painless,
• Hydrogen peroxide : cleanliness of wound pimple-like ulceration on the
• Lindane Lotion penis, labia majora, minora
NURSING MANAGEMENT and lips
• Apply cream at bedtime, from neck to toes - May erupt in the genitalia,
• Instruct patient to avoid bathing for 8 to 12 hours anus, nipple, tonsils or eyelids
• Dry-clean or boil bedclothes
• Report any skin irritation - Lymphadenopathy
• Family members and close contact treatment
• Good handwashing
• Terminal disinfection

SEXUALLY TRANSMITTED DISEASES

AIDS SYPHILIS AIDS SYPHILIS

SIGNS AND SYMPTOMS 2. SECONDARY SYPHILIS

MAIN PROBLEM
Final and most serious stage
of HIV disease, which causes
severe damage to the immune
system
ETIOLOGIC AGENT
Retrovirus – Human T-cell
lymphotropic virus III
(HTLV-3)
- Skin rash
Infectious disease caused
- Mucous patches
by a spirochete
- Hair loss
- CONDYLOMATA LATA:
coalescing papules which
form a gray-white plaque
Treponema pallidum frequently in skin folds

INCUBATION PERIOD

3 to 6 months to 8 to 10 years 10-90 days

AIDS SYPHILIS AIDS SYPHILIS

MODE OF TRANSMISSION SIGNS AND SYMPTOMS 3. TERTIARY SYPHILIS
• Sexual contact – oral, anal or - 1 to 10 years after infection
vaginal sex - Appear on the skin, bones,
mucus membrane, URT, liver
•Blood transfusion and stomach

•Mother -to-child - GUMMA: chronic, superficial

nodule or deep
•Indirect contact through soiled granulomatous lesion that is
solitary, painless, indurated
articles

CD-Bucud 9
 AIDS SYPHILIS CHLAMYDIA GONORRHEA
DIAGNOSTIC PROCEDURES COMPLICATIONS
Women

1.ELISA 1.Dark Field Pelvic inflammatory

disease
Illumination test Ectopic pregnancy
2. Western blot
Sterility
2. Flourescent
3. RIPA
Treponemal Men

4. PCR Antibody Epididymitis

Absorption Test Newborn

Sterility
Conjunctivitis Newborn
3. VDRL Otitis media Gonococcal ophthalmia
Pneumonia

AIDS SYPHILIS CHLAMYDIA GONORRHEA

TREATMENT MODALITIES TREATMENT MODALITIES
1. Penicillin G Benzathine 1. Cefixime
1. Antivirals - Disease < 1 year: 2.4 M units 1. Azithromycin
once in two injection sites (Zithromax) - Drug of choice
- Shorten the clinical
- Disease > 1 year: 2.4 M units because of oral
course, prevent - Drug of choice because
in 2 injection sites x 3 doses efficacy, single dose
complications, prevent of single-dose treatment
development of 2. Doxycycline – if allergic to effectiveness and lower
penicillin
2. Ciprofloxacin
latency, decrease cost
transmission 3. Tetracycline 3. Ceftriaxone
2. Doxycycline
- if allergic to penicillin
- Example: Zidovudine - Secondary drug of 4. Erythromycin
- Contraindicated for
(Retrovir) pregnant women choice

CANDIDIASIS HERPES SIMPLEX

CHLAMYDIA GONORRHEA MAIN PROBLEM

A viral disease
Mild superficial fungal characterized by the
MAIN PROBLEM
appearance of sores and
Sexually transmitted disease caused by a bacteria infection
blisters on the skin
Purulent inflammation of mucous
membrane surfaces
ETIOLOGIC AGENT
ETIOLOGIC AGENT Herpes simplex virus
Chlamydia trachomatis Neisseria gonorrhea
Candida albicans types 1 and 2
INCUBATION PERIOD INCUBATION PERIOD
2-3 weeks (males)
2-10 days
2-3 weeks 2-12 days
Asymptomatic (females)
MODE OF TRANSMISSION

Sexual contact: Oral, vaginal or anal sex

CANDIDIASIS HERPES SIMPLEX

CHLAMYDIA GONORRHEA MODE OF TRANSMISSION

1. Rise in glucose as in TYPE 1
SIGNS AND SYMPTOMS Women diabetes mellitus - Respiratory droplets
Women Bleeding after intercourse
2. Lowered body - Direct exposure to
Abdominal or pelvic pain Burning sensation during resistance as in cancer infected saliva
Bleeding after intercourse and urination
in-between menses Yellow or bloody vaginal 3. Increase in estrogen - Kissing and sharing
Unusual vaginal discharge discharge level in pregnant women utensils
4. Broad-spectrum TYPE 2
Men
antibiotics are used
Burning with urination - Sexual or genital
contact
Swollen, painful testicles
White, yellow or
Discharge from the penis green pus from the SIGNS AND SYMPTOMS (Candidiasis)
penis ONYCHOMYCOSIS
• Red, swollen darkened nailbeds
• Purulent discharge
• Separation of pruritic nails from nailbeds
DIAPER RASH
• Scaly, erythematous, papular rash
• Covered with exudates
CD-Bucud 10